ICE Clear EUROPE

Customer Clearing Account Request Form

January 2018

Version 3.0

1.Introduction...... 1

2.Main Contact...... 2

3.Customer Clearing Accounts...... 3

4.Member Testing

INTERCONTINENTAL EXCHANGE CUSTOMER CLEARING ACCOUNT REQUEST FORM | VERSION 3.0 | JANUARY2018

© 2016 Intercontinental Exchange, Inc.

CUSTOMER CLEARING ACCOUNT REQUEST FORM

1.Introduction

This form should be used by Clearing Members to request a customer omnibus or an Individually Segregated Margin-flow Co-mingled (ISOC) account. Once submitted, the ICE Clear Europe Operations department will be in contact to co-ordinate the setup of the accounts.

Once ICE Clear Europe Operations receive this completed form, they will advise the ICE Clear Europe Treasury team who will in turn send the contact a Treasury On-boarding Questionnaire (TOBQ). The Member will then have to provide the bank details for the new account and the TOBQ will have to be signed by an authorised signatory.

NOTE: The TOBQ is not required for a P or O account for FCM’s.

Please return this form to ICE Clear Europe Operations as described on the front sheet. If you have any questions on this document, please contact ICE Clear Europe Operations on +44 (0)20 7065 7600 or

2.MAIN Contact

Please provide name of the Clearing Member on whose behalf the request is being made
Clearing Member Name:
ICE Clear Europe mnemonic
Please indicate whether the Clearing Member is registered as a futures commission merchant with the CFTC and/or as a broker dealer with the SEC:
Yes No
Please provide the name and contact details of the person completing/coordinating the completion of this questionnaire:
Name:
E-mail
Telephone

3.Customer Clearing Accounts

Please select the required clearing account
Account Name / Account Code / Required Y/N
Segregated Customer Omnibus Account (Gross Margined) / S/C
Segregated Customer Omnibus Account (Net Margined) / E
Standard Omnibus Indirect Account (Gross Margined) / O
Standard Omnibus Indirect Account (Net Margined) / X
Segregated TTFCA Customer Omnibus Account (Gross Margined) / T
Segregated TTFCA Customer Omnibus Account (Net Margined) / K
Standard TTFCA Omnibus Indirect Account (Gross Margined) / P
Standard TTFCA Omnibus Indirect Account (Net Margined) / Y
Segregated Customer Omnibus Account (Affiliate Account, Gross Margined) / F
Segregated Customer Omnibus Account (Affiliate Account, Net Margined) / R
Margin-flow Co-mingled Account Segregated Account (ISOC) / I
Margin-flow Co-mingled Account TTFCA Customers (ISOC) / J
Segregated Gross Indirect Accounts for Segregated Customers (Gross Margined) / A
Segregated Gross Indirect Accounts for Segregated TTFCA Customers. (Gross Margined) / B
DCM Customer Account / W

INTERCONTINENTAL EXCHANGE CUSTOMER CLEARING ACCOUNT REQUEST FORM | VERSION 3.0 | JANUARY2018

© 2016 Intercontinental Exchange, Inc.

4.Member Testing (If applicable)

Please provide the details of the individual responsible for coordinating Member testing within the firm?
Name:
E-mail
Telephone
Please indicate for which accounts you require testing?
Account Code(s):
Please confirm vendor/internal software package:
Middle Office Software (Vendor / Package)
Back Office Software (Vendor / Package)
Reconciliations Software (Vendor / Package)
Other Software (Vendor / Package)

INTERCONTINENTAL EXCHANGE CUSTOMER CLEARING ACCOUNT REQUEST FORM | VERSION 3.0 | JANUARY2018

© 2016 Intercontinental Exchange, Inc.