Subpart C Election Form

Appendix B to Part 39 – Subpart C Election Form.
COMMODITY FUTURES TRADING COMMISSION
SUBPART C ELECTION FORM
GENERAL INSTRUCTIONS

GENERAL INSTRUCTIONS: Intentional misstatements or omissions of fact may constitute federal
criminal violations (7 U.S.C. 13 and 18 U.S.C. 1001).
DEFINITIONS
Unless the context requires otherwise, all terms used in this Subpart C Election Form have the same meaning as in
the Commodity Exchange Act (“Act”), and in the General Rules and Regulations of the Commodity Futures Trading
Commission (“Commission”) thereunder. All references to Commission regulations are found at 17 CFR Ch. 1.
For purposes of this Subpart C Election Form, the term “Applicant” shall mean a derivatives clearing organization
that is filing this Subpart C Election Form with a Form DCO as part of an application for registration as a derivatives
clearing organization pursuant to Section 5b of the Act and 17 CFR 39.3(a).
GENERAL INSTRUCTIONS
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Any derivatives clearing organization requesting an election to become subject to subpart C of part 39 of the
Commission’s regulations must file this Subpart C Election Form. The Subpart C Election Form includes the
election to be subject to the provisions of subpart C of part 39 of the Commission’s regulations, certain required
certifications, disclosures, and exhibits, and any supplements or amendments thereto filed pursuant to 17 CFR
39.31(b) or (c) (collectively, the “Subpart C Election Form”).
Any derivatives clearing organization wishing to request an extension of up to one year to comply with any of
the provisions of 17 CFR 39.34, 17 CFR 39.35 or 17 CFR 39.39, pursuant to 17 CFR 39.34(d) or 17 CFR
39.39(f) must do so prior to filing this Subpart C Election Form. Such requests shall become part of this
Subpart C Election Form.
Individuals’ names, except the executing signature, shall be given in full (Last Name, First Name, Middle
Name).
The signatures required in this Subpart C Election Form shall be the manual signatures of: a duly authorized
representative of the derivatives clearing organization as follows: If the Subpart C Election Form is filed by a
corporation, it must be signed in the name of the corporation by a principal officer duly authorized; if filed by a
limited liability company, it must be signed in the name of the limited liability company by a manager or
member duly authorized to sign on the limited liability company’s behalf; if filed by a partnership, it must be
signed in the name of the partnership by a general partner duly authorized; if filed by an unincorporated
organization or association which is not a partnership, it must be signed in the name of such organization or
association by the managing agent, i.e., a duly authorized person who directs or manages or who participates in
the directing or managing of its affairs.
All applicable items must be answered in full.
Under Section 5b of the Act and the Commission’s regulations thereunder, the Commission is authorized to
solicit the information required to be supplied by this Subpart C Election Form from any Applicant seeking
registration as a derivatives clearing organization and from any registered derivatives clearing organization.
Disclosure of the information specified in this Subpart C Election Form is mandatory prior to the processing of
the election to become a derivatives clearing organization subject to the provisions of subpart C of part 39 of the

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Commission’s regulations. The Commission may determine that additional information is required in order to
process such election.
A Subpart C Election Form that is not prepared and executed in compliance with applicable requirements and
instructions may be returned as not acceptable for filing. Acceptance of this Subpart C Election Form, however,
shall not constitute a finding that the Subpart C Election Form is acceptable as filed or that the information is
true, current or complete.
Except as provided in 17 CFR 39.31(d), in cases where a derivatives clearing organization submits a request for
confidential treatment with the Secretary of the Commission pursuant to the Freedom of Information Act and 17
CFR 145.9, information supplied in this Subpart C Election Form will be included routinely in the public files
of the Commission and will be made available for inspection by any interested person.

APPLICATION AMENDMENTS
17 CFR 39.31(b)(3) and (c)(4) require a derivatives clearing organization that has submitted a Subpart C Election
Form to promptly amend its Subpart C Election Form if it discovers a material omission or error in, or if there is a
material change in, the information provided to the Commission in the Subpart C Election Form or other
information provided in connection with the Subpart C Election Form. When amending a Subpart C Election Form,
a derivatives clearing organization must re-file the Election and Certifications page, amended if necessary, and
including all required executing signatures, and attach thereto revised exhibits or other materials marked to show
changes, as applicable.
WHERE TO FILE
This Subpart C Election Form must be filed electronically with the Secretary of the Commission in the format and
manner specified by the Commission.

