Investment Account Application and Client Agreement

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Investment Account Application and Client Agreement"

Transcription

1 FOR INTERNAL USE ONLY ACCOUNT NUMBER: ACCOUNT TITLE: REVISED: SEPTEMBER 2014 PLEASE COMPLETE, SIGN AND RETURN THIS APPLICATION TO YOUR ADVISOR, WHO WILL INFORM YOU OF ANY FURTHER REQUIREMENTS. I. Account Information Individual/joint Partnership Corporation Time Horizon: Less than 1 year PHC/ PIC Sole proprietor Other (Specify): 1 to 10 years More than 10 years Liquidity Needs: (% of principal to fund current year spending needs) 0% 1 25% 26 50% over 50% Risk Tolerance Low Moderate Aggressive Speculative Funding Method: Check Wire Transfer ACAT Internal Transfer* Other* *Account number for internal transfer or details for other method: Investment Objective (identify one): Current Income Preservation of capital with a primary consideration on current income Balanced A balance between capital appreciation and current income with the primary consideration being current income Growth & Income A balance between capital appreciation and current income with the primary consideration being capital appreciation Growth Capital appreciation through quality equity investments and little or no income Maximum Growth Maximum capital appreciation with higher risk and little to no income Speculation Maximum total return involving a higher degree of risk through investment in a broad spectrum of securities Special notes on account handling: Primary Account Owner Name (Print Name): SS# or Tax ID: of Birth: Place of birth: Citizenship: U.S. U.S. Permanent Resident Alien(green card) Non-U.S./Country of Citizenship: Other countries of citizenships: Marital Status (Check One): Single Domestic Partner Divorced Widowed Married If married, spouse s Citizenship: Spouse s other country of citizenship: Home phone: Business phone: Mobile: Primary: address: Alt address: Permanent Legal Address for this Account (For Individual or Entity) Check here if permanent legal address is same as mailing address Check here if all account owners share this address Street Address: Mailing Address for this account (if in US, complete Acknowledgment of US Mailing Address form) Check here if all account owners share this address Street address: Selection of security feature Mobile CAD Physical CAD Mobile No: Model No:

2 2. 2. Additional Account Owner Name (Print Name): SS# or Tax ID: of Birth: Place of birth: Citizenship: U.S. U.S. Permanent Resident Alien(green card) Non-U.S./Country of Citizenship: Other countries of citizenships: Marital Status (Check One): Single Domestic Partner Divorced Widowed Married If married, spouse s Citizenship: Spouse s other country of citizenship: Home phone: Business phone: Mobile: Primary: address: Alt address: Permanent Legal Address for this Account (For Individual or Entity) Check here if permanent legal address is same as mailing address Check here if all account owners share this address Street Address: Mailing Address for this account (if in US, complete Acknowledgment of US Mailing Address form) Check here if all account owners share this address Street address: Selection of security feature Mobile CAD Physical CAD Mobile No: Model No: Additional Account Owner Name (Print Name): SS# or Tax ID: of Birth: Place of birth: Citizenship: U.S. U.S. Permanent Resident Alien(green card) Non-U.S./Country of Citizenship: Other countries of citizenships: Marital Status (Check One): Single Domestic Partner Divorced Widowed Married If married, spouse s Citizenship: Spouse s other country of citizenship: Home phone: Business phone: Mobile: Primary: address: Alt address: Permanent Legal Address for this Account (For Individual or Entity) Check here if permanent legal address is same as mailing address Check here if all account owners share this address Street Address: Mailing Address for this account (if in US, complete Acknowledgment of US Mailing Address form) Check here if all account owners share this address Street address: Selection of security feature Mobile CAD Physical CAD Mobile No: Model No: 2

3 II. Additional information Primary Account Owner Information (Print Name): Financial Information: Source of Wealth (check all that apply) Compensation Inheritance/Gift Real Estate Business Ownership Tax Bracket: % Primary source of income: Estimated Annual Compensation: Estimated Liquid Net Worth Security Investments Private Investments Other (specify): Employment (Check One): Employed Self-Employed Unemployed Retired Student Employer Name: Employer Address: Relationship to Other Account Participants: 1. Self Retirement Assets: Nature of Business: Other sources of income: Estimated Total Annual Income: Occupation: Estimated Total Net Worth (excluding primary residence) Years employed: Professional Affiliations Are you or a member of your household a: Director, Executive Officer or 10% Shareholder of a Company. A senior officer of a financial institution. A senior foreign political figure (must complete PEP Questionnaire). Employed by another broker/dealer (B/D), a stock exchange or FINRA Registered OR Have a financial interest in or able to make decisions in an account at another B/D. Employed by StateTrust or related to a StateTrust Employee. Employer or broker/dealer name: StateTrust Division: Person s Relationship to StateTrust Employee: StateTrust Employee s Social Security Number: Investment Knowledge General Investment Knowledge and Experience (Check One): None Limited Moderate Extensive Product Type Knowledge None Limited Moderate Extensive Equities Fixed Income Options & Derivatives Commodities & Futures Mutual Funds Preferred Stocks Structured Products Hedge Funds Private Equity Money Markets & CDs Exchange Traded Products CDOs International Markets (currency or sovereign risk) Annuities Investing Since (Year) 3

