Interactive Broker Account Application Aug2011
Interactive Broker Account Application Aug2011
Interactive Broker Account Application Aug2011
newaccounts.uk@interactivebrokers.co.uk
Interactive Brokers (U.K.) Limited Attn: Document Processing Gotthardstrasse 3 6301 Zug Switzerland +41-41-726-9500 +(41-41) 726-9599 Interactive Brokers (U.K.) Limited Attn: Document Processing P.O. Box 254 6301 Zug Switzerland
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State/Province
Account Type (check only one) Individual Joint (check one): Joint Tenants - Right of Survivorship (if one holder dies, interest passes to other holder) Community Property (for married couples in community property states - check state law) Tenants in Common (if one holder dies, his/her percentage interest passes to estate) For Tenants in Common o n l y, please enter percentages: Holder 1: % Holder 2: %
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Account Holder
First Name
Last Name
Last Name
Middle Initial
Suffix
Middle Initial
Suffix
Home Street Address (n o P.O. boxes or "in care of" addresses allowed)
City
City
State/Province
State/Province
Country
Country
Zip/Postal Code
Zip/Postal Code
Mailing Address (if different from above). P.O. boxes are allowed. Street Address
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City
State/Province
Country
Zip/Postal Code
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Account Holder
Date of Birth (mm/dd/yyyy)
Number of Dependents 0 1 2 3 4 5+
Number of Dependants 0 1 2 3 4 5+
Country of Citizenship
Country of Citizenship
>
If you are a U.S. citizen, a U.S. resident or have a U.S Social Security Number, you must provide a Social Security Number:
If you are a U.S. citizen, a U.S. resident or have a U.S Social Security Number, you must provide a Social Security Number:
If you are n o t a U.S. resident, please check which form of identification you will provide to Interactive Brokers (you must provide a copy of o n e of the following): Driver's License Alien Identification Card Passport National Identity Card Country of Issuance:
If you are n o t a U.S. resident, please check which form of identification you will provide to Interactive Brokers (you must provide a copy of o n e of the following): Driver's License Alien Identification Card Passport National Identity Card Country of Issuance:
Number:
Number:
Account Holder
Employment Type (choose one) Employed by Another Self-Employed Retired Unemployed
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Occupation
Occupation
Name of Employer
Name of Employer
City
City
State/Province
State/Province
Country
Country
Zip/Postal Code
Zip/Postal Code
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Please pick a security question from each of the three lists below and provide the answers to those questions so that we may use it in the future for verification purposes: What is the name of your hometown newspaper? What is the name of the High School you graduated from? What is the middle name of your eldest child? What city were you born in? What was the name of your first pet? What is the street number of the house you grew up in? What is your favorite cartoon character? What is your favorite color? What is your wife's middle name? What is the street name your work office is located on? Answer:
What is the name of your favorite sports team? What is the last name of your favorite politician? In what city were you married? In what city or town was your first job? What is your favorite place to shop? Who was your childhood hero? What was your High School mascot? What was the name of a best friend during childhood? What was the first concert you attended? What is your grandmother's first name? Answer:
What is name of first boyfriend/girlfriend? What is the name of a school you attended? What is your favorite vegetable? What is your shoe size (use decimals, if necessary)? Who was your first grade teacher? Where did you go on your honeymoon? What was your father's occupation? What was your childhood nickname? What was the model of your first car? Where is your favorite vacation spot? Answer:
Additional Sources of Income Source of Income Annual percentage from this source Description of this source
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Employment Income
Consulting
Disability
Inheritance
Interest
Other
Real Estate
Rental
Severance
Spouse
Unemployment
Account Financial Background (answer for both account holders if this is a joint account)
Investment Objectives and Intended Purpose of Trading (check all that apply) Preservation of Capital Income Growth Trading Profits Speculation Hedging
Investment Experience (please fill in all blanks) Years Trading Experience Stocks Number of Trades Per Year Knowledge Level (check one for each product type) Extensive Good Limited
Bonds
Extensive
Good
Limited
Options
Extensive
Good
Limited
Futures
Extensive
Good
Limited
Forex
Extensive
Good
Limited
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List other sources of funds aside from employment (if any) (this is required information if you are unemployed)
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Regulatory Information
Will this account be used to trade and/or invest on behalf of any other person(s) besides the named account holder? Yes No Will all funds in this account belong to the named account holder ONLY and NOT from any third-party individual or entity, in any capacity? Yes No Have you received authorization from your employer's compliance department to open this account with IB? IB may require proof of this authorization from your employer before processing your account. Yes No Are duplicate statements and confirmations required to be sent to your firm's compliance department? IB may require proof from your employer indicating whether or not duplicate statements and confirmation are required before processing your account. Yes No Is the account holder or any immediate family member who resides in the same household, registered as a broker-dealer or an employee, director or owner of a securities or commodities brokerage firm? Yes No If Yes: Person's Name: Is the account holder a member of an exchange or a regulatory or a self-regulatory organization, or an associated person, affiliated person or employee of an exchange member? Yes No If yes, list firm and exchanges:
Has the account holder ever been the subject of, or initiated, litigation, arbitration or any other type of dispute or settlement procedure with another broker or dealer? Yes No If yes, please provide details, including the disposition of the litigation, arbitration or procedure:
Brokerage Firm Address: Has the account holder ever been the subject of an investigation or proceeding by any commodities or securities exchange or regulatory authority or self-regulatory authority? Yes No If yes, please provide details, including the disposition of the investigation or proceeding:
Is the account holder: i) a director; ii) a 10% shareholder; or iii) a policymaking officer of any publicly traded company? Yes No If yes, enter the stock symbol(s) of the company(ies), separated by commas:
NOTE: If the account holder or any immediate family member who resides in the same household is employed by a brokerage firm, the compliance officer of that firm must authorize this account by sending an e-mail to Interactive Brokers Processing Department at newaccounts@interactivebrokers.com. The compliance officer should note "Employee Account Authorization" in the subject heading of the e-mail. The e-mail must state the following: "Interactive Brokers is authorized to establish and maintain an account for [Fill in Customer name]. [Fill in Name of Brokerage Firm] agrees to accept copies of daily confirmations and monthly s t a t e m e n t s b y e - m a i l t o [Fill in E-mail Address]."
