Trading Counterparty Form
*Counterparty Legal Entity Name (Exact):
*Contact Name:
*Address 1:
Address 2:
*City:
*State:
..State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*Zip:
*Phone:
*Email:
*Type of Trade Execution
Global Equity
Fixed Income
Required Documentation
Application Form:
(Accepted file types: .pdf, .doc, .docx, .xls, .xlsx, .zip)
Choose file
Most Recent SEC FOCUS Form III Report:
(Accepted file types: .pdf, .doc, .docx, .xls, .xlsx, .zip)
Choose file
Current Agency Credit Report/Rating:
(Accepted file types: .pdf, .doc, .docx, .xls, .xlsx, .zip)
Choose file
Summary/Highlight of Relevant Firm Capabilities:
(Accepted file types: .pdf, .doc, .docx, .xls, .xlsx, .zip)
Choose file
Chart of Legal Ownership and Capital Structure, Showing Affiliations to all Related Companies:
(Accepted file types: .pdf, .doc, .docx, .xls, .xlsx, .zip)
Choose file
List of All Pertinent Professional Liability Insurance Coverage and Certificate(s) of Insurance:
(Accepted file types: .pdf, .doc, .docx, .xls, .xlsx, .zip)
Choose file
Index or Table of Contents for your Code of Conduct, Compliance Manual, Business Continuity Plan:
(Accepted file types: .pdf, .doc, .docx, .xls, .xlsx, .zip)
Choose file
Clearing Agreement and Clear Firm's Most Recent FOCUS Report or Financial Statements (if different from the firm) if applicable:
(Accepted file types: .pdf, .doc, .docx, .xls, .xlsx, .zip)
Choose file
Additional Comments:
Attention:
Florida has a very broad public records law. This communication (including your email address, any attachments and other email contents) may be subject to disclosure to the public and media.
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