When Your Broker Calls,
Take Notes!

A Form To Use When Talking to a Broker

Use this form to record your conversation with any broker who recommends that you buy or sell an investment.

Name of Broker:_________________________________________________ Company: ______________________________________________ Company Location:______________________________________________ Date:_________________        Time: ____________   ___ Phone call   ___ Meeting      Location: ____________________ Recommended that I:     ___ buy         ___ sell Name of security: _________________________________________ How does this recommendation meet my investment objectives? What are the specific reasons why I should invest in this? (or sell this?) ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ What are the specific risks if I buy this investment? ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ I asked to receive written information about this investment before making a decision:     ___ yes         ___ no I asked for: ___ a prospectus ___ most recent annual report (10K) ___ most recent quarterly report (10Q) ___ any other recent report (8K) ___ any other available written material ___ other _____________________ After looking at the written material, I decided to: ___ do nothing ___ buy ___ sell how much? _______________ at what price? _______________ The total cost of this transaction will be: _______________ Other Notes:     Date: __________________________

If you suspect wrongdoing, contact:

Office of Investor Education and Assistance
U.S. Securities & Exchange Commission
450 Fifth St. N.W.
Washington D.C. 20549-0213
Fax: (202) 942-9634
Online Complaint Form

http://www.sec.gov/complaint/callform.htm