Form 8-R - Individual Application Template Page 13

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TEMPLATE: DO NOT SEND TO NFA
INDIVIDUAL APPLICATION (FORM 8-R)
COMMODITY FUTURES TRADING COMMISSION
NATIONAL FUTURES ASSOCIATION
Personal Information (cont.)
Birth Information
Enter information about applicant’s date and location of birth
Date of Birth*
Month________________________________ Day_______________________ Year_____________________
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
Page 13 | OMB Numbers 3038-0023 (exp. November 30, 2018) & 3038-0072 (exp. July 31, 2018) | CFTC Form 8-R (April 2017)

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