8-T Individual Withdrawal

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Instructions for Using the Individual Withdrawal Template
This document is not an Individual Withdrawal Notice form. Do not send this document to NFA. It is a
template that you may use to assist in filing the electronic notice.
You may fill out the template online and save and/or print it when you are finished or you can download
the template and/or print it and fill it out later.
Not every section applies to every individual. Certain sections apply depending on the whether some
or all of the individual’s registration categories with the individual’s sponsor are being withdrawn. The
text above these sections explains who must complete the section. In the electronic notice, only the
applicable sections will appear.
Defined Terms
Terms that are underlined throughout the template are defined below. If you are completing this online,
clicking on the underlined term will open a separate document containing the definitions.
DEFINITION OF TERMS (The following terms are defined solely for the purpose of using NFA’s Online
Registration System.)
10% OR MORE INTEREST: direct or indirect ownership of 10% or more of an applicant’s or registrant’s stock; entitlement to vote or empowered to sell 10% or more of an applicant’s or registrant’s voting securities; contribution of
10% or more of an applicant’s or registrant’s capital; or entitlement to 10% or more of an applicant’s or registrant’s
net profits.
ADJUDICATION: in a criminal case, a determination by the court that the defendant is guilty or not guilty.
ALIAS: another name utilized by an individual or previously used by an entity.
CHARGE: a formal complaint, information, indictment or equivalent instrument containing and accusation of a
crime.
DBA: abbreviation for Doing Business As. The firm is doing business under this name.
ENJOINED: subject to an injunction.
ENTITY: any person other than an individual.
FELONY: any crime classified as a felony and for states and countries that do not differentiate between a felony
or misdemeanor, an offense punishable by a sentence of at least one year imprisonment and/or a fine of at least
$1,000. The term also includes a general court martial.
FINANCIAL SERVICES INDUSTRY: the commodities, securities, accounting, banking, finance, insurance, law or
real estate industries.
FOUND: subject to a determination that conduct or a rule violation has occurred. The term includes consent
decrees and settlements in which the findings are neither admitted nor denied or in which the findings are for
settlement or record purposes only.
INTERNAL REVENUE CODE:
Section 7203: Willful Failure to File Return, Supply Information or Pay Tax
Section 7204: Fraudulent Statement or Failure to Make Statement
Section 7205: Fraudulent Withholding Exemption Certificate or Failure to Supply Information
Section 7207: Fraudulent Returns, Statements or Other Documents

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TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Instructions for Using the Individual Withdrawal Template
INVESTMENT RELATED STATUTES:
• The Commodity Exchange Act
• The Securities Act of 1933
• The Securities Exchange Act of 1934
• The Public Utility Holding Company Act of 1935
• The Trust Indenture Act of 1939
• The Investment Advisers Act of 1940
• The Investment Company Act of 1940
• The Securities Investors Protection Act of 1970
• The Foreign Corrupt Practices Act of 1977
• Chapter 96 of Title 18 of the United States Code
• Any similar statute of a State or foreign jurisdiction
• Any rule, regulation or order under any such statutes; and
• The rules of the Municipal Securities Rulemaking Board
MISDEMEANOR: any crime classified as a misdemeanor and for states and countries that do not differentiate
between a felony or misdemeanor, an offense punishable by a sentence of less than one year imprisonment and/or
a fine of less than $1,000. The term also includes a special court martial.
PERSON: an individual, association, partnership, corporation, limited liability company, limited liability partnership,
trust, or other form of business organization.
PRINCIPAL: an individual who is:
• a sole proprietor of a sole proprietorship;
• a general partner of a partnership;
• a director, president, chief executive officer, chief operating officer or chief financial officer of a corporation, limited liability company or limited partnership;
• in charge of a business unit, division or function of a corporation, limited liability company or limited partnership if the unit, division or function is subject to regulation by the Commission; or
• a manager, managing member or a member vested with the management authority for a limited liability
company or limited liability partnership; or
• an individual who directly or indirectly, through agreement, holding companies, nominees, trusts or otherwise:
- is the owner of 10% or more of the outstanding shares of any class of a registrant’s stock;
- is entitled to vote 10% or more of any class of a registrant’s voting securities;
- has the power to sell or direct the sale of 10% or more of any class of a registrant’s voting securities;
- has contributed 10% or more of a registrant’s capital;
- is entitled to receive 10% or more of a registrant’s net profits; or
- has the power to exercise a controlling influence over a registrant’s activities that are subject to
regulation by the Commission; or
an entity that:
- is a general partner of a registrant; or
- is the direct owner of 10% or more of any class of a registrant’s securities; or

