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pdfIndividual Application (Form 8-R)
COMMODITY FUTURES TRADING COMMISSION
NATIONAL FUTURES ASSOCIATION
Instructions for Completing the Individual Application
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.
THE FAILURE TO DISCLOSE A DISCIPLINARY MATTER EITHER IN AN APPLICATION OR AN
UPDATE WILL RESULT IN THE IMPOSITION OF A LATE DISCLOSURE FEE IN
ACCORDANCE WITH NFA REGISTRATION RULE 210(c).
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.
DEFINED TERMS
Words that are underlined in this form are either defined terms and have the meanings contained in
the Definition of Terms section or links to the text of Commodity Exchange Act provisions, CFTC
Regulations or NFA Rules.
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 Investigations or Legal (“RIL”)
staff) 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 RIL 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
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.
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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 of the
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 of the conversation, the name of the NFA staff person giving the
advice and a description of the 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 or the records sealed, there was no
adjudication or finding 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
Regulatory actions taken by the Commodity Futures Trading Commission, NFA or U.S. 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 awards or CFTC reparations matters unless the applicant
or registrant has failed to pay an award related to a CFTC-related product or an order entered in a
reparations matter.
Only adversary actions that a bankruptcy trustee 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.
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
ADDITIONAL DOCUMENTS
For each matter that caused a “Yes” answer, a Disclosure Matter Page ("DMP"), which is
accessible using NFA's DMP Filing System, must be filed. In addition to the required DMP, other
documents about the matter must be provided 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. Electronic copies
of the documents can be uploaded using NFA's DMP Filing System or you can send documents to
NFA by emailing electronic documents to [email protected], faxing documents to (312)
559-3411 or mailing documents to NFA Registration Department, 300 S. Riverside Plaza, Suite
1800, Chicago IL 60606.
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 of the 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 entity's stock;
entitlement to vote or empowered to sell 10% or more of an entity's voting securities; contribution of
10% or more of an entity's capital; or entitlement to 10% or more of an entity'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.
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 of the 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.
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
ENJOINED: subject to an injunction.
ENTITY: any person other than an individual.
ENTITY FLOOR TRADER: an applicant that files or registrant that filed a Form 7-R to apply for
registration as a floor trader.
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 imprisonment for 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.
FLOOR TRADER ORDER ENTERER: an individual responsible for entry of orders from an Entity
Floor Trader's own account.
FOUND: subject to a determination that conduct or 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.
INDIRECT OWNER: an individual who through agreement, holding companies, nominees, trusts or
otherwise:
• is the owner of 10% or more of the outstanding shares of any class of an entity's equity
securities, other than non-voting securities;
• is entitled to vote 10% or more of the outstanding shares of any class of an entity's equity
securities, other than non-voting securities;
• has the power to sell or direct the sale of 10% or more of the outstanding shares of any
class of an entity's equity securities, other than non-voting securities;
• is entitled to receive 10% or more of an entity's net profits; or
• has the power to exercise a controlling influence over an entity's activities that are subject
to regulation by the Commission.
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 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
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
•
•
•
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 that could result in imprisonment for
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.
NON-U.S.NATURAL PERSON: an individual who has not resided in the U.S. since reaching the
age of 18 years.
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.
OUTSIDE DIRECTOR: an individual who is director of an applicant or registrant and who
• is not an officer or employee of the applicant or registrant;
• is not engaged in or have direct supervisory responsibility over persons engaged in the
solicitation of
o or acceptance of customers' orders or retail forex customers' orders;
o funds, securities or property for participation in a commodity pool;
o a client's or prospective client's discretionary account;
o leverage customers' orders for leverage transactions;
o or acceptance of a swap agreement; or
• does not regularly have access to the keeping, handling or processing of:
o transactions involving "commodity Interests", as that term is defined in CFTC
Regulation 1.3(yy);
o customer funds, retail forex customer funds, leverage customer funds, foreign
futures or foreign options secured amount, or adjusted net capital.
PERSON: an individual, association, partnership, corporation, limited liability company, limited
liability partnership, trust, or other form of business organization.
