Form 8-R Individual Application Template with Instructions

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
ftistructions for Using the Individual Application Template
READ THESE INSTRUCTIONS CAREFULLY BEFORE COMPLETING OR REVIEWING THE APPLICATION.
THE FAILURE TO ANSWER ALL QUESTIONS COMPLETELY AND ACCURATELY OR THE OMISSION OF
REQUIRED INFORMATION MAY RESULT IN THE DENIAL OR REVOCATION OF REGISTRATION.
This document is not an application form. Do not send this document to NFA. It is a template that you
may use to assist in filing the electronic application.
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 applicant. Certain sections apply depending on the registration category or categories being applied for. The text above these sections explains who must complete the
section. In the electronic application, only the applicable sections will appear.
DEFINED TERMS
Words that are underlined in this form are defined terms and have the meanings contained in the Definition of Terms section.
GENERAL
Read the Instructions and Questions Carefully
A question that is answered incorrectly because it was misread or misinterpreted can result in severe
consequences, including denial or revocation of registration. Although this applies to all questions in the
application, it is particularly important to the questions in the Disciplinary Information Section.
Rely Only on Advice from NFA Staff
A question that is answered incorrectly because of advice received from a lawyer, employer, a judge
or anyone else (other than a member of NFA's Registration, Compliance, Legal or Information Center
("RCLI") departments) can result in severe consequences, including denial or revocation of registration.
This also applies to all questions in the form, but is particularly important regarding the Disciplinary Information Section. If the language of a question in the Disciplinary Information Section requires disclosure
of a matter, a "Yes" answer to the question is required no matter what other advice has been received
from anyone other than NFA's RCLI staff. Additionally, the applicant or registrant remains responsible for
failures to disclose even if someone completes the form on the applicant's or registrant's behalf.
Update the Information on the Application
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NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION

Instructions for Using the Individual Application Template
if information provided on the application changes or a matter that would have required disclosure on
the application occurs after the application is filed, the new information must be promptly filed. APs and
Principals should advise their Sponsors of the new information, and the Sponsor must file the update
on their behalf. The failure to promptly update information can result in severe consequences, including
denial or revocation of registration.
Compliance with Disclosure Requirements of Another Regulatory Body is not Sufficient
With some exceptions, which are described below in the Regulatory and Financial Disclosures sections,
if any question requires the provision of information, that information must be provided. In particular, if
a question in the Disciplinary Information Section requires disclosure of a matter, the question must be
answered "Yes" and additional documents must be provided even if the matter has been disclosed to another regulatory body such as FINRA, an exchange or a state regulator. Similarly, disclosure is required
even if another regulatory body does NOT require disclosure ofthe same matter.
Call NFA with Questions
If there is any question about whether particular information must be provided, whether a particular matter must be disclosed or whether a particular question requires a "Yes" answer, call the NFA Information Center at (800) 621-3570 or (312) 781-1410. Representatives are available from 8:00 a.m. to 5:00 p.m..
Central Time, Monday through Friday. If the advice of NFA staff is sought, a written record containing
the date ofthe conversation, the name ofthe NFAstaff person giving the advice and a description ofthe
advice should be made during the conversation and kept in the event an issue concerning disclosure of
the matter arises later.
DISCIPLINARY INFORMATION SECTION
Criminal Disclosures
Some common mistakes in answering the criminal disclosure questions involve expungements, diversion
programs and similar processes. The Commodity Futures Trading Commission requires a "Yes" answer
even if the matter has been expunged orthe records sealed, there was no adjudication orfinding of guilt,
the guilty plea was vacated or set aside or the matter was dismissed upon completion of the diversion
program.
Another common error regarding criminal matters concerns matters that do not involve the futures industry. All criminal matters must be disclosed, even if a matter is unrelated to the futures industry, unless
the case was decided in a juvenile court or under a Youth Offender law.
Regulatory Disclosures
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TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Instructions for Using the Individual Application Template
Regulatory actions taken by the Commodity Futures Trading Commission, NFA or domestic futures exchanges do not need to be disclosed since NFA is already aware of them once they are entered into
NFA's BASIC system.
Financial Disclosures
It is not necessary to disclose arbitration or CFTC reparations matters unless the applicant or registrant
has failed to pay an award issued in a futures-related arbitration or an order entered in a reparations
matter.
Only adversary actions that a bankruptcy trustee or a trustee's attorney files must be disclosed. Adversary actions that creditors file are not disclosable. A person named as a party to an adversary action in a
bankruptcy proceeding must disclose the action, even if the person is not the bankrupt person.
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 a 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 person must provide a written explanation for their unavailability.
Like answering the questions correctly, providing all documents to NFA is important. Failure to do so will
delay the registration process and may result in a denial ofthe application.
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.
ADVERSARY ACTION: a lawsuit arising in or related to a bankruptcy case commenced by a creditor or bankruptcy
trustee by filing a complaint with the bankruptcy court.
ALIAS: another name utilized by an individual or previously used by an entity.
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NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION

