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Notice Form 7-R - Commodity Futures Trading Commission - National Futures Association Page 2

CFTC

NOTICE FORM 7-R

NFA

(07-01)

INSTRUCTIONS

Registration as a Futures Commission Merchant or Introducing Broker will be effective upon receipt by NFA of a properly

completed Notice Form 7-R.

Mail this form to:

National Futures Association

Registration Department

300 S. Riverside Plaza

Suite 1800

Chicago, IL 60606-6615

Written confirmation of registration will be mailed to the contact person listed on this form.

PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE

The information on CFTC Notice Form 7-R is being collected pursuant to authority granted in Sections 4f, 4n, 8a and 19

of the Commodity Exchange Act [7 U.S.C. §§ 6f, 6n, 12a and 23]. Under Section 4d of the Commodity Exchange Act

[7 U.S.C. §6d], it is unlawful for anyone to act as a futures commission merchant or introducing broker without being regis-

tered in that capacity under the Act.

The information requested in Notice 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.

All information requested on Notice Form 7-R must be furnished before the form will be processed. The failure by an

applicant or registrant to timely file a properly completed Notice Form 7-R may result in the denial of an application for

registration or withdrawal thereof.

This Notice Form 7-R is considered by the CFTC to be a public record and will be available for inspection by any inter-

ested person. Copies will be maintained by National Futures Association, Registration Department, Suite 1800, 300 S.

Riverside Plaza, Chicago, IL 60606-6615.

Forms which have not been prepared and executed in compliance with applicable requirements may be returned as not

acceptable for filing. Acceptance of this form shall not constitute any finding that it has been filed as required or 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.

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 Notice Form 7-R may vary depending upon individual circumstances. The estimated

average time is 5 minutes.

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Notice Form 7-R - Commodity Futures Trading Commission - National Futures Association Page 2