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TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Instructions for Using the Individual Withdrawal Template
- has directly contributed 10% or more of a registrant’s capital unless such capital contribution
consists of subordinated debt contributed by:
♦ an unaffiliated bank insured by the Federal Deposit Insurance Corporation;
♦ a United States branch or agency of an unaffiliated foreign bank that is licensed under the
laws of the United States and regulated, supervised and examined by United States government authorities having regulatory responsibility for such financial institutions; or
♦ an insurance company subject to regulation by any State.
SELF-REGULATORY ORGANIZATION (SRO): a private, non-governmental organization authorized to set and enforce standards or conduct for an industry. NFA, NASDR, and the securities and futures exchanges in the U.S. are
examples of domestic SROs.
UNITED STATES CRIMINAL CODE:
Section 152:
Concealment of assets, making false claims or bribery in connection with a bankruptcy
Section 1341,
1342 or 1343: Mail fraud
Chapter 25:
Counterfeiting and forgery
Chapter 47:
Fraud or false statements in a matter within the jurisdiction of a United States department or
agency
Chapter 95
or 96:
Racketeering and Racketeering Influence

Withdrawal Reason and Disciplinary Information Sections
These sections concern matters that are required to be disclosed if all of the individual’s registration
categories with the sponsor are being withdrawn. Before completing this section, it is important to
carefully read the instructions and the questions.
The Disciplinary Information section does not need to be completed if the individual’s registration
categories are being terminated because the individual is deceased.
Only Sponsors that are SEC registered Broker-Dealers may elect to complete the Disciplinary
Information-Form U-5 section.
The following instructions apply to the Disciplinary Information-Form 8-T section.
Criminal Questions

Common mistakes in answering the criminal disclosure questions involve expungements. The Commodity
Futures Trading Commission requires a “Yes” answer even if the matter has been expunged, no matter
what the individual’s lawyer or the judge may have said.
Another common error regarding criminal matters concerns matters that do not involve the futures
industry. The fact that a matter is unrelated to the futures industry does not mean that the individual does
not need to disclose it.
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TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Instructions for Using the Individual Withdrawal Template
Regulatory Question

Regulatory actions taken by the Commodity FuturesTrading Commission, NFA or domestic futures
exchanges do not need to be disclosed since NFA is already aware of them because they are entered
into NFA’s BASIC system.
Financial Question

It is not necessary to disclose arbitration or CFTC reparations matters unless they are unpaid.
Additional Documents
For any matter that caused a “Yes” answer, a written explanation detailing the events and conduct must
be provided. That explanation can be entered on the Matter pages by giving it name, e.g., the docket
number of the case, and describing it in the text box. Alternatively, the explanation can be sent in hard
copy format to NFA.
In addition to the required explanation, other documents about the matter must be sent to NFA. If court
documents are unavailable, a letter from the court verifying that must be sent to NFA. If documents
other than court documents are unavailable, the sponsor must provide written explanation for their
unavailability.
Like answering the questions correctly, providing all documents to NFA is important.
Additional Assistance
Additional information regarding registration requirements and specific topics can be found on the Registration
page of NFA’s web site at www.nfa.futures.org. NFA’s Information Center, (800-621-3570), is also available to provide assistance. It’s normal hours are Monday through Friday, from 8:00 AM to 5:00 PM CT.

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TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Individual Name*
Individual NFA ID#*
Sponsor Name*:
Sponsor NFA ID#*
Withdrawal Categories*
Enter the withdrawal date for each category being withdrawn:
Category

Withdrawal Date

ASSOCIATED PERSON
BRANCH MANAGER
PRINCIPAL

Complete this section only if all of the individual’s registration categories with the Sponsor are being
withdrawn.
Withdrawal Reasons*
Select one:
Deceased
Discharged
Permitted to Resign
Voluntary
Other

*Required to file withdrawal

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Complete this section only if all of the individual’s registration categories with the Sponsor are being
withdrawn.
Do not complete if the individual is deceased.
Only Sponsors that are SEC registered Broker-Dealers may elect to complete this section in lieu of the
Disciplinary Information-Form 8-T section.