COMMODITY FUTURES TRADING COMMISSION
SUBPART C ELECTION FORM
ELECTION AND CERTIFICATIONS

______________________________________________________________________________________
Exact Name of the Derivatives Clearing Organization
(as set forth in its charter, if an Applicant,
or as set forth in its most recent order of registration, if registered with the Commission)

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1.

Check here and complete sections 1 and 3 below, if the organization is an Applicant.
Check here and complete sections 2 and 3 below, if the organization currently is registered with the
Commission as a derivatives clearing organization.
The derivatives clearing organization named above hereby elects to become subject to the provisions of subpart
C of part 39 of the Commission’s regulations in the event that the Commission approves its application for
registration as a derivatives clearing organization.
The derivatives clearing organization and the undersigned each certify that, in the event that the Commission
approves the derivatives clearing organization’s application for registration and permits its election to become
subject to subpart C of part 39 of the Commission’s regulations:
a.

The derivatives clearing organization will be in compliance with such regulations as of the date set
forth in the notice thereof provided by the Commission pursuant to 17 CFR 39.31(c)(2), except to the
limited extent that the Commission has granted the derivatives clearing organization an extension of
time to comply with: (1) specified provisions of 17 CFR 39.34, pursuant to 17 CFR 39.34(d) and/or
(2) specified provisions of 17 CFR 39.35 and/or 17 CFR 39.39, pursuant to 17 CFR 39.39(f);

b.

The derivatives clearing organization will be in compliance with all provisions of 17 CFR 39.34, 39.35
and/or 39.39 for which the Commission, pursuant to 17 CFR 39.34(d) and/or 17 CFR 39.39(f), has
granted an extension of time to comply in accordance with the terms of such extensions; and

c.

The derivatives clearing organization will remain in compliance with the provisions contained in
subpart C of part 39 of the Commission’s regulations until this election is rescinded pursuant to 17
CFR 39.31(e).

______________________________________________________________________________________
Name of Derivatives Clearing Organization

By:___________________________________________________________________________________
Manual Signature of Duly Authorized Person
______________________________________________________________________________________
Print Name and Title of Signatory

2.

The derivatives clearing organization named above hereby elects to become subject to the provisions of subpart
C of part 39 of the Commission’s regulations as of:

________________________________________ (“Effective Date”)
[insert date, which must be at least 10 business days after the date this Subpart C Election Form is filed
with the Commission].
The derivatives clearing organization and the undersigned each certify that:
a.

As of the Effective Date set forth above, the derivatives clearing organization shall be in compliance
with subpart C of part 39 of the Commission’s regulations, except to the limited extent that the
Commission has granted the derivatives clearing organization an extension of time to comply with: (1)
specified provisions of 17 CFR 39.34, pursuant to 17 CFR 39.34(d) and/or (2) specified provisions of
17 CFR 39.35 and/or 17 CFR 39.39, pursuant to 17 CFR 39.39(f);

b.

The derivatives clearing organization will be in compliance with all provisions of 17 CFR 39.34, 39.35
and/or 39.39 for which the Commission, pursuant to 17 CFR 39.34(d) and/or 17 CFR 39.39(f), has
granted an extension of time to comply in accordance with the terms of such extensions; and

c.

The derivatives clearing organization will remain in compliance with provisions contained in subpart C
of part 39 of the Commission’s regulations until this election is rescinded pursuant to 17 CFR 39.31(e).

______________________________________________________________________________________
Name of Derivatives Clearing Organization

By:___________________________________________________________________________________
Manual Signature of Duly Authorized Person
______________________________________________________________________________________
Print Name and Title of Signatory
3.

The derivatives clearing organization named above has duly caused this Subpart C Election Form (which
includes, as an integral part thereof, the Election and Certifications and all Disclosures and Exhibits) to be
signed on its behalf by its duly authorized representative as of the ___________ day of
________________________________, 20_____. The derivatives clearing organization and the undersigned
each represent hereby that, to the best of their knowledge, all information contained in this Subpart C Election
Form is true, current and complete in all material respects. It is understood that all required items including,
without limitation, the Election and Certifications and Disclosures and Exhibits, are considered integral parts of
this Subpart C Election Form.

