FORM MA-W
Notice of Withdrawal from Registration as a Municipal Advisor
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
OMB APPROVAL
OMB Number:
3235-0681
Estimated average burden hours per response: 0.5
Please refer to the General Instructions for forms in the MA series
before completing this form. All italicized terms herein are defined
or described in the Glossary of Terms appended to the General Instructions.
A municipal advisor must complete this Form MA-W to
withdraw its municipal advisor registration with the SEC.
WARNING:
Complete this form truthfully. False statements or omissions may
result in administrative or civil action or criminal
prosecution.
Filer Information
Filer CIK:
Filer CCC:
File Number:
Contact Information
Vanessa Greene
Name:
508-247-5680
Phone:
vgreene@capecodfive.com
Email Address:
Notification Information
Notification will automatically be sent to the Login CIK,
Submission Contact, and Primary Issuers. Specify additional
addresses below.
Notification Email Address:
vgreene@capecodfive.com
Item 1 Identifying Information
A.
Full Legal Name: The name entered here must be the same as the name entered on
the registrant's most recent Form MA. Do not report a
name change on this Form MA-W.
CAPE COD FIVE CENTS SAVINGS BANK
B.
SEC File Number
Item 2 Contact Person (for
Municipal Advisory
Firms)
The registrant's contact person must be a principal or employee
(not outside counsel) of the municipal advisor authorized to
receive
information and respond to questions about this Form MA-W.
Name, title, and contact information:
Greene
Vanessa
Lynne
Last Name:
First Name:
Middle Name:
Director of Compliance & CRA Officer
Title
19 West Road
Street Address 1:
Street Address 2:
Orleans
MASSACHUSETTS
02653
City:
State/Country:
Postal Code:
508-247-5680
vgreene@capecodfive.com
Telephone Number:
Email Address:
Item 3 Money Owed to Clients
Has the registrant:
A.
Received any pre-paid municipal advisory fees for
municipal advisory activities, including pre-paid services and
subscription fees for publications, that have not been delivered?
Yes
No
If "Yes," what is the amount owed for these pre-paid services
(including subscriptions)?
$
B.
Borrowed any money from
clients
that has not been repaid?
Yes
No
If "Yes," what is the amount owed for these borrowed funds?
$
Item 4 Advisory Contract Assignments
Has the registrant assigned any contracts to another person
that engages in municipal advisory activities?
Yes
No
If "Yes", list on Section 4 of Schedule W1 each person to whom
the registrant has assigned any such municipal advisory contracts
and provide the requested information.
Item 5 Judgments and Liens
Are there any unsatisfied judgments or liens against the
registrant?
Yes
No
Item 6 Books and Records
NOTE: Rule 15Ba1-8 under the Exchange Act requires a municipal
advisor to preserve its books and records after the municipal
advisor ceases to conduct or discontinues business as a municipal
advisor.
Provide in Schedule W1 the name and address of each person who has or
will have custody or possession of the
municipal advisor's
books and records and each location at which any of such books and
records are or will be kept.
Item 7 Statement of Financial Condition
If registrant answered "Yes" to Item 3A, Item 3B, or Item 5,
complete Schedule W2, disclosing the nature and amount of the
registrant's assets and liabilities and net worth as of the last day
of the month prior to the filing of this Form MA-W.
Execution
For a Sole Proprietor:
I, the undersigned, certify, under penalty of perjury under the
laws
of the United States of America, that the information and statements
made in this Form MA-W, including exhibits and any other
information
submitted, are true. I further certify that the books
and records of my
municipal advisor-related
business will be preserved and available for inspection as required
by law, and that all information submitted on my most recent Form
MA
and Form MA-I is accurate and complete as of this date. I understand
that if any information contained in this Form MA-W is different
from
the information contained on my Form MA and Form MA-I, the
information on this Form MA-W will replace the corresponding entry on
my Form MA and Form MA-I. Finally, I authorize any person having
custody or possession of these books and records to make them
available to authorized regulatory representatives.
