Form 24-101F1

Registered Firm Exception report of Dap/Rap Trade Reporting and Matching

CALENDAR QUARTER PERIOD COVERED:

From:                                                to:                                            

REGISTERED FIRM IDENTIFICATION AND CONTACT INFORMATION:

1.             Full name of registered firm (if sole proprietor, last, first and middle name):

2.             Name(s) under which business is conducted, if different from item 1:

3.            
3a.          Address of registered firm's principal place of business:

3b.          Indicate below the jurisdiction of your principal regulator within the meaning of NI 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations:

c Alberta

c British Columbia

c Manitoba

c New Brunswick

c Newfoundland & Labrador

c Northwest Territories

c Nova Scotia

c Nunavut

c Ontario

c Prince Edward Island

c Québec

c Saskatchewan

c Yukon

3c.           Indicate below all jurisdictions in which you are registered:

c Alberta

c British Columbia

c Manitoba

c New Brunswick

c Newfoundland & Labrador

c Northwest Territories

c Nova Scotia

c Nunavut

c Ontario

c Prince Edward Island

c Québec

c Saskatchewan

c Yukon

4.             Mailing address, if different from business address:

5.             Type of business:                            [  ]   Dealer                  [   ]  Adviser

6.             Category of registration:

7.             (a)           Registered Firm NRD number:

                  (b)           If the registered firm is a participant of a clearing agency, the registered firm’s CUID number:

8.             Contact employee name:

                Telephone number:

                  Email address:

INSTRUCTIONS:

Deliver this form for both equity and debt DAP/RAP trades together with Exhibits A, B and C pursuant to section 4.1 of the Instrument, covering the calendar quarter indicated above, within 45 days of the end of the calendar quarter if

(a)           less than 90 per cent of the equity and/or debt DAP/RAP trades executed by or for you during the quarter matched within the time required in Part 3 of the Instrument, or

(b)           the equity and/or debt DAP/RAP trades executed by or for you during the quarter that matched within the time required in Part 3 of the Instrument represent less than 90 per cent of the aggregate value of the securities purchased and sold in those trades.

EXHIBITS:

Exhibit A – DAP/RAP trade statistics for the quarter

Complete Tables 1 and 2 below for each calendar quarter.

(1)           Equity DAP/RAP trades

(2)           Debt DAP/RAP trades

Exhibit B – Reasons for not meeting exception reporting thresholds

Describe the circumstances or underlying causes that resulted in or contributed to the failure to achieve the percentage target for matched equity and/or debt DAP/RAP trades within the maximum time prescribed by Part 3 of the Instrument. Reasons given could be one or more matters within your control or due to another trade-matching party or service provider. If you have insufficient information to determine the percentages, the reason for this should be provided. See also Companion Policy 24- 101CP to the Instrument.

Exhibit C – Steps to address delays

Describe what specific steps you are taking to resolve delays in the equity and/or debt DAP/RAP trade reporting and matching process in the future. Indicate when each of these steps is expected to be implemented. The steps being taken could be internally focused, such as implementing a new system or procedure, or externally focused, such as meeting with a trade- matching party to determine what action should be taken by that party. If you have insufficient information to determine the percentages, the steps being taken to obtain this information should be provided. See also Companion Policy 24-101CP to the Instrument.

CERTIFICATE OF REGISTERED FIRM

The undersigned certifies that the information given in this report on behalf of the registered firm is true and correct.

DATED at                                                         this           day of                                 20       

(Name of registered firm - type or print)

(Name of director, officer or partner - type or print)

(Signature of director, officer or partner)

(Official capacity - type or print)