Does the account holder control the trading in, or have a beneficial ownership interest in, any other IB accounts? Yes No If yes, enter the Usernames of these accounts, separated by commas:
Accredited Investor Qualification (answer for both account holders if this is a joint account)
Please answer at least one of the following questions in order to qualify for accredited investor offers. Is your individual gross income in excess of USD 200,000 in each of the two most recent calendar years and do you have a reasonable expectation of reaching the same income level in the current year? (If your answer to the above question is yes, you do not need to answer the below question. However, if your answer to the above question is no and you are married, you may answer below question.) Note: You may answer the following question if you are married and your individual gross income is less than $200,000. Yes No
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Is your joint gross income with your spouse in excess of USD 300,000 in each of the two most recent calendar years and do you have a reasonable expectation of reaching the same income level in the current year? I confirm under penalties of law that the foregoing answers are true and correct. I agree that if I am granted access to IB's Private Placement Site, I shall keep confidential and not provide to any other person or entity, any information made available to me on the IB Private Placement Site.
Yes No Yes No
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Global Australia Austria Belgium Canada France Germany Hong Kong Italy Japan Korea Mexico Singapore Spain Sweden Switzerland The Netherlands United Kingdom United States United States (Algorithmic Execution Venue) United States (Floor Based Exchanges)
Please n o t e t h a t SEC restrictions p r e v e n t U.S. legal r e s i d e n t s f r o m t r a d i n g OPTIONS o n s t o c k a n d i n d e x e s i n N o n - U.S. countries. Single Stock F u t u r e s t r a d i n g r e q u i r e s a Reg T o r Portfolio Margin Account Type. Data Protection N o t i c e: By applying f o r a n a c c o u n t w i t h Interactive Brokers (U.K.) Limited, y o u a r e c o n s e n t i n g t o IB UK, i t s affiliates, i t s c o n n e c t e d c o m p a n i e s , a n d t h e i r respective delegates transmitting, using, s t o r i n g a n d p r o c e s s i n g a n y p e r s o n a l i n f o r m a t i o n t h a t y o u h a v e p r o v i d e d o u t s i d e t h e E u r o p e a n Economic Area (EEA) a n d t h r o u g h o u t t h e world. You h a v e t h e right t o request the personal information that we hold about you.
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III.a ADVISOR FEE ARRANGEMENT Choose o n e of the following advisor fee billing methods:
No Fee No fees are charged by your advisor for managing your account. Direct Billing You advisor bills you directly for fees and you pay your advisor directly (IB does not deduct the fees from your account). Automatic Billing Interactive Brokers calculates Advisor Fees and deducts these fees from your client account automatically and sends them to your advisor as specified. Check all that apply and fill-in the required amounts: Annualized Percentage of Net Liquidation Value applied on a daily basis (enter annual percentage) %
Annualized Flat Fee applied on a daily basis, apportioned by 252 days (enter annual amount)
Percentage of Quarterly Positive P&L applied as of March, June, Sept., Dec. (enter quarterly percentage) Per-Trade Unit Advisory Fee. If this method is chosen, you must complete the fee schedule below. Monthly/Quarterly Invoicing Your advisor calculates the Advisor Wrap Fees and removes the fees from your account up to a limit of
per month/
or
per quarter.
IB standard UK fees of .1%, and stamp tax of .5% would be subtracted from the absolute fee specified above. Only 1 fee type (i.e. absolute markup, % markup, or absolute amount) may be entered for each asset class/currency. It should be noted that in no case may you enter more than 7 times IB's standard commission. Advisor Fee Cap IB caps the amount of advisor fees earned in any 360 day period to 25% of the client's average equity over this period, with additional cap limits at 30 day increments in-between (i.e. 7.2% over the last 30 days, 17.7% over the last 180 days). When any fee cap is exceeded for a client, the advisor will not receive any client fees until the fee cap is no longer exceeded. IB will continue to charge its standard commissions when the fee cap limit is exceeded. Please be aware that advisors are solely responsible for ensuring that the fees they charge are reasonable and in accordance with regulatory requirements. For a complete fee cap, visit h t t p : / / w w w . i n t e r a c t i v e b r o k e r s . c o m / e n / a c c o u n t s / a d v i s o r s /
advisorWrapFees.php?ib_entity=llc.
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Absolute Amount Pass Currency Unit Minimum Fee Absolute Markup % Markup Fee #1 Vol #1 Fee #2 Vol #2 Fee #3 t h r o u g h Fees* Stocks
USD
Shares
EUR
CHF
GBP
CAD
Shares
SEK
JPY
HKD
EUR
EUR
EUR
AUD
MXN
Warrants
EUR
HKD
USD
Contracts
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Absolute Amount Pass Currency Unit Minimum Fee Absolute Markup % Markup Fee #1 Vol #1 Fee #2 Vol #2 Fee #3 t h r o u g h Fees*
EUR
Contracts
HKD
Contracts
CHF
Contracts
GBP
Contracts
CAD
Contracts
JPY
Contracts
KRW
SEK
Contracts
AUD
Contracts
USD
Contracts
AUD
Contracts
EUR
Contracts
HKD
Contracts
CHF
Contracts
GBP
Contracts
CAD
Contracts
JPY
Contracts
KRW
Contracts
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Absolute Amount Pass Currency Unit Minimum Fee Absolute Markup % Markup Fee #1 Vol #1 Fee #2 Vol #2 Fee #3 t h r o u g h Fees*
USD
USD
USD
USD
USD
SEK
Contracts
MXN
Contracts
Forex
AUD
CAD
CHF
EUR
GBP
HKD
JPY
USD
NZD
NOK
Bonds
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Absolute Amount Pass Currency Unit Minimum Fee Absolute Markup % Markup Fee #1 Vol #1 Fee #2 Vol #2 Fee #3 t h r o u g h Fees* $1000 Face Value
USD
*Pass through exchange and regulatory fees applies to Absolute Amount only.
