Self Managed Super Fund (SMSF)

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1 For any assistance or queries with this form, please contact our Support Team on +61 (0) , or or live chat with us. International Capital Markets Pty Ltd Level 2 / 2 Bligh Street Sydney, NSW, 2000 Phone: +6 (0) Fax: +61 (0) Web: Trust or Superannuation Details - To be completed by the applicant acting in their own capacity Trust/Super Name: Trust/Super Type: Trust/Super No.: Country of Registration: Main Contact: Position: Registered (if different from above) Contact Details : Phone Number: After Hours: Fax: Account Standard Standard Standard Leverage: 1:1 1:25 1:50 1:100 1:200 1:300 1:400 1:500 Currency: AUD USD EUR GBP SGD NZD JPY HKD CHF CAD 1

2 Trustee Details (Individual Trustees Only) First Name: Last Name: Given Names: Date of Birth: Trustee Details (Corporate Trustees Only) Company Name: Company Type: ABN/ACN/ Company: Address Contact Details Mobile: Other Trustees Full Name: Full Name: Please attach a separate sheet if more information is required. 2

3 Beneficial Owner/Membership Class Details Under part 1 of the Australian Anti-Money Laundering Counter Terrorism Financing Act 2006 we are required in the case of a Trust or Superannuation to obtain details of either the Beneficial Owners OR each Class of Membership. Please attach a separate sheet if more information is required. 3

4 Declaration By ALL Trustees signing this application you declare to International Capital Markets Pty Ltd that: You confirm that you have read and understood the PDS including the terms and conditions of Contracts that form part of the PDS. You understand the risks associated with investing in the Contracts described in the PDS. You understand that Contracts are leveraged products. This means a small movement in the market can lead to a much larger movement in the value of your investment. This can work against you as well as for you. You acknowledge that you could sustain a loss greater than and not limited to the margin that you have deposited with us. You believe that, based on your review of the PDS, you are capable of assessing the merits of and understanding the terms, conditions and risks of Contracts. Therefore, the Contracts are an appropriate product for you to invest in. That the information that you have provided in this application form is true and correct and you will notify International Capital Markets Pty Ltd in writing if any information provided changes or ceases to be correct. This application form requires you to disclose personal information. The Privacy section of the PDS explains how we collect personal information and then how we maintain, use and disclose this information. By signing and returning this application form, you acknowledge having reviewed the Privacy section of the PDS and you consent to us collecting, using and disclosing information about any person named in this application form for the purposes de- scribed in the Privacy section of the PDS as permitted by the Privacy Act Have ALL Trustees read and understood the PDS? Have ALL Trustees read and understood the FSG? Do ALL Trustees understand the nature and risks of margined products? Signature Name Date Signature Name Date Signature Name Date 4

5 Secret Question and Answer To ensure the safety of your account at all times IC Markets will ask you a secret question when dealing with us on the Phone, Live Chat or . This allows us to verify that you are the account owner when communicating with us. Please write a question of your choice and enter an answer. All nominated account holders must know the question and answer. Security Question: Security Answer: Introducing Broker How did you hear about IC Markets? If you are part of a trading group or were Introduced to IC Markets by someone please let us know the details: Introducing Broker: 5

6 Identity Requirements International Capital Markets Pty Ltd is required by the Australian Anti-Money Laundering and Counter Terrorism Financing Act 2006 to verify the identity of the Trust or Superannuation fund. The identity requirements are as follows: ID Required for Trust or Superannuation Trust Deed OR Certified Extract from the Trust Deed If Trustee is a Company If Trustee is an Individual Certificate of Company Incorporation + ID For EACH Director 1 x Primary Photo ID (Passport, Driver s License or Government Issued Photo ID) 1 x Primary Photo ID (Passport, Driver s License or Government Issued Photo ID) 1 x Secondary ID (Utility Bill - less than 3 months old, Notice from Government Tax Office - less than 3 months old) 1 x Secondary ID (Utility Bill - less than 3 months old, Notice from Government Tax Office - less than 3 months old) * If ID is NOT in English it must be accompanied with a translation. Once you have completed this application form please submit to us via one of the following methods. Please allow up to two business days for your trading account to be approved and opened. Risk Warning: Trading Derivatives carries a high level of risk to your capital and you should only trade with money you can afford to lose. Trading Derivatives may not be suitable for all investors, so please ensure that you fully understand the risks involved, and seek independent advice if necessary. A Product Disclosure Statement (PDS) can be obtained either from this website or on request from our offices and should be considered before entering into a transaction with us. True ECN accounts offer spreads from 0.0 pips with a commission charge of AUD $3.50 per 100k traded. Standard account offer spreads from 1 pips with no additional commission charges. Spreads on CFD indices start at 0.4 points. The information on this site is not directed at residents in any country or jurisdiction where such distribution or use would be contrary to local law or regulation. International Capital Markets holds an Australian financial services licence (AFSL) to carry on a financial services business in Australia, limited to the financial services covered by its AFSL. International Capital Markets Pty Ltd. ACN AFSL No For Any Assistance: Fax: +61 (0) International Capital Markets Pty Ltd Level 2 / 2 Bligh Street, Sydney, NSW

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