Fill and Sign the Albert James Bert Shoosmith Scholarship Application Vnla Vnla Form

Application for Corporate Membership / Incentive Program Participation Corporate Information 1. Organization’s Full Legal Name ____________________________________________ 2. Type of organization (check one) Corporation organized under the laws of __________________________________ C Corporation Subchapter S Corporation (check one) Limited Liability Company organized under the laws of Limited Partnership organized under the laws of General Partnership organized under the laws of Other (please specify) 3. Date Established 4. Tax Identification Number 5. Main Address Phone Number ____________________ 6. Web Site Address_____________________ Indicate the name(s), title(s) and contact information of individuals authorized to represent the organization before the Exchange(s) and its Committees. Phone Number ____________________ E-Mail Address_______________________ Application for Corporate Membership / Incentive Program Participation Corporate Information 7. Please respond to the following: Question Yes A. Has your organization or its principals ever been denied registration, or had a registration suspended, revoked, or conditioned by a governmental or regulatory authority? B. No Has your organization or its principals ever been denied membership or clearing privileges by any commodity or securities exchange/clearing organization? C. Has any commodity exchange, securities exchange, clearing organization or other self-regulatory body ever fined, suspended, conditioned, or revoked privileges of your organization or its principals? D. Has your organization or its principals ever been convicted, pled guilty, entered a plea of “no contest” or entered into a voluntary settlement as to any violation of any criminal or penal code? E. Is your organization or its principals subject to any investigation or have any charges been brought by any governmental or regulatory authority or exchange/clearing organization for violation of its laws or rules? F. Does your organization or its principals currently have any judgments, liens, attachments, or other encumbrances filed against it? If your response is “Yes” to any of the above, please describe below and provide supporting documentation. 2 September 2010 Application for Corporate Membership / Incentive Program Participation Corporate Information 8. Does your organization engage in futures and options customer business? If yes, describe the nature of the customer business (e.g. U.S. or non-U.S. customers and type of trading activity), who clears this business and whether it is cleared on an omnibus or fully disclosed basis. 9. Is your organization subject to any restrictions which would prohibit it from becoming a corporate member/incentive program participant? 10. Is your organization registered in any capacity with a regulatory agency? If so, indicate the nature and country of the registration(s), your primary regulator(s) and the regulator’s Web Site(s). 11. List all commodity or security exchanges/clearing organizations, U.S. and non-U.S., at which membership privileges are held or pending. Please indicate the type of membership held (e.g. clearing or non-clearing). 12. List all CME Group Inc. membership or incentive programs held or pending. If applicable, please indicate the type of membership held (e.g. clearing or non-clearing). 3 September 2010 Application for Corporate Membership / Incentive Program Participation Corporate Information 13. Describe the nature of your organization’s anticipated firm trading activity. Please indicate the products you intend to trade, whether the trading will utilize automated trading systems (ATS), be electronic or floor-traded or both, speculative or for hedging purposes, and if you will day trade, carry positions overnight, or a combination. 14. Complete the chart below for your organization’s firm account controllers/traders. Firm Account Controllers/Traders (include all firm related trading activity) Number of Traders Bona-fide Employees ________ Owners ________ Exchange Members ________ Commodity Trading Advisors ________ Independent Contractors ________ Other (describe) __________________________________ __________________________________ 15. ________ ________ Indicate the CME, CBOT, NYMEX and/or COMEX clearing member(s) that will clear your organization’s firm trades and the trading account number(s). Clearing Member Account Number ___________________________________ ______________________________ ___________________________________ ______________________________ ___________________________________ ______________________________ ___________________________________ ______________________________ 4 September 2010 Application for Corporate Membership / Incentive Program Participation Corporate Information 16. Indicate the name(s), title(s) and contact information of individuals authorized to act on behalf of the organization regarding this application and to contact for questions concerning the application. Phone Number 17. E-Mail Address Please indicate the type(s) of corporate membership / incentive program being applied for. CME Rule 106.H. Trading Member Firm CBOT Rule 106.H. Trading Member Firm CME Rule 106.I. Affiliate Member Firm CBOT Rule 106.I. Affiliate Member Firm CME Rule 106.J. Equity Member Firm CBOT Rule 106.J. Equity Corporate Member Firm CME Rule 106.R. Electronic Corporate Member Firm CBOT Rule 106.R. Electronic Corporate Member Firm NYMEX Rule 106.J. Member Firm COMEX Rule 106.J. Member Firm International Incentive Program Asia-Pacific Incentive Program Latin America Bank Incentive Program Latin America Commercial Incentive Program Latin American Fund Manger Incentive Program eFX Bank Incentive Program Complete the appropriate CME, CBOT, NYMEX, and/or COMEX Application for Corporate Membership - Agreement for Membership or applicable Application for Incentive Program – Agreement for Participation. 5 September 2010 Application for Corporate Membership / Incentive Program Participation Corporate Information 18. Please include with this application the following: • Articles of Incorporation, Certificate of Incorporation, Articles of Association, Limited Liability Company Operating Agreement, and/or Partnership Agreement, as applicable. • Most recent Certified Financial Statement. If a Certified Financial Statement is not available, please submit a financial statement indicating the assets, liabilities, and capital of the company or a recent tax return filing. • A copy of a recent account statement(s) from a CME, CBOT, NYMEX and/or COMEX clearing member indicating that the organization’s account is opened and funded. • An ownership chart detailing the organization’s ownership including percentages of ownership. • A listing of firm traders and, as applicable, evidence of bona-fide employment for employee-traders, documentation of IRS Form 1099-MISC or foreign equivalent for independent contractor-traders, and/or most recent capital account balance for owner-traders. • Trader agreements, if applicable. • The appropriate CME, CBOT, NYMEX and/or COMEX Application for Corporate Membership - Agreement for Membership or applicable Application for Incentive Program – Agreement for Participation with all attachments including the (a) Attestation, Authorization and Agreement (b) Firm Trading Attestation and (c) Designated Spokesperson and Authorized Signor Acknowledgment. Completed applications along with all supporting documentation should be submitted to: CME Group Inc. Audit Department 20 S. Wacker Drive Chicago, IL 60606 CME Group Inc. policies require all directors, officers, employees, consultants and agents (“Representatives”) to treat as confidential and to use a reasonable degree of care to maintain the confidential nature of all information received from an applicant in conjunction with an application for member firm status on a CME Group Exchange (i.e., CME, CBOT, NYMEX and COMEX). Such confidential information may only be disclosed to CME Group representatives who have a need to know such information and who are bound by these policies or who agree to protect the confidential information from unauthorized use and disclosure. CME Group Inc. acknowledges that such confidential information may not be disclosed to any third party person or entity (except pursuant to administrative or judicial process) without the prior written consent of the applicant providing such confidential information. Print Form 6 Clear All Fields September 2010