Disciplinary Information - Form U5*
Answer the following questions.
Investigation Disclosure
A.*

Currently is, or at termination was, the individual the subject of an investigation
or proceeding by a domestic or foreign governmental body or self-regulatory
organization with jurisdiction over investment-related businesses?

YES NO

Internal Review Disclosure
B.*

Currently is, or at termination was, the individual under internal review for fraud
or wrongful taking of property, or violating investment-related statutes,
regulations, or rules or industry standards of conduct?

YES NO

Criminal Disclosure
C.*

While employed by or associated with your firm, or in connection with events
that occurred while the individual was employed by or associated with your firm,
was the individual:
(1) convicted of or did the individual plead guilty or nolo contendere (“no
contest”) in a domestic, foreign or military court to any felony?
(2) charged with any felony?
(3) convicted of or did the individual plead guilty or nolo contendere (“no
contest”) in a domestic, foreign or military court to a misdemeanor
involving: investments or an 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?
(4) charged with a misdemeanor specified in 7(C)(3)?

YES NO

Regulatory Action Disclosure
D.*

While employed by or associated with your firm, or in connection with events that
occurred while the individual was employed by or associated with your firm, was the
individual involved in any disciplinary action by a domestic or foreign governmental body or
self regulatory organization (other than those designated as a “minor rule violation” under
a plan approved by the U.S. Securities and Exchange Commission) with jurisdiction over
the investment-related businesses?

*Required to file withdrawal

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YES NO

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Disciplinary Information - Form U5 continued*
Customer Complaint/Arbitration/Civil Litigation Disclosure
E.*

1. In connection with events that occurred while the individual was employed by or
associated with your firm, was the individual named as a respondent/defendant in an
investment-related, consumer-initiated arbitration or civil litigation which alleged that the
individual was involved in one or more sales practice violations and which:
(a) is still pending, or;
(b) resulted in an arbitration award or civil judgment against the individual,
regardless of amount, or;
(c) was settled for an amount of $10,000 or more.

YES NO

2. In connection with events that occurred while the individual was employed by or
associated with your firm, was the individual the subject of an investment-related,
consumer-initiated complaint, not otherwise reported under question 7(E)(1) above, which
alleged that the individual was involved in one or more sales practice violations, and which
complaint was settled for an amount of $10,000 or more?
3. In connection with events that occurred while the individual was employed or associated
with your firm, was the individual the subject of an investment-related, consumer-initiated,
written complaint, not otherwise reported under questions 7(E)(1) or 7(E)(2) above, which:
(a) would be reportable under question 14I(3)(a) on Form U4, if the individual were
still employed by your firm, but which has not previously been reported on the
individual’s Form U4 by your firm; or
(b) would be reportable under question 14I(3)(b) on Form U4, if the individual were
still employed by your firm, but which has not previously been reported on the
individual’s Form U4 by your firm.

Termination Disclosure
F.*

Did the individual voluntarily resign from your firm, or was the individual discharged or
permitted to resign from your firm, after allegations were made that accused the individual
of:
(1) violating investment-related statutes, regulations, rules or industry standards of
conduct?
(2) fraud or the wrongful taking of property?
(3) failure to supervise in connection with investment-related statutes, regulations,
rules or industry standards of conduct?

YES NO

ADDITIONAL FILIINGS
The individual must provide additional documentation for each matter disclosed above unless the individual has previously
provided all documentation for that matter. If the individual must provide additional documentation, the individual may
provide a hard copy U5 DRP or complete an electronic Matter Information page. Check all that apply.
No additional documentation needs to be provided.
Hardcopy U5 DRP(s) will be provided.
Matter Information page will be completed.

*Required to file withdrawal

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Complete this section only if all of the individual’s registration categories with the Sponsor are being
withdrawn.
Do not complete if the individual is deceased.