4 2. 2. Additional Account Owner Information (Print Name): Financial Information: Source of Wealth (check all that apply) Compensation Inheritance/Gift Real Estate Business Ownership Tax Bracket: % Primary source of income: Estimated Annual Compensation: Estimated Liquid Net Worth Security Investments Private Investments Other (specify): Employment (Check One): Employed Self-Employed Unemployed Retired Student Employer Name: Employer Address: Relationship to Other Account Participants: Self 3. Retirement Assets: Nature of Business: Other sources of income: Estimated Total Annual Income: Occupation: Estimated Total Net Worth (excluding primary residence) Years employed: Professional Affiliations Are you or a member of your household a: Director, Executive Officer or 10% Shareholder of a Company. A senior officer of a financial institution. A senior foreign political figure (must complete PEP Questionnaire). Employed by another broker/dealer (B/D), a stock exchange or FINRA Registered OR Have a financial interest in or able to make decisions in an account at another B/D. Employed by StateTrust or related to a StateTrust Employee. Employer or broker/dealer name: StateTrust Division: Person s Relationship to StateTrust Employee: StateTrust Employee s Social Security Number: Investment Knowledge General Investment Knowledge and Experience (Check One): None Limited Moderate Extensive Product Type Knowledge None Limited Moderate Extensive Equities Fixed Income Options & Derivatives Commodities & Futures Mutual Funds Preferred Stocks Structured Products Hedge Funds Private Equity Money Markets & CDs Exchange Traded Products CDOs International Markets (currency or sovereign risk) Annuities Investing Since (Year) 4

5 3. 3. Additional Account Owner Information (Print Name): Financial Information: Source of Wealth (check all that apply) Compensation Inheritance/Gift Real Estate Business Ownership Tax Bracket: % Primary source of income: Estimated Annual Compensation: Estimated Liquid Net Worth Security Investments Private Investments Other (specify): Employment (Check One): Employed Self-Employed Unemployed Retired Student Employer Name: Employer Address: Relationship to Other Account Participants: Self Retirement Assets: Nature of Business: Other sources of income: Estimated Total Annual Income: Occupation: Estimated Total Net Worth (excluding primary residence) Years employed: Professional Affiliations Are you or a member of your household a: Director, Executive Officer or 10% Shareholder of a Company. A senior officer of a financial institution. A senior foreign political figure (must complete PEP Questionnaire). Employed by another broker/dealer (B/D), a stock exchange or FINRA Registered OR Have a financial interest in or able to make decisions in an account at another B/D. Employed by StateTrust or related to a StateTrust Employee. Employer or broker/dealer name: StateTrust Division: Person s Relationship to StateTrust Employee: StateTrust Employee s Social Security Number: Investment Knowledge General Investment Knowledge and Experience (Check One): None Limited Moderate Extensive Product Type Knowledge None Limited Moderate Extensive Equities Fixed Income Options & Derivatives Commodities & Futures Mutual Funds Preferred Stocks Structured Products Hedge Funds Private Equity Money Markets & CDs Exchange Traded Products CDOs International Markets (currency or sovereign risk) Annuities Investing Since (Year) Interested Party This account will have duplicate copies of certain correspondence delivered to either a secondary owner(s) or a third party. A SEPARATE FORM IS REQUIRED. 5

6 III. Account Handling Trade Settlement/Sweep Option All trades require 100% cash balance in your settlement account at the time you place your order. When I select a trade settlement/sweep option, payment for my transactions will be drawn from that option and proceeds from any sales transactions will be credited to that option. COR Insured Deposits (DLD) (no minimum) Retail Class: $50, minimum - (please specify)*: Treasury Class: $100, minimum - (please specify)*: Institutional: $5,000, minimum-(please specify)*: Other - (please specify): Do Not Sweep proceeds to Money Market * Consult your investment firm for available options. Dividend Reinvestment Reinvest dividends into additional shares automatically (fees may apply). Speak to your advisor to select which dividends to reinvest. W-9 Certification Under penalties of perjury I certify that: 1) The taxpayer identification number shown on this form is my correct taxpayer identification number. 2) I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Services (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) The IRS has notified me that I am no longer subject to backup withholdings, and 3) I am a US Person including a US resident alien (defined in the W-9 Instructions which will be provided upon request). 4) The FATC code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions: you must cross out item 2 above if you have been notified by the IRS that you are currently subjected to backup withholdings because you have failed to report all interest and dividends on your tax return. Check appropriate reporting type: Individual/ Sole Proprietor Corporation Partnership Limited Liability Company Enter the tax classification (D=Disregard Entity, C=Corporation, P=Partnership) Other Exempt payee S Corporation Exemption from FATCA Reporting code (if any 6

7 IV. Acceptance of Terms and Conditions of Agreements (Please read and sign below) U.S. Federal law requires us to obtain, verify and record information that identifies each person or entity that opens an account. What this means for you is that when you open an account, we will ask you for your name, a street address, date of birth, and an identification number, such as a Social Security No. or other identification number that Federal law requires us to obtain. We may also ask to see a driver s license, corporate formation document (for corporate entities) or other identifying documents that will allow us to identify you or the corporate entity seeking to open an account. We appreciate your cooperation. CAD security program: StateTrust s CAD security program involves the use of digital access codes, generated by an application or token, to authenticate the identity of our customers and prevent fraud attempts on their accounts. This program helps protect the confidentiality of our customers data, allowing it to be accessed only by those authorized to do so. This method of authentication will be used prior to disseminating any account information for instances such as confirm transfer instructions and investments in an account, receive assistance for access and use of our electronic platforms, receive confidential information and customized assistance on accounts and portfolios, and other assistance in general. Investment Products: NOT FDIC INSURED, NOT A BANK DEPOSIT, NOT INSURED BY ANY FEDERAL GOVERNMENT AGENCY, NO BANK GUARANTEE, MAY LOSE VALUE. I hereby request that COR Clearing LLC ( COR ) and StateTrust Investments, Inc. ( StateTrust ) open an account in the name(s) listed as account owner(s) on this application. By signing below, I acknowledge that I have received, read, understand and agree to be bound by the terms & conditions as set forth in the Customer Agreement ( Customer Agreement ) as currently in effect and as amended from time to time. I represent that I am of required legal age to enter into this Agreement. I understand and acknowledge that COR does not provide investment, tax, legal, accounting, financial or other advice. I agree to notify StateTrust Investments of any status change to my account registration. Please note: COR and StateTrust will verify information provided on this form through a third-party provider in accordance with the USA Patriot Act. Special note: with respect to assets custodied by COR on my behalf, I acknowledge that income and capital gains or distributions to me from this account may be taxable in my home jurisdiction. Furthermore, interest paid to COR under this agreement, such as but not limited to margin interest, may be subject to withholding tax in my home jurisdiction. It is my obligation to pay such withholding tax, if applicable. I acknowledge to StateTrust and to COR that I have taken my own tax advice to this regard. Disclosure: When a customer sends a payment instruction to StateTrust Investments (STI) that exceeds the minimum security amount level as defined by the company, STI will proceed to confirm and authenticate the payment instructions, at its own discretion. Please note that instructions will not be executed until the security and compliance procedures are completed in a satisfactory manner. Additional support documentation and identification of beneficiaries may be requested. Minimum Security Amount Level: $0.00 USD (all transactions will be subject to call-back verification procedure). This agreement may be signed by the client and delivered by facsimile or PDF, transmission, all of which shall be deemed as the original version for all purposes. All foreign joint accounts are classified as joint with rights of survivorship. WITH MY SIGNATURE ON THE ACCOUNT APPLICATION, I ACKNOWLEDGE THAT I HAVE RECEIVED, READ, UNDERSTOOD AND AGREED TO THE TERMS SET FORTH IN THE FOREGOING AGREEMENT. Account Owner Signature Financial Advisor Signature General Principal 7

