Form MA-I Applicant's Information

Filer's CIK:
0001610215
Filer's CCC:

Submission Contact Information

Name:
Nicole Roberts
Phone:
4159561030
Email Address:
nroberts@dalescott.com

Notification Information

Notification will automatically be sent to the Login CIK, Submission Contact, and Primary Issuers. Specify additional addresses below.

Email Address:
nroberts@dalescott.com

Please read the General Instructions for this form and other forms in the MA series, as well as its subsection, "Specific Instructions for Form MA-I," before completing this form. All italicized terms herein are defined or described in the Glossary of Terms appended to the General Instructions.

PART 1

This form must be completed by

Every municipal advisory firm applying for registration or registered as a municipal advisor on Form MA, to provide information regarding each natural person who is an associated person of the firm and engages in municipal advisory activities on the firm's behalf (for purposes of Form MA-I, the "individual"); and

Every natural person (sole proprietor) applying for registration as a municipal advisor on Form MA, to provide additional personal information.

WARNING

Complete this form truthfully.  False statements or omissions may result in denial of a municipal advisor's application, revocation or suspension of such registration, or criminal prosecution.  Form MA-I must be amended promptly whenever any information previously provided becomes inaccurate.  See General Instruction 9. 

Type of Filing:

This is an (check the appropriate box):
checkbox unchecked Initial Form MA-I
Execution Pages: Before submitting this form, you must complete the Execution Page.
Supporting Documentation: If you are required to make reportable disclosures in the Disclosure Reporting Pages, you must attach the supporting documentation.
Non-Resident Individuals: If the individual is a non-resident of the United States, you must attach a completed Form MA-NR signed by the individual to this Form MA-I at the time of initial filing of Form MA-I. See the General Instructions.

checkbox unchecked Amendment to the most recent Form MA-I

checkbox checked Amendment to indicate that the individual is no longer an associated person of the municipal advisory firm or no longer engages in municipal advisory activities on its behalf. (If you check this box, complete only Item 1-A and Item 7 below.)

Item 1 Identifying Information

A. The Individual

Full Legal Name:
Enter all the letters of each name and not initials or other abbreviations. If no middle name, enter NMN on that line.
Last Name:
McCULLOUGH
First Name:
JAMES
Middle Name:
MICHAEL
Suffix:
Individual CRD No.: (if any)

B. Municipal Advisory Firms Where the Individual Is Employed

In providing your responses, please note that the definition of "employee" for purposes of this form includes an independent contractor who engages in municipal advisory activities on behalf of a municipal advisory firm. See Glossary of Terms.

Is the individual employed at more than one municipal advisory firm?
radio button unchecked YES radio button checked NO
Enter the number of municipal advisory firms the individual is employed with (sole proprietors not employed with any other firm enter 1).

(For individuals who are employed with more than one firm, provide the information required by this Item 1-B for each such firm. For sole proprietors, enter the legal name under which you conduct your municipal advisor-related activities, and skip to Item 1-B.1.)

1
Municipal Advisory Firm's CIK:  
0001610215
Full Legal Name of municipal advisory firm with which the individual is employed: 
Dale Scott & Co., Inc.
Name under which municipal advisor-related business is primarily conducted, if different from above:
Date that the individual's most recent employment with this municipal advisory firm commenced (MM/DD/YYYY):
06-05-2015
Does the individual have an independent contractor relationship with the above-named firm?
radio button unchecked YES radio button checked NO

(1) Municipal Advisory Firm's Registration Information:

Notification will automatically be sent to the Login CIK, Submission Contact, and Primary Issuers. Specify additional addresses below.

Is the municipal advisory firm currently registered on Form MA as a municipal advisor? (Answer "Yes" if you have already filed Form MA and your application for registration on that form has been approved. Otherwise, answer "No.")
radio button checkedYES radio button uncheckedNO
SEC File No.:
867-00537

(2) Office

Enter the requested information for each office of the municipal advisory firm where the individual is or will be physically located, and each office from which the individual is or will be supervised: 

The individual is or will be checkbox checked Located At checkbox unchecked Supervised From
Start Date:
06-05-2015
Street Address 1:
650 CALIFORNIA ST.
Street Address 2:
8TH FLOOR
City:
SAN FRANCISCO
State/Country:
CA
Postal Code:
94108
Private Residence Check Box: Is the Office of Employment address a private residence?

