Brokerage Account Application

BROKERAGE ACCOUNT APPLICATION

Client Name:

Account Registration

Select account type (check all that apply):

Individual    Joint Tenants    Tenants in Common    Trust/IRA/Other Trust

Custodial Account    Corporation    Partnership    Other:

Applicant Information

Date of Birth: Month Day Year

Primary Phone:    Alternate Phone:

Identification

Government ID type:    Number:

Issuing state/country:    Expiration:

Employment and Financial Information

Annual income:    Net worth (excluding primary residence):    Liquid net worth:

Investment Profile

Investment objectives (select all applicable): Income   Growth   Speculation/Short-term trading   Capital preservation

Estimated annual trading frequency:

Stocks   Bonds   Options   Futures

Agreements, Options & Margin

I request the following features on my account (check box and initial where required):

I request margin privileges. I have read and agree that margin trading involves borrowing and substantial risks, including the potential for losses exceeding deposited funds. I agree to the firm's margin agreement and pledge of securities. Initials:

I request options trading privileges. I understand options strategies can involve significant risk and authorize the firm to approve suitable option strategies. Initials:

I request both margin and options. I confirm I have read the risks described above and agree to any applicable agreements and disclosures.

Tax Certification and FATCA

Under penalties of perjury, I certify that the taxpayer identification number provided is correct, and that I am not subject to backup withholding unless I have been notified that I am subject. I agree to notify the firm promptly if the information furnished changes.

Privacy, Electronic Delivery, and Consent

I consent to receive account agreements, confirmations, statements and disclosures electronically unless I revoke such consent in writing. I authorize the firm to obtain credit reports, verify my employment and financial information, and to share account information as necessary to effect transactions and comply with applicable law.

I consent to electronic delivery of account documents.

Acknowledgments, Authorizations and Arbitration

By submitting this application I represent and warrant that the information provided is true, complete, and correct to the best of my knowledge. I authorize the broker-dealer to open and maintain the account and to follow instructions regarding transactions placed by me or my authorized agents. I understand that all transactions will be subject to the firm's account agreement, fee schedules, and margin or options agreements as applicable.

I acknowledge receipt of and agree to be bound by the firm’s standard account agreement and dispute resolution procedures, which may include binding arbitration for disputes arising out of or relating to my account. I understand that arbitration limits remedies available in a court of law.

Certification and Signature

By signing below I certify under penalties of perjury that the information provided in this application is true, correct and complete, and that I am authorized to open this account. I agree that this application, when accepted by the firm, constitutes a contract governing the account and authorizes the firm to act on my behalf in accordance with its policies and agreements.

Sign Now