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Missing Information Request

Please complete the form below

(8-10 digits)

Are you a relative of -or do you share the same home with- an officer, director, employee, or associated person of fxcm?*

If yes, please describe relationship

Are you a general partner, officer, director, owner of more than ten percent of the equity interest, associate person or employee of retail forex counterparty? *

If yes, please list the name of the equity interest, registered associated person or employee of the retail foreign exchange dealer (RFED) or futures commission merchant (FCM) registered with the National Futures Association

Are you a relative of or do you share the same home with - a general partner, officer, director, owner of more than ten percent of the equity interest, associate person or employee of retail forex counterparty? *

If yes, please list the name of the company, the name of the affiliated individual, and your relationship to them

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