2 Provide account holder information (Please attach necessary documents.)

2 Provide account holder information (Please attach necessary documents.) Brokerage Account 1 Specify type of account ownership (Please attach necessary documents.) ( Minimum opening balance of $1,000 in cash and/or securities is required.) Select the type of account ownership:

More information

Ameriprise Brokerage Non-Qualified Account Application For Internal Use Only Account Number

Ameriprise Brokerage Non-Qualified Account Application For Internal Use Only Account Number DOC0105402192 Ameriprise Financial Services, Inc. 70100 Ameriprise Financial Center Minneapolis, MN 55474 Ameriprise Brokerage Non-Qualified Account Application Part 1 Account Owner Details Account Owner

More information

Bank. Account Number. Employer. Business Address. E-Mail Address. Liquid Net Worth

Bank. Account Number. Employer. Business Address. E-Mail Address. Liquid Net Worth DOC0105 Ameriprise Financial Services, Inc. 70100 Ameriprise Financial Center Minneapolis, MN 55474 Ameriprise Brokerage Individual Retirement Account (IRA) Application Part 1 Account Owner Details Account

More information

Please complete and sign this Application, along with any required supplemental forms identified through this application process.

Please complete and sign this Application, along with any required supplemental forms identified through this application process. Retail Brokerage Account Application About this Application This is a. Please read it carefully, as you will select products and services, tell us how you want to communicate with us, and agree to certain

More information

About this Client Information Form

About this Client Information Form About this Client Information Form This is a Family Investors Company Client Information Form. Please read it carefully, as you will select products and services, tell us how you want to communicate with

More information

*TDA1086* Business Account Application

*TDA1086* Business Account Application Business Account Application PO Box 2760 Omaha, NE 68103-2760 Fax: 866-468-6268 Questions? Call a New Accounts representative at 800-276-8746. Please visit us at www.tdameritrade.com for more information

More information

Roth IRA Account Application (10/05/2015)

Roth IRA Account Application (10/05/2015) For Office Use Only: Acct.# Office: Reg. Rep: Name for Filing: Hilltop Securities Inc. and/or Broker/Dealers for which it Clears Hilltop Securities Inc. - Member: NYSE/ FINRA/ SIPC New Account Account

More information

Please complete and sign this Application, along with any required supplemental forms identified through this application process.

Please complete and sign this Application, along with any required supplemental forms identified through this application process. Brokerage ABZ 153 Securities Way, Suite 1001 Richmond, VA 00150 15.31.5543 www.brokerageabz.com About this Application This is a Retail Brokerage Account Application. Please read it carefully, as you will

More information

BROKERAGE ACCOUNT APPLICATION

BROKERAGE ACCOUNT APPLICATION BROKERAGE ACCOUNT APPLICATION Sub Branch Account Number RR Number About the Application This is a Brokerage Account Application. Please read it carefully. You will select products and services, tell us

More information

LLC, DO NOT USE THESE FORMS.

LLC, DO NOT USE THESE FORMS. Opening an Investment Club account is easy. Simply complete and fax (866-699-0563) or mail us this form. Then, if you have not done so already, create a Username and a Password at www.tradeking.com to

More information

Please complete and sign this Application, along with any required supplemental forms identified through this application process.

Please complete and sign this Application, along with any required supplemental forms identified through this application process. About this Application This is a Brokerage Account Application. Please read it carefully, as you will select products and services, tell us how you want to communicate with us, and agree to certain provisions

More information

SIMPLE IRA CUSTODIAL ACCOUNT ADOPTION AGREEMENT

SIMPLE IRA CUSTODIAL ACCOUNT ADOPTION AGREEMENT SIMPLE IRA CUSTODIAL ACCOUNT ADOPTION AGREEMENT Please complete this application to establish a new SIMPLE IRA. This application must be preceded or accompanied by a current Disclosure Statement and Custodial

More information

New Account Application Advisor Class and Service Class

New Account Application Advisor Class and Service Class New Account Application Advisor Class and Service Class PNC Advantage Institutional Treasury Money Market Fund IMPORTANT INFORMATION PLEASE READ Please complete the investment selection and account information

More information

SIMPLE IRA CUSTODIAL ACCOUNT ADOPTION AGREEMENT

SIMPLE IRA CUSTODIAL ACCOUNT ADOPTION AGREEMENT Please complete this application to establish a new SIMPLE IRA. This application must be preceded or accompanied by a current Disclosure Statement and Custodial Agreement. For Additional Copies or Assistance

More information

IRA APPLICATION STEP 1. IRA Type. Traditional IRA. Roth IRA SEP-IRA. Complete, sign, and mail to the above address

