Client Application Form (Joint) Thank you for choosing OM Financial Limited ( OMF, we, us and our ). Whether you are wishing to trade financial or commodity futures and options, trade in equity markets or looking to trade foreign exchange, OMF is the broker of first choice. This Account Application is for use if you wish to use OMF to facilitate dealing in derivative Contracts and/or Securities (together, Instruments ). Should you have any queries about completing this Account Application then please call us on +64 9 520 9310 and we will be happy to assist you further. This Account Application must be read together with our General Terms and Conditions. Capitalised terms used in this Account Application and not defined have the meanings given in the General Terms and Conditions. If we accept your application for an Account, the agreement between us and you (the Account Holder, you and your ) will comprise this Account Application and the General Terms and Conditions ( Agreement ). OMF s General Terms and Conditions are available free of charge on our website www.omf.co.nz. We are authorised by the Financial Markets Authority to carry on the business of dealing in Off-Exchange and Exchange Traded Instruments. We employ Advisors who can provide investment and product advice to you in relation to Instruments. We will deal in Instruments as instructed by you in accordance with the terms of this Agreement. Account Opening Requirements To avoid the possible rejection of your Account Application, please ensure that you have provided the following: Identification Documents Under the Anti-Money Laundering and Countering Financing of Terrorism Act 2009 OMF is required to identify and verify the identity of any person associated with this Account. To open this Account you MUST provide one form of Photographic Identification for each Account Holder and any Authorised Representative or Attorney listed on your account. Acceptable Photographic Identification New Zealand Passport New Zealand Firearms Licence Overseas Passport National Identity Card New Zealand Driver s Licence, plus a signed bank issued card, OR a bank statement or IRD notice that has been issued within the last 12 months All documents must be in the name of the person and sighted by either an OMF staff member or certified using OMF s Certificate of Certification and Verification of Client Documents ( AML Certificate ). Alternatively, we do accept certified documents without the AML Certificate, but you must ensure that the certification wording reads: This is to certify that this is a true copy of the original document which I have sighted and represents the identity of the named person on the document The certification must be dated within the preceding 3 months and by signed by the Approved Certifier. Documents must be certified by a person who is legally able to take statutory declarations in New Zealand or an overseas country. See page 1 of the AML Certificate for who Client Application Form Joint 1.4 1
constitutes as an Approved Certifier. In addition to the above, Attorneys MUST also provide a Certified copy of an enduring power of attorney and a certificate of non-revocation (if the power of attorney is dated longer than 12 months). Address Verification We also require proof of residential address for each Account Holder and any Authorised Representative or Attorney that are dated within the past 12 months. Acceptable documents are: Utility bills Rates notices Bank statements Inland Revenue Department ( IRD ) notices Any other government issued document Bank Account Verification To open this Account we are required to have evidence of bank account details in the same name as the Account Holders listed on your account. Acceptable forms of verification are: Bank encoded deposit slip Bank statement Any other confirmation issued by your bank confirming your bank account name and number As OMF is a NZX accredited firm, we are unable to open your account until the original documents above have been received and approved. Client Application Form Joint 1.4 2
1. Account Registration Details Please select the type of account that you wish to open with OMF. OMF ctrader/margin Foreign Exchange Foreign Exchange Hedging & Payment Solutions OMF MarketTrader Global equities, equity options, CFDs NZ Equities Carbon Trading Electricity Trading Dairy Trading Futures Trading Account name If you are trading NZX Securities, they will be registered to this address Registration address Postcode Where you provide an email address you are agreeing to all statements, Contract tes, remittance advice, statutory disclosures and other communications from us being sent to this address If no email address is provided, all correspondence will be mailed to the mailing address stated above Primary email address Primary contact number U.S. Person Declaration In keeping with U.S. tax laws and foreign tax obligations, it is illegal for a