Commodity Futures Trading Commission Confidential Customer Survey

CFTC PRIVACY ACT STATEMENT
The Commodity Futures Trading Commission (“Commission”) is providing this statement to you as required by the Privacy Act of 1974, 5 U.S.C. § 552a(e)(3), to inform you about why we are requesting this information. Authority: The Commission has the authority to collect information and evidence pertinent to the effective enforcement of the Commodity Exchange Act (the “Act”) and the Commission’s Regulations. 7 U.S.C. §§ 2, 5, 9, 12(a), 13a-1, 15. Purpose: The Commission will use the information you provide primarily to enforce compliance with the Act and Commission regulations, develop additional facts, and identify potential witnesses in the above-referenced litigation. The Commission may also use the information you provide to contact you to further discuss your responses. Routine Uses: In addition, the Commission may also disclose the information you provide as a “routine use” to, for example, other parties in the litigation, such as the court-appointed receiver; other law enforcement agencies to address a potential violation of law within their jurisdiction; or to other agencies when necessary to meet statutory or regulatory requirements. A complete list of routine uses may be found in the relevant Privacy Act system of records notice, CFTC-10, Investigatory Records, available at CFTC.gov/privacy/SORN/index.htm. Consequences of Failing to Provide the Information: Providing this information to the Commission is voluntary and there are no direct effects or sanctions for failing to provide any or all of the requested information. Any information you do provide, however, must be truthful. A person who is found to have knowingly and willfully submitted false, fictitious and/or fraudulent statements to the Commission may be fined and/or imprisoned up to five years for such conduct. 18 U.S.C. §1001; 17 C.F.R. §11.6(b).
SURVEYMONKEY
The CFTC is using the SurveyMonkey platform to facilitate the collection of the requested information. You are not required to set up an account with SurveyMonkey to complete the survey and provide the requested information. If you elect to set up an account, SurveyMonkey may collect additional information not required or requested by the Commission. You may wish to review the SurveyMonkey Privacy Policy and Terms of Service before using its services to understand how and when SurveyMonkey collects, uses, and shares the information you submit.
THE MORE INFORMATION PROVIDED, THE EASIER IT WILL BE TO TRACE YOUR FUNDS.

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* 1. What is your name?

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* 2. Please provide

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* 3. Are you a U.S. Citizen or Resident?

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* 4. What is your preferred way of contact?

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* 5. How many Traders Domain accounts did you have?

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* 6. What was the name(s) on your Traders Domain account(s)?

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* 7. What was your Traders Domain account number(s)? (Do not provide password)

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* 8. What email address was tied to your Traders Domain account?

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* 9. Approximate month and year, when you first funded your Traders Domain account?

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* 10. How many times did you send crypto?

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* 11. From which wallet address(es) did you send the crypto?

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* 12. To which wallet address(es) did you send the crypto?

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* 13. Transaction Hash/ID(s)

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* 14. Amount sent and month and year (for each):

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* 15. Approximate worth in USD of crypto when sent?

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* 16. Total of each crypto you sent?

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* 17. How many times did you send fiat (USD or other currency)?

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* 18. From which bank account (name) did you send your funds?

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* 19. To which bank account (name and number) did you send funds?

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* 20. Amount sent and month and year (for each):

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* 21. Total fiat (USD or other currency) you sent?

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* 22. What was the total profit reported to you by Traders Domain?

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* 23. How much fiat (USD or other currency) was returned to you?

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* 24. How much crypto was returned to you?

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* 25. Did you submit a withdrawal request to Traders Domain but not receive your funds?

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* 26. Did you submit a withdrawal request to Trubluefx but did not receive your funds?

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* 27. What is the total amount of your outstanding withdrawal requests? How much of that is principal that you deposited?

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* 28. Did you open a Savvy wallet because of Traders Domain?

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* 29. How did you learn of Traders Domain?

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* 30. Name of person, website or other?

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* 31. Who was your Traders Domain Sponsor (choose all that apply)

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* 32. Is there any additional information you would like us to know?

Thank you for completing the survey. We are hearing from a large number of customers right now, including from people in your position. Without customers and other people coming forward, we could not address these types of fraudulent schemes. If we need additional information or assistance from you, we will contact you. Please be patient. We are looking into the various individuals and entities associated with this scheme, and are moving as expeditiously as possible. Resolution to the litigation will take time and any information that can be shared with the public will be announced on our website, www.cftc.gov. You may also wish to review any updates published by the Receiver in the matter, which can be found at www.tradersdomainreceivership.com.
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