| filer_cik | Central Index Key of withdrawing entity | Number (10-digit) | Original |
| filer_ccc | EDGAR access code (Confidential Code for Computers) | Text (8-char) | Original |
| filer_name | Legal name of municipal advisor | Text | Original |
| filer_crd_number | FINRA Central Registration Depository number | Number | Original |
| filer_email | Email of municipal advisor | Text | Original |
| withdrawal_date | Effective date of registration withdrawal | Date (YYYY-MM-DD) | Original |
| reason_for_withdrawal | Primary cause for withdrawal (e.g., "Ceased municipal advisory activities") | Text | Original |
| successor_municipal_advisor | Name/CRD of entity assuming client obligations (if applicable) | Text + Number | Original |
| client_notification | Confirmation that clients were notified of withdrawal | Boolean (Yes/No) | Original |
| signature_name | Name of authorized signatory | Text | Original |
| signature_title | Title of authorized signatory | Text | Original |
| signature_date | Date of form execution | Date (YYYY-MM-DD) | Original |