Print this page FUNDS WITHDRAWAL FORM To withdraw funds or close an account, fill out the Withdrawal Form on-line, print it and sign. Please mail or fax the form to IFX Commerce with the information listed on the right. IFX Commerce  419 Boylston Street, Suite 700,   Boston, MA 02116  USA  Fax: 1-617-357-0055 Client's Information Customer Name Customer User Name     Customer A/C Number Method of Withdrawal Wire            Check  Withdrawal Amount $ USD Amount - Convert USD Amount to Foreign Currency -  EUR, GBP, JPY, AUD, NZD, CHF, SGD, HKD, DKK, NOK, SEK, CAD, ZAR     Type the Currency  Beneficiary's Information  Beneficiary's Name Address, City, State, Zip BANK NAME If non US Bank include the name of the US intermediary bank Bank Address ABA or Swift # Account Number # Reference IFX Commerce trading account holder only. IFX Commerce may not make or receive payment via third party. Are you closing your account?  Yes No   What is the reason for closing your account? _____________________________________________________________ Customer Signature  ___________________________                  Date     Customer Signature (joint accounts only)  ___________________________                  Date     Thank you for using IFX Commerce.  If you have any questions or concerns, please contact us at tel. 1-617-357-0682. Disclaimer: The undersigned hereby authorizes IFX Commerce to initiate payments to a checking account indicated above. The account holder certifies that the information provided is accurate and truthful.  Client authorizes, IFX Commerce to verify any and all of the above information. Further, client authorizes IFX Commerce to convert funds from one currency type to another currency type, as directed within this document, or specified by client over the phone or fax. IFX Commerce is a division of IFX Markets Inc. NFA ID: 0327627 Regulated by the CFTC