COMMODITY FUTURES TRADING COMMISSION

FORM SEF

SWAP EXECUTION FACILITY 

APPLICATION OR AMENDMENT TO APPLICATION FOR REGISTRATION 

COVER SHEET

________________________________________________________________________________________________

Exact name of Applicant as specified in charter

________________________________________________________________________________________________

Address of principal executive offices

 If this is an APPLICATION for registration, complete in full and check here.

 If this is an AMENDMENT to an application, or to an existing order of registration, list all items that are

amended and check here.

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

GENERAL INFORMATION

1. Name under which the business of the swap execution facility is or will be conducted, if different than name

specified above (include acronyms, if any):

____________________________________________________________________________________________

2. If name of swap execution facility is being amended, state previous swap execution facility name:

____________________________________________________________________________________________

3. Contact information, including mailing address if different than address specified above:

____________________________________________________________________________________________

Number and Street

____________________________________________________________________________________________

City State Country Zip Code

___________________________________________________________________________________________

Main Phone Number Fax

 ___________________________________________________________________________________________

Website URL E-mail Address
4. List of principal office(s) and address(es) where swap execution facility activities are/will be conducted:

Office Address

 _______________________________ _______________________________________________

 _______________________________ _______________________________________________

 _______________________________ _______________________________________________

5. If the Applicant is a successor to a previously registered swap execution facility, please complete the following:

a. Date of succession

______________________

b. Full name and address of predecessor registrant

__________________________________________________________________________________

Name

__________________________________________________________________________________

Number and Street

__________________________________________________________________________________

City State Country Zip Code

__________________________________________________________________________________

Main Phone Number Website URL

BUSINESS ORGANIZATION

6. Applicant is a:

 Corporation

 Partnership

 Limited Liability Company

 Other form of organization (specify) ____________________________

7. Date of incorporation or formation: _____________________________________________

8. State of incorporation or jurisdiction of organization: ______________________________________________

9. The Applicant agrees and consents that the notice of any proceeding before the Commission in connection with

this application may be given by sending such notice by certified mail to the person named below at the address

given.

____________________________________________________________________________________________

Print Name and Title

____________________________________________________________________________________________

Name of Applicant

____________________________________________________________________________________________

Number and Street

____________________________________________________________________________________________

City State Zip Code
SIGNATURES

10. The Applicant has duly caused this application or amendment to be signed on its behalf by the undersigned,

hereunto duly authorized, this ___________ day of ________________________________, 20_____. The

Applicant and the undersigned represent hereby that all information contained herein is true, current, and

complete. It is understood that all required items and Exhibits are considered integral parts of this Form SEF and

that the submission of any amendment represents that all unamended items and Exhibits remain true, current, and

complete as previously filed.

____________________________________________________________________________________________

Name of Applicant

____________________________________________________________________________________________

Signature of Duly Authorized Person

____________________________________________________________________________________________

Print Name and Title of Signatory

23rd October 19