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Bylaw 1101 Form Submission (C)

Bylaw 1101 Submission Form

Re:  CFTC REGISTRATION/NFA MEMBERSHIP

Millburn Ridgefield Corporation (“Millburn”) is a member of the National Futures Association (“NFA”).  As a member of NFA, Millburn is not permitted to have business dealings with those that should be NFA members and registered with the Commodity Futures Trading Commission (the “CFTC”), but are not.  NFA requires us to periodically verify the status of investors in order to comply with this rule. 

Since you are invested in a fund for which Millburn serves as commodity pool operator (“CPO”), we ask that you please complete one of the forms below according to your investor type.  By submitting this form, you represent and warrant to Millburn that the information set forth below is true and accurate and may be relied upon by Millburn, and that you will promptly notify Millburn if any of the below information is no longer true or accurate.

If you have any questions regarding how to complete this form, please contact our Client Services Department at 203-625-7554.  

Entities that are NFA Members and/or Those Required to Register with the CFTC

FORM C

The Investor (or, if the Investor is a commodity pool, the operator thereof) represents and warrants that it is a member of the NFA and is registered with the CFTC.

Please indicate below the capacity in which the Investor (or the operator thereof) is registered.