PRINCIPAL - means, with respect to an applicant, a registrant, or a person required to be
registered under the Act:
(1)
•
•
•
•
•
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, chief financial officer, or
a person in charge of a business unit, division or function subject to regulation by the
Commission of a corporation, limited liability company or limited liability partnership;
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
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
(2) 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 an applicant or
registrant’s equity securities, other than non-voting securities;
• is entitled to vote 10% or more of the outstanding shares of any class of an applicant or
registrant’s equity securities, other than non-voting securities;
• has the power to sell or direct the sale of 10% or more of the outstanding shares of any
class of an applicant or registrant’s equity securities, other than non-voting securities;
• is entitled to receive 10% or more of an applicant or registrant’s net profits; or
• has the power to exercise a controlling influence over an applicant or registrant’s activities
that are subject to regulation by the Commission; or
(3) an entity that:
• is a general partner of a partnership; or
• is the direct owner of 10% or more of the outstanding shares of any class of an applicant or
registrant’s equity securities, other than non-voting securities; or
(4) an individual who or an entity that:
• has contributed 10% or more of an applicant or registrant’s capital unless such capital
contribution consists of subordinated debt contributed by:
♦
an unaffiliated bank insured by the Federal Deposit Insurance Corporation;
♦
an unaffiliated ‘‘foreign bank,’’ as defined in 12 CFR 211.21(n) that currently
operates an ‘‘office of a foreign bank,’’ as defined in 12 CFR 211.21(t), which is
licensed under 12 CFR 211.24(a);
♦
such office of an unaffiliated, licensed foreign bank; or
♦
an insurance company subject to regulation by any State,
provided such debt is not guaranteed by an individual who or entity that is not a principal of the
applicant or registrant.
For the purpose of answering Questions A, B, C, D, E, F, G, I and K of the Disciplinary Information
sections, PRINCIPAL also means an individual described in (1), (2) or (4) above with respect to any
entity whether or not the entity is an applicant, registrant, or a person required to be registered
under the Act.
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
Sections 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.
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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) or the Limited Futures Examination-Regulations (Series
32):
♦
within two years prior to the date the application is filed; or
♦
more than two years prior to the 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.
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 prior to the date the application is filed; or
♦
more than two years prior to the 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.
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 of the date the application is filed or
♦
since the date the applicant last 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 individual 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.
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
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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.
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, (800-6213570 or 312-781-1410), is also available to provide assistance. Its normal hours are Monday
through Friday, from 8:00 AM to 5:00 PM, CT.
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Name
Enter all required information.
Enter 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.
First & Middle Name*
NFA ID#
Last Name (Surname)
Suffix
Sponsor Information and Registration Categories
Indicate sponsor and office where applicant is located and check category(ies).
Sponsor Information
Sponsor*
Main/Branch Office
Categories*
□
□
□
□
Associated Person
Branch Office Manager
Principal
Floor Trader Order Enterer
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, or the
supervision of persons involved in such solicitation activities?*
Yes
○
No
○
Applicants whose sponsor is designated as a Swap Firm answer these questions
Will your activities involve the solicitation of customers for swaps transactions subject to the
jurisdiction of the Commodity Futures Trading Commission or the supervision of persons
involved in such solicitation activities?*
Yes
○
Individual’s activities involve:
No
○
○
Swaps transactions only
○
Swaps, futures and options on
futures and/or retail off-exchange
foreign currency transactions
*Required to file application
9
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Associated Person applicants who are registered with other sponsors complete this section.
Current Sponsor Information
Our records indicate that the applicant is currently an Associated Person of the following
sponsor(s). If the applicant is no longer an Associated Person of any sponsor(s) listed below,
check all that apply.
□
□
[Sponsor Name]
[Sponsor Name]
*Required to file application
10
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Floor broker and floor trader applicants complete this section
Registration Categories
Select category(ies)
Categories*
Floor Broker
Floor Trader
□
□
Are you requesting a change from floor broker to floor trader? ○
Yes
○
No
Are you requesting a change from floor trader to floor broker? ○
Yes
○
No
*Required to file application
11
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Individuals filing as principals complete this section
Principal Information
Check all that apply.
