8-R Individual Application

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Name*
NF
A ID#*
NFA

Registration Categories and Sponsor Information
Only individuals filing as Associated Persons, Branch Office Managers or Principals
complete this section.
Check category(ies) and enter sponsor information.
Registration Categories*
Associated Person
Branch Office Manager
Principal
Sponsor Information
Sponsor*
Branch ID*
Only individuals filing as Floor Brokers or Floor TTraders
raders complete this section.
Registration Categories*
Floor Broker
rader
Floor TTrader
Check here if you are requesting a change from floor trader to floor broker or floor broker to
trader..
floor trader
Only individuals filing as Principals complete this section.

Principal Information
Enter information.
Title*
10% or more interest
interest**

yes

no

*Required to file application

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A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION

Personal Information
Enter information.
Name
First and Middle*
Last and Suffix*
Residential Address
P.O. Box address is not acceptable.
Street Address1*
Street Address2
Street Address3
City**
State* (US Only)
Province
Zip/Postal Code**
Country*
Birth Information
Date of Birth*
City
State* (US Only)
Province
Country*
Social Security #
E-mail Address
CRD/IARD ID***
*Required to file application
**Required to file application for United States address
***Required for individuals who intend to satisfy proficiency requirements based on their status as a registered General
Securities Representative of the Sponsor and for individuals filing as Branch Office Managers who are eligible to be
Branch Office Managers under NYSE/NASD rules.
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A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Other Names
Enter any other name by which you are or have been known.
Other Names
First Name

Last Name

First Name

Last Name

First Name

Last Name

First Name

Last Name

Only individuals filing as Floor Brokers or Floor TTraders
raders complete this section.

Exchange Affiliation
Select the exchange(s) at which you have been granted membership or trading privileges or
at which you have an application pending.
ACC

Amex Commodities Corporation

CBOT

Chicago Board of TTrade
rade

CEI

Commodity Exchange Inc.

CFE

CBOE Futures Exchange LLC

CME

Chicago Mercantile Exchange

CX

Cantor Financial Futures Exchange

KCBT

Board of TTrade
rade of Kansas City

MGE

Minneapolis Grain Exchange

NYBT

ork Board of TTrade
rade
New YYork

NYME

New YYork
ork Mercantile Exchange

PBOT

Philadelphia Board of TTrade
rade

-8-

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Only individuals filing as Floor Brokers or Floor TTraders
raders complete this section.

Business Mailing Address
Enter information.
Business Mailing Address
Street Address1*
Street Address2
Street Address3
City**
State* (US Only)
Province
Zip/Postal Code**
Country*
E-mail Address

*Required to file application
**Required to file application for United States address
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TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Disciplinary Information - Criminal Disclosures
For additional assistance and information on completing this page, refer to the Instructions and
Definition of TTerms
erms at the beginning of this document.
Answer the following questions. YYou
ou must answer “Y
es” to the questions on this page even if:
“Yes”
• adjudication of guilt was withheld or there was no conviction; or
• there was a conditional discharge or post-conviction dismissal after successful completion of
a sentence; or
• a state certificate of relief from disabilities or similar document was issued relieving the holder
of forfeitures, disabilities or bars resulting from a conviction; or
• the record was expunged or sealed; or
• a pardon was granted.
You may answer “no” if the case was decided in a juvenile court or under a YYouth
outh Offender Law
Law..
A.*

(1) Have you personally
or
(2) has any entity of which you were a principal (based on activities that occurred while you were a
principal
principal))
ever pled guilty or nolo contendere (“no contest”) to or been convicted or found guilty of any felony in any
domestic, foreign or military court?
Yes
No

B.*

(1) Have you personally
or
(2) has any entity of which you were a principal (based on activities that occurred while you were a
principal
principal))
ever pled guilty to or been convicted or found guilty of any misdemeanor in any domestic, foreign or military
court which involves:
• embezzlement, theft, extortion, fraud, fraudulent conversion, forgery, counterfeiting, false
pretenses, bribery, gambling, racketeering or misappropriation of funds, securities or
property; or
• violation of sections 7203, 7204, 7205 or 7207 of the Internal Revenue Code of 1986
1986;; or
• violation of sections 152, 1341, 1342, or 1343 or chapters 25, 47, 95 or 96 of the United States
Criminal Code
Code;; or
• any transaction in or advice concerning futures, options, leverage transactions or
securities?
No
Yes