Instructions for Using the Individual Application Template
CHARGE: a formal complaint, information, indictment or equivalent instrument containing an accusation of a crime.
DBA: abbreviation for Doing Business As. The firm is doing its futures, retail off-exchange forex or swaps business
by this name.
DESIGNATED SUPERVISOR: solely for the purpose of determining whether the Branch Manager Examination
(Series 30) is required, Designated Supervisor means a person who is registered with FINRA (formerly known as
NASD) as a General Securities Representative and has been designated to act as the supervisor of an office that is
not an Office of Supervisory Jurisdiction ("non-OSJ"), provided that:
• either the futures activity conducted in the non-OSJ that is subject to the Designated Supervisor's
supervision is limited to activity not requiring the Series 3 Examination and both the Designated
Supervisor and the Branch Manager of the Office of Supervisory Jurisdiction to which the non-OSJ
reports have otherwise satisfied NFA's Proficiency Requirements appropriate to their supervisory
activities; or
• the activity that is conducted in the non-OSJ that requires the Series 3 Examination is supervised by
the Branch Manager ofthe Office of Supervisory Jurisdiction to which the non-OSJ reports and both the
Designated Supervisor and Branch Office Manager have passed the Series 3 Examination.
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 that could result in imprisonmentfor any period of more than one year. 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 conductor a rule violation has occurred. The term applies to dispositions
of any type, including but not limited to consent decrees or 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
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 InvestmentAdvisersActof 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 ofthe United States Code
• Any similar statute of a State or foreign jurisdiction
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NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Instructions for Using the Individual Application Template
• Any rule, regulation or order under any such statutes; and
• The rules ofthe Municipal Securities Rulemaking Board
MISDEMEANOR: any crime classified as a misdemeanor and for states and countries that do not differentiate between afelony or misdemeanor, an offense that could result in imprisonmentfor any period of at least six days but
not more than one year. By way of example, an offense for which the maximum period of imprisonment is 60 days
would be considered a misdemeanor. The term also includes a special court martial.
OTHER NAME: For firms or sole proprietors, any other name that the applicant uses or has used in the past for its
futures, retail off-exchange forex or swaps business but not the name of any other legal entity that the applicant
has an affiliation or association with (see DBA). For individuals, this is any name the person is or has been known
by. For example, a maiden name, an alias name that you use or are known by, or a previous name if you have
changed your legal name.
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; or
• a general partner of a partnership; or
• a director, president, chief executive officer, chief operating officer or chief financial officer of a corporation, limited liability company or limited partnership; or
• in charge of a business unit, division or function of a corporation, limited liability company or limited partnership if the unit, division orfunction is subjectto 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
• a chief compliance officer; or
• an individual who directly or indirectly, through agreement, holding companies, nominees, trusts or otherwise:
-is the owner of 10% or more ofthe outstanding shares of any class of a registrant's stock; or
- is entitled to vote 10% or more of any class of a registrant's voting securities; or
-has the powertosell or directthe sale of 10% or more of any class of a registrant's voting securities; or
- has contributed 10% or more of a registrant's capital; or
- 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
- 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; or
. a United States branch or agency of an unaffiliated foreign bankthat is licensed underthe
laws ofthe United States and regulated, supervised and examined by United States government
authorities having regulatory responsibility for such financial institutions; or
• an insurance company subjectto regulation by any State.
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INDIVIDUAL APPLICATION
Instructions for Using the Individual Application Template
SELF-REGULATORY ORGANIZATION (SRO): a private, non-governmental organization authorized to set and enforce standards or conduct for an industry. NFA, FINRA (formerly known as NASD) 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;
Chapter 95
or 96;

Fraud or false statements in a matter within the jurisdiction of a United States department or
agency
Racketeering and Racketeering Influence

