Complete Bad Actor Form Online

Complete the InvestSecure Bad Actor Form directly on our website using the same information required in the downloadable application.

Issuer & Covered Person Information

You will be asked to provide information about the issuer and any covered persons subject to the Bad Actor review. Please ensure all information is complete and accurate.

Consent & disclosure

I, , acknowledge that I have reviewed and understand the SEC’s Bad Actor disqualifying events as outlined in this application.

I certify that the information provided in this application is true, complete, and accurate to the best of my knowledge. If I am completing this application on behalf of another individual or entity, I certify that I am authorized to submit this information and that it is accurate based on the information available to me. I acknowledge that providing false or incomplete information may result in civil or criminal liability.

I understand that InvestSecure will generate a Bad Actor Report based solely on the information provided in this application and publicly available records related to the disqualifying event categories under SEC Rule 506(d).

I understand that the results of this Bad Actor Report may be shared with the requesting party, the subject of the report (if different), and authorized users of the InvestSecure platform for compliance and due diligence purposes.

I understand that this disclosure does not constitute legal advice and that InvestSecure does not determine eligibility for any securities offering.

I agree to promptly notify the requesting party if I become aware of any information that would materially change the disclosures provided in this application.

Consent & disclosure
Signature
Date

Report Delivery Information

Full Name

Email Address (Required)

Phone Number (Optional)

The information submitted will be used to prepare the Bad Actor Reports.

Request More Information