IRA APPLICATION STEP 1. IRA Type. Traditional IRA. Roth IRA SEP-IRA. Complete, sign, and mail to the above address Eventide Funds c/o Gemini Fund Services LLC PO Box 541150 Omaha, NE 68154 877-771-EVEN (3836) WWW.EVENTIDEFUNDS.COM IRA APPLICATION Complete, sign, and mail to the above address IMPORTANT Eventide Funds

More information

HOOVER FINANCIAL ADVISORS, PC FINANCIAL PLANNING AND CONSULTING AGREEMENT

HOOVER FINANCIAL ADVISORS, PC FINANCIAL PLANNING AND CONSULTING AGREEMENT FINANCIAL PLANNING AND CONSULTING AGREEMENT This financial planning and/or consulting agreement ( Agreement ) made as of the day of, 2016 between the undersigned party, ( Client ), the Investment Advisory

More information

REGULAR ACCOUNT APPLICATION

REGULAR ACCOUNT APPLICATION REGULAR ACCOUNT APPLICATION DRIVEN BY RESEARCH IMPORTANT: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain,

More information

*TDA1186* LLC, Investment Club, or Partnership Account Application

*TDA1186* LLC, Investment Club, or Partnership Account Application LLC, Investment Club, or Partnership Account Application PO Box 2760 Omaha, NE 68103-2760 Fax: 866-468-6268 Questions? Call a New Accounts representative at 800-276-8746. Please visit us at www.tdameritrade.com

More information

SIMPLE IRA CUSTODIAL ACCOUNT ADOPTION AGREEMENT

SIMPLE IRA CUSTODIAL ACCOUNT ADOPTION AGREEMENT Please complete this application to establish a new SIMPLE IRA. This application must be preceded or accompanied by a current Disclosure Statement and Custodial Agreement. For Additional Copies or Assistance

More information

Individual Retirement Account (IRA) Application

Individual Retirement Account (IRA) Application PO Box 2237 Omaha, NE 68103-2237 Fax: 816-243-3765 ACCOUNT NUMBER Office Code Rep Code 1 Individual Retirement Account (IRA) Application Type of Account Please select only one. I want to establish a: A

More information

NEW CLIENT FORM. 1. Client Investment Ownership. 2. Client Information

NEW CLIENT FORM. 1. Client Investment Ownership. 2. Client Information NEW CLIENT FORM The completion of this New Client Form by the client does not constitute the opening of an investment with Democracy Funding. This form is for the express purpose meeting the requirements

More information

Transfer of Ownership Request

Transfer of Ownership Request Transfer of Ownership Request Use this form to transfer ownership of shares from an existing Thrivent Mutual Fund account to a new owner within the same Thrivent Mutual Fund. Complete the Transfer of Ownership

More information

INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT ADOPTION AGREEMENT

INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT ADOPTION AGREEMENT INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT ADOPTION AGREEMENT Please complete this application to establish a new Traditional IRA or Roth IRA. This application must be preceded or accompanied by a current

More information

IRA APPLICATION STEP 1. IRA Type. Traditional IRA. Roth IRA SEP-IRA. Complete, sign, and mail to the above address

IRA APPLICATION STEP 1. IRA Type. Traditional IRA. Roth IRA SEP-IRA. Complete, sign, and mail to the above address Eventide Funds c/o Gemini Fund Services LLC PO Box 541150 Omaha, NE 68154 877-771-EVEN (3836) WWW.EVENTIDEFUNDS.COM IRA APPLICATION Complete, sign, and mail to the above address IMPORTANT Eventide Funds

More information

Financial Advisor New Account Application

Financial Advisor New Account Application Financial Advisor New Account Application For Trusts, Partnerships, Corporations, Estates, or Other Entities Complete this application to establish an account for a trust, partnership, corporation, estate,

More information

Education Savings Account Contribution Type

Education Savings Account Contribution Type Eventide Funds c/o Gemini Fund Services LLC PO Box 541150 Omaha, NE 68154 877-771-EVEN (3836) WWW.EVENTIDEFUNDS.COM COVERDELL EDUCATION SAVINGS ACCOUNT (ESA) APPLICATION IMPORTANT Eventide Funds is required

More information

INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT ADOPTION AGREEMENT

INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT ADOPTION AGREEMENT INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT ADOPTION AGREEMENT Please complete this application to establish a new Traditional IRA or Roth IRA. This application must be preceded or accompanied by a current

More information

ROTH IRA APPLICATION. SECTION 1: Account Information. SECTION 2: Contribution Type. SECTION 3: Investment Section

ROTH IRA APPLICATION. SECTION 1: Account Information. SECTION 2: Contribution Type. SECTION 3: Investment Section ROTH IRA APPLICATION IMPORTANT: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information

More information

Brokerage Account Application (Non-IRA)

Brokerage Account Application (Non-IRA) Brokerage Account Application (Non-IRA) One Beacon Street Boston, MA 02108-3102 (800) 822-2021 brownco.com For BrownCo Use Only: Account Number Instructions: Please complete in full and print clearly in

More information

COMPLETE INVESTMENT ACCOUNT APPLICATION

COMPLETE INVESTMENT ACCOUNT APPLICATION COMPLETE INVESTMENT ACCOUNT APPLICATION COMPLETE YOUR E*TRADE APPLICATION IN THREE EASY STEPS The Complete Investment Account Application you requested begins on the following page. To complete your application,

More information

NEW ACCOUNT APPLICATION Please Print Clearly

NEW ACCOUNT APPLICATION Please Print Clearly NEW ACCOUNT APPLICATION Please Print Clearly P.O. Box 513100, Los Angeles, California 90051-1100 (800) 634-1100 Customer Identification Verification/USA PATRIOT Act - To help the government fight the funding

More information

DPF - W Share Class (Ticker ZDPFWX) DPF - I Share Class (Ticker ZDPFIX) Brokerage Account Number, if applicable Home Telephone E-mail Address

