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Form 16: Application for Renewal of
Dealer's Registration
The undersigned hereby applies for renewal of its registration as a securities dealer in West Virginia. The
following information, representations of fact, and attached Exhibits are submitted in support of said renewal
registration.
A certified check for payment of the renewal fee in the amount of $250.00 payable to the STATE
AUDITOR of West Virginia, is attached.
Form 16: Application for Renewal of Dealer's Registration
For further information, please contact John
Seymour at 304.558.2257
(Rev. 8-99)
Disclaimer
The West Virginia Securities Commission uses links to other Web sites for the convenience of the user. Whenever you
click on links provided, you are leaving the West Virginia Securities Commission and entering an external site. The
Security Commission cannot attest to the accuracy of the information provided by the external linked sites, nor does
the Securities Commission endorse any products or information obtained from these external sites.
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