Second Signature (required only for joint and other accounts where multiple signatures needed)
Date
Date
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g.
8 . IB UK r e q u i r e s IB UK C u s t o m e r s t o r e m i t all f u n d s r e l a t e d t o t h e i r IB UK T r a n s a c t i o n s o r t o t h e i r IB UK Accounts, o r otherwise t e n d e r e d p u r s u a n t t o t h e IB UK C u s t o m e r Agreement, either: (a) directly t o IB LLC o r (b) t o a d e s i g n a t e d financial institution w i t h which IB LLC m a i n t a i n s a c u s t o m e r account. F u n d s m a i n t a i n e d b y IB LLC a r e m a i n t a i n e d i n c u s t o m e r a c c o u n t s t h a t a r e h e l d i n t h e n a m e o f IB LLC a n d a r e located o u t s i d e o f t h e U.K. 9 . IB UK a n d IB LLC s h a r e responsibility f o r t h e provision o f certain p o r t i o n s o f t h e IB UK website a n d f o r t h e provision o f c u s t o m e r service facilities. IB UK h a s u l t i m a t e responsibility f o r r e s p o n d i n g t o c u s t o m e r c o m p l a i n t s regarding a n y IB UK T r a n s a c t i o n o r a n y IB UK Account, b u t IB LLC is a u t h o r i z e d t o accept, p r o c e s s a n d r e s p o n d t o s u c h c o m p l a i n t s . 1 0 . IB UK a n d IB LLC a r e a u t h o r i z e d t o disclose i n f o r m a t i o n o r d o c u m e n t a t i o n relating t o IB UK C u s t o m e r s o r IB UK A c c o u n t s a n d IB UK T r a n s a c t i o n s t o e a c h o t h e r a n d t o t h e i r respective affiliates. IB UK, IB LLC a n d t h e i r affiliates a r e a u t h o r i z e d t o u s e , store, o r p r o c e s s p e r s o n a l i n f o r m a t i o n p r o v i d e d b y IB UK c u s t o m e r s (or t h e i r employees, a g e n t s o r representatives) o r otherwise a c q u i r e d f r o m t h e m a s s e t f o r t h i n t h e IB UK C u s t o m e r Agreement. 1 1 . IB LLC d o e s n o t control, a u d i t o r s u p e r v i s e t h e activities o f IB UK o r i t s registered representatives, n o r d o e s it verify a n y i n f o r m a t i o n p r o v i d e d b y IB UK regarding a n y IB UK C u s t o m e r s , o r d e r s , Transactions, o r Accounts.
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Options 3 . Variable d e g r e e o f risk T r a n s a c t i o n s i n o p t i o n s carry a h i g h d e g r e e o f risk. P u r c h a s e r s a n d sellers o f o p t i o n s s h o u l d familiarize t h e m s e l v e s w i t h t h e t y p e o f o p t i o n (i.e. p u t o r call) which t h e y c o n t e m p l a t e t r a d i n g a n d t h e a s s o c i a t e d risks. You s h o u l d calculate t h e e x t e n t t o which t h e value o f t h e o p t i o n s m u s t increase f o r y o u r p o s i t i o n t o b e c o m e profitable, taking i n t o a c c o u n t t h e p r e m i u m a n d all t r a n s a c t i o n costs. T h e p u r c h a s e r o f o p t i o n s m a y o f f s e t o r exercise t h e o p t i o n s o r allow t h e o p t i o n s t o expire. T h e exercise o f a n o p t i o n r e s u l t s e i t h e r i n a c a s h s e t t l e m e n t o r i n t h e p u r c h a s e r acquiring o r delivering t h e underlying interest. If t h e o p t i o n is o n a f u t u r e , t h e p u r c h a s e r will acquire a f u t u r e s p o s i t i o n w i t h a s s o c i a t e d liabilities f o r m a r g i n (see t h e section o n F u t u r e s above). If t h e p u r c h a s e d o p t i o n s expire worthless, y o u will s u f f e r a t o t a l l o s s o f y o u r i n v e s t m e n t which will c o n s i s t o f t h e o p t i o n p r e m i u m p l u s t r a n s a c t i o n costs. If y o u a r e c o n t e m p l a t i n g p u r c h a s i n g d e e p o u t -o f -t h e -m o n e y o p t i o n s , y o u s h o u l d b e a w a r e t h a t t h e c h a n c e o f s u c h o p t i o n s b e c o m i n g profitable ordinarily is r e m o t e . Selling (`writing' o r ` g r a n t i n g ' ) a n o p t i o n generally entails considerably g r e a t e r r i s k t h a n p u r c h a s i n g o p t i o n s . Although t h e p r e m i u m received b y t h e seller is fixed, t h e seller m a y s u s t a i n a l o s s well i n excess o f t h a t a m o u n t . T h e seller will b e liable f o r additional m a r g i n t o m a i n t a i n t h e p o s i t i o n if t h e m a r k e t m o v e s unfavorably. T h e seller will a l s o b e e x p o s e d t o t h e r i s k o f t h e p u r c h a s e r exercising t h e o p t i o n a n d t h e seller will b e obligated t o e i t h e r s e t t l e t h e o p t i o n i n c a s h o r t o acquire o r deliver t h e underlying interest. If t h e o p t i o n is o n a f u t u r e , t h e seller will acquire a p o s i t i o n i n a f u t u r e w i t h a s s o c i a t e d liabilities f o r m a r g i n (see t h e section o n F u t u r e s above). If t h e o p t i o n is ` c o v e r e d ' b y t h e seller holding a c o r r e s p o n d i n g p o s i t i o n i n t h e underlying i n t e r e s t o r a f u t u r e o r a n o t h e r option, t h e r i s k m a y b e r e d u c e d . If t h e o p t i o n is n o t covered, t h e r i s k o f l o s s c a n b e unlimited. Certain exchanges i n s o m e jurisdictions p e r m i t d e f e r r e d p a y m e n t o f t h e o p t i o n p r e m i u m , exposing t h e p u r c h a s e r t o liability f o r m a r g i n p a y m e n t s n o t exceeding t h e a m o u n t o f t h e p r e m i u m . T h e p u r c h a s e r is still s u b j e c t t o t h e r i s k o f losing t h e p r e m i u m a n d t r a n s a c t i o n c o s t s . When t h e o p t i o n is exercised expires, t h e p u r c h a s e r is r e s p o n s i b l e f o r a n y u n p a i d p r e m i u m o u t s t a n d i n g a t t h a t time. Additional risks c o m m o n t o futures a n d options. 