A private residential address will not be included in publicly available versions of this registration form.

radio button unchecked YES radio button unchecked NO

Item 2 Other Names

Enter the following information for all other names that the individual has used or is using, or by which the individual is known or has been known, other than the individual´s legal name, since the age of 18. 

This space should include, for example, nicknames, aliases, and names used before or after marriage.

(Enter all the letters of each name and not initials or other abbreviations. If no middle name, enter NMN on that line.)

Last Name:
McCULLOUGH
First Name:
MIKE
Middle Name:
NMN
Suffix:


Item 3 Residential History

Starting with the current address, enter the following information for all the individual´s residential addresses for the past 5 years. Leave no gaps greater than three months between addresses. Report changes in an amendment to this form as they occur in the future. Private residential addresses will not be included in publicly available versions of this form.

Current Address

From:
To:
Street Address 1:
Street Address 2:
City:
State/Country:
Postal Code:

Item 4 Employment History

Provide complete employment history of the individual for the past 10 years. Include the municipal advisory firm(s) entered in Item 1-B. Enter the following information for each employer. Account for all time, leaving no gaps longer than three months. Include full- and part-time employment, self-employment, military service, and homemaking. Also include statuses such as unemployed, full-time education, extended travel, or other similar statuses. Such statuses should be entered in the space provided below for "Name of Municipal Advisory Firm or Company." 

Current Employer

From:
06-2015
To: of Municipal Advisory Firm or Company:
Name of Municipal Advisory Firm or Company:
DALE SCOTT & CO., INC.
City: of Municipal Advisory Firm or Company:
SAN FRANCISCO
State/Country: of Municipal Advisory Firm or Company:
CA
Postal Code:
94109
Municipal Advisor-Related Business?
radio button checked YES radio button unchecked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
PUBLIC FINANCE ANALYST

Prior to the Above

Prior employment history must be entered in reverse chronological order.


Prior Address

From (MM/YYYY):
01-2014
To (MM/YYYY):
05-2015
Name of Municipal Advisory Firm or Company:
THE PFM GROUP, PUBLIC FINANCIAL MANAGEMENT, INC.
City:
PHILADELPHIA
State/Country:
PA
Postal Code:
19103
Municipal Advisor-Related Business?
radio button checked YES radio button unchecked NO
Investment-Related Business?
radio button checked YES radio button unchecked NO
Position Held:
FINANCIAL ANALYST, QUANTITATIVE STRATEGIES GROUP

Prior Address

From (MM/YYYY):
09-2013
To (MM/YYYY):
01-2014
Name of Municipal Advisory Firm or Company:
POLITICLOUT.COM, LLC
City:
ALEXANDRIA
State/Country:
VA
Postal Code:
22308
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
PRINCIPAL & EQUITY STAKEHOLDER, POLITICAL SALES STRATEGY

Prior Address

From (MM/YYYY):
01-2012
To (MM/YYYY):
09-2013
Name of Municipal Advisory Firm or Company:
UNIVERSITY OF PENNSYLVANIA
City:
PHILADELPHIA
State/Country:
PA
Postal Code:
19104
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
STUDENT & THESIS STUDENT

Prior Address

From (MM/YYYY):
03-2012
To (MM/YYYY):
04-2013
Name of Municipal Advisory Firm or Company:
DEPARTMENT OF ENERGY and OIKOS PROJOURNO.ORG
City:
ALEXANDRIA
State/Country:
VA
Postal Code:
22308
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
WRITER / EDITOR

Prior Address

From (MM/YYYY):
11-2010
To (MM/YYYY):
01-2012
Name of Municipal Advisory Firm or Company:
PHILADELPHIA GLOBAL WATER INITIATIVE/GLOBAL WATER COMPACT
City:
PHILADELPHIA
State/Country:
PA
Postal Code:
19107
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
FIELD RESEARCHER / RESEARCH ASSISTANT

Prior Address

From (MM/YYYY):
08-2010
To (MM/YYYY):
12-2010
Name of Municipal Advisory Firm or Company:
V-PITCH / ENGAJER
City:
ALEXANDRIA
State/Country:
VA
Postal Code:
22308
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
SALES AND POLITICAL MARKETING (PART-TIME)

Prior Address

From (MM/YYYY):
11-2008
To (MM/YYYY):
05-2010
Name of Municipal Advisory Firm or Company:
LAWRENCE REIMAN, LLC
City:
ALEXANDRIA
State/Country:
VA
Postal Code:
22308
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
RESEARCH ANALYST & COPY EDITOR