U.S. citizen, permanent resident or Green-Card holder ( U.S. Person ) to transact in certain products offered by OMF. If you believe that you, your Authorised Representative or Attorney constitutes a U.S. Person, please contact your OMF Adviser before proceeding with this Account Application. Are either Account Holders, Authorised Representative or Attorney a U.S. Person or a U.S. tax resident residing in the U.S.? Yes Are either Account Holders, Authorised Representative or Attorney a U.S. Person or a U.S tax resident residing outside the U.S.? Yes If you answered Yes to any of these questions, this Account may be deemed a reportable account under the Foreign Account Tax Compliance Act ( FATCA ) and additional information will be required. You should seek independent advice from your tax adviser as to how these requirements may affect you. Shareholding Registration If you wish to trade Securities through the markets provided by NZX or NZAX, and you already hold a Common Shareholder Number ( CSN ), please provide your CSN below: If you do not have a CSN already and wish to trade on the NZX then you will be allocated one CSN Client Application Form Joint 1.4 3
2. Scope of Service Please select which type of service you wish OMF to provide. If you select personalised advice, we will be required to gather more details from you in order to assess your risk tolerance and financial position. Online/Execution only (you do not require any financial advice or you prefer to execute your trades online). Personalised advice (you will be provided with financial advice that relates specifically to your personal circumstances). Class advice (you may, from time to time, receive financial advice, however this advice will be of a general nature and does not take into account your personal circumstances). Unless you have made an election to receive personalised financial advice from one of our Authorised Financial Advisers and you have received a detailed Statement of Advice, OMF and our dealers provide class services only for the purposes of the Financial Advisers Act 2008. That is, we will not consider your particular financial situation or goals when providing recommendations or opinions in relation to disposing of financial products. You must decide whether the financial adviser services we provide are suitable for your individual needs and risk profile. 3. Joint Account Holder Details All Account Holders must complete this section. Please provide the full legal name of each Account Holder. Each Account Holder must be a beneficial owner of this Account. If you are applying for a Joint Account with more than two Account Holders then please contact us and we will provide you further guidance. The Primary Account Holder will be the first point of contact on this Account Primary Account Holder Details Title Surname Given name(s) Any other name known by Date of birth Country of birth Country of citizenship Primary Account Holder Address and Contact Details PO Boxes are not acceptable as a residential address Residential address Postcode Country of residence If different to the above Mailing address Phone (home) Phone (business) Phone (mobile) Client Application Form Joint 1.4 4
Primary Account Holder Statement of Financial Position These details must be completed prior to the Account being opened. Occupation Industry Employer Gross annual income/salary (NZ$) (please tick) $0 $50,000 $50,001 $100,000 $100,001 $250,000 $250,001 + Net worth (please tick) $0 $100,000 $100,001 $500,000 $100,001 $500,000 $1,000,001 $5,000,000 $5,000,001 + Source of wealth (tick all that apply) Earned income Savings/investments Inheritance Sale of assets Other (please specify) The Secondary Account Holder will be the point of contact on a Joint Account if we are unable to contact the primary Account Holder Secondary Account Holder Details Title Surname Given name(s) Any other name known by Date of birth Country of birth List all if more than one Country of citizenship Secondary Account Holder Address and Contact Details PO Boxes are not acceptable as a residential address Residential address Postcode Country of residence If different to the above Mailing address Phone (home) Phone (business) Phone (mobile) Secondary Account Holder Statement of Financial Position These details must be completed prior to the Account being opened. Occupation Industry Employer Gross annual income/salary (NZ$) (please tick) $0 $50,000 $50,001 $100,000 $100,001 $250,000 $250,001 + Net worth (please tick) $0 $100,000 $100,001 $500,000 $100,001 $500,000 $1,000,001 $5,000,000 $5,000,001 + Client Application Form Joint 1.4 5