4 . T e r m s a n d conditions o f contracts You s h o u l d a s k t h e f i r m w i t h which y o u d e a l a b o u t t h e t e r m s a n d c o n d i t i o n s o f t h e specific f u t u r e s o r o p t i o n s which y o u a r e t r a d i n g a n d a s s o c i a t e d obligations (e.g. t h e c i r c u m s t a n c e s u n d e r which y o u m a y b e c o m e obligated t o m a k e o r t a k e delivery o f t h e underlying i n t e r e s t o f a f u t u r e s c o n t r a c t a n d , i n r e s p e c t o f o p t i o n s , expiration d a t e s a n d restrictions o n t h e t i m e f o r exercise). U n d e r certain c i r c u m s t a n c e s t h e specifications o f o u t s t a n d i n g c o n t r a c t s (including t h e exercise price o f a n option) m a y b e m o d i f i e d b y t h e exchange o r clearing h o u s e t o reflect c h a n g e s i n t h e underlying interest. 5 . S u s p e n s i o n or restriction o f trading a n d pricing relationships Market c o n d i t i o n s (e.g. illiquidity) a n d / o r t h e o p e r a t i o n o f t h e r u l e s o f certain m a r k e t s (e.g. t h e s u s p e n s i o n o f t r a d i n g i n a n y c o n t r a c t o r c o n t r a c t m o n t h b e c a u s e o f price limits o r "circuit breakers") m a y increase t h e r i s k o f l o s s b y m a k i n g it difficult o r impossible t o effect t r a n s a c t i o n s o r l i q u i d a t e /o f f s e t positions. If y o u h a v e s o l d o p t i o n s , t h i s m a y increase t h e r i s k o f loss. Further, n o r m a l pricing relationships b e t w e e n t h e underlying i n t e r e s t a n d t h e f u t u r e , a n d t h e underlying i n t e r e s t a n d t h e o p t i o n m a y n o t exist. This c a n o c c u r when, f o r example, t h e f u t u r e s c o n t r a c t underlying t h e o p t i o n is s u b j e c t t o price limits while t h e o p t i o n is n o t . T h e a b s e n c e o f a n underlying reference price m a y m a k e it difficult t o j u d g e "fair" value. 6 . D e p o s i t e d c a s h a n d property You s h o u l d familiarize yourself w i t h t h e p r o t e c t i o n s a c c o r d e d m o n e y o r o t h e r p r o p e r t y y o u d e p o s i t f o r d o m e s t i c a n d foreign t r a n s a c t i o n s , particularly i n t h e e v e n t o f a f i r m insolvency o r b a n k r u p t c y . T h e e x t e n t t o which y o u m a y recover y o u r m o n e y o r p r o p e r t y m a y b e g o v e r n e d b y specific legislation o r local rules. In s o m e jurisdictions, p r o p e r t y which h a d b e e n specifically identifiable a s y o u r o w n will b e p r o -r a t e d i n t h e s a m e m a n n e r a s c a s h f o r p u r p o s e s o r d i s t r i b u t i o n i n t h e e v e n t o f a shortfall. 7 . C o m m i s s i o n a n d other c h a r g e s Before y o u begin t o t r a d e , y o u s h o u l d o b t a i n a clear explanation o f all commission, f e e s a n d o t h e r c h a r g e s f o r which y o u will b e liable. T h e s e c h a r g e s will affect y o u r n e t p r o f i t (if any) o r increase y o u r loss. 8 . Transactions i n other jurisdictions T r a n s a c t i o n s o n m a r k e t s i n o t h e r jurisdictions, including m a r k e t s formally linked t o a d o m e s t i c m a r k e t , m a y e x p o s e y o u t o additional risk. Such m a r k e t s m a y b e s u b j e c t t o regulation which m a y offer different o r d i m i n i s h e d investor protection. Before y o u t r a d e y o u s h o u l d i n q u i r e a b o u t a n y r u l e s relevant t o y o u r particular transactions. Your local regulatory a u t h o r i t y will b e u n a b l e t o c o m p e l t h e e n f o r c e m e n t o f t h e r u l e s o f regulatory a u t h o r i t i e s o r m a r k e t s i n o t h e r jurisdictions w h e r e y o u r t r a n s a c t i o n s h a v e b e e n effected. You s h o u l d a s k t h e f i r m w i t h w h i c h y o u d e a l f o r details a b o u t t h e t y p e s o f r e d r e s s available i n b o t h y o u r h o m e jurisdiction a n d o t h e r relevant jurisdictions b e f o r e y o u s t a r t t o trade. 9 . Currency r i s k s T h e p r o f i t o r l o s s i n t r a n s a c t i o n s i n foreign c u r r e n c y -d e n o m i n a t e d c o n t r a c t s (whether t h e y a r e t r a d e d i n y o u r o w n o r a n o t h e r jurisdiction) will b e affected b y fluctuations i n currency r a t e s w h e r e t h e r e is a n e e d t o c o n v e r t f r o m t h e currency d e n o m i n a t i o n o f t h e c o n t r a c t t o a n o t h e r currency. 1 0 . Trading facilities Most o p e n -o u t c r y a n d electronic t r a d i n g facilities a r e s u p p o r t e d b y c o m p u t e r -b a s e d c o m p o n e n t s y s t e m s f o r t h e o r d e r -routing, execution, matching, registration o r clearing o f t r a d e s . As w i t h all facilities a n d s y s t e m s , t h e y a r e vulnerable t o t e m p o r a r y d i s r u p t i o n o r failure. Your