- continued on next page *Required to file application

- 10 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Disciplinary Information - Criminal Disclosures
For additional assistance and information on completing this page, refer to the Instructions and
Definition of TTerms
erms at the beginning of this document.
C.*

(1) Are you personally
OR
(2) has any entity of which you were a principal (based on activities that occurred while you were a
principal
principal))
a party to any action, or is there a charge pending, the resolution of which could result in a “Y
es”
“Yes”
answer to the above questions?
Yes
No

Individuals who are filing their first application for registration in the futures industry do not answer this question.
For any “Y
es” answer to the questions above, have you previously provided NF
A or the CFTC all supplemental
“Yes”
NFA
documentation for all matters requiring a “Y
es” answer?*
“Yes”
Yes
No
Would you like to provide details of any criminal matter?
Yes

*Required to file application

No

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TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Criminal Disclosures
For each matter for which you have not provided all supporting documentation, you
must provide a detailed explanation of the event or conduct. YYou
ou can enter up to three (3)
matters in this document. If you have more than three (3) matters which you must
explain, please do so in another document such as Microsoft W
ord and attach it to this
Word
document.
If you must provide a detailed explanation for a matter
matter,, the explanation must be in
writing and sent to NF
A or entered below
NFA
below.. The explanation must include:
Matter Name:
(e.g., 1999 Theft Arrest/Charge; 99-CM-105)
When and where the event occurred, parties involved, circumstances, case number and court
jurisdiction, allegations/
charges
allegations/charges
charges,, classification of the charges
charges,, plea and sentencing information,
and the final disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of court documentation which show:
• the charges
charges;;
);
• the classification of the offense, (i.e., felony or misdemeanor
misdemeanor);
• the plea, sentencing and probation information, as applicable; and
• the final disposition.
If you are unable to obtain the documents for the criminal matter
matter,, you must provide a letter from
the court verifying the documents’ unavailability
unavailability..
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TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Criminal Disclosures (additional matters, if needed)
Matter Name:
(e.g., 1999 Theft Arrest/Charge; 99-CM-105)
When and where the event occurred, parties involved, circumstances, case number and court
jurisdiction, allegations/
charges
allegations/charges
charges,, classification of the charges
charges,, plea and sentencing information,
and the final disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of court documentation which show:
• the charges
charges;;
);
• the classification of the offense, (i.e., felony or misdemeanor
misdemeanor);
• the plea, sentencing and probation information, as applicable; and
• the final disposition.
If you are unable to obtain the documents for the criminal matter
matter,, you must provide a letter from
the court verifying the documents’ unavailability
unavailability..

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TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Criminal Disclosures (additional matters, if needed)
Matter Name:
(e.g., 1999 Theft Arrest/Charge; 99-CM-105)
When and where the event occurred, parties involved, circumstances, case number and court
jurisdiction, allegations/
charges
allegations/charges
charges,, classification of the charges
charges,, plea and sentencing information,
and the final disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of court documentation which show:
• the charges
charges;;
);
• the classification of the offense, (i.e., felony or misdemeanor
misdemeanor);
• the plea, sentencing and probation information, as applicable; and
• the final disposition.
If you are unable to obtain the documents for the criminal matter
matter,, you must provide a letter from
the court verifying the documents’ unavailability
unavailability..

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TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Disciplinary Information - Regulatory Disclosures
For additional assistance and information on completing this page, refer to the Instructions and
Definition of TTerms
erms at the beginning of this document.
Answer the following questions.
D.*

In any case brought by a domestic or foreign governmental body (other than the CFTC),
(1) have you personally
or
(2) has any entity of which you were a principal (based on activities that occurred while you were a
principal
principal))
ever been permanently or temporarily enjoined after a hearing or default or as the result of a
settlement, consent decree or other agreement, from engaging in or continuing any activity involving:
• any transaction in or advice concerning futures, options, leverage transactions or
securities; or
• embezzlement, theft, extortion, fraud, fraudulent conversion, forgery, counterfeiting, false
pretenses, bribery
bribery,, gambling, racketeering or misappropriation of funds, securities or
property?
Yes
No

