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Buy Sell Form

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					                                                                                           CBOE REIMBURSEMENT REQUEST
                                                                                             STRATEGIES REBATE FORM

CBOE Trading Permit Holder or TPH Organization Name:                                                                             Clearing Trading Permit Holder Name:

CBOE Trading Permit Holder or TPH Organization Acronym:                                                                          Clearing Trading Permit Holder #:

TPH Organization Affiliation, if applicable:

                        A                      B          C            D            E              F                G                  H              I (G + H)       J         K (I x J)        L        M (K - L)
                                                      Columns A - H to be completed by requestor                                                                   Columns J - M to be completed by CBOE Accounting
                Type of Strategy &
                                                                                                                                                                   Rate per
                   Description:
                                                                                                                                                                   Contract
                 C - Conversion
                   D - Dividend                                                                                                                                   (Standard
                   J - Jelly Roll                                                                                                                                    Rate
                    M - Merger                                                                                 Buy #         Sell #                    Total      Subject to     Total     $1,000 Cap
                  R - Reversals                                        Root        Option                   Contracts       Contracts                Contracts     Volume     Transaction   Per Day,     Net Rebate
                 S - Short Stock       Ex-Date      Trade Date        Symbol       Symbol Div Rate (1) Per Strategy Per Strategy                     Per Side     Discounts) Fees Assessed Per Class      Request
             Please note: The information on the first three lines below is provided as an example for completing the form.
Buy Side      D - CYQ Apr 10 Call       4/6/2010       4/5/2010    CSCO AB        CYQ          $1.00                 5,000                                5,000
Sell Side    D - CYQ Apr 12.5 Call      4/6/2010       4/5/2010    CSCO AV        CYQ          $1.00                                    5,000             5,000
       Total                                                                                                                                             10,000
Buy Side                                                                                                                                                      0
Sell Side                                                                                                                                                     0
       Total                                                                                                                                                  0
Buy Side                                                                                                                                                      0
Sell Side                                                                                                                                                     0
       Total                                                                                                                                                  0
Buy Side                                                                                                                                                      0
Sell Side                                                                                                                                                     0
       Total                                                                                                                                                  0
Buy Side                                                                                                                                                      0
Sell Side                                                                                                                                                     0
       Total                                                                                                                                                  0
                                                                                           (1) Dividend rate only applies to Dividend Strategies.
                                                                                                                                                                                   Less License Fees (              )
             CERTIFICATION                                                                                                                                                                                      $0.00
             I certify that the transactions identified above and by way of this electronic submission represent options trades executed
             under a "conversion", "dividend", "jelly roll", "merger", "reversals" or "short stock interest" strategy and are eligible for the
             rebate as defined in CBOE rules and CBOE fees schedule. I understand that, as CBOE Trading Permit Holders or TPH organizations
             executing strategies eligible for the rebate, I must provide supporting documentation such as trade confirmations and
             exercise notices, with this request, identifying the transactions subject to the reimbursement. I understand this reimbursement
             request is subject to examination, review, and verification by CBOE staff and is only valid if filed with CBOE staff and with the
             CBOE Help Desk within 3 business days of the transaction date.



             Trading Permit Holder (Individual) Name                                       Date                                                     Phone #



             E-mail address




           bdd5515b-3c23-4f74-81ac-8f1b86d40de8.xls
           Revised and Effective 6/21/10
                                                                               CBOE REIMBURSEMENT REQUEST
                                                                                 STRATEGIES REBATE FORM

