Individual Application Form

Transcription

1 Individual Application Form Important Along with this Application please forward 1 document from List A and 2 photocopies or original documents from list B. List A Photocopy of current drivers licence Or, Original or notarized copy of current passport List B Utility bill (NOT a cell phone bill) Bank/credit card or mortgage statement Internal Revenue Service documentation For security reasons we suggest any original documents should be sent to us by registered mail. All original documents received by CMC Group will be returned to you by registered mail within two days of receipt. Please post all documents to: If you have any questions, please call us on Toll free: FOREX.TRADE (from the USA) or (from outside the USA). All information given will be treated in the strictest of confidence. CMCForex is the trading name of. Authorized and regulated by the Financial Services Authority in the UK (FSA registration ). Member of the NFA.

2 INFORMATION DISCLOSURE Please complete ALL sections of this form. CMC Group PLC ( CMC ) requires the following information to process your application in accordance with FSA Rules. When completed, this application will form part of your Customer Agreement with CMC. CMC WILL ONLY CONDUCT BUSINESS WITH A CUSTOMER FOR WHOM IT CONSIDERS SUCH BUSINESS TO BE SUITABLE AND IN ASSESSING SUITABILITY, WILL RELY ON THE INFORMATION PROVIDED BY THE CUSTOMER ON HIS/HER APPLICATION FORM. FOR THIS REASON, IT IS ESSENTIAL THAT YOU IMMEDIATELY ADVISE US IN WRITING (FAX OR TRANSMISSION IS ACCEPTABLE) IF THERE IS SUBSEQUENTLY ANY ADVERSE CHANGE IN THE INFORMATION WHICH YOU HAVE PROVIDED. GENERAL INFORMATION 1. Full name: EMPLOYMENT INFORMATION 1. Employer s name and address (if self employed please provide details): 2. Nationality: (a) Passport number: (b) Social Security number: (c) Tax Identification Number: 3. Residential address: 2. Employer s principal type of business: 3. Position held: 4. Years there: 5. Is your employer a USA regulated member firm? 4. address: 5. Telephone: Home IF YES. Please advise us of the address to which copy contract notes should be sent to satisfy personal account trading rules. Work 6. Cell phone : 7. Facsimile : 8. Date of birth (Month/Day/Year): JOINT APPLICATION For joint accounts each applicant should complete a separate form. Please contact a sales executive who will provide another form if necessary. FINANCIAL INFORMATION This information is provided to assist CMC in assessing your suitability, and will not have the effect of limiting your potential losses to the amount indicated. 1. Approximate annual income all sources: 2. Approximate net worth (excluding private residence): INVESTMENT SERVICES 1. Will any other person aside from you personally give us instructions regarding trading to be undertaken on your account, or will an agent act on your behalf? 3. Approximate value of your investment portfolio: 4. Approximate risk capital, the loss of which would not have an adverse effect on you or your family s lifestyle, available for trading with CMC: IF YES: Please contact our sales department who will provide you with the necessary forms. N.B. Full proof of address and identity will be required for any third party. 5. Are your investment objectives (please tick one or more of the following): Speculation Hedge against other investments

3 PREVIOUS TRADING EXPERIENCE 1. Do you understand the nature of margined transactions? 2. Do you understand the risks involved in margined transactions? ACCURACY OF INFORMATION I/We represent that the information contained in this Customer Account Application is true and accurate and I/We will promptly notify you in writing if any of the representations contained herein shall materially change or cease to be true and correct. Signature: 3. Do you have experience of trading margined products e.g. spot/forward FX, FX options or futures? Date (Month/Day/Year): IF YES: A) What type of investments do you have experience of? B) How many years/months experience do you have? C) How frequently do you trade and what is your average deal size? D) Which banks/companies have you traded with before? Important - please read APPLICANTS 4. Do you have experience of trading FX products? IF YES: A) How many years experience do you have? B) How frequently do you trade and what is your average deal size? C) Which brokers have you traded with? PLEASE NOTE THAT EACH FULLY COMPLETED AND SIGNED APPLICATION FORM MUST BE ACCOMPANIED BY THE FOLLOWING: Signed and dated Intermediate Customer tice in both sections (2 pages). Forward 1 document from List A and 2 photocopies or original documents from List B. List A Photocopy of current drivers licence or, Original or notarized copy of current passport List B Utility bill (NOT a cell phone bill) Bank/credit card or mortgage statement Internal Revenue Service documentation Any Limited Power of Attorney(s) required if applicable. te all authorized person(s) must provide an original proof of address and notarized copy of signature D) Do you trade on an execution-only capacity? 5. Do you have any other relevant investment experience? IF YES. Please give details here. PLEASE MAIL ALL DOCUMENTS TO If you have any questions, please call us on Toll free: FOREX.TRADE (from the USA.) or (from outside the USA). All information given will be treated in the strictest of confidence. CMCForex is the trading name of. Authorized and regulated by the Financial Services Authority in the UK (FSA registration ). Member of the NFA.