E.*

In any case brought by a domestic or foreign governmental body (other than the CFTC),
(1) have you personally
or
(2) has any entity of which you were a principal (based on activities that occurred while you were a
principal
principal))
ever been found after a hearing or default or as the result of a settlement, consent decree or other
agreement, to:
• have violated any provision of any investment-related statute or regulation; or
• have violated any statute, rule, regulation or order which involves embezzlement, theft,
extortion, fraud, fraudulent conversion, forgery
forgery,, counterfeiting, false pretenses, bribery
bribery,,
gambling, racketeering or misappropriation of funds, securities or property; or
• have willfully aided, abetted, counseled, commanded, induced or procured such violation by any
other person?
Yes
No

F.*

(1) Have you personally
or
(2) has any entity of which you were a principal (based on activities that occurred while you were a
principal
principal))
ever been debarred by any agency of the United States from contracting with the United States?
Yes
No
-continued on next page-

*Required to file application

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TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Disciplinary Information - Regulatory Disclosures
For additional assistance and information on completing this page, refer to the Instructions and
Definition of TTerms
erms at the beginning of this document.
Answer the following questions.
G.*

(1) Have you personally
or
(2) has any entity of which you were a principal (based on activities that occurred while you were a
principal
principal))
ever been the subject of any order issued by or a party to any agreement with a domestic or foreign
regulatory authority (other than the CFTC), including but not limited to a licensing authority, or self-regulatory
organization (other than NFA or a domestic
futures exchange) that prevented or restricted your ability to
domesticfutures
engage in any business in the financial services industry
industry??
Yes
No

H.*

Are any of the orders or other agreements decribed in Question G currently in effect against you?
Yes
No

I.*

(1) Are you personally
OR
(2) has any entity of which you were a principal (based on activities that occurred while you were a
principal
principal))
a party to any action, or is there a charge pending, the resolution of which could result in a “Y
es” answer to
“Yes”
the above questions?
Yes
No

Individuals who are filing their first application for registration in the futures industry do not answer this question.
For any “Y
es” answer to the questions above, have you previously provided NF
A or the CFTC all supplemental
“Yes”
NFA
documentation for all matters requiring a “Y
es” answer?*
“Yes”
Yes
No
Would you like to provide details of any regulatory matter?
Yes

No

*Required to file application
- 16 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Regulatory Disclosures
For each matter for which you have not provided all supporting documentation, you
must provide a detailed explanation of the event or conduct. YYou
ou can enter up to three (3)
matters in this document. If you have more than three (3) matters which you must
explain, please do so in another document such as Microsoft W
ord and attach it to this
Word
document.
If you must provide a detailed explanation for a matter
matter,, the explanation must be in
writing and sent to NF
A or entered below
NFA
below.. The explanation must include:
Matter Name:
(e.g., March 1999 SEC case; NASD Case No. CM10034)
When the event occurred, parties involved, case number
number,, allegations/charges, and the final
disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of documentation which show:
• the allegations;
• the final disposition.
If you are unable to obtain the documents you must provide an explanation on a separate sheet
stating why documents are not obtainable.

- 17 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Regulatory Disclosures (additional matters, if needed)
Matter Name:
(e.g., March 1999 SEC case; NASD Case No. CM10034)
When the event occurred, parties involved, case number
number,, allegations/charges, and the final
disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of documentation which show:
• the allegations;
• the final disposition.
If you are unable to obtain the documents you must provide an explanation on a separate sheet
stating why documents are not obtainable.

- 18 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Regulatory Disclosures (additional matters, if needed)
Matter Name:
(e.g., March 1999 SEC case; NASD Case No. CM10034)
When the event occurred, parties involved, case number
number,, allegations/charges, and the final
disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of documentation which show:
• the allegations;
• the final disposition.
If you are unable to obtain the documents you must provide an explanation on a separate sheet
stating why documents are not obtainable.

- 19 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Disciplinary Information - Financial Disclosures
For additional assistance and information on completing this page, refer to the Instructions and
Definition of TTerms
erms at the beginning of this document.
Answer the following questions.
J.*

Have you currently failed to comply with any order to pay any futures-related civil monetary penalties,
restitution amounts, disgorgement amounts, reparation amounts or arbitration awards?

Yes
K.*

No

(1) Have you personally
or
(2) has any entity of which you were a principal (based on activities that occurred while you were a
principal
principal))
ever been the subject of an adversary action brought by, or on behalf of, a bankruptcy trustee?