Source of wealth (tick all that apply) Earned income Savings/investments Inheritance Sale of assets Other (please specify) Associations Is either Account Holder, or any Authorised Representative/Attorney on this Account, any of the following: A Prescribed Person of another NZX Participant or NZX Derivatives Firm? Yes (please provide details) A director or senior manager of a publically listed company? Yes (please provide details) An employee of a registered bank in New Zealand or overseas ( Bank ) and subject to internal trading restrictions? Yes (please provide details) 4. Tax Details Only one tax rate can be applied to a Joint Account. If you are unsure of which rate to select then please consult with a tax specialist IRD number Are you GST registered? Yes GST number (if applicable) Provision of your IRD Number is optional; however you should be aware that if one is not lodged, we are required to deduct withholding tax at the highest marginal rate from interest payable. New Zealand tax resident and overseas tax resident with a New Zealand fixed establishment Where an overseas tax resident carries on business in New Zealand through a fixed establishment in New Zealand they will be taxed under the New Zealand withholding tax rules that apply to New Zealand Tax Residents. A fixed establishment means a fixed place of business through which substantial business is carried on by a person. Withholding Tax on Interest Earnings 10.5% 17.5% 30% 33% Exempt* * a copy of your IRD exemption certificate must be enclosed Overseas tax resident without a New Zealand fixed establishment Country of residence Tax on Interest Earnings (please tick one) Approved Issuer Levy ( AIL ) n-resident Withholding Tax ( NRWT ) AIL is an alternative to NRWT. If AIL is elected a 2% levy will be paid instead of NRWT. By electing AIL, you may not be able to get a credit for the levy against your tax liability in your country of residence. If you have more than one Foreign Tax Number, please provide these separately Foreign Tax Number Country of issue Client Application Form Joint 1.4 6
5. Payment Instructions To open this Account we are required to have evidence of bank account details in the same name as the Account Holder. Primary Settlement Instructions If you do not intend to make third party payments, please go to section 6 We will use the bank account provided as your bank account verification as a primary standard settlement instruction and funds will be paid into this account. Additional accounts can be added for settlement instructions by completing OMF s Standard Settlement Instruction form. Third Party Payments A third party payment is a payment to an account in a name other than that of the Account Holder. How many (on average) per month will be required? What is the purpose of these payments? What is the source of funds for these payments? Will the payments be to non-nz bank accounts? If yes, please state the main countries for payments to be made to 6. Trading Objectives and Experience As a NZX Advising Firm and a Market Participant (as those terms are defined in the NZX Participant Rules) and a FMC Derivatives Issuer, OMF is required to ask you for this information. This section does not constitute a full client risk profile or suitability assessment as may be required in certain circumstances under the Financial Markets Conduct Act 2013 and the Financial Advisers Act 2008 but will assist us to understand your requirements in opening this Account. Warning: We are required to request this information from you in order to assess whether derivative trading is suitable for you. Without this information we may not be able to assess whether you have the necessary knowledge and experience to understand the derivative and the risks involved and may not be able to proceed with your application. Consequently, we strongly advise you to provide us with the requested information which we believe is necessary to enable us to assess your suitability. Purpose of the Account Trading objectives (tick all that apply) Hedging risk Diversification Investment Deliverable FX Speculative trading Other Comments Relevant Investment Experience Foreign Exchange Margin FX Futures Options CFDs Equities Bonds/Fixed Interest Experience (Years) Other Investment Experience? (Please provide details): Number of Trades (per annum) Contract Value (Average $) Client Application Form Joint 1.4 7
Derivatives If you intend on trading derivatives, please complete this section Do you understand the nature and risks of derivative instruments? Can you access investment research and information about derivative trading? Yes Yes Do you have experience trading derivatives? Yes Wholesale Classification A Wholesale Investor is a person or entity that meets specific criteria under FMCA and FAA. Wholesale Investors are considered to have a greater level of understanding of financial markets, or have the ability to understand more complex and sophisticated products. OMF currently consider clients as Wholesale Investors if they: (i) (ii) are a large investor meet the required investment activity criteria If you have answered Yes to this question you will be required to complete and sign a Wholesale Investor Certificate. Please contact your OMF