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ability t o recover certain l o s s e s m a y b e s u b j e c t t o limits o n liability i m p o s e d b y t h e s y s t e m provider, t h e m a r k e t , t h e clearing h o u s e a n d /o r m e m b e r firms. Such limits m a y vary: y o u s h o u l d a s k t h e f i r m w i t h which y o u d e a l f o r details i n t h i s r e s p e c t . 1 1 . Electronic trading Trading o n a n electronic t r a d i n g s y s t e m m a y differ n o t only f r o m t r a d i n g i n a n o p e n -o u t c r y m a r k e t b u t a l s o f r o m t r a d i n g o n o t h e r electronic t r a d i n g s y s t e m s . If y o u u n d e r t a k e t r a n s a c t i o n s o n a n electronic t r a d i n g s y s t e m , y o u will b e e x p o s e d t o r i s k s a s s o c i a t e d w i t h t h e s y s t e m including t h e failure o f h a r d w a r e a n d software. T h e r e s u l t o f a n y s y s t e m failure m a y b e t h a t y o u r o r d e r is e i t h e r n o t e x e c u t e d according t o y o u r i n s t r u c t i o n s o r is n o t e x e c u t e d a t all. 1 2 . O f f -e x c h a n g e transactions In s o m e jurisdictions, a n d only t h e n i n r e s t r i c t e d circumstances, f i r m s a r e p e r m i t t e d t o effect o f f - exchange transactions. T h e f i r m w i t h which y o u d e a l m a y b e acting a s y o u r c o u n t e r p a r t y t o t h e transaction. It m a y b e difficult o r impossible t o liquidate a n existing position, t o a s s e s s t h e value, t o d e t e r m i n e a fair price o r t o a s s e s s t h e e x p o s u r e t o risk. For t h e s e r e a s o n s , t h e s e t r a n s a c t i o n s m a y involve i n c r e a s e d risks. O f f - exchange t r a n s a c t i o n s m a y b e l e s s r e g u l a t e d o r s u b j e c t t o a s e p a r a t e regulatory regime. Before y o u u n d e r t a k e s u c h transactions, y o u s h o u l d familiarize yourself w i t h applicable r u l e s a n d a t t e n d a n t risks.
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I hereby acknowledge that I have received and understood this risk disclosure statement: Signature of Account Holder Signature of Joint Account Holder
Date
Date
Arbitration Provisions
Any controversy or claim between IB UK or any of its respective directors, officers, shareholders, employees, associates or agents, on the one hand, and Customer or, if applicable, Customer's directors, officers, shareholders, employees, associates, agents, or trustees, on the other hand, arising out of, or relating to, this Agreement, any other Agreement between Customer and IB UK, any Transaction under such agreements, or any of Customer's accounts, may be settled by arbitration, in accordance with the rules then prevailing of any one of the following arbitration schemes, as Customer may elect and to the extent that the claim or controversy properly falls within the scope of the arbitration scheme: (1) If the dispute involves a Transaction in a security, option to purchase or sell a security, or an option on a securities index that is traded on a U.S. exchange, the arbitration schemes of: (a) The American Arbitration Association; (b) The New York Stock Exchange; (c) if the dispute involves IB LLC, any exchange of which IB LLC is a member, or (d) the NASD; (2) If the dispute involves a Transaction in a futures contract or an option on a futures contract that is traded on a U.S. exchange, any one of three or more "qualified forums" provided by IB UK. A "qualified forum" is an organization whose procedures for conducting arbitration comply with the requirements of CFTC Rules; (3) In any other type of dispute, the arbitration schemes of: (a) The American Arbitration Association; (b) any exchange of which IB UK is a member; or (c) a securities or futures association, as applicable; or (4) In all cases, the FSA's Consumer Arbitration Scheme or any other arbitration forum that IB UK may suggest. Customer may obtain information regarding the FSA's Consumer Arbitration Scheme by requesting such information via an e-mail addressed to the IB Customer Service Department at help@interactivebrokers.com, specifying "Attn: IB UK Compliance Director" in the subject heading.
Futures Trading Arbitration Agreement for Disputes Between Customer and Interactive Brokers LLC
If you trade stocks or stock options in your IB account, you will be covered by a mandatory arbitration agreement, which states that any disputes regarding your account will be resolved through arbitration. The following optional arbitration agreement covers trading in futures or options on futures, in the event that you and your advisor choose to trade these investment products in your account. You are not required to sign the Futures Trading Arbitration Agreement below, but if you do not sign it your account will be restricted to a one contract trading limit. Futures Trading Arbitration Agreement: Any controversy or claim between Interactive Brokers LLC ("IB") and the undersigned ("Customer") arising out of or relating to Customer's Account with IB, to transactions between IB and Customer, to the Customer Agreement with IB or any other agreement between IB and Customer, or to the breach of any such transaction or agreement shall, except as provided below, be resolved by arbitration before a forum chosen in accordance with the procedure set out below. If, by reason of any applicable statute, regulation, exchange rule or otherwise, Customer's advance agreement to submit a controversy to arbitration would not be enforceable by IB, this provision shall not permit Customer to enforce IB's advance agreement to submit to arbitration. Any award rendered in any arbitration conducted pursuant to this agreement shall be final, binding and enforceable in accordance with the laws of the State of Connecticut and judgment may be entered on any such award by any court having jurisdiction thereof. At such time as Customer notifies IB that Customer intends to submit a claim to arbitration, or at such time as IB notifies Customer that IB intends to submit a claim to arbitration, Customer will have the opportunity to choose a forum from a list of three or more qualified forums provided by IB. A "qualified forum" is an organization whose procedures for conducting arbitrations comply with the