Bear Stearns stock exchange firm employee information form

EFTA00187061¶

STOCK EXCHANGE FIRM EMPLOYEE INFORMATION RECORD¶

(To be completed upon acceptance of application)¶

INFORMATION RECORD¶

Please answer all questions listed below as completely and accurately as possible, information disclosed on this form will be held in strict confidence and will be preserved after termination of employment in accordance with Rules 17a.3 and 17a.4 of the Securities and Exchange Commission and Rule 345.19 of the New York Stock Exchange.¶

1. First Name: [Name]
2. Last Name: [Name]
3. Middle Name: [Name]
4. (a) Have you ever been bonded? Yes
5. (b) Have you ever been refused a bond by a surety company? Yes
6. (c) Has such a bond ever been denied or revoked? Yes
7. (d) Has any surety company paid out any funds on your coverage? Yes
8. If answer to either (b), (c) or (d) is ‘yes’, attach details including name of surety company.
9. Have you ever been a member of any stock exchange, commodity exchange, or registered association of security or commodity brokers, dealers, investment banks or investment advisors? Yes
10. If ‘yes’, give name (s) and dates.
11. (a) Have you ever been suspended, expelled or otherwise disciplined by any regulatory body or by any such exchange or association; or even been denied membership therein; or ever withdrawn your application for such membership? Yes
12. (b) Have you ever been associated with any organization, as a director, controlling stockholder, partner, officer, employee or other representative of a broker-dealer which has been, or a principal of which has been, suspended or expelled from any such exchange or registered association, or was denied membership therein, or withdrawn an application for membership; or whose registration as a broker-dealer with the SEC or any State or agency has been denied, suspended or revoked? Yes
13. (c) Has any permanent or temporary injunction ever been entered against you? Yes
14. (d) Has any corporation, firm, or association, with which you were associated, been enjoined during the period of your association? Yes
15. (e) If answer to question 4 (a), (b), (c) or (d) is ‘yes’, attach details including any finding that you were a cause of any disciplinary action or had violated any law.
16. In your previous business connections or employment in any capacity, have transactions under your attention ever been the subject of complaint or legal proceedings? Yes
17. If ‘yes’, give names and details.
18. Have you ever been arrested, summoned, arraigned, indicted or convicted of a felony of any kind, or of a misdemeanor except minor traffic offenses? Yes
19. If ‘yes’, attach details.
20. Have you ever been known personally by any other name used an alias, or have you ever conducted business or carried brokerage or bank accounts in any other name than that shown above? Yes
21. If ‘yes’, give details and dates of use.

I hereby certify that I have read and understand the foregoing statements and that each of my responses thereto is true and complete. I authorize my prior employers to make available to my prospective employer, or to any Federal, State or Municipal agency, any information it may have concerning me, and I hereby release my employees from any and all liability of whatsoever nature by reason of furnishing such information.¶

[Signature of Employee]¶

EFTA00187062¶

EMPLOYEE	SECURITIES	TRANSACTIONS

PLEASE ATTEST TO THE FOLLOWING;¶

It is the policy of this firm, in compliance with the New York Stock Exchange and Federal Regulations, that no employee may maintain an account with another firm, effect securities transactions through a bank or obtain a loan from a bank collateralized by securities without the permission of the firm. Such permission should be requested in writing directed to the Compliance Department. This restriction applies to the employee, his spouse and minor children and any account in which the employee places orders.¶

“I have no brokerage accounts other than at Bear, Stearns & Co. and I have no bank loans collateralized by securities except: (if none, state NONE, indicate accounts of your spouse, minor children and any account in which you place orders).”¶

EFTA00187063¶

We have examined the above-named applicant for employment.¶

We find him / it / he / her / they / we / you /¶

Suitable for employment.¶

( ) Suitable for limited employment.¶

Remarks:¶

K. Xiaoyan, R.N.¶

MAHU - 975-27¶