FormofFeedbackontheAffirmationofthe-上海期货交易所.doc

实际控制关系账户申报信息确认情况反馈表 序号客户号客户名称申报类型限仓标准账户组客户数量客户反馈情况（请选择）备注1XXXXXX控制人普通客户31　2YYYYYY被控制账户普通客户32　3ZZZXXX被控制账户普通客户33　4AAAAAA被控制账户非期货公司会员101　 客户反馈情况可以选择的内容： 客户全部确认控制关系，原先未申报的客户进行补申报； 客户全部否认存在实际控制关系，提供书面说明并签署《合规声明及承诺书》； 客户变更、撤销申报内容； 其他，请在备注中简要说明情况（包括部分确认部分否认的情形，也应提供书面说明并签署《合规声明及承诺书》）； 注：1、本反馈表适用于单向报备的客户。 2、申报类型：是指用于实际控制关系账户分组的申报人的角色。 3、除本反馈表外，会员提交给交易所的其他取自客户的附件均为复印件并加盖会员公章，客户提供的原件保存在会员处以备交易所日后核查。 4、客户反馈情况可多选。被控制人应征求控制人意见，保持相同的答复口径。 会员编号： 会员名称： 日期： 签字或盖章： Feedback Form for Confirmation of Reported Accounts Involving Actual Control Relationship No. Client NumberClient’s NameType of ReportingPosition Limit StandardNumber of Clients in the Account GroupClient’s Feedback (Please Choose)Notes1XXXXXXControllerGeneric Client31　2YYYYYYControlled AccountGeneric Client32　3ZZZXXXControlled AccountGeneric Client33　4AAAAAAControlled AccountNon-futures Company Member101　 Options for clients’ feedback： The client confirmed a complete control relationship. Clients who confirmed such and who had not yet reported made up for it. The client denied any existence of actual control relationship in written statements and signed the Compliance Statement and Letter of Commitment. The client changed or canceled the reported information. Other situations. Please state briefly in the notes (including partial confirmation and partial denial that should also come with written statements and a signed Conformity Announcement and Letter of Commitment). Notes: This form of feedback is applicable to the clients reporting uni-directionally. Type of reporting: referring to the role of the reporter in a group of accounts involving actual control relationship. Except for this form of feedback, all the other attachments the member company gets from the clients and submits to the exchange should be copies with the company stamp on them. The original documents of the c