Disciplinary Information - Form 8-T*
Answer the following questions.
Criminal Disclosure
A.*

While associated or affiliated with your firm, has the individual pled guilty or nolo
contendere (“no contest”) to or been convicted of or found guilty of any felony in any
domestic, foreign or military court?
Yes

B.*

No

While associated or affiliated with your firm, has the individual 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;
• Violation of sections 7203, 7204, 7205 or 7207 of the Internal Revenue Code of 1986;
• Violation of sections 152, 1341, 1342 or 1343 or chapter 25, 47, 95 or 96 of the United
States Criminal Code; or
• Any transaction in or advice concerning futures, options on futures, leverage
transactions or securities?
Yes

No
Regulatory Disclosures

C.*

While associated or affiliated with your firm, was the individual the subject of any order
issued by a domestic or foreign regulatory authority (excluding the CFTC) or selfregulatory organization (other than NFA or a domestic futures exchange) that prevented
or restricted the individual’s ability to engage in any business in the financial services
industry?
Yes

*Required to file withdrawal

No

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TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Disciplinary Information - Form 8-T continued*
Financial Disclosures
D.*

Does the individual have any unpaid futures or securities-related civil monetary
penalties, reparation amounts or arbitration awards?
Yes

No

Pending Action Disclosures
E.*

Is the individual a party to any action, or is there a charge pending, the resolution of
which could result in a “yes” answer to the questions in the Criminal Disclosures or
Regulatory Disclosures section?
Yes

No
ADDITIONAL FILIINGS

The individual must provide additional documentation for each matter disclosed above unless the
individual has previously provided all documentation for that matter. If the individual must provide
additional documentation, the individual may provide hard copy documentation or complete an
electronic Matter Information page. Check all that apply.
No additional documentation needs to be provided.
Hardcopy documentation will be provided.
Matter Information page will be completed

*Required to file withdrawal

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Matter Information
For each matter for which the individual has not provided all supporting documentation, provide a detailed
explanation of the event or conduct. You 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 Word and
attach it to this document.
The explanation must be in writing and sent to NFA or entered below. The explanation must include:

Matter Name:
(e.g., 1999 Theft Arrest/Charge; 00-R100 Unpaid Award, NASD Case No. CM10000)
When and where the event occurred, parties involved, circumstances, case number and court
jurisdiction, allegations/charges (if criminal matter), classification of the charges, plea and sentencing
information (if criminal matter), and the final disposition.

AND IN ADDITION, THE APPLICANT MUST PROVIDE THE FOLLOWING:
Copies of court documentation which show:
• the charges;
• the classification of the offense, (i.e., felony or misdemeanor);
• the plea, sentencing and probation information, as applicable; and
• the final disposition.
If the applicant is unable to obtain the documents for the criminal matter, it must provide a letter from the court verifying the
documents’ unavailability.
FOR NON-CRIMINAL MATTERS:
Copies of the documentation which show:
• the allegations; and
• the final disposition.
If the applicant is unable to obtain the documents for the non-criminal matter, it must provide an explanation stating why
documents are not obtainable.

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Matter Information - Additional Matters, if needed
Matter Name:
(e.g., 1999 Theft Arrest/Charge; 00-R100 Unpaid Award, NASD Case No. CM10000)
When and where the event occurred, parties involved, circumstances, case number and court
jurisdiction, allegations/charges (if criminal matter), classification of the charges, plea and sentencing
information (if criminal matter), and the final disposition.

AND IN ADDITION, THE APPLICANT MUST PROVIDE THE FOLLOWING:
Copies of court documentation which show:
• the charges;
• the classification of the offense, (i.e., felony or misdemeanor);
• the plea, sentencing and probation information, as applicable; and
• the final disposition.
If the applicant is unable to obtain the documents for the criminal matter, it must provide a letter from the court verifying the
documents’ unavailability.
FOR NON-CRIMINAL MATTERS:
Copies of the documentation which show:
• the allegations; and
• the final disposition.
If the applicant is unable to obtain the documents for the non-criminal matter, it must provide an explanation stating why
documents are not obtainable.

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Matter Information - Additional Matters, if needed
Matter Name:
(e.g., 1999 Theft Arrest/Charge; 00-R100 Unpaid Award, NASD Case No. CM10000)
When and where the event occurred, parties involved, circumstances, case number and court
jurisdiction, allegations/charges (if criminal matter), classification of the charges, plea and sentencing
information (if criminal matter), and the final disposition.