Principal Title*
□
□
□
□
□
□
□
SOLE PROPRIETOR
GENERAL PARTNER
DIRECTOR
PRESIDENT
CHIEF EXECUTIVE OFFICER
CHIEF OPERATING OFFICER
CHIEF FINANCIAL OFFICER
10% or more interest*
○
□
□
□
□
□
□
□
□
CHIEF COMPLIANCE OFFICER
HEAD OF A BUSINESS UNIT, DIVISION OR FUNCTION
MANAGER – LLC OR LLP
MANAGING MEMBER – LLC OR LLP
VESTED WITH MANAGEMENT AUTHORITY – LLC OR LLP
OWNER
INDIRECT OWNER
NO LISTED TITLE
○
Yes
No
*Required to file application
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Personal Information
Enter all required information.
Other Names
Enter any other name by which you are or have been known.
First and Middle Name
Last Name (Surname) and Suffix
Birth Information
Enter information about applicant's date and location of birth
Date of Birth* (Month)
(Day)
Year (YYYY)
City**
State* (US Only)
Province
Country*
Residential Address
P.O. Box address is not acceptable.
Street Address 1*
Street Address 2
Street Address 3
City**
State* (US Only)
Province
Zip/Postal Code**
Country*
U.S. Social Security #
*Required to file application
**Required to file application for United States address
13
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Floor broker and floor trader applicants complete this section
Business Mailing Address
Street Address 1*
Street Address 2
Street Address 3
City**
State* (US Only)
Province
Zip/Postal Code**
Country*
E-mail
CRD ID
Fingerprint Card Information
○ The applicant's properly signed fingerprint cards will be sent to NFA.
○The applicant is a non-U.S. natural person and:
Pursuant to CFTC Regulation 3.21(e), the sponsor has caused a criminal history
background check to be performed for the applicant and the criminal history
background check:
A) Is of a type that would reveal all matters listed under Sections 8a(2)(D)
or 8a(3)(D), (E) or (H) of the Act;
B) Does not reveal any matters that constitute a disqualification under
Sections 8a(2)(D) or 8a(3)(D), (E) or (H) of the Act, other than those
disclosed to NFA; and
C) Was completed not more than one calendar year prior to the date this
application is filed.
○The applicant is an outside director and the sponsor will file with NFA a notice pursuant to
CFTC Regulation 3.21(c).
○The applicant's fingerprint card was sent to FINRA within the past 90 days.
*Required to file application
**Required to file application for United States address
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Fingerprint Card Demographic Information
Individuals submitting a fingerprint card or who sent a fingerprint card to FINRA within the past 90
days complete this section.
The following information is used to conduct a criminal background check with the U.S. Federal
Bureau of Investigations. The FBI requires this information to be submitted with your fingerprints to
perform this check.
Gender*
Eye Color*
Height*
feet
Country of Citizenship
inch(es)
Race*
Hair Color*
Weight*
pounds
Floor broker and floor trader applicants 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.
Chicago Board of Trade
Commodity Exchange Inc.
CBOE Futures Exchange LLC
Chicago Mercantile Exchange
ICE Futures US Inc.
Minneapolis Grain Exchange
NASDAQ Futures Inc.
New York Mercantile Exchange
□
□
□
□
□
□
□
□
*Required to file application
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OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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.
For each matter that requires a "Yes" answer to Questions A, B or C below, you must provide
additional information by filing a Criminal Disclosure Matter Page ("DMP") for each criminal
matter using NFA's DMP Filing system that requests:
•
•
•
•
•
who was involved;
when it occurred;
what the allegations were;
what the final determination was, if any; and
the date of the determination.
You must also provide documents regarding each criminal matter requiring a "Yes" answer, that
show
• the charges;
• the classification of the offense, i.e., felony or misdemeanor;
• the plea, sentencing and probation information, as applicable;
• the final disposition; and
• a summary of the circumstances surrounding the criminal matter.
You may provide these documents electronically using the upload function in the DMP Filing
System or sending them to NFA (See Instruction).
Question A.*
(1) Have you personally or
*Required to file application
16
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
(2) has any entity of which you were a Principal at the time the activities occurred
ever pled guilty or nolo contendere (“no contest”) to or been convicted or found guilty of any
felony in any U.S., non-U.S. or military court?
