This information must be provided on the Dealer (Floor Broker)’s letterhead and signed by the registered Floor Broker 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: 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 (Floor Broker)’s knowledge, the registration information relating to the Dealer (Floor Broker) has not changed in any manner that would require reporting to the Commission. Name of Sponsoring Dealer (Floor Broker) Signature of Floor Broker
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