Completing the Proficiency Requirements Section
Individuals who are applying for registration as an AP or who are principals of a sole proprietorship must satisfy
proficiency requirements. Individuals who have already satisfied the proficiency requirements do not need to complete the Proficiency Requirements section. An individual will have satisfied the proficiency requirements if:
• NFA has evidence that the individual has taken and passed the National Commodity Futures Examination (Series 3) orthe Limited Futures Examination-Regulations (Series 32);
- within two years prior to the date the application is filed; or
- more than two years priortothe date the application is filed and since that date there has
not been a period of two consecutive years during which the individual was not registered as an
AP or FB or was not an approved principal of a registrant; or
• The individual is registered as a Floor Broker on the date the application is filed.
The electronic version of the application will assess whether an individual has already satisfied the proficiency
requirements, and, if so, those pages will not be displayed.
Individuals who must complete the Proficiency Requirements section must indicate whether they intend to use
the Series 3 examination or one or more alternative means to satisfying proficiency requirements. Some of the
alternatives require that an individual limit the activities that he or she intends to engage in and to pass an alternative examination. Individuals who have already passed an alternative examination do not complete the questions
related to alternative examinations if;
• NFA has evidence that the individual has taken and passed the examination that the individual intends to
use to satisfy the alternative proficiency requirement:
-within two years priortothe date the application is filed; or
- more than two years priortothe date the application is filed and since that date there has
not been a period of two consecutive years during which the individual was not registered as an
AP or FB or was not an approved principal of a registrant.
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TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
'Instructions for Using the Individual Application Template
The electronic version ofthe application will assess whether an individual has already passed the applicable alternative examination, and, if so, questions about those examinations will not be displayed.
Individuals seeking approval as a forex associated person or as a sole proprietor forex firm must satisfy proficiency requirements before engaging in off-exchange forex business with retail customers. Individuals who have
already satisfied the proficiency requirements do not need to complete the Proficiency Requirements section. An
individual will have satisfied the proficiency requirements if:
• NFA has evidence that the individual has passed the Series 3 or Series 32 exam requirement (as described above)and
- NFA has received satisfactory evidence that the applicant has passed the Series 34 within two
years ofthe date the application is filed or
- since the date the applicantlast passed the Series 34 there has not been a period of two consecutive years during which the applicant has not been either registered as an AP or FB or was
not an approved principal of a registrant; or
•the applicant was registered as an AP FB or an approved sole proprietor principal on May 22,2008, and
there has not been a period of two consecutive years since that date during which the applicant has not
been either registered as an AP or FB or was not an approved principal of a registrant.
The electronic version ofthe application will assess whether an individual has already satisfied the proficiency
requirements, and, if so, those pages will not be displayed.
Individuals filing as Branch Office Managers must indicate whether they will satisfy the Branch Manager proficiency requirements using the Branch Manager Examination (Series 30) or an alternative. The individual does
not complete the Branch Manager proficiency section if the individual has already satisfied the Branch Manager
proficiency requirements. An individual will have already satisfied the Branch Manager proficiency requirements
if NFA has evidence that the individual has taken and passed the Series 30 and since the date the individual last
ceased acting as a branch office manager, there has not been a period of two consecutive years during which he
or she has not been registered as an AP
The electronic version ofthe application will also assess whether an individual filing as a Branch Office Manager
has already satisfied the Branch Manager proficiency requirements, and, if so, that section will not be displayed.
Additional Assistance
Additional information regarding registration requirements and specific topics can be found on the Registration
page of NFA's web site atwww.nfa.futures.org. NFA's Information Center, (800-621-3570 or 312-781-1410), 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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NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Indicate the individual's full legal name. Do not use nicknames or abbreviations. For example, if the
individual's name is Charles, enter Charles, not Chuck.
Suffix [ ^

Last*

First & Middle*
NFA ID#*

Sponsor Information and Registration Categories
Only individuals filing as Associated Persons, Branch Office Managers, Forex Associated Persons,
Swap Associated Persons or Principals complete this section.
Enter sponsor information and check category(ies).
Sponsor Information
Sponsor*
Branch ID*
Registration Categories*
^

Associated Person

•

Branch Office Manager

•

Principal

Only applicants whose sponsor is designated as a Forex Firm answer this question.
Will your activities involve the solicitation of customers for managed accounts, pooled investment vehicles,
or individual accounts or transactions in off-exchange foreign currency transactions as described in Sections
2(c)(2)(B) or 2(c)(2)(C) of the Act, orthe supervision of persons involved in such solicitation activities?*
Yes O

No O

Only applicants whose sponsor is designated as a Swap Firm answerthese questions.
Will your activities involve the solicitation of customers for swaps transactions subjectto the jurisdiction ofthe
Commodity Futures Trading Commission or the supervision of persons involved in such solicitation activities?*
YesO
NoO
Will you limit your solicitation activities exclusively to the solicitation or the supervision of persons involved in
the solicitation of customers for swaps transactions subject to the jurisdiction of the Commodity Futures
Trading Commission?*
YesO
NoO
Only individuals filing as Floor Brokers or Floor Traders complete this section.
Registration Categories*
^

Floor Broker

^

Floor Trader

*Required to file application

^

Check here if you are requesting a change from floor
trader to floor broker or floor broker to floor trader.

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Only individuals filing as Principals complete this section.

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

NoO

Personal Information
Enter information.
•'?•-

Residential Address
P.O. Box address is not acceptable.
Street Addressi*
Street Address2
Street Address3
City**
Province

State* (US Only)
Zip/Postal Code**
Country*

J

Birth Information
Date of Birth*
City
State* (US Only)

Province

Country*

Social Security #

*Required to file application
**Required to file application for United States address

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NATIONAL FUTURES ASSOCIATION
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Personal Information (continued)
Fingerprint Card Demographic Information
The following information is used to conduct a criminal background checkwith the U.S. Federal Bureau of Investigations.
The FBI requires this information to be submitted with your fingerprints to perform this check.

Gender*

QMale

QFemale

Race*
Eye Color*
Hair Color*
Height*

feet

Weight*

pounds

inch(es)

Country of Citizenship
E-mail Address
CRD ID*
*Required to file application
**Required for individuals who intend to satisfy proficiency requirements based on their status as a registered General
Securities Representative ofthe Sponsor and for individuals filing as Branch Office Managers who are eligible to be Branch
Office Managers under FINRA rules.

Other Names
Enter any othername by which you are or have been known.
Other Names
1

First Name

Last Name

First Name

Last Name

First Name

Last Name

First Name

Last Name

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Only individuals filing as Floor Brokers or Floor Traders 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.
CBOT
Chicago Board of Trade
CEI

^^

CFE

Commodity Exchange Inc.
CBOE Futures Exchange LLC

ICE

D
D

KCBT

—

MGE

~~

Minneapolis Grain Exchange

NFX

D

NASDAQ QMX Futures Exchange Inc

—

New York Mercantile Exchange

CME

NYME

Chicago Mercantile Exchange
ICE Futures US Inc.
Kansas City Board of Trade

Only individuals filing as Floor Brokers or Floor Traders complete this section.

