FORM 13-503F1
(Commodity Futures Act)  PARTICIPATION FEE CALCULATION

General Instructions

1. This form must be completed by firms registered under the Commodity Futures Act but not under the Securities Act.  It must be returned to the Ontario Securities Commission by December 1 each year, as required by section 2.2 of OSC Rule 13-503 (the Rule), except in the case where firms register after December 1 in a calendar year. In this exceptional case, this form must be filed within 60 days of registration.
2. The completion of this form will serve as an application for the renewal of both the firm and all its registered individuals wishing to renew under the Commodity Futures Act.
3. IIROC members must complete Part I of this form. All other registrant firms must complete Part II.
4. IIROC members may refer to Statement E of the Joint Regulatory Financial Questionnaire and Report for guidance.
5. If a firm’s permanent establishments are situated only in Ontario, all of the firm’s total revenue for the previous financial year is attributed to Ontario. If permanent establishments are situated in Ontario and elsewhere, the percentage attributed to Ontario for a previous financial year will ordinarily be the percentage of the firm’s taxable income that is allocated to Ontario for Canadian income tax purposes for the same financial year. For firms that do not have a permanent establishment in Ontario, the percentage attributable to Ontario will be based on the proportion of total revenues generated from CFA activities in Ontario.
6. All figures must be expressed in Canadian dollars.  All figures other than the participation fee must be rounded to the nearest thousand.
7. Information reported on this form must be certified by an individual specified in section 2.4 of this Rule to attest to its completeness and accuracy.

1. Firm Information

Firm NRD number: ____________________________________

Firm legal name:  ______________________________________

2. Contact Information for Chief Compliance Officer

Please provide the name, e-mail address, phone number and fax number for your Chief Compliance Officer.

Name:  _______________________________________

E-mail address:  ________________________________

Phone: _______________________ Fax: ________________________

3. Financial Information

Is the firm providing a good faith estimate under section 2.3 of the Rule?

  Yes                   No (one selection)

If no, end date of previous financial year: _____/____/___

yyyy   mm   dd

If yes, end date of financial year for which the good faith estimate is provided        ____/____/___

yyyy   mm   dd

4. Participation Fee Calculation

Part I — IIROC Members

Part II – Other Registrants:

1. Total revenues is defined as the sum of all revenues reported on the audited financial statements. Audited financial statements should be prepared in accordance with generally accepted accounting principles. Items reported on a net basis must be adjusted for purposes of the fee calculation to reflect gross revenues.
2. Where the advisory services of a registrant firm, or of an unregistered exempt international firm under Rule 13-502 Fees of the Securities Act, are used by the person or company to advise on a portion of its assets under management, such sub-advisory costs are permitted as a deduction on this line to the extent that they are otherwise included in total revenues.