Broker Name definition

Broker Name. Contact: ________________ Telephone: ________________

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Broker Name. Broker Dealer: ______________________

Broker Name. Firm Name:___________________ NSCC Participant Number:______________ DTC Participant Number:_________ Telephone Number:____________________ Fax Number:___________________ Type of order (Check One) Creation of _________ Redemption of _________ CLAYMORE EXCHANGE-TRADED FUND TRUST: Claymore/BNY Mellon BRIC ETF (EEB) _______ Claymore/Zacks Sector Rotation ETF (XRO) ______ Claymore/Zacks Multi-Asset Income Index ETF (CVY) ______ Claymore/Sabrient Insider ETF (NFO) _____ Claymore/Sabrient Stealth ETF (STH) ______ Claymore/Sabrient Defensive Equity Index ETF (DEF) _____ Claymore/Ocean Tomo Patent ETF (OTP) _____ Claymore/Beacon Spin-Off ETF (CSD) _____ Claymore/Zacks Mid-Cap Core ETF (CZA) _____ Claymore/Ocean Tomo Growth Index ETF (OTR) _____ Claymore/BNY Mellon International Small Cap LDRs ETF (XGC)_____ Claymore/S&P Global Dividend Opportunities Index ETF (LVL)____ Claymore/Zacks Dividend Rotation ETF (IRO)____ Claymore/Raymond James SB-1 Equity ETF (▇▇▇) ____ Wilshire 5000 Total Market ETF (WFVK) ____ Wilshire 4500 Completeion ETF (WXSP) ____ Wilshire US REIT ETF (WREI) ___ CLAYMORE EXCHANGE-TRADED FUND TRUST 2: Claymore/BNY Mellon EW Euro-Pacific LDRs ETF (▇▇▇)_____ Claymore S&P Global Water Index ETF (CGW)____ Claymore/Beacon Global Exchanges, Brokers & Asset Managers Index ETF (EXB)____ Claymore/SWM Canadian Energy Income Index ETF (ENY)____ Claymore/Zacks Country Rotation ETF (CRO)____ Claymore/Zacks International Multi-Asset Income Index ETF (HGI)____ Claymore/Robb Report Global Luxury Index ▇▇▇ (ROB)____ Claymore/Beacon Global Timber Index ETF (CUT)____ (continued on next page) Claymore/AlphaShares China Real Estate ETF (TAO)____ Claymore/AlphaShares China Small Cap Index ETF (HAO) ____ Claymore/MAC Global Solar Energy Index ETF (TAN) ____ Claymore/BNY Mellon Frontier Markets ETF (FRN) ____ Claymore/NYSE Arca Airline ETF (FAA) ____ Claymore/AlphaShares China All-Cap ETF (YAO) ____ Claymore China Technology ETF (CQQQ) ___ Claymore Shipping ETF (SEA) ____ If creation/redemption is a custom basket order, indicate the restricted security name, ticker and number of shares to be settled in cash as part of the Cash Component. -------------------------------------------------------------------------------- Name ____________________________ Symbol _________ Number of Shares_____________ Name ____________________________ Symbol _________ Number of Shares_____________ -------------------------------------------------------------------------------- PARTICIPANT INTE...