Business Mailing Address
Enter information.
Business Mailing Address
Street Addressi*
Street Address2
Street Address3
City**
State* (US Unly)
Province
Zip/Postal Code""
Country*
:

E-mail Address

^Required to file application
**Required to file application for United States address
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NATIONAL FUTURES ASSOCIATION
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Disciplinary Information - Criminal Disclosures
For additional assistance and information on completing this page, refer to the Instructions and
Definition of Terms at the beginning of this document.
ANSWER THE FOLLOWING QUESTIONS. YOU MUST ANSWER "YES" TO THE QUESTIONS ON THIS PAGE EVEN IF:
• 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 YOUTH OFFENDER LAW.
A.*

(1) Have you personally
or
(2) has any entity of which you were a principal (based on activitiesthat occurred while you were a
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?

O
B.*

Yes

O No

(1) Have you personally
or
(2) has any entity ofwhich you were a principal (based on activitiesthatoccurred while you were a
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 ofthe Intemal Revenue Code of 1986: or
• violation of sections 152.1341.1342. or 1343 or chapters 25.47.95 or 98 ofthe United States
Criminal Code: or
• any transaction in or advice concerning futures, options, leverage transactions or
securities?

O Yes

O ^°

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*Required to file application

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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 Terms at the beginning of this document.

c*

(1) Are you personally
OR
(?) ha.s any entity of which you were a principal (based on activities that occurred while you were a
principal)
a party to any action, or is there a charge pending, the resolution of which could result in a "Yes"
answer to the above questions?

QVes

Q[^o

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

O Yes

*Required to file application

O No

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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. 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.
If you must provide a detailed explanation for a matter, 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; 99-CM-105)
When and where the event occurred, parties involved, circumstances, case number and court
jurisdiction, allegations/charges, classification ofthe 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:
• the classification ofthe offense, (i.e.. felony or 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, you must provide a letter from the
L court verifying the documents' unavailability.
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Matter Information - Criminal Disclosures (additional matters, it 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, classification of the 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:
the classification of the offense, (i.e., felony or 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, you must provide a letter from the
court verifying the documents' unavailability.

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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, classification of the 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:
the classification ofthe offense, (i.e.. felony or 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, you must provide a letter from the
court verifying the documents' unavailability.

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Disciplinary Information - Regulatory Disclosures
For additional assistance and information on completing this page, refer to the Instructions and
Definition of Terms 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),
(l)have you personally
or
(2) has any entity of which you were a principal (based on activities that occurred while you were a
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, gambling, racketeering or misappropriation of funds, securities or
property?

O Yes
E.*

O ^°

In any case brought by a domestic or foreign governmental body (other than the CFTC),
(1) have you personally
or
(2) hasanyentjty of which you were a principal (based on activitiesthat occurred while you were a
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, counterfeiting, false pretenses, 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?

O Yes
P.*

O ^°

(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)
ever been debarred by any agency ofthe United States from contracting with the United States?

Yes O

^° Q
-continued on next page-

*Required to file application

-17-

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Disciplinary Information - Regulatory Disclosures
For additional assistance and information on completing this page, refertothe Instructions and
Definition of Terms 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)
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-reaulatory
organization (other than NFA or a domestic futures exchange) that prevented or restricted your ability to
engage in any business in the financial services industry?

O Yes
H.*

Are any of the orders or other agreements decribed in Question G currently in effect against you?

O Yes
!.*

O ^°
O ^°

(1) Are you personally
OR
(2) has any entity of which you were a principal (based on activitiesthatoccurred while you were a
principal)
a party to any action, or is there a charge pending, the resolution of which could result in a "Yes" answer to
the above questions?

O Yes

O ^°

Individuals who are filing their first application for registration in the futures industry do not answer this question.
For any "Yes" answerto the questions above, have you previously provided NFA orthe CFTC all supplemental
documentation for all matters requiring a "Yes" answer?*

O Yes

O ^°

Would you like to provide details of any regulatory matter?

O Yes

O No

*Required to file application
-M

TEMPLATE: DO NOT SEND TO 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 ofthe 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.
If you must provide a detailed explanation for a matter, the explanation must be in writing and
sent to NFA or entered below. The explanation must include:

Matter Name:
(e.g., March 1999 SEC case; FINRA Case No. CM10034)
When the event occurred, parties involved, case 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 statinc
why documents are not obtainable.

19-

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Regulatory Disclosures (additional matters, if needed)

latter Name:
(e.g., March 1999 SEC case; FINRA Case No. CM10034)
When the event occurred, parties involved, case 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.

•20-

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Matter Information - Regulatory Disclosures laddrtionai matters, if needed)

Matter Name:
(e.g., March 1999 SEC case; FINRA Case No. CM10034)
When the event occurred, parties involved, case 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.

-21-

TEMPLATE: DO NOT SEND TO 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 Terms 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?

O
K*

Yes

O No

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

O Yes

trustee?

O ^°

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

OYBS

ONO

Would you like to provide details of any financial matter?