Yes

No

Individuals who are filing their first application for registration in the futures industry do not answer this question.
For any “Y
es” answer to the questions above, have you previously provided NF
A or the CFTC all supplemental
“Yes”
NFA
documentation for all matters requiring a “Y
es” answer?*
“Yes”

Yes

No

Would you like to provide details of any financial matter?
Yes

No

*Required to file application
- 20 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Financial Disclosures
For each matter for which you have not provided all supporting documentation, you
must provide a detailed explanation of the event or conduct. YYou
ou can enter up to three (3)
matters in this document. If you have more than three (3) matters which you must
explain, please do so in another document such as Microsoft W
ord and attach it to this
Word
document.
If you must provide a detailed explanation for a matter
matter,, the explanation must be in
writing and sent to NF
A or entered below
NFA
below.. The explanation must include:
Matter Name:
(e.g., 00-R100 Unpaid A
ward; 98-0125476 Bankruptcy Denied)
Award;
When the event occurred, parties involved, circumstances, case number and court jurisdiction,
allegations/charges, and the final disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of documentation which show:
• the allegations;
• the final disposition.
If you are unable to obtain the documents you must provide an explanation on a separate sheet
stating why documents are not obtainable.

- 21 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Financial Disclosures

(additional matters, if needed)

Matter Name:
(e.g., 00-R100 Unpaid A
ward; 98-0125476 Bankruptcy Denied)
Award;
When the event occurred, parties involved, circumstances, case number and court jurisdiction,
allegations/charges, and the final disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of documentation which show:
• the allegations;
• the final disposition.
If you are unable to obtain the documents you must provide an explanation on a separate sheet
stating why documents are not obtainable.

- 22 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Financial Disclosures

(additional matters, if needed)

Matter Name:
(e.g., 00-R100 Unpaid A
ward; 98-0125476 Bankruptcy Denied)
Award;
When the event occurred, parties involved, circumstances, case number and court jurisdiction,
allegations/charges, and the final disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of documentation which show:
• the allegations;
• the final disposition.
If you are unable to obtain the documents you must provide an explanation on a separate sheet
stating why documents are not obtainable.

- 23 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Disciplinary Information - Employment Disclosures
For additional assistance and information on completing this page, refer to the Instructions and
Definition of TTerms
erms at the beginning of this document.
Answer the following questions.
L.*

Have you ever been discharged or permitted to resign for cause as a result of allegations of:
• embezzlement, theft, extortion, fraud, fraudulent conversion, forgery
forgery,, counterfeiting, false
pretenses, bribery
bribery,, gambling, racketeering or misappropriation of funds, securities or
property; or
person’ss activities as a registrant of
• failure to supervise another person in the conduct of such person’
the CFTC, SEC, NFA, NASDR or other domestic or foreign self-regulatory organization
organization??

Yes

No

Individuals who are filing their first application for registration in the futures industry do not answer
this question.
For any “Y
es” answer to the question above, have you previously provided NF
A or the CFTC all
“Yes”
NFA
supplemental documentation for all matters requiring a “Y
es” answer?*
“Yes”
Yes

No

Would you like to provide details of any employment matter?
Yes

No

*Required to file application
- 24 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Employment Disclosures
For each matter for which you have not provided all supporting documentation, you
must provide a detailed explanation of the event or conduct. YYou
ou can enter up to three (3)
matters in this document. If you have more than three (3) matters which you must
explain, please do so in another document such as Microsoft W
ord and attach it to this
Word
document.
If you must provide a detailed explanation for a matter
matter,, the explanation must be in
writing and sent to NF
A or entered below
NFA
below.. The explanation must include:
Matter Name:
(e.g., ABC Company Discharge)
When the event occurred, parties involved, circumstances, allegations/charges, and the final
disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of documentation which show:
• the allegations;
• the final disposition.
If you are unable to obtain the documents you must provide an explanation on a separate sheet
stating why documents are not obtainable.

- 25 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information-Employment Disclosures (additional matters, if needed)
Matter Name:
(e.g., ABC Company Discharge)
When the event occurred, parties involved, circumstances, allegations/charges, and the final
disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of documentation which show:
• the allegations;
• the final disposition.
If you are unable to obtain the documents you must provide an explanation on a separate sheet
stating why documents are not obtainable.

- 26 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information-Employment Disclosures (additional matters, if needed)
Matter Name:
(e.g., ABC Company Discharge)
When the event occurred, parties involved, circumstances, allegations/charges, and the final
disposition.

AND IN ADDITION, YOU MUST PROVIDE THE FOLLOWING:
Copies of documentation which show:
• the allegations;
• the final disposition.
If you are unable to obtain the documents you must provide an explanation on a separate sheet
stating why documents are not obtainable.

