Fee-Charged Market Data Service Order Form

I wish to purchase the TOCOM market data specified below, and agree to abide by the purchasing procedures and Usage Regulations described herein.

Purchaser information Company Name
Department Name
Personal Name
Mailing Address
Phone
E-mail
Type of Data and Data Period * Please check the appropriate box(es).
1. Historical Data (Frequency of Delivery: 1 time)
    Tick Data
       / to / (MM/YYYY) = Year(s) / Frequency of delivery: 1 time
    Open Interest by Categories
       / to / (MM/YYYY) = Year(s) / Frequency of delivery: 1 time

2. Tick Data Update Service (Purchase unit: 1 year)
       / to / (MM/YYYY) = Year(s) / Frequency of delivery: time(s)
Purpose of Use * Please check the appropriate box.
Private Use (TOCOM member)
Private Use (Non-member)
Supply to the third parties
Non-profit organization
Total Amount of Purchase * Please fill in the blanks as appropriate.
Total amount of purchase yen
  = (Data CD price yen + Delivery charge yen) x Frequency of delivery time(s)
Billing Address Company Name
Department Name
Personal Name
Mailing Address
Phone
E-mail
Name of Remitter
* Please refer to TOCOM Privacy Policy with regard to the Exchange’s use of personal information.