O Yes

O No

^Required to file application
22-

TEMPLATE: DO NOT SEND TO 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 ofthe 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.
If you must provide a detailed explanation for a matter, the explanation must be in writing and
sent to NFA or entered below. The explanation must include:

Matter Name:
(e.g., 00-R100 Unpaid Award; 98-0125476 Bankruptcy Denied)
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-

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

(additional matters, if needed)

Matter Name:
(e.g., 00-R100 Unpaid Award; 98-0125476 Bankruptcy Denied)
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.

•24-

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

(additional matters, if needed)

Matter Name:
(e.g., 00-R100 Unpaid Award; 98-0125476 Bankruptcy Denied)
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.

-25-

TEMPLATE: DO NOT SEND TO 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 Terms 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, counterfeiting, false
pretenses, bribery, gambling, racketeering or misappropriation of funds, securities or
property; or
• failure to supervise another person in the conduct of such person's activities as a registrant of
the CFTC, SEC, NFA, FINRA or other domestic or foreign self-regulatory organization?

O

Yes

O No

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

ONO

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

O No

^Required to file application
26-

TEMPLATE: DO NOT SEND TO 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. 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.
If you must provide a detailed explanation for a matter, the explanation must be in writing and
sent to NFA or entered 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.

-27

TEMPLATE: DO NOT SEND TO 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 ADDmON,YOU MUST PROVIDETHE 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.

28-

TEMPLATE: DO NOT SEND TO 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 PROVIDETHE 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.

•29-

TEMPLATE: DO NOT SEND TO NFA
NATrONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Employment and Education History
The CFTC requires that sponsors attempt to communicate with all ofthe applicant's 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, if no contact was made, the
reason why.
Enter your employment and personal history, working back 10 years. All time must be accounted
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/Year

Employment/School

From*:

Name*:
Location:

Tn'

(city, state or country)

Position Held and
Reason for Leaving:

Month/Year

Employment/School

From*:

Name*:
Location:

Tn-

(city, state or country)

Position Held and
Reason for Leaving:

Month/Year

Employment/School

From*:

Name*:
Location:

Tn-

(city, state or country)

Position Held and
Reason for Leaving:

^'Required to file application
•30-

'

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

Employment/School

From*:

Name*:
Location:

|

(city, state or country)

I

Tn-

Position Held and
Reason for Leaving:

Month/Year

Employment/School

From*:

Name*:

Tn-

1 nnatinn(nitv state nr nniintrv)

Position Held and
Reason for Leaving:

Month/Year

Employment/School

From*:

Name*:
Location:

Tn-

(city, state or country)

Position Held and
Reason for Leaving:

Month/Year

Employment/School

From*:

Name*:
Location:

Tn-

(city, state or country)

Position Held and
Reason for Leaving:

*Required to file application
•31

TEMPLATE: DO NOT SEND TO NFA
NATrONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Employment and Education History (additional spaces,if needed)
Month/Year

Employment/School

From*:

Name*:

Tn-

1

1 nr^atinnIriU/ ctpto nr rniintr\/l

Position Held and
Reason for Leaving:

1

Month/Year

Employment/School

From*:

Name*:

Tn-

1 npatinn(nitv .state nr nniintrv)

Position Held and
Reason for Leaving:

1

MonthA'ear

Employment/School

From*:

Name*:

Tn-

1 nrntinn(nity, state nr nniintry)

Position Held and
Reason for Leaving:

*Required to file application
•32-

'

TEMPLATE: DO NOT SEND TO 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 Word and attach it to this
document.
Month/Year

Address

From*:
Tn-

Month/Year

Address

From*:
Tn-

Month/Year

Address

From*:
Tn-

Month/Year

Address

From*:
Tn-

1
Month/Year

Address

From*:
Tn-

•

*^Required to file application

•33-

TEMPLATE: DO NOT SEND TO 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*
O You have passed the Series 3 Examination within the past two (2) years.
O You intend to take the Series 3 Examination.
O You intend to satisfy Alternative Proficiency Requirement.

Only individuals filing as forex associated persons complete this section. Select one.
Series 34 Examination*
O

You have passed the Series 34 Examination within the past two years.

O

You intend to take the Series 34 Examination.

Only individuals filing as Branch Office Managers complete this section. Select one.
Series 30 Examination*
O You have passed the Series 30 Examination within the past two (2) years.
O You intend to take the Series 30 Examination.
O You are eligible to be a Branch Office Manager or Designated Supervisor under FINRA 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.

E
If you have indicated that you intend to satisfy proficiency requirements through an alternative to the Series 3 examination,
or if you area registered General Securities Representative of the sponsor and are applying for an AP registration that limits
your futures activity to any of the two following activities, check each that applies:
—I You limit futures activities to those activities covered in the Futures Managed Funds Examination (Series 31):
the solicitation of pool participants and/or the solicitation of discretionary accounts managed by a CTA, or the
supervision of others engaged in such solicitations.
p-, You limityour futures activity as provided in Registration Rule 401(b) to referring clients to another AP of the sponsor
—I or to supervising others who make such referrals.

n

Check here if you have been registered or licensed to solicit futures business by a foreign regulatory authority
located in Canada orthe United Kingdom within the pasttwo years and are therefore eligible to satisfy the
proficiency requirements by passing the Limited Futures Examination - Regulations (Series 32).