○Yes
○ No
Question B.*
(1) Have you personally or
(2) has any entity of which you were a Principal at the time the activities occurred
ever pled guilty to or been convicted or found guilty of any misdemeanor in any U.S., nonU.S. 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; or
• violation of sections 152, 1341, 1342, or 1343 or chapters 25, 47, 95 or 96 of the
U.S. Criminal Code; or
• any transaction in or advice concerning futures, options, leverage transactions or
securities?
○ Yes
○ No
Question C.*
(1) Are you personally or
(2) is any entity of which you were a Principal at the time the activities occurred
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?
○ Yes
○ No
Applicants with all "No" answers above answer this question
Even though you answered "No" to all of the above questions, would you like to provide a Criminal
DMP?*
○ Yes
○ No
*Required to file application
17
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Applicants with "Yes" answers above answer this question
Will you be filing a Criminal DMP with respect to a new matter?*
○ Yes
○ No
*Required to file application
18
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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.
For each matter that requires a "Yes" answer to Questions D, E, F, G, H or I below, you must
provide additional information by filing a Regulatory DMP for each regulatory matter using
NFA's DMP Filing system that requests:
•
•
•
•
•
•
who was involved;
when it occurred;
what the allegations were;
what the final determination was, if any;
the date of the determination; and
a summary of the circumstances surrounding the regulatory matter.
You must also provide documents regarding each regulatory matter requiring a "Yes" answer, that
show
• the allegations; and
• the final disposition.
You may provide these documents electronically using the upload function in the DMP Filing
System or sending them to NFA (See Instruction).
Answer the following questions.
Question D.*
In any case brought by a U.S. or non-U.S. governmental body (other than the CFTC),
(1) have you personally or
(2) has any entity of which you were a Principal at the time the activities occurred
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?
○ Yes
○ No
*Required to file application
19
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Question E.*
In any case brought by a U.S. or non-U.S. governmental body (other than the CFTC),
(1) have you personally or
(2) has any entity of which you were a Principal at the time the activities occurred
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
thereunder; 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; or
• have failed to supervise another person's activities under any investment-related
statute or regulation thereunder?
○ Yes
○ No
Question F.*
(1) Have you personally or
(2) has any entity of which you were a Principal at the time the activities occurred
ever been debarred by any agency of the U. S. from contracting with the U. S.?
○ Yes
○ No
Question G.*
(1) Have you personally or
(2) has any entity of which you were a Principal at the time the activities occurred
ever been the subject of any order issued by or a party to any agreement with a U.S. or
non-U.S. regulatory authority (other than the CFTC), including but not limited to a licensing
authority, or self-regulatory organization (other than NFA or a U.S. futures exchange) that
prevented or restricted your ability to engage in any business in the financial services
industry?
○ Yes
○ No
*Required to file application
20
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Question H.*
Are any of the orders or other agreements described in Question G currently in effect
against you personally?
○ Yes
○ No
Question I.*
(1) Are you personally or
(2) is any entity of which you were a Principal at the time the activities occurred
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?
○ Yes
○ No
Applicants with all "No" answers above answer this question
Even though you answered "No” to all of the above questions, would you like to provide a
Regulatory DMP?*
○ Yes
○ No
Applicants with "Yes" answers above answer this question
Will you be filing a Regulatory DMP with respect to a new matter?*
○ Yes
○ No
*Required to file application
21
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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.
For each matter that requires a "Yes" answer to Questions J and K below, you must provide
additional information by filing a Financial DMP for each financial matter using NFA's DMP
Filing system that requests:
•
•
•
•
•
•
who was involved;
when it occurred;
what the allegations were;
what the final determination was, if any;
the date of the determination; and
a summary of the circumstances surrounding the financial matter.
For actions filed with bodies other than NFA or the CFTC, you must also provide documents
regarding each financial matter requiting a "Yes" answer that show
•
•
the allegations; and
the final disposition.
You may provide these documents electronically using the upload function in the DMP
Filing System or sending them to NFA (See Instruction).
Answer the following questions.