Signature:
Date:
Printed Name:
Title:
For a
Municipal Advisory Firm:
I, the undersigned, have signed this Form MA-W on behalf of, and
with
the authority of, the
municipal advisor
withdrawing its registration. The advisor and I both certify,
under
penalty of perjury under the laws of the United States of America,
that the information and statements made in this Form MA-W, including
exhibits and any other information submitted, are true.
I further certify that the
municipal advisor’s
books and records will be preserved and available for inspection as
required by law, and that all information submitted on the
municipal advisor
’s most recent Form MA is accurate and complete as of this date.
The
municipal advisor
and I understand that if any information contained in this Form
MA-W
is different from the information contained on Form MA, the
information on this Form MA-W will replace the corresponding entry
on
the
municipal advisor
’s Form MA. Finally, I authorize any
person
having custodyor possession of these books and records to make them
available to authorized regulatory representatives.
Joel Brickman
08-22-2016
Signature:
Date:
Joel Brickman
EVP & General Counsel
Printed Name:
Title:
FORM MA-W: Schedule W1
Certain items in Form MA-W may require additional information
on
this Schedule W1. Use this Schedule W1 to report details for
items
listed below. Report only new information or changes/updates
to
previously submitted information. Do not repeat previously
submitted
information.
SECTION 6 Books and Records
Complete the following information for each
person
that has or will have custody or possession of any of the registrant's books and records.
A separate Schedule W1 must be completed for each
person . If the same person
has or will have custody of any such books and
records at more than one location, a separate Schedule W1 must be
completed for this person for each such location.
Person
with Custody:
Name and business address of the person with custody or possession of books and records:
James Eldredge
Name:
532 Main Street
Street Address 1:
Street Address 2:
Harwichport
MASSACHUSETTS
02646
City:
State/Country:
Postal Code:
508-247-2357
Telephone Number:
Is this address a private residence?
Yes
No
Location of Books and Records:
Main Office
Name of Location, if any:
532 Main Street
Street Address 1:
Street Address 2:
Harwichport
MASSACHUSETTS
02646
City:
State/Country:
Postal Code:
508-247-2357
Telephone Number:
Is this address a private residence?
Yes
No
Briefly describe the books and records kept at
this location.
Legal files, bond bidding sheets, hard copies of bid sheets, 8038-G's, material event disclosures, certificates, and designation forms.
Complete the following information for each
person
that has or will have custody or possession of any of the registrant's books and records.
A separate Schedule W1 must be completed for each
person . If the same person
has or will have custody of any such books and
records at more than one location, a separate Schedule W1 must be
completed for this person for each such location.
Person
with Custody:
Name and business address of the person with custody or possession of books and records:
Stanley Hodkinson
Name:
212 Mid-Tech Drive
Street Address 1:
Street Address 2:
West Yarmouth
MASSACHUSETTS
02673
City:
State/Country:
Postal Code:
508-247-1875
Telephone Number:
Is this address a private residence?
Yes
No
Location of Books and Records:
Name of Location, if any:
212 Mid-Tech Drive
Street Address 1:
Street Address 2:
West Yarmouth
MASSACHUSETTS
02673
City:
State/Country:
Postal Code:
508-247-1875
Telephone Number:
Is this address a private residence?
Yes
No
Briefly describe the books and records kept at
this location.
Bond payment files
Complete the following information for each
person
that has or will have custody or possession of any of the registrant's books and records.
A separate Schedule W1 must be completed for each
person . If the same person
has or will have custody of any such books and
records at more than one location, a separate Schedule W1 must be
completed for this person for each such location.
Person
with Custody:
Name and business address of the person with custody or possession of books and records:
Vanessa Greene
Name:
19 West Road
Street Address 1:
Street Address 2:
Orleans
MASSACHUSETTS
02653
City:
State/Country:
Postal Code:
508-247-5680
Telephone Number:
Is this address a private residence?
Yes
No
Location of Books and Records:
Operations Center
Name of Location, if any:
19 West Road
Street Address 1:
Street Address 2:
Orleans
MASSACHUSETTS
02653
City:
State/Country:
Postal Code:
508-247-5680
Telephone Number:
Is this address a private residence?
Yes
No
Briefly describe the books and records kept at
this location.
Yes
No