This information must be provided on the letterhead of the Dealer (Merchant) and signed by the registered Floor Trader APPLICATION UNDER MSC NOTICE 2001-31 EXPEDITED RENEWAL PROCESS FOR REGISTRATION Name of Registered Firm: Category of Registration: Renewal Registration applied under : (The Securities Act or The Commodity Futures Act) Head office address: Address for service: Names (in alphabetical order by last name) and category of registration of each individual applying for renewal of registration: Payment:
The undersigned hereby confirms that application is made under MSC Notice 2001-31, Expedited Renewal Process for Registration. To the best of the Dealer (Merchant)'s knowledge, the registration information relating to the Dealer (Merchant) and each individual registrant has not changed in any manner that would require reporting to the Commission. Name of Sponsoring Dealer (Merchant) Signature of Floor Trader
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