'•Required to file application
•34-

TEMPLATE: DO NOT SEND TO 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, CTA or both complete this section. Select one.

~\ Check here if you have been registered or licensed to solicit futures business by a foreign regulatory authority
located in Canada orthe United Kingdom within the pasttwo years and are therefore eligible to satisfy the
proficiency requirements by passing the Limited Futures Examination - Regulations (Series 32).
~ | Check here if your sponsor is a CPO that operates pools primarily engaged in securities transactions or a CTA that
provides futures trading advice solely incidental to its securities advisory services and your sponsor has been
granted or is seeking a waiver from the Series 3 for its APs pursuant to the Interpretive Notices to Registration Rule
402.
^

Check here if your sponsor is a CPO that trades swaps subjectto the jurisdiction of the CFTC in a commodity pool
that but for the trading of such swaps would be eligible for the exclusion under CFTC Regulation 4.5(c)(2)(iii)(A) or
(B) or the exemption under CFTC Regulations 4.13(a)(3) and the sponsor has been granted or is seeking a waiver
from the Series 3 for its APs pursuant to NFA Registration Rule 401(e)(2)(ii).

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

O You have passed the Series 31 Examination within the pasttwo (2) years.
O 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

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

^Required to file application
•35-

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Only individuals whose sponsor is a broker-dealer complete this section. Select one.

Fingerprint Card

Fingerprint Card
O The applicant's properly signed fingerprint card(s) will be sent to NFA.
O The applicant's properly signed fingerprint card(s) were sent to FINRA within the past 90 days.

-36-

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Privacy Act and Paperwork Reduction Act Notice
OMB# 3038-0072
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 2c, 4f, 4k, 4n, 4s, 8a and 19 of the Commodity Exchange Act (7 U.S.C. §§ 6f, 6k, 6n, 6s, 12a and 23]. Under Section 2c,
it is unlawful for anyone to engage in off-exchange foreign currency futures transactions or off-exchange foreign currency
leveraged, margined or financed transactions with persons who are not eligible contract participants without registration, or
exemption from registration, as a retail foreign exchange dealer, futures commission merchant, introducing broker, commodity
pool operator or commodity trading advisor, as appropriate. 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 ofthe Commodity Exchange Act [7 U.S.C. §6m], it is unlawful for a commodity
trading advisor or commodity pool operator to make use ofthe 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 underthe Act, exceptthat a commodity trading advisor who, during the course ofthe 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 4s ofthe Commodity Exchange Act [7 U.S.C. §6s], itis
unlawful for anyone to act as a swap dealer or major swap participant without being registered in that capacity under the Act.
Under Section 19 of the Commodity Exchange Act (7 U.S.C. §23] and Section 31.5 ofthe 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, orthe public interest to permit withdrawal from
registration.
The information requested in Form 8-R and onthefingerprint 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 orfloortraderorto be a principal
of a futures commission merchant, swap dealer, major swap participant, retail foreign exchange dealer, introducing broker,
commodity trading advisor, commodity pool operator, leverage transaction merchant or non-natural person floor trader.
Portions ofthe 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 subjectto the CFTC's jurisdiction.
With the exception ofthe social security number, all information in Forms 8-R and 8-T must be furnished. Disclosure ofthe
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 ofthe registration process can be usedfor 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 orwithdrawalthereof or, inthe case of an annual records
maintenance fee, treating the registrant as having petitioned for withdrawal. Failure by an applicant, registrant or principal

- continued on next page-37-

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Privacy Act and Paperwork Reduction Act Notice
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 ofthe application or other enforcement or
disciplinary action by the CFTC or NFA.
With the exception ofthe 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 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 1800,
300 S. Riverside Plaza, Chicago, IL 60606-6615. 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 ofthe 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, pursuantto 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 ofthe 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, pursuantto 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
SD
MSP
RFED

0.5 hours
1.0 hour
1.0 hour
0.5 hours

IB
CPO
CTA
FT

0.4
0.4
0.4
0.5

hours
hours
hours
hours

oo .