requirements of the Commodity Futures Trading Commission ("CFTC") Rule 166.5. As required by CFTC Rule 166.5, IB will pay any incremental fees which may be assessed by a qualified forum for provision of a mixed arbitration panel, unless the arbitrators hearing the controversy determine that Customer has acted in bad faith in initiating or conducting the arbitration. A "mixed arbitration panel" is an arbitration panel composed of one or more persons, a majority of whom are not members or associated with a member of a contract market or employee thereof, and who are not otherwise associated with a contract market. In connection with this Arbitration Agreement, IB is required to furnish to you the following statement, pursuant to Rule 166.5 of the CFTC: THREE FORUMS EXIST FOR THE RESOLUTION OF COMMODITY DISPUTES: CIVIL COURT LITIGATION, REPARATIONS AT THE COMMODITY FUTURES TRADING COMMISSION ("CFTC"), AND ARBITRATION CONDUCTED BY A SELF-REGULATORY OR OTHER PRIVATE ORGANIZATION. THE CFTC RECOGNIZES THAT THE OPPORTUNITY TO SETTLE DISPUTES BY ARBITRATION MAY IN SOME CASES PROVIDE MANY BENEFITS TO CUSTOMERS, INCLUDING THE ABILITY TO OBTAIN AN EXPEDITIOUS AND FINAL RESOLUTION OF DISPUTES WITHOUT INCURRING SUBSTANTIAL COSTS. THE CFTC REQUIRES, HOWEVER, THAT EACH CUSTOMER INDIVIDUALLY EXAMINE THE RELATIVE MERITS OF ARBITRATION AND THAT YOUR CONSENT TO THIS ARBITRATION AGREEMENT BE VOLUNTARY. BY SIGNING THIS AGREEMENT, YOU: (1) MAY BE WAIVING YOUR RIGHT TO SUE IN A COURT OF LAW; AND (2) ARE AGREEING TO BE BOUND BY ARBITRATION OF ANY CLAIMS OR COUNTERCLAIMS WHICH YOU OR IB MAY SUBMIT TO ARBITRATION UNDER THIS AGREEMENT. YOU ARE NOT, HOWEVER, WAIVING YOUR RIGHT TO ELECT INSTEAD TO PETITION THE CFTC TO INSTITUTE REPARATIONS PROCEEDINGS UNDER SECTION 14 OF THE COMMODITY EXCHANGE ACT WITH RESPECT TO ANY DISPUTE WHICH MAY BE ARBITRATED PURSUANT TO THIS AGREEMENT. IN THE EVENT A DISPUTE ARISES, YOU WILL BE NOTIFIED IF IB INTENDS TO SUBMIT THE DISPUTE TO ARBITRATION. IF YOU
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BELIEVE A VIOLATION OF THE COMMODITY EXCHANGE ACT IS INVOLVED AND IF YOU PREFER TO REQUEST A SECTION 14 "REPARATIONS" PROCEEDING BEFORE THE CFTC, YOU WILL HAVE 45 DAYS FROM THE DATE OF SUCH NOTICE IN WHICH TO MAKE THAT ELECTION. YOU NEED NOT SIGN THIS AGREEMENT TO OPEN OR MAINTAIN AN ACCOUNT WITH IB. SEE 17 CFR 166.5. I hereby acknowledge that I have read and understood and that I agree to the Futures Trading Arbitration Agreement: Signature of Account Holder Signature of Joint Account Holder
Date
Date
Discretionary Trading Authorization/Power of Attorney for Financial Advisor and Request to Send Trade Confirmations and Account Statements to Advisor
You are appointing a financial advisor ("Advisor"), chosen by you, to manage your Interactive Brokers account. The designated Advisor will be able to execute trades, deposit and withdraw money to and from your account (all withdrawals must be in your name), request information, receive account statements and confirmations, change certain of your customer information, and generally manage your Interactive Brokers account as specified below: General: The terms and conditions of this Authorization are in addition to the provisions of all other agreements between Interactive Brokers LLC, Interactive Brokers (U.K.) Ltd. and Customer or Advisor. The agreements applicable to Customer's account(s) will govern all orders and transactions, and Advisor is bound by all terms of those agreements. Request to Deduct Advisory Fees if Applicable: Customer requests and authorizes IB to deduct from Customer's IB account Advisory Fees and to disburse those Fees directly to the Advisor, based on the fee arrangement that Customer has agreed upon with the Advisor ("Fees") and specified to IB. If the Advisor bills Customer directly for Fees, or if Advisor does not charge Customer a Fee for Advisory services, Customer will specify that to IB. Request to Send Confirmations and Statements to Advisor: Customer requests that IB send all trade confirmations and account statements directly to Advisor and not to Customer directly. If Customer changes this instruction and decides that confirmations and account statements should be sent directly to Customer, Customer agrees to contact IB Customer Service at help@interactivebrokers.com or by calling the toll free Customer Service number listed on IB's website at www.interactivebrokers.com or www.interactivebrokers.co.uk or www.interactivebrokers.ca. Upon Customer's request, IB will provide Customer with a username and password so that Customer may view account statements online at the IB website. Advisor's Authority: This agreement authorizes Interactive Brokers to accept the instructions of the Advisor on behalf of the Customer. This authorization will be applicable to all assets Customer holds in all Interactive Brokers accounts for which Advisor has been designated. Customer hereby authorizes Advisor to inquire in, trade, buy, sell (including short sales), exchange, convert, tender, trade, or otherwise acquire or dispose of stocks, bonds, options securities, futures, security futures, foreign exchange and any other investments, on margin or otherwise, for and at the risk of the Customer. Customer understands that a commission will be charged to the account each time a trade is effected. The Advisor is also permitted to arrange for the deposit of funds and assets to the Customer's account(s) and to redeem or withdraw funds or assets from the Customer's account (including the delivery of securities from the account), for the benefit of the Customer, regardless of the tax consequences. The Advisor may initiate