Advisor for more information (iii) are an investment business Based on the above, do you consider yourself to be a Wholesale Investor? Yes 7. Account Preferences We want to ensure you receive communications that you find relevant, informative and useful to your trading. By completing your subscription preferences below you can let us know which reports you would like to receive: Morning commentary Bank Bills Equities / IPOs Grains & softs Dairy Carbon Power Bonds General company announcements Trade recommendations Metals SPI Breaking news 24 hour Breaking news from 8pm to 8pm Email Email Mobile Mobile 8. Security Details From time to time, we may require you to verify your identity. These questions and answers, meant for your security, will serve to identify you when communicating sensitive information (e.g. passwords) over the phone. Security Check Questions Mother s maiden name Favourite pet s name Client Application Form Joint 1.4 8
9. Authorised Representatives/Attorneys If you do not intend to nominate an Authorised Representative/ Attorney, please go to section 10 This section must only be completed if: You wish to nominate an Authorised Representative; or You have appointed an Attorney under a power of attorney and: He/she will be signing this Account Application on your behalf; and/or He/she will be acting on your behalf in relation to your Account Please complete this section if you wish to nominate an Authorised Representative or an Attorney in relation to your Account. An Authorised Representative can instruct us in relation to the limited matters set out in clause 10.7 of OMF s General Terms and Conditions only. An Attorney can instruct us and can otherwise act in relation to your Account to the extent specified in the power of attorney. If an Authorised Representative is also an Attorney, the Authorised Representative will be able to instruct us and otherwise act in relation to your Account to the extent specified in the power of attorney, even if such instructions and actions are outside the scope of the matters set out in clause 10.7 of OMF s General Terms and Conditions. OMF may accept instructions from an Authorised Representative or an Attorney without referring to you until you advise us not to do so in writing. OMF accepts no responsibility for any unauthorised or fraudulent actions undertaken by your Authorised Representative or your Attorney in relation to your Account. If there is more than one Authorised Representative and/or Attorney, please provide this information for the other Authorised Representative(s) and/or Attorney(s) under a separate cover sheet. Title Surname Given name(s) Any other name known by PO Boxes are not acceptable as a residential address Residential address Postcode Country of residence Date of birth Country of birth List all if more than one Country of citizenship Email address Relationship to Account Holder Phone (home) Phone (mobile) Phone (business) Occupation Employer Signature of Authorised Representative Date Client Application Form Joint 1.4 9
10. Risk Disclosure Statement The risk of loss in trading in Contracts can be substantial. You should therefore carefully consider whether that kind of trading is appropriate for you in the light of your financial circumstances. In deciding whether or not you will become involved in that kind of trading, you should be aware of the following matters: (a) (b) (c) (d) (e) (f) (g) You could sustain a total loss of the Margin funds that you deposit with us to establish or maintain a position on the Derivatives Market, on a F&O Exchange or in relation to a Contract traded Off-Exchange. If the market price moves against your position, you may be required, at short notice, to deposit with us additional Margin funds in order to maintain your position. Those additional funds may be substantial. If you fail to provide those additional funds within the required time, your position may be liquidated at a loss and in that event you will be liable for any shortfall in your Account resulting from that failure. Under certain conditions, it could become difficult or impossible for you to liquidate a position (this can, for example, happen when there is a significant change in prices over a short period). The placing of contingent orders (such as a stop-loss or stop price order) may not always limit your losses to the amounts that you may want. Conditions may make it difficult to execute such orders. A spread position is not necessarily less risky than a long or short position. The high degree of leverage that is obtainable in trading Contracts because of small margin requirements can work against you as well as for you. The use of leverage can lead to large losses as well as large gains. If you propose to trade in options, the maximum loss in buying an option is the amount of the premium, but the risks in selling an option are the same as in other Contracts. The risk of Short Selling of