DPF - W Share Class (Ticker ZDPFWX) DPF - I Share Class (Ticker ZDPFIX) Brokerage Account Number, if applicable Home Telephone E-mail Address TRANSFEROR/SELLER SECTION To be completed by individual transferring/selling Dividend Capital Diversified Property Fund shares. Throughout this form, references to prospectus mean the prospectus in effect

More information

FIDELITY ROLLOVER IRA APPLICATION

FIDELITY ROLLOVER IRA APPLICATION FIDELITY ROLLOVER IRA APPLICATION To complete this application, fill in all relevant sections, sign in ink, and return the application to Fidelity at: Fidelity Management Trust Company, Corporate Rollover

More information

New Account Application Please do not use this application for IRA s

New Account Application Please do not use this application for IRA s New Account Application Please do not use this application for IRA s In compliance with the USA PATRIOT Act, all financial institutions (including mutual funds) are required to obtain, verify and record

More information

SIMPLE IRA Account Application (10/05/2015)

SIMPLE IRA Account Application (10/05/2015) Hilltop Securities Inc. and/or Broker/Dealers for which it Clears Hilltop Securities Inc. - Member: NYSE/ FINRA/ SIPC New Account Account Update 1. Type of IRA (Check ONE) SIMPLE IRA Account Application

More information

NEW ACCOUNT APPLICATION

NEW ACCOUNT APPLICATION NEW ACCOUNT APPLICATION ACCOUNT NUMBER BRANCH NUMBER I (We) would like to open a brokerage account with you ( my broker ). I understand that you have designated Apex Clearing Corporation ( Clearing Firm

More information

Forex Account Application

Forex Account Application In order to expedite your account opening process, if you have been working with a Representative, please enter that person s name below: Representative s Name: _ Promotional Code: _ Leverage 1:50 1:100

More information

SCHOLARSHARE COLLEGE SAVINGS PLAN (529 PLAN) ACCOUNT APPLICATION

SCHOLARSHARE COLLEGE SAVINGS PLAN (529 PLAN) ACCOUNT APPLICATION SCHOLARSHARE COLLEGE SAVINGS PLAN (529 PLAN) ACCOUNT APPLICATION Please complete this application to establish a 529 Plan account with Fidelity Investments. One application must be submitted for each account

More information

Questions? Call Prudential Retirement at (fax: )

Questions? Call Prudential Retirement at (fax: ) IRA Application For Prudential use only: Questions? Call Prudential Retirement at 1-888-244-6237 (fax: 1-877-493-9854) www.prudential.com/prs Office F72 703 1 Choose type of IRA Rollover IRA I elect that

More information

Individual Retirement Account (IRA) New Account Application

Individual Retirement Account (IRA) New Account Application Individual Retirement Account (IRA) New Account Application ederated The USA PATRIOT Act requires the Funds to obtain, verify, and record information that identifies each person who opens an account. Failure

More information

Individual Retirement Account (IRA) Application

Individual Retirement Account (IRA) Application Individual Retirement Account (IRA) Application Overnight Delivery: Regular Mail: Palmer Square Funds Palmer Square Funds 803 W. Michigan St. P.O. Box 2175 Milwaukee, WI 53233-2301 Milwaukee, WI 53201-2175

More information

Individual Retirement Account (IRA) New Account Application

Individual Retirement Account (IRA) New Account Application Individual Retirement Account (IRA) New Account Application ederated The USA PATRIOT Act requires the Funds to obtain, verify, and record information that identifies each person who opens an account. Failure

More information

New Account Application

New Account Application New Account Application For Trusts, Partnerships, Corporations, Estates, or Other Entities Complete this application to establish an account for a trust, partnership, corporation, estate, or other entity.

More information

Traditional, Roth, SEP-IRA, or SIMPLE IRA Application

Traditional, Roth, SEP-IRA, or SIMPLE IRA Application Traditional, Roth, SEP-IRA, or SIMPLE IRA Application A fund family of Everence Please call if you have any questions about filling out this application. (800) 977-2947 Send this application, and if applicable,

More information

Request for Name or Ownership or Beneficiary Change

Request for Name or Ownership or Beneficiary Change Request for Name or Ownership or Beneficiary Change Regular Mail Send to: Express Mail Send to: Questions/Customer Service The Guardian Life Insurance Co. of America The Guardian Life Insurance Co. of

More information

CONTRIBUTION AGREEMENT of INCROWD ALABAMA FUND I, LLC

CONTRIBUTION AGREEMENT of INCROWD ALABAMA FUND I, LLC CONTRIBUTION AGREEMENT of INCROWD ALABAMA FUND I, LLC INSTRUCTIONS TO INVESTORS EACH PROSPECTIVE INVESTOR IN INCROWD ALABAMA FUND I, LLC (THE COMPANY ) SHOULD EXAMINE THE SUITABILITY OF THIS TYPE OF INVESTMENT

More information

Fill in the necessary information corresponding to the account s owner.

Fill in the necessary information corresponding to the account s owner. IRA APPLICATION It s easy to establish your account. Simply fill out this application, completing all relevant sections, sign in ink and return to: Regular Mail FundX Upgrader Funds c/o US Bancorp Fund

More information

as a custodian for under the UGMA/UTMA. Custodian s Name (only one permitted) Minor s Name (only one permitted) State

as a custodian for under the UGMA/UTMA. Custodian s Name (only one permitted) Minor s Name (only one permitted) State Account Application ASSET MANAGEMENT Do not use this application to establish an Individual Retirement Account. Please print all items clearly (except signature). To avoid having your application returned,

More information

Business Account Application

Business Account Application Business Account Application Individuals, partners and owners of a business must be eligible for membership or be a member(s) in good standing of Philadelphia Federal Credit Union before opening a business

More information

Roumell Opportunistic Value Fund

Roumell Opportunistic Value Fund Roumell Opportunistic Value Fund A series of the Starboard Investment Trust SEP-IRA Application Form Make check payable to & mail to: Roumell Opportunistic Value Fund c/o Nottingham Shareholder Services