AND IN ADDITION, THE APPLICANT MUST PROVIDE THE FOLLOWING:
Copies of court documentation which show:
• the charges;
• the classification of the offense, (i.e., felony or misdemeanor);
• the plea, sentencing and probation information, as applicable; and
• the final disposition.
If the applicant is unable to obtain the documents for the criminal matter, it must provide a letter from the court verifying the
documents’ unavailability.
FOR NON-CRIMINAL MATTERS:
Copies of the documentation which show:
• the allegations; and
• the final disposition.
If the applicant is unable to obtain the documents for the non-criminal matter, it must provide an explanation stating why
documents are not obtainable.

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Privacy Act and Paperwork Reduction Act Notice
OMB# 3038-0023
Privacy Act and Paperwork Reduction Act Notice
The information in Forms 7-R, 7-W, 8-R and 8-T and on the fingerprint card is being collected pursuant to authority granted
in Sections 4f, 4k, 4n, 8a and 19 of the Commodity Exchange Act [7 U.S.C. §§ 6f, 6k, 6n, 12a and 23]. Under Section 4d of the
Commodity Exchange Act [7 U.S.C. §6d], it is unlawful for anyone to act as a futures commission merchant or introducing
broker without being registered in that capacity under the Act. Under Section 4m of the Commodity Exchange Act [7 U.S.C.
§6m], it is unlawful for a commodity trading advisor or commodity pool operator to make use of the mails or any means or
instrumentality of interstate commerce in connection with his business as a commodity trading advisor or commodity pool
operator without being registered in the appropriate capacity under the Act, except that a commodity trading advisor who,
during the course of the preceding 12 months, has not furnished commodity trading advice to more than 15 persons and
does not hold himself out generally to the public as a commodity trading advisor, need not register. Under Section 19 of
the Commodity Exchange Act [7 U.S.C. §23] and Section 31.5 of the CFTC’s regulations, it is unlawful for anyone to act as a
leverage transaction merchant without being registered in that capacity under the Act.
The information requested in Form 7-R is designed to assist NFA and the CFTC, as appropriate, in determining whether the
application for registration should be granted or denied and to maintain the accuracy of registration files. The information
in Form 7-W is designed to assist NFA and the CFTC in determining whether it would be contrary to the requirements of
the Commodity Exchange Act, or any rule, regulation or order thereunder, or the public interest to permit withdrawal from
registration.
The information requested in Form 8-R and on the fingerprint card will be used by the CFTC or NFA, as appropriate, as a basis
for initiating an inquiry into the individual’s fitness to be an associated person, floor broker or floor trader or to be a principal
of a futures commission merchant, introducing broker, commodity trading advisor, commodity pool operator or leverage
transaction merchant. Portions of the information requested in Form 8-R will be used by the CFTC and, in appropriate cases,
by NFA, to confirm the registration of certain associated persons. The information requested in Form 8-T will be used by the
CFTC, and, in appropriate cases, by NFA, to record the registration status of the individual and, in appropriate cases, as a
basis for further inquiry into the individual’s fitness to remain in business subject to the CFTC’s jurisdiction.
With the exception of the social security number, all information in Forms 8-R and 8-T must be furnished. Disclosure of the
social security number is voluntary. Disclosure of the Federal employer identification number is voluntary. The Social security
number and the Federal employer identification number are sought pursuant to the Debt Collection Improvement Act of
1996. Under the Debt Collection Improvement Act, a social security number or a taxpayer identifying number furnished to the
CFTC as part of the registration process can be used for purposes of collecting and reporting on any debt owed to the U.S.
Government, including civil monetary penalties. The furnishing of a social security number or Federal employer identification
number, however, assists the CFTC and NFA in identifying individuals and firms and therefore expedites the processing of
those forms.
The failure by an applicant, registrant or principal to timely file a properly completed Form 7-R and all other related required
filings may result in the denial of an application for registration or withdrawal thereof or, in the case of an annual records
maintenance fee, treating the registrant as having petitioned for withdrawal. Failure by an applicant, registrant or principal
to timely file or cause to be filed a properly completed Form 8-R or 8-T, any other required related filings, or a fingerprint card
may result in the lapse, denial, suspension or revocation of registration, withdrawal of the application or other enforcement or
disciplinary action by the CFTC or NFA.
With the exception of the fingerprint card, any information contained in the Personal Information Section and any information
contained in Matter Information pages related to the Disciplinary Information Sections on Form 8-R and on Form 8-T or