Prior Address

From (MM/YYYY):
05-2009
To (MM/YYYY):
09-2009
Name of Municipal Advisory Firm or Company:
FABIANI & CO.
City:
WASHINGTON D.C.
State/Country:
DC
Postal Code:
20004
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
TECHNOLOGY ASSISTANT

Prior Address

From (MM/YYYY):
04-2007
To (MM/YYYY):
02-2009
Name of Municipal Advisory Firm or Company:
US SENATOR ROBERT CASEY, JR.
City:
ALEXANDRIA
State/Country:
VA
Postal Code:
22308
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
STAFF ASSISTANT

Prior Address

From (MM/YYYY):
11-2006
To (MM/YYYY):
04-2007
Name of Municipal Advisory Firm or Company:
UNEMPLOYED
City:
PHILADELPHIA
State/Country:
PA
Postal Code:
19104
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
JOB SEEKER

Prior Address

From (MM/YYYY):
10-2006
To (MM/YYYY):
11-2006
Name of Municipal Advisory Firm or Company:
ROBERT CASEY FOR US SENAT
City:
ALEXANDRIA
State/Country:
VA
Postal Code:
22308
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
CAMPAIGN INTERN

Prior Address

From (MM/YYYY):
01-2006
To (MM/YYYY):
09-2006
Name of Municipal Advisory Firm or Company:
UNIVERSITY OF PENNSYLVANIA
City:
PHILADELPHIA
State/Country:
PA
Postal Code:
19104
Municipal Advisor-Related Business?
radio button unchecked YES radio button checked NO
Investment-Related Business?
radio button unchecked YES radio button checked NO
Position Held:
FULL TIME STUDENT & RESEARCH STUDENT

Item 5 Other Business

Is the individual currently engaged in any other business either as a proprietor, partner, officer, director, employee, trustee, agent or otherwise?
radio button unchecked YES radio button checked NO

Item 6 Disclosure Information

IF THE ANSWER TO ANY OF THE QUESTIONS IN ITEMS 6A – 6J AND 6M IS "YES," PROVIDE DETAILS OF ALL EVENTS OR PROCEEDINGS ON THE APPROPRIATE DISCLOSURE REPORTING PAGES (DRPs).

One event or proceeding may result in the requirement to answer "Yes" to more than one question below.

Refer to the Glossary of Terms for definitions or descriptions of italicized terms.

CRIMINAL ACTION DISCLOSURE

If the answer is "Yes" to any question below in Item 6A or 6B, complete a Criminal Action DRP.

Item 6A.

(1) Has the individual ever:

(a) been convicted of any felony, or pled guilty or nolo contendere ("no contest") to any charge of a felony in a domestic, foreign, or military court?
radio button unchecked YES radio button checked NO
(b) been charged with any felony?
radio button unchecked YES radio button checked NO

(2) Based upon activities that occurred while the individual exercised control over it, has an organization ever:

(a) been convicted of any felony or pled guilty or nolo contendere ("no contest") in a domestic or foreign court to any charge of a felony?
radio button unchecked YES radio button checked NO
(b) been charged with any felony?
radio button unchecked YES radio button checked NO

Item 6B.

(1) Has the individual ever:

(a) been convicted of any misdemeanor or pled guilty or nolo contendere ("no contest") in a domestic, foreign or military court to any charge of a misdemeanor involving: municipal advisory activities or a municipal advisor-related or investment-related business or any fraud, false statements or omissions, wrongful taking of property, bribery, perjury, forgery, counterfeiting, extortion, or a conspiracy to commit any of these offenses?

radio button unchecked YES radio button checked NO

(b) been charged with any misdemeanor of the kind described in 6B(1)(a)?

radio button unchecked YES radio button checked NO
(2) Based upon activities that occurred while the individual exercised control over it, has an organization ever:
(a) been convicted of any misdemeanor or pled guilty or nolo contendere ("no contest") in a domestic or foreign court to any charge of a misdemeanor of the kind specified in 6B(1)(a)?
radio button unchecked YES radio button checked NO
(b) been charged with any misdemeanor of the kind specified in 6B(1)(a)?
radio button unchecked YES radio button checked NO

REGULATORY ACTION DISCLOSURE

If the answer is "Yes" to any question below in Items 6C-6G(1), complete a Regulatory Action DRP.

Item 6C.