______________________________________________________________________________________
Name of Derivatives Clearing Organization
By:___________________________________________________________________________________
Manual Signature of Duly Authorized Person
______________________________________________________________________________________
Print Name and Title of Signatory

COMMODITY FUTURES TRADING COMMISSION
PART 39, SUBPART C ELECTION FORM

DISCLOSURES AND EXHIBITS
Each derivatives clearing organization that requests an election to become subject to the provisions set forth in
subpart C of part 39 of the Commission’s regulations shall provide the Disclosures and Exhibits set forth below:
DISCLOSURES:
The derivatives clearing organization shall:
1.

Publish on its website in a readily identifiable location the derivatives clearing organization’s responses to
the Disclosure Framework for Financial Market Infrastructures (“Disclosure Framework”), published by
the Committee on Payment and Settlement Systems (“CPSS”) and the Board of International Organization
of Securities Commissions (“IOSCO”) that are required to be completed pursuant to 17 CFR 39.37. The
derivatives clearing organization’s responses must be completed in accordance with section 2.0 and
Annex A of the Disclosure Framework and must fully explain how the derivatives clearing organization
observes the Principles for Financial Market Infrastructures (“PFMIs”) published by CPSS and IOSCO.
Provide the URL to the specific page on the derivatives clearing organization’s website where its
responses to the Disclosure Framework may be found:

_____________________________________________________________________________

2.

In the event that CPSS and IOSCO publish final criteria for the disclosure by a Financial Market
Infrastructure (“FMI”) of quantitative information to enable stakeholders to evaluate FMIs and to make
cross comparisons referenced in section 2.5 of the Disclosure Framework (“Quantitative Information
Disclosure”), publish such Quantitative Information Disclosure in a readily identifiable location on the
derivatives clearing organization’s website.
If applicable, provide the URL to the specific page on the derivatives clearing organization’s website
where its Quantitative Information Disclosure may be found:

EXHIBITS:
EXHIBIT INSTRUCTIONS:
1.

The derivatives clearing organization must include a Table of Contents listing each Exhibit required by this
Subpart C Election Form.

2.

If the derivatives clearing organization is an Applicant, in its Form DCO, the derivatives clearing
organization may summarize such information and provide a cross-reference to the Exhibit in this Subpart
C Election Form that contains the required information.

The derivatives clearing organization shall provide the following Exhibits to this Subpart C Election Form:
EXHIBIT A – COMPLIANCE WITH SUBPART C
Attach, as Exhibit A, a regulatory compliance chart that separately sets forth for §§ 39.32-39.39 of the
Commission’s regulations, citations to the relevant rules, policies, and procedures of the derivatives
clearing organization that address each such regulation and a summary of the manner in which the
derivatives clearing organization will comply with each regulation. All citations and compliance
summaries shall be separated by individual regulation and shall be clearly labeled with the corresponding
regulation.

EXHBIT B – GOVERNANCE
Attach, as Exhibit B, documents that demonstrate compliance with the governance requirements set forth
in § 39.32 of the Commission’s regulations.
EXHIBIT C – FINANCIAL RESOURCES
Attach, as Exhibit C, documents that demonstrate compliance with the financial resource requirements set
forth in § 39.33 of the Commission’s regulations.
EXHIBIT D – SYSTEM SAFEGUARDS
Attach, as Exhibit D, documents that demonstrate compliance with the system safeguard requirements set
forth in § 39.34 of the Commission’s regulations.
EXHIBIT E – DEFAULT RULES AND PROCEDURES FOR UNCOVERED LOSSES OR SHORTFALLS
Attach, as Exhibit E, documents that demonstrate compliance with the requirements for default rules and
procedures for uncovered losses or shortfalls set forth in § 39.35 of the Commission’s regulations.
EXHIBIT F – RISK MANAGEMENT
Attach, as Exhibit F, documents that demonstrate compliance with the risk management requirements set
forth in § 39.36 of the Commission’s regulations.
EXHIBIT G – RECOVERY AND WIND-DOWN
Attach, as Exhibit G, documents that demonstrate compliance with the recovery and wind-down
requirements set forth in § 39.39 of the Commission’s regulations.