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TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Privacy Act and Paperwork Reduction Act Notice
Item 7 on Form 8-W, the Forms 7-R, 7-W, 8-R and 8-T are considered by the CFTC to be public records and will be available
for inspection by any person. Copies will be maintained by National Futures Association, Registration Department, Suite
1400, 200 W. Madison St., Chicago, IL 60606-3447. Further, the CFTC or NFA may disclose the fingerprint card and any other
information described above to third parties pursuant to routine uses which the CFTC has published in the Federal Register
or as otherwise authorized under the Privacy Act, [5 U.S.C. §552a], and the Commodity Exchange Act. Disclosure of such
information may be made by the CFTC as follows: (1) in connection with administrative proceedings or matters in litigation; (2)
in connection with investigations; (3) where the information is furnished to regulatory, self-regulatory and law enforcement
or other governmental agencies to assist them in meeting responsibilities assigned to them by law or made available to any
member of Congress who is acting in his or her capacity as a member of Congress; (4) where disclosure is required under
the Freedom of Information Act [5 U.S.C. §552]; (5) in connection with an employer’s hiring or retention of an employee; (6)
in connection with the verification of information submitted for sponsorship purposes; (7) in other circumstances in which
the withholding of such information appears unwarranted; and (8) in connection with legally required or authorized reports.
Disclosure may be made by NFA in accordance with rules approved by the CFTC.
If an individual believes that the placing in the CFTC’s or NFA’s public files of any of the information contained in the Personal
Information Section or in Matter Information pages related to Disciplinary Information on Form 8-R and on Form 8-T or Item
7 on Form 8-W, or on the fingerprint card would constitute an unwarranted invasion of his personal privacy, the individual
may petition the CFTC, pursuant to 17 CFR 145.9, to treat such information as confidential in response to requests under
the Freedom of Information Act (FOIA) [5 U.S.C. §552]. The CFTC will make no determination as to confidential treatment of
information submitted unless and until the information is the subject of an FOIA request. The filing of a petition for confidential
treatment, however, does not guarantee that the information will be treated confidentially in response to an FOIA request.
Forms which have not been prepared and executed in compliance with applicable requirements may not be acceptable for
filing. Acceptance of this form shall not constitute any finding that the information is true, current or complete. Misstatements
or omissions of fact may constitute federal criminal violations [7 U.S.C. §13 and 18 U.S.C. §1001] or grounds for disqualification
from registration.
This notice is provided in accordance with the requirements of the Privacy Act, [5 U.S.C. §552a(e)(3)] and summarizes some
of an individual’s rights under the Privacy Act [5 U.S.C. §552a] and the Freedom of Information Act [5 U.S.C. §552]. Individuals
desiring further information should consult the CFTC’s regulations under the Privacy Act, 17 CFR Part 146, and under the
Freedom of Information Act, 17 CFR Part 145, and the CFTC’s annual notice, published in the Federal Register, pursuant to the
Privacy Act, of the existence and character of each system of records maintained by the CFTC.
You are not required to provide the information requested on a form subject to the Paperwork Reduction Act unless
the form displays a valid OMB Control Number.
The time needed to complete and file Form 7-R, Form 3-R, Form 7-W, Form 8-R and Form 8-T and Form 8-W may vary
depending upon individual circumstances. The estimated average times are:

Form 7-R
FCM
IB
CPO
CTA

30 minutes
24 minutes
24 minutes
24 minutes

Form 3-R
Form 7-W
Form 8-R
Form 8-T
Form 8-W

3 minutes
3 minutes
20 minutes
6 minutes
3 minutes

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL WITHDRAWAL
Withdrawal Agreement
BY FILING THIS FORM 8-T, THE SPONSOR AGREES THAT SUCH FILING CONSTITUTES THE SPONSOR’S
certification that the answers and the information provided in the Form 8-T are true, complete and
accurate and that in the light of the circumstances under which the sponsor has given them, the answers
and statements in the Form 8-T are not misleading in any material respect; certification that the person
who electronically files the Form 8-T on behalf of the sponsor is authorized by the sponsor to file the
Form 8-T on behalf of the sponsor and to make all required certifications and acknowledgements; and
acknowledgement that the sponsor is subject to the imposition of criminal penalties under Section 9(a) of
the Act and 18 U.S.C. §1001 for any false statements or omissions made in the Form 8-T.