- 27 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Employment and Education History
The CFTC requires that sponsors attempt to communicate with all of the applicant’
applicant’ss previous
employers and educational institutions for the past three years and to maintain documentation in
their files that includes the names of the persons contacted and the dates of contact or
or,, if no
contact was made, the reason why
why..
Enter your employment and personal history
history,, working back 10 years. All time must be accounted
for
for,, including self-employment, part-time employment, unemployment, military service and full-time
education. There are 10 spaces available to submit this information. If more than 10 spaces are
needed, complete the information in another document such as Microsoft Word and attach it to this
document.
Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

*Required to file application
- 28 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Employment and Education History (additional spaces, if needed)
Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

*Required to file application
- 29 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Employment and Education History (additional spaces, if needed)
Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

Month/Y
ear
Month/Year

Employment/School

From*:

Name*:

To:

Location:
(city
(city,, state or country)

Position Held and
Reason for Leaving:

*Required to file application
- 30 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Residential History
List your past residential addresses, working back five (5) years. Post office box address is not
acceptable. There are five (5) spaces available to submit this information. If more than five (5)
spaces are needed, complete the information in another document such as Microsoft W
ord and
Word
attach it to this document.
Month/Y
ear
Month/Year

Address

From*:
To:

Month/Y
ear
Month/Year

Address

From*:
To:

Month/Y
ear
Month/Year

Address

From*:
To:

Month/Y
ear
Month/Year

Address

From*:
To:

Month/Y
ear
Month/Year

Address

From*:
To:

*Required to file application

- 31 -

TEMPLA
TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Only individuals filing as Associated Persons or as Principals of sole proprietorships complete the
Proficiency Requirements sections.

Proficiency Requirements
Select one.
Series 3 Examination*
You have passed the Series 3 Examination within the past two (2) years.
You intend to take the Series 3 Examination.
You intend to satisfy Alternative Proficiency Requirement.
Only individuals filing as Branch Office Managers complete this section. Select one.
Series 30 Examination*
You have passed the Series 30 Examination within the past two (2) years.
You intend to take the Series 30 Examination.
You are eligible to be a Branch Office Manager or Designated Supervisor under NASD/NYSE
Rules.
Only individuals who indicated that they intend to satisfy an alternative proficiency requirement and
whose sponsor is an FCM or IB complete this section. Check either of the first two boxes that apply
or check the last box.

If you have indicated that you intend to satisfy proficiency requirements through an alternative to the Series 3
Examination you must fill in the following information, or if you are a registered General Securities Representative of
the sponsor and limit your futures business to any of the following activities, check all that apply:
You limit futures activities to the solicitation of pool participants and/or the solicitation of discretionary
accounts managed by a CT
A or the supervision of others engaged in such solicitations.
CTA
You limit futures activities to referring clients to an AP or to supervising others who make such referrals.

You have been registered or licensed with a foreign regulatory authority located in Canada or the United
Kingdom within the past two years.

*Required to file application
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NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Proficiency Requirements
Only individuals who indicated that they intend to satisfy an alternative proficiency requirement and
whose sponsor is a CPO, CT
A or both complete this section. Select one.
CTA

You have been registered or licensed with a foreign regulatory authority located in Canada or the United
Kingdom within the past two years.
Your sponsor is a CPO that operates pools primarily engaged in securities transactions or a CT
A that
CTA
provides futures trading advice solely incidental to its securities advisory services.

Only individuals who indicated that they intend to limit their activities to solicitation of managed
funds complete this section. Select one.
Series 31 Examination*
Futures Managed Funds Examination

You have passed the Series 31 Examination within the past two (2) years.
You intend to take the Series 31 Examination.

Only individuals who indicated that they have been registered in the U.K. or Canada in the last two
years complete this section. Select one.
Series 32 Examination*
Limted Futures Examination

You have passed the Series 32 Examination within the past two (2) years.
You intend to take the Series 32 Examination.

*Required to file application
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TE: DO NOT SEND TO NF
A
TEMPLATE:
NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Only individuals whose sponsor is a broker
-dealer complete this section, Select one.
broker-dealer

Fingerprint Card
Fingerprint Card
The applicant’
A.
applicant’ss properly signed fingerprint card(s) will be sent to NF
NFA.
applicant’ss properly signed fingerprint card(s) were sent to NASD
The applicant’
within the past 90 days.

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