More information

ACCOUNT APPLICATION FEDERAL CUSTOMER IDENTIFICATION REGULATIONS 1. ACCOUNT REGISTRATION (PLEASE INDICATE ACCOUNT TYPE)

ACCOUNT APPLICATION FEDERAL CUSTOMER IDENTIFICATION REGULATIONS 1. ACCOUNT REGISTRATION (PLEASE INDICATE ACCOUNT TYPE) Please return this completed application to: The Lazard Funds, Inc. P.O. Box 8514 Boston, MA 02266-8514 For assistance please call: (800) 986-3455 ACCOUNT APPLICATION Use this form to purchase Lazard mutual

More information

Federated National Underwriters Phone: (800) 293-2532 (option 4) 14050 N.W. 14 th Street, Suite 180 Fax: (954) 308-1397

Federated National Underwriters Phone: (800) 293-2532 (option 4) 14050 N.W. 14 th Street, Suite 180 Fax: (954) 308-1397 AGENCY QUESTIONNAIRE Thank you for your interest in Federated National Underwriters representing Federated National Insurance Company and other nationally recognized insurance companies. Please complete

More information

Customer Account Information

Customer Account Information 7 World Trade Center, 32nd Floor New York, NY 10007 USA P: +1.212.791.3933 F: +1.212.937.3845 Customer Account Information Thank you for choosing FX DIRECT DEALER, LLC FXDD. To make it easy and convenient

More information

Internet Commercial Account Application Page 1 of 7

Internet Commercial Account Application Page 1 of 7 Presidential Bank ATTN: New Accounts 4520 East-West Highway 240-333-9059 800-383-6266 fax 301-951-3582 www.presidential.com Bethesda, MD 20814 Instructions Internet Commercial Account Application Page

More information

United Development Funding IV Account Transfer Form

United Development Funding IV Account Transfer Form United Development Funding United Development Funding Toll-Free 1-800-859-9338 SECTION 1 - TRANSFER FROM THE FOLLOWING ACCOUNT (Must complete for all transfers) UDF Account Number Name(s) on the Account

More information

IRA Application For Traditional, ROTH, SEP, and SIMPLE IRAs

IRA Application For Traditional, ROTH, SEP, and SIMPLE IRAs IRA Application For Traditional, ROTH, SEP, and SIMPLE IRAs >> Mail to: The Plumb Funds c/o U.S. Bancorp Fund Services, LLC PO Box 701 Milwaukee, WI 53201-0701 Overnight Express Mail To: The Plumb Funds

More information

SEP-IRA New Account Application ederated

SEP-IRA New Account Application ederated SEP-IRA New Account Application ederated The USA PATRIOT Act requires Federated to obtain, verify, and record information that identifies each person who opens an account. Failure to provide required information

More information

Pioneer Investments Account Application

Pioneer Investments Account Application Pioneer Investments Account Application Pioneer Mutual Funds Class A, Class C, and Class R Shares Use this application to purchase shares in a non-retirement account, except as indicated in Section 1C.

More information

1 ORIGINAL IRA OWNER S INFORMATION

1 ORIGINAL IRA OWNER S INFORMATION LEGG MASON FUNDS 1 NON-SPOUSE, TRUST, ESTATE OR ENTITY BENEFICIARY IRA INHERITANCE REQUEST FORM If you have any questions, please call Shareholder Services at 1-800-822-5544 Monday through Friday, 8:00

More information

USAA NEW YORK MONEY MARKET FUND SUPPLEMENT DATED APRIL 1, 2016 TO THE FUND'S PROSPECTUS DATED AUGUST 1, 2015

USAA NEW YORK MONEY MARKET FUND SUPPLEMENT DATED APRIL 1, 2016 TO THE FUND'S PROSPECTUS DATED AUGUST 1, 2015 USAA NEW YORK MONEY MARKET FUND SUPPLEMENT DATED APRIL 1, 2016 TO THE FUND'S PROSPECTUS DATED AUGUST 1, 2015 This Supplement updates certain information contained in the above-dated prospectus for the

More information

» Your Permanent street address» A check for your initial investment payable to Calamos Funds

» Your Permanent street address» A check for your initial investment payable to Calamos Funds Mail to: Calamos Family of Funds c/o U.S. Bancorp Fund Services, LLC P. O. Bo 701 Milwaukee, WI 53201-0701 Overnight mail to: Calamos Family of Funds c/o U.S. Bancorp Fund Services, LLC 615 E. Michigan

More information

TRANSFER AND ASSIGNMENT OF SHARES

TRANSFER AND ASSIGNMENT OF SHARES TRANSFER AND ASSIGNMENT OF SHARES Use this form to transfer or change the ownership of your account. Custodial held account changes must be authorized (signed) by the Custodian. 1. TRANSFER FROM THE FOLLOWING

More information

New Account Application Individual/Joint/Custodian

New Account Application Individual/Joint/Custodian TradePMR Use Only: Sub Firm: 211 Account #: Open Date: RIA Firm: 1 Registration Type Account Type (Select only one): Individual New Account Application Individual/Joint/Custodian Joint Tenants with Rights

More information

TRUST DEPARTMENT AGENCY AGREEMENT

TRUST DEPARTMENT AGENCY AGREEMENT TRUST DEPARTMENT AGENCY AGREEMENT This Agency Agreement is entered into this day of, 200, between: as Principal, and the MARQUETTE BANK TRUST DEPARTMENT, as Agent. 1. Account Type: Agent will hold in safekeeping

More information

IRA ADOPTION AGREEMENT

IRA ADOPTION AGREEMENT IRA ADOPTION AGREEMENT Please complete and sign this IRA Adoption Agreement after you have read the prospectus carefully. You may invest in as many of the UMB Scout Funds as you wish using just this application.

