N.H. Issuer-Dealer License Application Checklist

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    1.  Issuer-Dealer 

    • Form D-1 
    • FEE - $50 Initial License

    2.  Issuer-Dealer Agent 

    3.  Form U-2 

    4.  Form U-2a 

    5.  Copy of the offering document and subscription agreement and a written statement that sets forth the New Hampshire Uniform Securities Act (RSA 421-B) provision (either registration or exemption from registration requirements) under which the offering of securities will be made. 

    6.  Copy of charter, articles of incorporation or certificate of organization (LP, LLC, LLP, etc.) certified by the proper state official. 

    7.  Copy of the by-laws (or limited partnership agreement, limited liability company agreement, or limited liability partnership agreement) certified by the authorized officer of the company. 

    8.  Copies of the Profit and Loss Statement and Balance Sheet as of last December 31, or close of fiscal year, certified by an authorized officer of the company. 

    9.  Pro-forma Balance Sheet (if new entity with no operating history). 

    10.  Three references, who are not affiliated with the company or its principals, who can attest to the character and business repute of the applicant and its principals. 

    TOTAL FEES - $125 (check payable to the State of New Hampshire)