Account Information

Information About Customer

Select Type of Personal Account

Personal Account
Joint Account (only Spouses)
Business Account

Account Information: Residential or Business Address (Do not use a p.o. Box)

Personal Information and Investment Objectives

If Employed, please provide us with information about your employer:
Industry and Other Affiliations: Are you, your spose, or any other immediate family members, including parent, in-laws, siblings and dependents employed by or associated with the securities industry? This includes anyone that I employed by, or associated with a briker dealer, investment advisor, bank, exchange or a securities regulator.

Financial Situation and Need, Liquidity Considerations and Tax Status

If Employed, please provide us with information about your employer:

Investment Risk Tolerance

Investing involves risk. Different investment products and strategies involve different degrees or risk. The higher the expected returns of a product or strategy the greater the risk that you could lose most of your investment. Investments should be chosen based on your objectives, timeframe, and tolerance for market fluctuations.
Please select the dregree of risk you are willing to take with the assets in this account (choose one):
Moderately Conservative
Moderately Aggressive
Significant Risk
Investment Experience: We are collecting the information below to better understand your investment experience. We recognize your responses may change over time as you work with us.
Please indicate how you intend to fund the account: (Select all that apply)
Insurance Payout
Pension or Retirement Savings
Fund from another account
Social Security Benefits
Home Equity Line of Credit / Reverse Mortgage
Sale of business or property
Are you an officer, director or 10% (or more) shareholder in a publicly-owned company ?

My Account and What I Intend to Trade:

Please let us know what instruments you intend to trade in this account:
Listed Equities
OTC Equities (Pink Sheets and Bulletin Board Stocks)
Equity and/or Index Options:
Covered Call Writing Option strategies
Buy calls or puts Option strategies
Option Spreads Option strategies
Naked Option Writing Option strategies
Commodity Futures
Fixed Income
Foreign exchange

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