Securities is that the market could move against you and you could suffer loss as a consequence. Investment and trading in Securities can present risks that may impact on income and yield performance, and place capital at risk. You should be aware of these risks that may include (without limitation) market, company, industry and country exposure risk, and currency, economic and political risk. There are increased risks associated with borrowing to purchase Securities or buying Securities which are not quoted on an Exchange. The risk of equity investments is that it may not be possible to recover your original investment where, for example, the sale price for your investment is less than the price paid, or your investment cannot be sold (where there is no market for them or the market is effectively illiquid), or the company in which you have invested is insolvent or placed in receivership or liquidation. The risks set out in the Risk Disclosure Statement may change from time to time. Please refer to our latest published Disclosure Statements in relation to our services. Client Application Form Joint 1.4 10
11. Client Acknowledgements and Declarations By completing and signing this Account Application, you acknowledge and declare that: (a) You have: Received a copy of OMF s General Terms and Conditions and either these are understood or they have been explained to you by an Advisor or another agent of OMF. You agree to be bound by the terms and conditions set out in this Agreement (as provided to you or posted on www.omf.co.nz, and as amended or replaced from time to time). Received and read section 10 above ( Risk Disclosure Statement ) and either you understand the terms used or such terms have been explained to you by an Advisor or another agent of OMF. Read OMF s Disclosure Statement (available on the OMF website). Received a copy of your OMF Advisor s Disclosure Statement. Read OMF s Product Disclosure Statements if applicable to this account. (b) (c) (d) (e) (f) (g) (h) You have determined that Trading through this Account is suitable for you. You have appointed us to facilitate dealing in Contracts and/or Securities in accordance with the terms of the Risk Disclosure Statement and all other terms of this Agreement. We are regulated in the conduct of our dealings in Instruments Traded on the Market by NZX in accordance with the Exchange Rules. We are also regulated by NZX (in relation to Contracts traded on a F&O Exchange or Off-Exchange) to the extent that we provide advice to and/or accept funds from you in respect of Contracts. This Account Application does not disclose all of the risks and other significant aspects involved in Trading Instruments on the Market or trading on a F&O Exchange or Off- Exchange. You should therefore study trading in Instruments carefully before becoming involved in it. You are not aware and do not have any reason to suspect that any Account Holder, Attorney or Authorised Representative is a Politically Exposed Person (as defined in the Anti-Money Laundering and Countering Financing of Terrorism Act 2009) or that any of the monies used to fund the transactions for this Account are derived from money laundering or terrorism financing or any other illegal activity as defined by the laws of New Zealand. You have declared in section 3 if you or an Authorised Representative/Attorney is a Prescribed Person, a director or senior manager of a publically listed company or an employee of a Bank and who is subject to internal trading restrictions. You confirm that all of the information you have provided to us, including in this Account Application is accurate and complete. Client Application Form Joint 1.4 11
12. Final Checklist To avoid the possible rejection of your Account Application, please ensure that you complete everything listed on the checklist below. We have completed all the relevant sections of this Account Application. We have completed all the required Declarations in section 11. Both Account Holders have signed in section 13. We have provided all required identity, address and bank documents as per the Account Opening Requirements listed on page 1. We have completed and signed a Wholesale Investor Certificate if I understand that I am a Wholesale Investor. We have attached original documents as required. 13. Signatures All Account Holders (or Attorney) must sign this Account Application. Where an Attorney signs on behalf of an Account Holder, an original or certified copy of the power of attorney and the certificate of non-revocation must be provided with this Account Application and the Attorney must complete section 9 above. Primary Account Holder signature Signed by (full name) Date Secondary Account Holder signature Signed by (full name) Date Once completed please return the original Account Application and the required documentation to PO Box 5830, Wellesley Street, Auckland 1141. Client Application Form Joint 1.4 12