transfers (including inter-broker transfers), rollovers, Roth IRA conversions, IRA recharacterizations or other transfers of assets between and among Customer accounts. Customer authorizes Interactive Brokers, acting on Advisor's instructions, to aggregate transaction orders for Customer's account(s) with orders for one or more other accounts over which Advisor has trading authority. The Advisor is authorized to receive all information regarding the account(s) and to receive account statements, confirmations and tax information. The Advisor is authorized to add, delete or change Customer or account information. Interactive Brokers is authorized, but not required to, conduct further inquiry or seek authorization from the Customer or further clarification from Advisor or Customer regarding any instruction from Advisor for Customer's account(s). Interactive Brokers reserves the right, in it sole discretion, to refuse to honor particular instructions from Advisor, or to no longer honor instructions from Advisor. Customer and Advisor acknowledge that all information provided by either of them on this form, or otherwise provided to Interactive Brokers in the application process, is subject to verification, and Customer and Advisor authorize Interactive Brokers to verify all information through the use of credit agencies or any other customary or reasonable means. Advisor will provide promptly any information reasonably requested by Interactive Brokers concerning the management of the account(s) or compliance with this Authorization. This provision shall not be read to imply that Interactive Brokers has any duty to supervise or monitor Advisor's management of Customer's account(s) or compliance with applicable law. Not a Substitute for Advisory Agreement: Customer and Advisor acknowledge that this Authorization merely authorizes Advisor to conduct certain activities with respect to Customer's account and is not a substitute for an Advisory Agreement and is not designed to satisfy any regulatory obligations applicable to Advisor to enter such agreement. Role of Interactive Brokers - Disclaimer and Waiver of Liability: ADVISOR WAS SELECTED SOLELY BY CUSTOMER AND HAS NOT BEEN RECOMMENDED OR ENDORSED BY IB. ADVISOR IS NOT EMPLOYED BY OR REGISTERED OR ASSOCIATED WITH IB. IB WILL NOT INVESTIGATE OR JUDGE THE COMPETENCE OR INTEGRITY OF THE ADVISOR OR MONITOR THE ACTIONS OF THE ADVISOR. IB WILL NOT REVIEW THE ADVISOR'S RECOMMENDATIONS OR JUDGE THE SUITABILITY OF ANY TRADING OR INVESTMENT RECOMMENDATION OR DECISION OF ADVISOR OR CUSTOMER. IB DOES NOT PROVIDE ADVISORY SERVICES TO IB CUSTOMERS AND WILL NOT PROVIDE INVESTMENT OR TRADING OR TAX ADVICE REGARDING THE ACCOUNT.
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Advisor's Compliance with State, Federal or Non-U.S. Law: Advisor will comply with all applicable state and federal securities laws and regulations, including the Investment Advisors Act of 1940, the Commodity Exchange Act and comparable state laws, and will comply with any applicable laws of Non-U.S. jurisdictions (hereinafter "Applicable Laws and Regulations"). Interactive Brokers assumes no responsibility for determining if Advisor is complying with Applicable Laws and Regulations regarding its provision of advisory services. CUSTOMER ACKNOWLEDGES THAT IB IS NOT RESPONSIBLE FOR DETERMINING WHETHER ADVISOR IS REQUIRED TO BE REGISTERED OR LICENSED OR WHETHER ADVISOR IS EXEMPT FROM REGISTRATION OR LICENSING. THIS IS SOLELY THE RESPONSIBILITY OF ADVISOR. IF CUSTOMER HAS QUESTIONS ABOUT THIS, CUSTOMER MUST CONTACT ADVISOR FOR FURTHER INFORMATION. Termination: Customer and/or Advisor agree(s) to notify Interactive Brokers immediately, in writing, if Customer or Advisor terminates, modifies or revokes this Authorization. Advisor agrees to notify Interactive Brokers immediately, in writing, if Customer dies or becomes incapacitated such that this Authorization would be rendered void. This Authorization shall remain in effect until Interactive Brokers receives written notice of its termination and has had sufficient time to process such notice and terminate Advisor's authority. Indemnification of Interactive Brokers by Customer: Customer agrees to indemnify and hold Interactive Brokers, and its affiliates, and its and their successors and assigns, and its and their directors, officers, employees and Advisors harmless from and against all claims, actions, costs and liabilities, including attorney's fees, arising out of or relating to their reliance on this Authorization or their execution of any of Advisor's instructions. Customer agrees that since Interactive Brokers will not supervise or monitor Advisor's trading decisions or other activities, Customer will not attempt to hold Interactive Brokers liable for any trade or decision or action of Advisor. Interactive Brokers'srights under this paragraph are in addition to any other rights it has under other agreements with Customer and/or Advisor. Indemnification of Interactive Brokers by Advisor: Advisor agrees to indemnify and hold Interactive Brokers, and its affiliates, and its and their successors and assigns, and its and their directors, officers, employees and Advisors harmless from and against all claims, actions, costs and liabilities, including attorney's fees, arising out of or relating to any breach by Advisor of any provision of this Agreement or other Agreements with Interactive Brokers and/or Customer; the performance or non-performance of the Advisor's services; any trade or action of Advisor in Customer's account(s); and any dispute involving Advisor and Customer. Interactive Brokers's rights under this paragraph are