Question J.*
Have you failed to pay any arbitration awards involving CFTC-regulated products, CFTC
civil monetary penalties, CFTC restitution amounts, CFTC disgorgement amounts, or CFTC
reparation amounts?
○ Yes
○ No
Question K.*
(1) Have you personally or
(2) has any entity of which you were a Principal at the time the activities occurred
ever been the subject of an adversary action brought by a U.S. bankruptcy trustee?
○ Yes
○ No
*Required to file application
22
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Applicants with all "No" answers above answer this question
Even though you answered "No" to all of the above questions, would you like to provide a Financial
DMP?*
○ Yes
○ No
Applicants with "Yes" answers above answer this question
Will you be filing a Financial DMP with respect to a new matter?*
○ Yes
○ No
*Required to file application
23
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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.
For each matter that requires a "Yes" answer to Question L below, you must provide additional
information by filing an Employment DMP for each employment matter using NFA's DMP Filing
system that requests:
•
•
•
•
•
•
who was involved;
when it occurred;
what the allegations were;
what the final determination was, if any;
the date of the determination; and
a summary of the circumstances surrounding the employment matter.
You must also provide documents regarding each employment matter requiring a "Yes"
answer that show
•
•
the allegations; and
the final disposition.
You may provide documents regarding each employment matter electronically using the
upload function in the DMP Filing System or sending them to NFA (See Instruction).
Answer the following question.
Question 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 U.S. or non-U.S. self-regulatory
organization?
○ Yes
○ No
Applicants with a "No" answer above answer this question
Even though you answered "No" to all of the above questions, would you like to provide an
Employment DMP?*
○ Yes
○ No
*Required to file application
24
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Applicants with "Yes" answers above answer this question
Will you be filing an Employment DMP with respect to a new matter?*
○ Yes
○ No
*Required to file application
25
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Employment, Education and Residential History
Employment and Education History
The CFTC requires that the sponsor attempt to communicate with all of the 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. If more spaces are needed, complete the information in another document and attach it
to this document.
Month and Year
Employment/School
From*:
To:
Name*:
Location:____________________________________
(leave blank if current) (City, state or country)
Position Held and
Reason for Leaving:
Month and Year
Employment/School
From*:
To:
Name*:
Location:____________________________________
(leave blank if current) (City, state or country)
Position Held and
Reason for Leaving:
Month and Year
Employment/School
From*:
Name*:
To:
Location:____________________________________
(leave blank if current) (City, state or country)
Position Held and
Reason for Leaving:
Month and Year
Employment/School
From*:
To:
Name*:
Location:____________________________________
(leave blank if current) (City, state or country)
Position Held and
Reason for Leaving:
*Required to file application
26
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Residential History
List your residential addresses, working back five (5) years. All time must be accounted for. Post
office box address is not acceptable. If more spaces are needed, complete the information in
another document and attach it to this document.
Month and Year
Residential Address
From:*
To:
(leave blank if current)
Month and Year
Residential Address
From:*
To:
(leave blank if current)
Month and Year
Residential Address
From:*
To:
(leave blank if current)
Month and Year
Residential Address
From:*
To:
(leave blank if current)
Month and Year
Residential Address
From:*
To:
(leave blank if current)
*Required to file application
27
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Associated Person applicants and principals of sole proprietors complete this section
Proficiency Requirements
Answer the following questions.
Have you passed the Series 3 Examination within the past two years?*
○ Yes
○ No
Only individuals intending to use an alternative(s) to satisfy the proficiency requirements complete
this section.
Check one of the following, if applicable
If you are a registered General Securities Representative of the sponsor, and your futures activity will be
limited to any of the two following activities, check each that applies:
□
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.
Have you passed the Series 31 Examination within the past two years?* ○ Yes
□
□
○ No
You limit your futures activity as provided in Registration Rule 401(b) to referring clients to
another AP of the sponsor or to supervising others who make such referrals.
Check here if you have been registered or licensed to solicit futures business by a foreign
regulatory authority located in Canada or the United Kingdom within the past two years and are
therefore eligible to satisfy the proficiency requirements by passing the Limited Futures
Examination – Regulations (Series 32).
