APPLICATION FOR AWARD FOR ORIGINAL INFORMATION PROVIDED
PURSUANT TO SECTION 23 OF THE COMMODITY EXCHANGE ACT
Please refer to the attached
as needed to help you complete this form. Or, to submit the form by mail or facsimile, print out the
and mail or fax the completed form to: CFTC, Whistleblower Office, 1155 21st Street, NW, Washington, DC 20581. Fax Number (202) 418-5975.
PLEASE NOTE: To help ensure your privacy and security, unless you affirmatively extend your session when prompted, the online form will timeout after 65 minutes, and ALL DATA WILL BE LOST. You will then need to re-access the form to re-enter information in all the fields. If you cannot enter and submit your information in the time allotted, please consider submitting substantive information as an attachment and referencing the attachment when completing the form.
Fields marked with a red exclamation () are required