Has the SEC or the CFTC ever:

(1) found the individual to have made a false statement or omission?

radio button unchecked YES radio button checked NO

(2) found the individual to have been involved in a violation of any SEC or CFTC regulation or statute?

radio button unchecked YES radio button checked NO

(3) found the individual to have been a cause of a denial, suspension, revocation, or restriction of the authorization of a municipal advisor-related business or investment-related business to operate?

radio button unchecked YES radio button checked NO

(4) entered an order against the individual in connection with municipal advisor-related or investment-related activity?

radio button unchecked YES radio button checked NO

(5) imposed a civil money penalty on the individual, or ordered the individual to cease and desist from any activity?

radio button unchecked YES radio button checked NO

(6) found the individual to have willfully violated any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the MSRB, or found the individal to have been unable to comply with any provision of such Acts, rules or regulations?

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(7) found the individual to have willfully aided, abetted, counseled, commanded, induced, or procured the violation by any person of any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the MSRB?

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(8) found the individual to have failed reasonably to supervise another person subject to his or her supervision, with a view to preventing the violation of any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the MSRB?

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Item 6D.

(1) Has any other federal regulatory agency or any state regulatory agency or foreign financial regulatory authority ever:

(a) found the individual to have made a false statement or omission or to have been dishonest, unfair or unethical?

radio button unchecked YES radio button checked NO

(b) found the individual to have been involved in a violation of municipal advisor-related or investment-related regulation(s) or statute(s)?

radio button unchecked YES radio button checked NO

(c) found the individual to have been a cause of a denial, suspension, revocation, or restriction of the authorization of a municipal advisor-related or investment-related business to operate?

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(d) entered an order against the individual in connection with a municipal advisor-related or investment-related activity?

radio button unchecked YES radio button checked NO

(e) denied, suspended, or revoked the individual's registration or license or otherwise, by order, prevented the individual from associating with a municipal advisor-related or investment-related business or restricted his or her activities?

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(2) Has the individual ever been subject to any final order of a state securities commission (or any agency or office performing like functions), a state authority that supervises or examines banks, savings associations, or credit unions, a state insurance commission (or any agency or office performing like functions), a federal banking agency, or the National Credit Union Administration, that:

(a) bars the individual from association with an entity regulated by such commission, authority, agency, or office, or from engaging in the business of securities, insurance, banking, savings association activities, or credit union activities; or

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(b) is based on violations of any laws or regulations that prohibit fraudulent, manipulative, or deceptive conduct?

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Item 6E.

Has any self-regulatory organization or commodities exchange ever:

(1) found the individual to have made a false statement or omission?

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(2) found the individual to have been involved in a violation of its rules (other than a violation designated as a "minor rule violation" under a plan approved by the SEC)?

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(3) found the individual to have been a cause of a denial, suspension, revocation, or restriction of the authorization of a municipal advisor-related or investment-related business to operate?

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(4) disciplined the individual by expelling or suspending him or her from membership, barring or suspending the individual's association with its members, or restricting the individual's activities?

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(5) found the individual to have willfully violated any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the MSRB, or found the individual to have been unable to comply with any provision of such Acts, rules or regulations?

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(6) found the individual to have willfully aided, abetted, counseled, commanded, induced, or procured the violation by any person of any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the MSRB?

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(7) found the individual to have failed reasonably to supervise another person subject to your supervision, with a view to preventing the violation of any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the MSRB?

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Item 6F.

Has the individual ever had an authorization to act as an attorney, accountant or federal contractor that was revoked or suspended?
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Item 6G.

Has the individual been notified, in writing, that he or she is currently the subject of any:

(1) regulatory complaint or proceeding that could result in a "Yes" answer to any part of 6C, D or E?
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INVESTIGATION DISCLOSURE

If the answer is "Yes" to Item 6G(2) below, complete an Investigation DRP.

(2) investigation that could result in a "Yes" answer to any part of 6A, B, C, D or E? (If "Yes," complete the Investigation Disclosure Reporting Page.)
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CIVIL JUDICIAL ACTION DISCLOSURE

If the answer is "Yes" to any question below in Item 6H, complete a Civil Judicial Action DRP.

Item 6H.

(1) Has any domestic or foreign court ever:

(a) enjoined the individual in connection with any municipal advisor-related or investment-related activity?
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(b) found that the individual was involved in a violation of any municipal advisor-related or investment-related statute(s) or regulation(s)?
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(c) dismissed, pursuant to a settlement agreement, a municipal advisor-related or investment-related civil action brought against the individual by a domestic jurisdiction or foreign financial regulatory authority?
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(2) Is the individual named in any currently pending civil proceeding that could result in a "Yes" answer to any part of 6H(1)?
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CUSTOMER COMPLAINT/ARBITRATION/CIVIL LITIGATION DISCLOSURE

If the answer is "Yes" to any question below in Item 6I, complete a Customer Complaint/Arbitration/Civil Litigation DRP.