Have you passed the Series 32 Examination within the past two years?* ○ Yes
○ No
□
Check here if your sponsor is a CPO that trades swaps subject to 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) or if your sponsor is a CTA that provides
advice on behalf of the sponsor to a commodity pool as described above.
□
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.
*Required to file application
28
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Only individuals filing as a forex associated person complete this section.
Have you passed the Series 34 Examination within the past two years?* ○ Yes
○ No
Only individuals filing as a branch office manager complete this section
Have you passed the Series 30 Examination within the past two years?* ○ Yes
○ No
Are you eligible to be a Branch Office Manager or Designated Supervisor
under FINRA rules?*
○ Yes
○ No
*Required to file application
29
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
Paperwork Reduction Act Notice
OMB Numbers 3038-0023 and 3038-0072
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 7-W, Form 8-R and Form 8-T may vary
depending upon individual circumstances. The estimated average times are:
Form 7-R
FCM
SD
MSP
RFED
0.6 hours
1.1 hour
1.1 hour
0.6 hours
IB
CPO
CTA
FT
0.5 hours
0.5 hours
0.5 hours
0.6 hours
Form 7-W
Form 8-R
Form 8-T
0.1 hours
1.0 hour
0.2 hours
Privacy 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 2(c), 4f, 4k, 4n, 4s, 8a and 19 of the Commodity Exchange
Act, 7 U.S.C. §§ 2(c), 6f, 6k, 6n, 6s, 12a and 23. Under Section 2(c), 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 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
4s of the Commodity Exchange Act, 7 U.S.C. §6s, it is 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 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 conducting 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, swap
30
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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 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 and Federal employer identification number, all
information in Forms 8-R and 8-T must be furnished. Disclosure of the social security number and
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,
which allows the CFTC to use the social security number or taxpayer identifying number furnished to
the CFTC as part of the registration process for purposes of collecting and reporting on any debt owed
to the U.S. Government, including civil monetary penalties. Although voluntary, the furnishing of a
social security number or Federal employer identification number 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.
NFA makes available to the public on NFA website(s), including the Background Affiliation Status
Information Center (BASIC), firm directories, business addresses, telephone numbers, registration
categories, effective dates of registration, registration status, and disciplinary action taken concerning
futures commission merchants, introducing brokers, commodity pool operators, commodity trading
advisors, swap dealers, major swap participants and retail foreign exchange dealers and their
associated persons and principals; non-natural person floor traders and their principals; and floor
trader order enterers.
Additional information on Forms 7-R, 7-W, 8-R and 8-T is publicly available, and may be accessed by
contacting the National Futures Association, Registration Department, Suite 1800, 300 S. Riverside
Plaza, Chicago, IL 60606-6615, except for the following information, which is generally not available for
public release unless required under the Freedom of Information Act (FOIA) :
• The fingerprint card, including its demographic information;
• social security number;
• date of birth;
• location of birth;
• current residential address; and
• any supplementary information filed in response to the Form 8-R “Personal Information,”
“Disciplinary Information,” “Matter Information,” or “Disclosure Matter” sections, Form 8-T
“Withdrawal Reasons,” “Disciplinary Information,” or “Matter Information” sections, and
Form 7-W, “Additional Customer Information” sections.
31
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
The CFTC, or NFA acting in accordance with rules approved by the CFTC, may disclose to third parties
any information provided on Forms 7-R, 7-W, 8-R and 8-T pursuant to the Commodity Exchange Act,
7 U.S.C. § 1 et. seq., Privacy Act of 1974, 5 U.S.C. § 552a (Privacy Act), and the Commission’s Privacy
Act routine uses published in the Federal Register, which may include, but is not limited to, disclosure
to Federal, state, local, or foreign law enforcement or regulatory authorities acting within the scope
of their jurisdiction or for their use in meeting responsibilities assigned to them by law. The
information will be maintained and disclosures will be made in accordance with CFTC Privacy Act
System of Records Notice CFTC-12, National Futures Association (NFA) Applications Suite System
(Exempted), CFTC-10, Investigatory Records (Exempted), or another relevant System of Records
Notice, available from the CFTC “Privacy Program” page,
http://www.cftc.gov/Transparency/PrivacyOffice.
