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Contingent Trade Reporting Form
Exchange For Physical (EFP)
Exchange For Risk (EFR)
Substitution of OTC Derivative Instruments for Futures Contracts (SUBS)
General Information
Individual submitting report
Name: *
Title: *
Email: *
Approved Participant: *
SAM authorized person executing the contingent transaction
Name: *
SAM user id: *
Phone: *
Fax:
Details of the contingent transaction
Counterparty name: *
Trade date and time: *
2013 - 05 -
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a.m.
p.m.
Futures contract component
Symbol: *
Quantity: *
(With no thousands separator)
Contract month & year: *
MM
Jan.
Feb.
Mar.
Apr.
May
June
July
Aug.
Sept.
Oct.
Nov.
Dec.
-
YY
2012
2013
2014
2015
2016
2017
Buyer: *
Seller: *
Price of the transaction: *
(With no thousands separator)
Cash component or OTC derivative instrument of the contingent transaction
Description: *
Quantity or value: *
(With no thousands separator)
Buyer: *
Seller: *
Market value: *
(With no thousands separator)
Additional Information:
Authorized person
means a SAM Authorized Person or any other person authorized by a regulator or a self-regulatory organization to deal in futures contracts.
The transmission of the above information to the Bourse and the subsequent validation and dissemination of the transaction by the Market Monitoring Department will not preclude the Bourse from initiating any analysis and/or investigation to ensure that the transaction has been made in accordance with the requirements of the Rules of the Bourse or of the Procedure for the Execution of EFP/EFR/SUBS Transactions. If, following such analysis or investigation, it appears that the transaction was not in full compliance with applicable regulatory requirements, the Bourse has the discretion to initiate a disciplinary process.
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