Examples of Broker Name in a sentence

Number of Shares: Original Issue or Transfer from Treasury Account Broker Name: Broker’s DTC Number: Contact and Phone: The Broker will initiate the DWAC transaction on (date).
Date: Broker Name: DTC Participant Number: Telephone Number: Time: Firm Name: Fax Number: (One Basket = 50,000 FXC Shares) Number of Baskets Surrendered: Order # Number written out: This Redemption Order is subject to the terms and conditions of the Depositary Trust Agreement of the CurrencyShares Canadian Dollar Trust as currently in effect and the Participant Agreement between the Authorized Participant, the Trustee and the Sponsor named therein.
Date: Broker Name: DTC Participant Number: Telephone Number: Time: Firm Name: Fax Number: (One Basket = 50,000 FXC Shares) Number of Baskets Transacted: Order # Number written out: This Purchase Order is subject to the terms and conditions of the Depositary Trust Agreement of the CurrencyShares Canadian Dollar Trust as currently in effect and the Participant Agreement between the Authorized Participant, the Trustee and the Sponsor named therein.
Date: Broker Name: DTC Participant Number: Telephone Number: Time: Firm Name: Fax Number: (One Basket = 50,000 FXA Shares) Number of Baskets Transacted: Order # Number written out: This Purchase Order is subject to the terms and conditions of the Depositary Trust Agreement of the CurrencyShares Australian Dollar Trust as currently in effect and the Participant Agreement between the Authorized Participant, the Trustee and the Sponsor named therein.
Date: Broker Name: DTC Participant Number: Telephone Number: Time: Firm Name: Fax Number: (One Basket = 50,000 [FXF] Shares) Number of Baskets Transacted: Order # Number written out: This Purchase Order is subject to the terms and conditions of the Depositary Trust Agreement of the CurrencyShares Swiss Franc Trust as currently in effect and the Participant Agreement between the Authorized Participant, the Trustee and the Sponsor named therein.
Date: Broker Name: DTC Participant Number: Telephone Number: Time: Firm Name: Fax Number: (One Basket = 50,000 [FXF] Shares) Number of Baskets Surrendered: Order # This Redemption Order is subject to the terms and conditions of the Depositary Trust Agreement of the CurrencyShares Swiss Franc Trust as currently in effect and the Participant Agreement between the Authorized Participant, the Trustee and the Sponsor named therein.
Date: Broker Name: DTC Participant Number: Telephone Number: Time: Firm Name: Fax Number: (One Basket = 50,000 FXA Shares) Number of Baskets Surrendered: Order # Number written out: This Redemption Order is subject to the terms and conditions of the Depositary Trust Agreement of the CurrencyShares Australian Dollar Trust as currently in effect and the Participant Agreement between the Authorized Participant, the Trustee and the Sponsor named therein.
Affiliated Broker Name Authorization # Affiliated Broker Name Authorization # Projected date for Support Broker services to begin* (enter date as mm/dd/yyyy) * These services will continue until the agreement is terminated (complete a Termination Form when terminating this agreement).
Date: Broker Name: DTC Participant Number: Telephone Number: Time: Firm Name: Fax Number: (One Basket = 50,000 FXY Shares) Number of Baskets Transacted: Order # Number written out: This Purchase Order is subject to the terms and conditions of the Depositary Trust Agreement of the CurrencyShares Japanese Yen Trust as currently in effect and the Participant Agreement between the Authorized Participant, the Trustee and the Sponsor named therein.
Date: Broker Name: DTC Participant Number: Telephone Number: Time: Firm Name: Fax Number: (One Basket = 50,000 [FXE] Shares) Number of Baskets Surrendered: Order # Number written out: This Redemption Order is subject to the terms and conditions of the Depositary Trust Agreement of the Euro Currency Trust as currently in effect and the Participant Agreement between the Authorized Participant, the Trustee and the Sponsor named therein.

More Definitions of Broker Name

Broker Name. Firm Name:________________________ DTC Participant Number:____________ Fax Number:_______________________ Telephone Number:__________________ (One Basket = 50,000 [FXA] Shares) Number of Baskets Transacted:__________ Order #______________________________ Number written out:_______________ This Purchase Order is subject to the terms and conditions of the Depositary Trust Agreement of the CurrencyShares Australian Dollar Trust as currently in effect and the Participant Agreement between the Authorized Participant, the Trustee and the Sponsor named therein. All representations and warranties of the Authorized Participant set forth in such Depositary Trust Agreement and such Participant Agreement are incorporated herein by reference and are true and accurate as of the date hereof. The undersigned does hereby certify as of the date set forth below that he/she is an Authorized Person under the Participant Agreement and that he/she is authorized to deliver this Purchase Order to the Trustee on behalf of the Authorized Participant. The Authorized Participant enters into this agreement based on an estimated Basket Australian Dollar Amount disseminated the previous business day and recognizes the final Basket Australian Dollar Amount represented will be decreased based on the Trust's daily accrual. At the conclusion of the trading day a final NAV will be disseminated to all Authorized Participants, and the Basket Australian Dollar Amount required for the Purchase Order entered into on this day will be finalized and this Purchase Order will serve as a legally binding contract for settlement in 3 business days. ___________________________________ __________________________________ Date Authorized Person's Signature

Broker Name. By: Signature: Printed Name: Date:

Broker Name. Authorized Participant Firm Name: DTC Participant Number: Fax Number:

Broker Name. Broker Phone Number: Agency Name: Broker Email: Does the Employer wish to provide Debit Cards Yes No Are the Employees to receive Debit Cards? Yes No Are Eligible Spouses to receive Debit Cards? Yes No Name of Health Insurance Carrier: Name of Health Plan: Health Plan Year Effective Date: Health Plan Year End Date: HRA Plan Year Effective Date: HRA Plan Year End Date: Who is responsible for MD State Extension/COBRA processes? Number of Employees that will be participating in the HRA Plan: The Advantage HRA Plan will follow the same eligibility guidelines (i.e. waiting periods, effective dates and termination dates) as the Health Plan. However, certain employees may not be eligible to participate in the tax advantages of an HRA (i.e. self-employed individuals, partners in a partnership, more than 2% shareholders in an S Corporation). Please consult with your tax accountant for specific information. Do you currently have a Health Reimbursement Arrangement (HRA) Plan: Yes No If Yes, what is the Plan Year? Medical Rx (Excludes over the counter drugs) Dental Vision