More information

Application for Customer Status

Application for Customer Status Application for Customer Status TERMS AND CONDITIONS OF SALES: The terms and condition of sales by Perfect 10 (hereafter referred to as Perfect 10 ) to the below named Customer (hereafter referred to as

More information

Initial Planning Questionnaire

Initial Planning Questionnaire Initial Planning Questionnaire Josh Koehnen CERTIFIED FINANCIAL PLANNER TM Registered representative of and offering securities and advisory services through Independent Financial Group, LLC (IFG) member

More information

Coverdell Education Savings Account Application

Coverdell Education Savings Account Application Coverdell Education Savings Account Application >> Mail to: The Plumb Funds c/o U.S. Bancorp Fund Services, LLC PO Box 701 Milwaukee, WI 53201-0701 In compliance with the USA PATRIOT Act, all mutual funds

More information

TAX ASPECTS OF MUTUAL FUND INVESTING

TAX ASPECTS OF MUTUAL FUND INVESTING Tax Guide for 2015 TAX ASPECTS OF MUTUAL FUND INVESTING INTRODUCTION I. Mutual Fund Distributions A. Distributions From All Mutual Funds 1. Net Investment Income and Short-Term Capital Gain Distributions

More information

TRUST OR CONSERVATORSHIP ACCOUNT APPLICATION

TRUST OR CONSERVATORSHIP ACCOUNT APPLICATION TRUST OR CONSERVATORSHIP ACCOUNT APPLICATION COMPLETE YOUR E*TRADE APPLICATION IN THREE EASY STEPS The Trust or Conservatorship Account Application you requested begins on the following page. To complete

More information

Investment Advisor Firm (Agent) and Primary Contact: Firm Name: Primary Contact:

Investment Advisor Firm (Agent) and Primary Contact: Firm Name: Primary Contact: INVESTMENT ADVISOR Beneficiary IRA Account Application Account # Advisor # Case # Investment Advisor Firm (Agent) and Primary Contact: Firm Name: Primary Contact: 1 2 DECEDENT S RETIREMENT ACCOUNT INFORMATION

More information

BUSINESS ACCOUNT AGREEMENT

BUSINESS ACCOUNT AGREEMENT BUSINESS ACCOUNT AGREEMENT OWNERSHIP OF ACCOUNT SOLE PROPRIETORSHIP CORPORATION NOT FOR PROFIT CORPORATION FOR PROFIT PARTNERSHIP LIMITED LIABILITY CO. DATE OPENED OPENED BY INITIAL AMOUNT $ FORM: CASH

More information

Change of Registration Joint Account Checklist

Change of Registration Joint Account Checklist Change of Registration Joint Account Checklist PO Box 55932 Boston, MA 02205-5932 800-240-4313 Use these forms to add or remove an owner(s) on a joint account or transfer a joint account to a new owner(s).

More information

Business Membership Application and Agreement

Business Membership Application and Agreement Business Membership Application and Agreement Application Business (DBA) Expiration (if DBA ) Current Street Address City, State Zip Current Mailing Address (if different) City, State Zip Phone Number(s)

More information

FATCA AND NEW ZEALAND LAW FIRMS

FATCA AND NEW ZEALAND LAW FIRMS This Practice Briefing does not constitute legal advice INTRODUCTION The FATCA agreement between New Zealand and United States is directed at reducing tax evasion by US taxpayers. New Zealand law firms

More information

Direct Rollover IRA Form

Direct Rollover IRA Form Direct Rollover IRA Form PO Box 55932 Boston, MA 02205-5932 800-379-7603 Use this form to invest an eligible rollover distribution from an employer s retirement plan into a new or existing IRA at Janus.

More information

ACCOUNT APPLICATION P. O. BOX 701 Milwaukee WI 53201 800.421.4184 Fax 855.394.8958 www.eagleasset.com

ACCOUNT APPLICATION P. O. BOX 701 Milwaukee WI 53201 800.421.4184 Fax 855.394.8958 www.eagleasset.com ACCOUNT APPLICATION P. O. BOX 701 Milwaukee WI 53201 800.421.4184 Fax 855.394.8958 www.eagleasset.com IMPORTANT: YOU MUST COMPLETE ALL 5 PAGES AND ALL OWNERS MUST SIGN THIS APPLICATION. IF YOU ARE UPDATING

More information

Business Membership Application

Business Membership Application ASE Credit Union Questions? Call (334) 270.9011 or (800) 634.9171 Business Membership Application Important Information Account Procedures for Opening a New Account: To help the government fight the funding

More information

UnionBanc Investment Services Bank Deposit Sweep Program

UnionBanc Investment Services Bank Deposit Sweep Program Effective January 1, 2014 UnionBanc Investment Services Bank Deposit Sweep Program (BDSP SM ) All About & Disclosure Document BDSP Summary This section highlights certain key features of the Bank Deposit

More information

CHECKLIST. SIS Insurance Services 3250 Grey Hawk Ct. Carlsbad, CA 92010

CHECKLIST. SIS Insurance Services 3250 Grey Hawk Ct. Carlsbad, CA 92010 Dear Producer: SafeBuilt Insurance Services, Inc. (SIS), DBA: Structural Insurance Services (SIS) looks forward to doing business with your agency and beginning a good working relationship. CHECKLIST Legible

More information

Online Brokerage Account Application

Online Brokerage Account Application Branch Prefix FOR BRANCH USE ONLY Account Number RR RR2 Agency Online Brokerage Account Application Are holders employees of your B/D? No Yes If you learned about this account from an FTS Online Brochure

More information

Institutional Class Account Application

Institutional Class Account Application U.S. Global Investors Funds Institutional Class Account Application YOUR ORIGINAL SIGNATURE(S) IS(ARE) REQUIRED IN SECTION 9 Accounts must have a valid physical U.S. address and each registered owner(s)

More information

Request for Change of Registration

Request for Change of Registration Request for Change of Registration To an Individual Account, Joint Account, Uniform Gifts/Transfers to Minors Act (UGMA/UTMA) Account, or Guardianship Account Complete this form to transfer ownership of