 INSTRUCTIONS
 Complete a separate form for each day's strategy.                             B.   Ex date of stock                                      J. Standard rate per contract per Fees Schedule
    Please include in the e-mail subject line                                  C.   Date of execution; must be day prior to "B"              as of 6/21/10, subject to sliding scale
    the type of rebate being requested and the transaction                     D.   Root symbol                                              - Market Maker/DPM - $0.20
    date. For example "Merger Rebate Request - Trans                           E.   Option symbol, if different from root symbol             - Broker Dealer - Manual (Equity, SPDR, Credit Default,
    date 4/5/10". Submit completed form and support                            F.   Rate of dividend                                             Other Indexes, ETFs & HOLDR, & QQQQ) - $0.25
    to CBOE at helpdesk@cboe.com.                                              G.   Number of "Buy" contracts per strategy                   - Broker Dealer - Electronic (Equity, SPDR, Credit Default,
 Columns A - H to be completed by the requestor.                               H.   Number of "Sell" contracts per strategy                      Other Indexes, ETFs & HOLDR, & QQQQ) - $0.45
 Columns J - M to be completed by CBOE Acctg.                                  I.   Total of "Buy & Sell" contracts (G + H)                  - Broker Dealer - OEX, XEO, SPX, S&P 500 Dividend Index,
 A. Type of strategy and description:                                                                                                            and Volatility Indexes - $0.40
    C - Conversion                                                                                                                           - Broker Dealer - AIM Executions - $0.20
    D - Dividend                                                                                                                             - Clearing Trading Permit Holder Proprietary - $0.20
    J - Jelly Roll                                                                                                                        K. Total contracts multiplied by rate (I x J)
    M - Merger                                                                                                                            L. Capped Fee Amount
    R - Reversals                                                                                                                         M. If Assessed Fees > than Cap, then
    S - Short stock interest                                                                                                                 difference (K - L)


 PROGRAM DESCRIPTION - Revised & Effective March 29, 2010
 Market-maker, Clearing Trading Permit Holder and broker-dealer transaction fees are capped at $1,000 for all (i) dividend, (ii) merger and (iii) short stock interest strategies
 executed on the same trading day in the same options class. In addition, market-maker and broker-dealer transaction fees are capped at $1,000 for all reversals,
 conversions and jelly roll strategies executed on the same trading day in the same FLEX option class, excluding any option class on which the Exchange charges
 the surcharge fee under footnote 14 of the CBOE Fees Schedule. Such transaction fees for these strategies are further capped at $25,000 per month per initiating
 Trading Permit Holder or TPH organization. Surcharge fees associated with dividend, merger and short stock interest strategies will be passed through to trading participants
 on these strategies on a pro-rata basis. Surcharge fees will not included in the calculation of the $1,000 per day class fee cap or the $ 25,000 per month fee cap for
 dividend, merger and short stock interest strategies. Floor brokerage fees assessed on any of these strategies are eligible for a full rebate (see below).

 A conversion strategy is defined as transactions that employ calls, puts and the underlying security to lock in a nearly risk free profit. Conversions
 employ long positions in the underlying security that accompany long puts and short calls sharing the same strike and expiration.

 A dividend strategy is defined as transactions done to achieve a dividend arbitrage involving the purchase, sale and exercise of
 in-the-money options of the same class, executed prior to the date on which the underlying stock goes ex-dividend.

 A jelly roll strategy is defined as a long calendar call spread combined with the same short calendar put spread, or vice versa. This option strategy
 aims to profit from a time value spread through the purchase and sale of two call and two put options, each with different expiration dates. A jelly roll
 is created by entering into two separate positions simultaneously. One position involves buying a put and selling a call with the same strike price and
 expiration. The second position involves selling a put and buying a call, with the same strike price, but a different expiration from the first position.

 A merger strategy is defined as transactions done to achieve a merger arbitrage involving the purchase, sale and exercise of options of the
 same class and expiration date, each executed prior to the date on which shareholders of record are required to elect their respective form
 of consideration, i.e., cash or stock.

 A reversal strategy is defined as transactions that employ calls, puts and the underlying security to lock in a nearly risk free profit. Reversals are
 established by combing a short security position with a short put and a long call position that shares the same strike and expiration.

 A short stock interest strategy is defined as transactions done to achieve a short stock interest arbitrage involving the purchase, sale and
 exercise of in-the-money options of the same class.

 To qualify transactions for the cap and floor brokerage fees rebate, a completed rebate request form with supporting documentation must be submitted
 electronically to the CBOE Help Desk at helpdesk@cboe.com within 3 business days of the transaction. Please contact Cheryl Ahrens at
 312-786-7450 or ahrens@cboe.com or Don Patton at 312-786-7026 or patton@cboe.com with any questions. Rebates will be issued to the Trading
 Permit Holder via electronic payments to the Clearing Trading Permit Holder as soon as practical.

bdd5515b-3c23-4f74-81ac-8f1b86d40de8.xls
Revised and Effective 6/21/10

				
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Description: Buy Sell Form document sample