Form
Form
Form
Form
Form

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

0.1
0.1
0.8
0.2
0.1

hours
hours
hours
hours
hours

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Sponsor Agreement
Certifications made by Sponsor of individuals filing as Associated Persons, Branch Office Managers,
Forex Associated Persons or Principals
BY FILING THIS FORM 8-R, THE SPONSOR AGREES THAT SUCH FILING CONSTITUTES THE SPONSOR'S
certification that the Form 8-R is, to the best ofthe sponsor's knowledge, information and belief, true, complete and accurate
and that in light of the circumstances under which the sponsor has given them, the answers and statements in the Form 8-R
are not misleading in any material respect;
certification that the AP applicant, Forex AP applicant, Swap AP applicant or principal has authorized the sponsor to
electronically file the Form 8-R on the AP applicant's, Forex AP applicant's or Swap AP applicant's behalf or the principal's
behalf and that the sponsor has authorized the person who files the application to file the Form 8-R and to make the
certifications, acknowledgements, authorizations, representations, requests and agreements contained in this Rule;
acknowledgement that the sponsor is subjectto the imposition of criminal penalties under Section 9(a) ofthe Act and 18
U.S.C. §1001 for any false statements or omissions it made in the Form 8-R; acknowledgement that while the individual is an
AP sponsored by or a principal ofthe sponsor, the sponsor is responsible for maintaining the information inthe Form 8-R in
a complete, accurate and current manner by electronically filing updates to the information contained therein; certification
that the sponsor has communicated or has attempted to communicate with all ofthe applicant's previous employers and
educational institutions for the past three years and has documentation on file with the names ofthe persons contacted
and the datesof contactor, if no contact was made, the reason therefor; certification that the applicant has been hired oris
employed by the sponsor or that it is the intention ofthe sponsor to hire or otherwise employ the applicant as an AP within 30
days after receipt of notification that the applicant has received a TL or has been registered; certification that the applicant
will not be permitted to act as an AP until the applicant has received a TL or has been registered as an AP, to act as a Forex
AP until the applicant has been approved as a Forex AP or to act as a Swap AP until the applicant has been approved as
a SwapAP; acknowledgement that it is the duty and obligation of the sponsor not to employ an individual with a statutory
disqualification under Section 8a(2) ofthe Act, to notify the Commission when any individual associated with the sponsor is
subject to a statutory disqualification under Section 8a(2) of the Act and to supervise any individual for whom the sponsor files
a Form 8-R, once the sponsor employs him, with a view toward preventing him or her from committing violations of the Act and
the rules, regulations and orders thereunder; certification, if the sponsor is a newsponsorfiling an application for registration
ofthe applicant as an AP pursuantto the provisions of Rule 207(a), that the sponsor has verified that the applicant is not
subjectto a disqualification from registration under Section 8a(2) of the Act and that the sponsor meets the requirements set
forth in Rule 509(b)(5); acknowledgement that information contained in the Form 8-R has been supplied to the sponsor for the
sole purpose of allowing it to verify the information contained in the Form 8-R; representation that the sponsor has taken, and
will take, such measures as are necessary to prevent the unwarranted dissemination of any of the information contained in
the Form 8-R and the records and documents retained in support of the Form 8-R; certification, if the applicant is applying for a
TL pursuantto Rule 301(a)(2), that the sponsor has reviewed the information concerning the applicant in NFA's BASIC system
and has received a copy ofthe notice ofthe institution of any proceeding in the BASIC system:
that is pending and was brought against the applicant under Sections 6(c), 6(d), 6c, 6d, 8a or 9 of the Act, Commission
Regulations3.55or3.60or NFA or exchange rules or that was instituted in accordance with the procedures provided in CFTC
Regulation 3.51 or Part 500 of these Rules and, within the prior 12 months, resulted in the Commission or NFA permitting the
withdrawal of such person's application for registration in any capacity; and representation, if the applicant is subjectto any
current NFA or Commission order imposing conditions on the registration ofthe applicant,that it meets the requirements
set forth in Rule 509(b)(5) to sponsor a conditioned registrant, that it has reviewed the conditions contained in any current
NFA or Commission order imposing conditions on the registration ofthe applicant and that it will supervise the applicant in
accordance with the conditions contained in the order.

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TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Floor Broker/Floor Trader Agreement
Certifications made by individuals filing as Floor Brokers or Floor Traders
BY FILING THIS FORM 8-R, THE APPLICANT AGREES THAT SUCH FILING CONSTITUTES THE
APPLICANT'S
certification that the answers and statements in the Form 8-R are true, complete and accurate and that
in light of the circumstances under which the applicant has given them, the answers and statements in
the Form 8-R are not misleading in any material respect; acknowledgement that the applicant is subject
to the imposition of criminal penalties under Section 9(a) ofthe Act and 18 U.S.C. §1001 for any false
statements or omissions made in the Form 8-R; acknowledgement that the applicant is responsible at
all times for maintaining the information in the Form 8-R in a complete, accurate and current manner by
electronically filing updates to the information contained therein; acknowledgement that the business
address provided on the Form 8-R may be deemed to be the address for delivery to the applicant of any
written communications from the Commission and NFA, including any notice of intent to deny, revoke
or otherwise affect the applicant's registration, any summons, complaint, reparations claim, arbitration
claim, order, subpoena, request for information, or any other written communication unless the applicant
specifies another address forthis purpose; acknowledgement that the applicant must keep current
the business address provided on the Form 8-R while registered and for two years after termination of
registration; authorization that NFA may conduct an investigation to determine the applicant's fitness for
registration and agreement to cooperate promptly and fully, consistent with applicable Federal law, in
such investigation, which investigation may include contacting foreign regulatory and law enforcement
authorities, including the submission of documents and information to NFA that NFA, in its discretion, may
require in connection with the applicant's application for registration; authorization and request that any
person, including but not limited to contract markets, furnish upon request to NFA or any agent acting on
behalf of NFA any information requested by NFA in connection with any investigation conducted by NFA
to determine the applicant's fitness for registration; agreement that any person furnishing information to
NFA or any agent acting on behalf of NFA in connection with the investigation so authorized is released
from any and all liability of whatever nature by reason of furnishing such information to NFA or any agent
acting on behalf of NFA; acknowledgement that the applicant is not registered and may not act as an
FB or FT until a notice has been issued that registration or a temporary license has been granted; and
express agreement that, if the applicant ever applies for and is granted registration as an Associate of
a Member of NFA, the applicant shall become and remain bound by all applicable NFA requirements,
including without limitation all applicable NFA Bylaws, Compliance Rules, Financial Requirements,
Registration Rules, Code of Arbitration and Member Arbitration Rules, as then and thereafter in effect,
and that this agreement shall apply each time that that the applicant is granted registration as an
Associate.