More information

2. ACCOUNT REGISTRATION AND CUSTOMER IDENTIFICATION INFORMATION

2. ACCOUNT REGISTRATION AND CUSTOMER IDENTIFICATION INFORMATION P.O. Box 8024 Boston, MA 02266-8024 800-222-5852 Overnight Mail: 30 Dan Road Canton, MA 02021-2809 SIMPLE IRA Application! Use this form to establish a SIMPLE IRA account only.! Make check payable to Principal

More information

BANK DEPOSIT SWEEP PROGRAM (BDSP SM ) DISCLOSURE DOCUMENT

BANK DEPOSIT SWEEP PROGRAM (BDSP SM ) DISCLOSURE DOCUMENT BANK DEPOSIT SWEEP PROGRAM (BDSP SM ) DISCLOSURE DOCUMENT Please read the complete Disclosure Document describing the Bank Deposit Sweep Program and your core account investment vehicle. You may consult

More information

Table of Contents. Personal Information

Table of Contents. Personal Information Estate Planning Fact Finder Table of Contents Personal Information 1 Income Information 5 Estimate Net Worth (Assets less Liabilities) 2 Life Insurance 5 Estimate Planning Goals 2 Qualified Plan/IRA Assets

More information

Guidance for companies, trusts and partnerships on completing a self-certification form

Guidance for companies, trusts and partnerships on completing a self-certification form Guidance for companies, trusts and partnerships on completing a self-certification form In order to combat tax evasion by both individuals and businesses, the UK and many other countries have entered into

More information

IRA Distribution Request Form

IRA Distribution Request Form Columbia Management Investment Services Corp. IRA Distribution Request Form Use this form when requesting a distribution from an Individual Retirement Account (IRA). Part 1 Depositor (investor) information:

More information

SUPPLEMENTAL APPLICATION FOR OPTION & MARGIN PRIVILEGES

SUPPLEMENTAL APPLICATION FOR OPTION & MARGIN PRIVILEGES SUPPLEMENTAL APPLICATION FOR OPTION & MARGIN PRIVILEGES 1. PRIMARY APPLICANT INFORMATION Brokerage Account Number Use this application to apply for the addition of margin or margin and option account privileges

More information

First Name MI Last Name Social Security Number/TIN. Gender: Male Female U.S. Citizen: Yes No First Name MI Last Name Social Security Number/TIN

First Name MI Last Name Social Security Number/TIN. Gender: Male Female U.S. Citizen: Yes No First Name MI Last Name Social Security Number/TIN Annuitant Gender: Male Female US Citizen: Yes No Fixed Annuity Application Mail to: PO Box 79905, Des Moines, IA 50325-0905 Overnight to: 4350 Westown Pkwy, West Des Moines, IA 50266 Street Address (PO

More information

Check here if you are establishing this Account in connection with a SIMPLE IRA plan maintained by your employer.

Check here if you are establishing this Account in connection with a SIMPLE IRA plan maintained by your employer. LEGG MASON FUNDS 1 BNY Mellon Investment Servicing Trust Company SIMPLE Individual Retirement Custodial Account Application and Adoption Agreement This application should be used to open a SIMPLE IRA investing

More information

Foreign Account Tax Compliance Act (FATCA) Frequently Asked Questions

Foreign Account Tax Compliance Act (FATCA) Frequently Asked Questions Foreign Account Tax Compliance Act (FATCA) Frequently Asked Questions For Momentum Retail (excluding Momentum Wealth International) General FATCA questions 1. What is FATCA? FATCA is the acronym for the

More information

After reading the information in this Welcome Guide, please follow the instructions below to open your SDB account.

After reading the information in this Welcome Guide, please follow the instructions below to open your SDB account. BB&T Dear Plan Participant: Thank you for your interest in opening a Self-Directed Brokerage (SDB) account. On the following pages, you will find the two forms you will need to open your account. You will

More information

Norristown Bell Credit Union

Norristown Bell Credit Union 1. Required Document Checklist Norristown Bell Credit Union Saving Our Members Money Business Membership Application All documentation listed below is required to open a business account. The highlighted

More information

855.550.5090. IMPORTANT:

855.550.5090. IMPORTANT: Cedar Ridge Funds Use this New Account Application to open an individual, joint, UGMA/UTMA, trust, or corporate account. If you have any questions about completing this form, please contact Shareholder

More information

Individual Retirement Account (IRA) Application

Individual Retirement Account (IRA) Application Individual Retirement Account (IRA) Application Use this form to open a Traditional, SEP or ROTH Individual Retirement Account ( IRA ). If you have questions about completing this form, please contact

More information

INSTITUTIONAL FUND CLASS I SHARES NEW ACCOUNT APPLICATION

INSTITUTIONAL FUND CLASS I SHARES NEW ACCOUNT APPLICATION INSTITUTIONAL FUND CLASS I SHARES NEW ACCOUNT APPLICATION (Please Print in Black Ink) For assistance in completing this application, please call your financial advisor or a Virtus Mutual Fund Services

More information

IRA Application. Class C and S Shares

IRA Application. Class C and S Shares IRA Application Class C and S Shares Instructions Use this form for IRA individual, custodial, trust,profit-sharing and pension plan accounts. Do not use this form for ICON Funds Class A accounts. For

More information

Traditional IRA s Contribution rules-

Traditional IRA s Contribution rules- A Traditional IRA is a retirement plan that allows you to save money for retirement. In the case of a traditional IRA, you may also be offered an immediate tax shelter for the contributions that you make

More information

HOMETOWN Financial Planning 1957 Lake Street Roseville, Minnesota 55113

HOMETOWN Financial Planning 1957 Lake Street Roseville, Minnesota 55113 HOMETOWN Financial Planning 1957 Lake Street Roseville, Minnesota 55113 (651) 638-9428 Fax (651) 638-9356 terry@hometownfp.com Terry Warren Nelson, CFP MS Registered Investment Advisor THIS CLIENT AGREEMENT

More information