Item 6I.

(1) Has the individual ever been the subject of a municipal advisor-related or investment-related, customer-initiated (written or oral) complaint that alleged that he or she was involved in fraud, false statements, omissions, theft, embezzlement, wrongful taking of property, bribery, forgery, counterfeiting, extortion, or dishonest, unfair or unethical practices, which:
(a) is still pending, or;
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(b) was settled?
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(2) Has the individual ever been the subject of a municipal advisor-related or investment-related, customer-initiated arbitration or civil litigation that alleged that he or she was involved in fraud, false statements, omissions, theft, embezzlement, wrongful taking of property, bribery, forgery, counterfeiting, extortion, or dishonest, unfair or unethical practices, which:
(a) is still pending, or;
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(b) resulted in an arbitration award or civil judgment against the individual, regardless of amount, or;
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(c) was settled?
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TERMINATION DISCLOSURE

If the answer is "Yes" to any question below in Item 6J, complete a Termination DRP.

Item 6J.

Has the individual ever voluntarily resigned, been discharged or permitted to resign after allegations were made that accused him or her of:

(1) violating municipal advisor-related or investment-related statutes, regulations, rules, or industry standards of conduct?
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(2) fraud or the wrongful taking of property?
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(3) failure to supervise in connection with municipal advisor-related or investment-related statutes, regulations, rules or industry standards of conduct?
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FINANCIAL DISCLOSURE

Item 6K.

Within the past 10 years:

(1) has the individual made a compromise with creditors, filed a bankruptcy petition or been the subject of an involuntary bankruptcy petition?
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(2) based upon events that occurred while the individual exercised control over it, has an organization made a compromise with creditors, filed a bankruptcy petition or been the subject of an involuntary bankruptcy petition?
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(3) based upon events that occurred while the individual exercised control over it, has a broker or dealer been the subject of an involuntary bankruptcy petition, had a trustee appointed, or had a direct payment procedure initiated under the Securities Investor Protection Act?
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Item 6L.

Has a bonding company ever denied, paid out on, or revoked a bond for the individual?
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JUDGMENT/LIEN DISCLOSURE

If the answer is "Yes" to any question below in Item 6M, complete a Judgment/Lien DRP.

Item 6M.

Are there currently any unsatisfied judgments or liens against the individual?
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Item 7 Signature and Self-Certification

NOTE:  In addition to completing Item 7, to the extent that the individual is a non-resident, a Form MA-NR completed and signed by the individual must be attached as an exhibit to this Form MA-I.

Complete Either Subpart A or Subpart B:

By typing a name in the signature field, the signatory acknowledges and represents that the entry constitutes in every way, use, or aspect, his or her legally binding signature.

A. For Municipal Advisory Firms filing this form:

The municipal advisory firm has obtained and retained written consent from the individual that service of any civil action brought by, or notice of any proceeding before, the SEC or any self-regulatory organization in connection with the individual's municipal advisory activities may be given by registered or certified mail to the individual's address given in Item 1.

I, the undersigned, sign this Form MA-I on behalf of, and with the authority of, the municipal advisory firm that is filing this form. The municipal advisory firm 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-I, including exhibits and any other information submitted, are true and correct, and that I am signing this Form MA-I as a free and voluntary act.

Date:
04-02-2021
By (signature):
Nicole Roberts
Title:
Compliance Contact

B. For Natural Person Municipal Advisors (Sole Proprietors) filing this form:

The individual named below consents that service of any civil action brought by, or notice of any proceeding before, the SEC or any self-regulatory organization in connection with the individual's municipal advisory activities may be given by registered or certified mail to the individual's address given in Item 1.

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-I, including exhibits and any other information submitted, are true and correct, and that I am signing this Form MA-I Execution Page as a free and voluntary act.

Date:

Full Legal Name of Municipal Advisor:
Enter all the letters of each name and not initials or other abbreviations. If no middle name, enter NMN on that line.

Last Name:
First Name:
Middle Name:
Suffix:
Individual CRD No. (if any):
By (signature):

Warning: Intentional misstatements or omissions of fact constitute Federal criminal violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).12.