•40-

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Individual Agreement
BY FILING THIS VERIFICATION, THE APPLICANT OR PRINCIPAL AGREES THAT SUCH FILING CONSTITUTES THE APPLICANT
OR PRINCIPAL'S
verification that the answers and statements in the application or Form 8-R are true, complete and accurate and that in light of
the circumstances under which the applicant or principal has given them, the answers and statements in the Form 8-R are not
misleading in any material respect;
acknowledgement that the applicant or principal is subject to the imposition of criminal penalties under Section 9(b) ofthe Act
and 18 U.S.C. §1001 for any false statements or omissions made in the Form 8-R;
acknowledgement that the applicant or principal is responsible at all times for maintaining the information in the Form 8-R in a
complete, accurate and current manner by promptly notifying the sponsor whenever any of the information on the Form 8-R is
no longer complete, accurate or current and authorizing the sponsor to electronically file updates to correct the information;
certification, if applying for a TL pursuantto the provisions of Rule 301(a)(2), that the applicant has advised the sponsor of
and has provided the sponsor with a copy of the notice of the institution of any pending adjudicatory proceeding that was
brought against the applicant under Sections 6(c), 6(d), 6c, 6d, 8a or 9 ofthe Act, Commission Regulations 3.55 or 3.60 or
NFA or exchange rules or any proceeding that was brought against the applicant under Regulation 3.51 or Part 500 of NFA
Registration Rules and, within the prior 12 months, resulted in the Commission or NFA permitting the withdrawal of such
person's application for registration in any capacity;
acknowledgement that the residential address provided on the Form 8-R may be deemed to be the address for delivery to the
applicant or principal of any written communications from the Commission and NFA, including any notice of intent to deny,
revoke or otherwise affect the applicant's registration or individual's status as principal, any summons, complaint, reparations
claim, arbitration claim, order, subpoena, request for information, or any other written communication unless the applicant or
principal specifies another address forthis purpose;
acknowledgement that the applicant or principal must keep current the residential address provided on the Form 8-R while
registered asan AP or affiliated as a principal and for two years after termination of registration or affiliation;
agreement that the applicant or principal submits to the jurisdiction of any contract market, of which the applicant's or
principal's sponsor or any current or future guarantor (under CFTC Rule 1.10(j)) ofthe applicant's or principal's sponsor is or
may become a member, which has or may adopt rules which applyto the applicant as an associated person or principal, and
that the applicant or principal shall abide by all such rules and to comply with, be subjectto, and abide by all requirements,
rulings, orders, directives and decisions of and any penalties, prohibitions and limitations imposed by any such contract
market;
authorization that NFA, and any contract market of which the applicant's or principal's sponsor or any current or future
guarantor (under CFTC Rule 1.10{j)) ofthe applicant's or principal's sponsor is or may become a member, may conduct an
investigation to determine the applicant's or principal's fitness for registration, and if applicable, for Associate status, and
agreement to cooperate promptly and fully, consistent with applicable Federal law, in such investigation, which may include
contacting foreign regulatory and law enforcement authorities, including the submission of documents and information to NFA
that NFA, in its discretion, may require in connection with the applicant's or principal's fitness for registration or Associate
status;

- continued on next page -41 -

TEMPLATE: DO NOT SEND TO NFA
NATIONAL FUTURES ASSOCIATION
INDIVIDUAL APPLICATION
Individual Agreement
authorization and requestthatany person, including but not limited to contract markets, or foreign regulatory or law
enforcement agencies, furnish upon request to NFA or any agent acting on behalf of NFA any information requested by NFA
in connection with any investigation conducted by NFA to determine the applicant's fitness for registration or fitness ofthe
principal;
agreement that any person furnishing information to NFA or any agent acting on behalf of NFA in connection with the
investigation so authorized is released from any and all liability of whatever nature by reason of furnishing such information to
NFA or any agent acting on behalf of NFA;
acknowledgement that the applicant is not registered and may not act as an AP until a notice has been issued that registration
or a TL has been granted, that, if applicable, the applicant is not approved as a Forex AP and may not act as a Forex AP until
approval has been granted and that, if applicable, the applicant is not approved as a Swap AP and may not act as a Swap AP
until approval has been granted;
express agreement that, if the applicant or principal ever applies for and is granted registration asan Associate of a Member
of NFA, the applicant or principal shall become and remain bound by all applicable NFA requirements, including without
limitation all applicable NFA Bylaws, Compliance Rules, Financial Requirements, Registration Rules, Code of Arbitration and
Member Arbitration Rules, as then and thereafter in effect, and that this agreement shall apply each time that the applicant or
principal is granted registration as an Associate; and
understanding that if the applicant is applying to obtain registration as an associated person, the applicant is also applying for
registration with NFA as an Associate if the applicant's sponsor is or becomes a Member of NFA.

•42-