If an individual believes that information on the forms is confidential, the individual may petition the
CFTC, pursuant to 17 CFR 145.9, to treat such information as confidential in response to requests under
FOIA. 5 U.S.C. §552. The filing of a petition for confidential treatment, however, does not guarantee
that the information will be treated confidentially in response to a FOIA request. 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.
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. 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 published System of
Records Notices, which describe the existence and character of each system of records maintained
by the CFTC, available at the CFTC “Privacy Program” page.
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.
Sponsor Agreement
Sponsor certifies that:
the Form 8-R is, to the best of the 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;
the AP applicant, Forex AP applicant, Swap AP applicant, principal or Floor Trader Order Enterer
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, the principal’s behalf or the Floor Trader Order Enterer's
behalf and that the Sponsor has authorized the person who files the application to file the Form 8R and to make the certifications and acknowledgements contained in this Sponsor Agreement;
32
OMB Nos. 3038-0023 (exp. Nov. 30, 2018) & 3038-0072 (exp. Jul. 31, 2018)
CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
the Sponsor has communicated or has attempted to communicate with all of the applicant’s
previous employers and educational institutions for the past three years and has documentation
on file with the names of the persons contacted and the dates of contact or, if no contact was
made, the reason therefor;
the applicant has been hired or is employed by the Sponsor or that it is the intention of the
Sponsor to hire or otherwise employ the applicant as an AP, Forex AP or Swap AP within 30 days
after receipt of notification that the applicant has received a temporary license or has been
registered;
the applicant will not be permitted to act as an AP until the applicant has received a temporary
license 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 Swap AP;
if the Sponsor is a new sponsor filing an application for registration of the applicant as an AP
pursuant to the provisions of NFA Registration Rule 207(a), that the Sponsor has verified that the
applicant is not subject to a disqualification from registration under Section 8a(2) of the
Commodity Exchange Act, 7 U.S.C. §12(a)(2), and that the Sponsor meets the requirements set
forth in NFA Registration Rule 509(b)(5);
if the applicant is applying for a temporary license pursuant to NFA Registration Rule 301(a)(2),
that the Sponsor has reviewed the information concerning the applicant in NFA’s BASIC system and
has received a copy of the notice of the 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
Commodity Exchange Act, 7 U.S.C. §§ 9, 13b, 13a-1, 13a-2, 12a, and 13, CFTC regulations 3.55 or
3.60 or NFA or exchange rules or that was instituted in accordance with the procedures provided in
CFTC regulation 3.51 or Part 500 of the 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;
if the applicant is subject to any current NFA or Commission order imposing conditions on the
registration of the applicant, that the Sponsor meets the requirements set forth in NFA
Registration 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 of the
applicant and that the Sponsor will supervise the applicant in accordance with the conditions
contained in the order; and
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.
Sponsor acknowledges that:
the Sponsor is subject to the imposition of criminal penalties under Section 9(a) of the Commodity
Exchange Act, 7 U.S.C. §13(a), and 18 U.S.C. §1001 for any false statements or omissions Sponsor
made in the Form 8-R;
while the individual is an AP, forex AP or Swap AP sponsored by or a principal of the Sponsor or is
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CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
responsible for entering orders on behalf of the Floor Trader's own account, the Sponsor is
responsible 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;
it is the duty and obligation of the Sponsor not to employ an individual as an AP with a statutory
disqualification under Section 8a(2) of the Commodity Exchange Act, 7 U.S.C. §§12(a)(2),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 or her, with a view toward preventing him
or her from committing violations of the Commodity Exchange Act and the rules, regulations and
orders thereunder; and
the 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.
Individual Agreement
The applicant, principal or Floor Trader Order Enterer verifies 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, principal or Floor Trader Order Enterer has
given them, the answers and statements in the Form 8-R are not misleading in any material respect.
The applicant certifies that
if applying for a temporary license pursuant to the provisions of NFA Registration 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 of the Commodity Exchange Act, 7 U.S.C. §§ 9,
13b, 13a-1, 13a-2, 12a, and 13, CFTC regulations 3.55 or 3.60 or NFA or exchange rules or any
proceeding that was brought against the applicant under CFTC regulation 3.51 or Part 500 of the
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.
