Required for: Market Maker applicants only.

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  Net Capital Statement (Template)
  *** PLACEHOLDER — FINAL DOCUMENT PENDING ***
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NET CAPITAL STATEMENT — MARKET MAKER

Market Maker applicants must submit a Net Capital statement demonstrating that the firm meets the
Exchange's minimum net-capital requirement. Complete the template below (or your firm's equivalent
statement) and upload the completed document in the portal.

  Firm name.................: ______________________________________________
  As-of date................: ____ / ____ / ________
  Total assets..............: $ ____________________
  Total liabilities.........: $ ____________________
  Net capital...............: $ ____________________
  Minimum required..........: $ ____________________
  Excess (deficit)..........: $ ____________________
  Prepared by...............: ______________________________________________
  Title.....................: ______________________________________________
  Signature / date..........: ______________________________________________

(This is a placeholder template describing the intended content only. The final, authoritative Net
Capital statement form will replace this document. Download it, complete it, and upload the completed
statement in the portal.)