4 TOLL FREE FOREX.TRADE ( ) T F E [email protected] Registered office 66 Prescot Street, London, E1 8HG, UK Registered in England Regulated and authorized by the Financial Services Authority in the UK (FSA registration ) A member of the NFA (National Futures Association) INDAPPFXUS03v1

5 LIMITED POWER OF ATTORNEY To: A company incorporated under the laws of England and Wales with limited liability, registered office 66 Prescot Street, London E1 8HG UK (registered number ) and whose branch office in the US is at 150 East 52nd Street,,,. This Limited Power of Attorney is made by way of Deed and I hereby appoint: whose signature appears below as my agent and attorney-in-fact with full power of authority for me and on my behalf to buy, sell (including short sales) and to trade in OTC Foreign Exchange products (including spots, forwards, options and other derivatives) whether trading on margin or otherwise, for my account or accounts held with you. CMC is authorized to follow the instructions of my agent and attorney-in-fact in every respect concerning my account with you; and, except as herein otherwise provided, such agent and attorney-in-fact is authorized to act with full power and authority for me and in my behalf in the same manner and with the same force and effect as I might or could do if personally present with respect to such transactions. EXCEPT AS SET FORTH IN THE TERMS CONTAINED HEREIN SAID AGENT AND ATTORNEY-IN-FACT IS NOT AUTHORISED TO WITHDRAW ANY MONEY, SECURITIES OR OTHER PROPERTY FROM MY ACCOUNT OR ACCOUNTS OR OTHERWISE HELD WITH YOU IN MY NAME. I hereby ratify and confirm any and all transactions, trades or dealings effected in and for my account or accounts by my said agent and attorney-in-fact and agree to indemnify you and hold you harmless from any loss, liability or damage by reason thereof. This Power of Attorney, authorisation and indemnity is in addition to and in no way limits or restricts any and all rights you may have under any other agreement or agreements between your firm and me, and shall inure and continue in favour of your present firm its successors and assigns. In addition you are further authorised and directed to deduct from my account or accounts and pay to said agent and attorney-in-fact the amount of all management fees, incentive fees, advisory fees and /or brokerage commissions to be paid to said agent and attorney-in-fact. I hereby agree to indemnify and hold CMC and its employees harmless from any loss, damage or dispute arising out of or relating to the calculation and payment of any such fees and commission. I also understand that CMC is in no way responsible for any loss to me occasioned by my agent and attorney-in-fact and that CMC does not, by implication or otherwise, endorse the operating methods of such agent and attorney-in-fact. This Power of Attorney shall continue in full force and effect, and you and your successors and assigns shall be indemnified in relying thereon until you shall receive written notice of revocation signed by me. Until you have received any such revocation or termination shall in no way affect the validity of this Power of Attorney and indemnity with respect to any transaction initiated by the said agent and attorney-in-fact prior to the actual receipt by you of notice of revocation or termination as provided aforesaid. This authority and appointment is made pursuant to the laws of England and in the event of dispute, the undersigned agrees to submit to the jurisdiction of the English Courts. Dated this: day of: Executed as a Deed by: Witnessed by: Signed: Signed: Print Name: Print Name: Address: I/We hereby acknowledge receipt of the foregoing Limited Power of Attorney and accept my/our appointment as the Customer's agent and attorney-in-fact. Signed (Authorised signatory): Print name/company: POAFXUS07/03v1