The applicant, principal or Floor Trader Order Enterer acknowledges that:
the applicant, principal or Floor Trader Order Enterer is subject to the imposition of criminal penalties
under Section 9(a) of the Commodity Exchange Act, 7 U.S.C. §13(a), and 18 U.S.C. §1001 for any false
statements or omissions made in the Form 8-R;
the applicant, principal or Floor Trader Order Enterer 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;
the residential address provided on the Form 8-R may be deemed to be the address for delivery to
the applicant, principal or Floor Trader Order Enterer of any written communications from the
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CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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 or subpoena; request for information; or any other written communication
unless the applicant, principal or Floor Trader Order Enterer specifies another address for this
purpose;
the applicant or principal must keep current the residential address provided on the Form 8-R while
registered as an AP or affiliated as a principal and for two years after termination of registration or
affiliation; and
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; 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, if applicable, the applicant is not
approved as a Swap AP and may not act as a Swap AP until approval has been granted.
The applicant, principal or Floor Trader Order Enterer authorizes that:
NFA, and any contract market of which the applicant’s or principal’s Sponsor or any current or future
guarantor (under CFTC regulation 1.10(j)) of the 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 NFA may conduct a background investigation
of the Floor Trader Order Enterer;
and requests that any person, including but not limited to contract markets, or non-U.S. 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 of the principal or any background
investigation of the Floor Trader Order Enterer;
The applicant, principal or Floor Trader Order Enterer agrees that:
the applicant, principal or Floor Trader Order Enterer will cooperate promptly and fully, consistent
with applicable Federal law, in any investigation in connection with the applicant’s or principal’s
fitness for registration or Associate status or any background investigation of the Floor Trader Order
Enterer, which may include contacting non-U.S. 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 or
the background investigation of the Floor Trader Order Enterer;
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 regulation 1.10(j)) of the
applicant’s or principal’s Sponsor is or may become a member, which has or may adopt rules which
apply to the applicant as an associated person or principal, and the applicant or principal shall abide
by all such rules and to comply with, be subject to, and abide by all requirements, rulings, orders,
directives and decisions of and any penalties, prohibitions and limitations imposed by any such
contract market;
any person furnishing information to NFA or any agent acting on behalf of NFA in connection with the
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CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
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;
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;
and
if the applicant 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 the applicant is granted registration as an Associate.
Floor Broker/Floor Trader Agreement
The applicant certifies 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.
The applicant acknowledges that:
the applicant is subject to the imposition of criminal penalties under Section 9(a) of the Commodity
Exchange Act, 7 U.S.C. §13(a), and 18 U.S.C. §1001 for any false statements or omissions made in
the Form 8-R;
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;
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 or subpoena; request for information; or any other
written communication unless the applicant specifies another address for this purpose;
the applicant must keep current the business address provided on the Form 8-R while registered
and for two years after termination of registration; and
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.
The applicant authorizes that:
NFA may conduct an investigation to determine the applicant’s fitness for registration;
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CFTC Form 8-R (Apr. 2017)
Individual Application (Form 8-R)
and requests that any person, including but not limited to contract markets or non-U.S. 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;
The applicant agrees that:
the applicant will cooperate promptly and fully, consistent with applicable Federal law, in any
investigation in connection with the applicant’s application for registration, which investigation
may include contacting non-U.S. 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;
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; and
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.
THE APPLICANT, PRINCIPAL OR FLOOR TRADER ORDER ENTERER ALSO AGREES TO THE
PRIVACY ACT NOTICE ABOVE, AND THE COLLECTION, PROCESSING, DISCLOSURE, AND USE
OF HIS OR HER PERSONAL INFORMATION BY NFA, THE CFTC, AND THIRD PARTIES AS STATED
IN THE NOTICE.
Agree
Cancel
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CFTC Form 8-R (Apr. 2017)
| File Type | application/pdf |
| Author | Michael Crowley |
| File Modified | 2017-05-11 |
| File Created | 2017-05-11 |