in addition to any other rights it has under other agreements with Customer and/or Advisor. Customer's Representations and Acknowledgments: A. C u s t o m e r h a s g r a n t e d t o Advisor t h e full discretion t o direct t h e t r a d i n g i n t h e a c c o u n t(s) o n C u s t o m e r ' s behalf a n d C u s t o m e r will n o t h a v e access t o IB's electronic s y s t e m s f o r placing o r d e r s f o r t h e account. Only t h e Advisor will b e able t o u s e t h e IB T r a d e r Workstation t o c o n d u c t trading in the account. B. If C u s t o m e r t e r m i n a t e s t h e relationship w i t h Advisor o r f o r a n y o t h e r r e a s o n w i s h e s t o t e r m i n a t e Advisor's access t o t h e a c c o u n t (s), o r if C u s t o m e r w i s h e s t o direct t h e t r a d i n g i n C u s t o m e r ' s account, o r if C u s t o m e r w i s h e s t o u s e advisory services o f a n o t h e r Advisor, C u s t o m e r will c o n t a c t IB immediately b y email t o help@interactivebrokers.com o r b y calling t h e toll f r e e C u s t o m e r Service n u m b e r listed o n IB's w e b s i t e a t www.interactivebrokers.com o r www.interactivebrokers.co.uk o r www.interactivebrokers.ca. C. Because C u s t o m e r h a s i n s t r u c t e d IB t o s e n d all c o n f i r m a t i o n s a n d a c c o u n t s t a t e m e n t s directly t o Advisor, C u s t o m e r will rely o n Advisor f o r i n f o r m a t i o n regarding C u s t o m e r ' s account. If C u s t o m e r h a s a n y q u e s t i o n s o r c o n c e r n s regarding t h e account, C u s t o m e r will c o n t a c t IB C u s t o m e r Service a t help@interactivebrokers.com o r b y calling t h e toll f r e e C u s t o m e r Service n u m b e r listed o n IB's website a t www.interactivebrokers.com o r www.interactivebrokers.co.uk o r www.interactivebrokers.ca. D. D e p e n d i n g o n t h e equity i n C u s t o m e r ' s account, d e d u c t i o n o f Advisory Fees i n a n IB m a r g i n a c c o u n t m a y c a u s e t h e a c c o u n t t o i n c u r m a r g i n interest. F u r t h e r m o r e , if d e d u c t i o n o f Advisory Fees w o u l d c a u s e t h e a c c o u n t t o h a v e insufficient equity t o cover m a r g i n r e q u i r e m e n t s o r t o satisfy a n y o t h e r obligation t o IB, IB may, a t i t s sole discretion: (1) d e d u c t t h e Fees a n d exercise a n y o f i t s r i g h t s a n d r e m e d i e s u n d e r t h e IB C u s t o m e r Agreement, including liquidating p o s i t i o n s i n t h e a c c o u n t w i t h o u t p r i o r notice i n o r d e r t o satisfy m a r g i n r e q u i r e m e n t s o r obligations; a n d /o r (2) decline t o d e d u c t t h e Fees, i n which c a s e C u s t o m e r will b e liable t o p a y s u c h Fees t o Advisor directly. E. All claims, q u e s t i o n s o r d i s p u t e s regarding IB's provision o f b r o k e r a g e services o r regarding IB's execution o f particular t r a d e s m u s t b e r e f e r r e d t o IB. Advisor h a s n o a u t h o r i t y t o resolve s u c h claims o r d i s p u t e s o n IB's behalf. F. ALL CLAIMS OR DISPUTES REGARDING ADVISOR's SERVICES OR ACTIONS (INCLUDING SPECIFIC CONDUCT, ADVICE,
RECOMMENDATIONS, OR TRADES PLACED BY ADVISOR OR FEES OWED) ARE SOLELY BETWEEN CUSTOMER AND ADVISOR. IB IS NOT LIABLE FOR ANY SUCH CLAIMS AND DISPUTES AND CUSTOMER UNDERSTANDS AND FULLY ACKNOWLEDGES THAT CUSTOMER CANNOT BRING A CLAIM AGAINST IB OR RECEIVE DAMAGES OR COMPENSATION OF ANY KIND FROM IB, INCLUDING CLAIMS FOR DIRECT, INDIRECT, COMPENSATORY, INCIDENTAL, SPECIAL, EXEMPLARY, PUNITIVE OR CONSEQUENTIAL DAMAGES. ALL CLAIMS OR DISPUTES REGARDING THE FEES OWED TO ADVISOR ARE SOLELY BETWEEN CUSTOMER AND ADVISOR. IF CUSTOMER DISPUTES ADVISOR's RECEIPT OF ANY FEES THAT IB HAS DEDUCTED FROM THE ACCOUNT AND SENT TO ADVISOR, CUSTOMER UNDERSTANDS THAT CUSTOMER's SOLE REMEDY IS AGAINST ADVISOR AND CUSTOMER AGREES NOT TO BRING ANY CLAIM AGAINST IB. G. Arbitration: T h e a g r e e m e n t s b e t w e e n Customer a n d Interactive Brokers (which are a l s o binding o n Advisor) contain mandatory arbitration c l a u s e s requiring all parties t o arbitrate a n y d i s p u t e s regarding securities trading. T h e a g r e e m e n t s m a y a l s o contain arbitration p r o v i s i o n s regarding futures trading. All applicable arbitration c l a u s e s are incorporated herein b y reference. Signature CUSTOMER REPRESENTS THAT CUSTOMER HAS RECEIVED THE PACKAGE OF DOCUMENTS TITLED "INTERACTIVE BROKERS U.K. AGREEMENTS AND DISCLOSURE DOCUMENTS" AND HAS READ AND UNDERSTOOD AND INTENDS TO BE BOUND BY THE INTERACTIVE BROKERS CUSTOMER AGREEMENT AND ALL OF THE PROVIDED DISCLOSURE DOCUMENTS.
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CUSTOMER REPRESENTS THAT CUSTOMER HAS READ AND UNDERSTOOD AND INTENDS TO BE BOUND BY THE ABOVE "DISCRETIONARY TRADING AUTHORIZATION/ POWER OF ATTORNEY FOR FINANCIAL ADVISOR AND REQUEST TO SEND TRADE CONFIRMATIONS AND ACCOUNT STATEMENTS TO ADVISOR"
CUSTOMER REPRESENTS THAT ALL INFORMATION PROVIDED DURING THE ACCOUNT APPLICATION PROCESS IS TRUE AND CORRECT AND AGREES TO NOTIFY INTERACTIVE BROKERS OF ANY MATERIAL CHANGES IN THAT INFORMATION.
U.S. TAX CERTIFICATION: UNDER PENALTIES OF PERJURY I DECLARE THAT: A. IF I HAVE PROVIDED A U.S. TAXPAYER ID NUMBER (W9) : 1) THE NUMBER PROVIDED IN THIS APPLICATION IS MY CORRECT TAXPAYER IDENTIFICATION NUMBER (OR I AM WAITING FOR A NUMBER TO BE ISSUED TO ME); AND 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 SERVICE (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 WITHHOLDING. B. IF I HAVE NOT PROVIDED A U.S. TAXPAYER ID NUMBER (W8BEN): 1) I AM THE BENEFICIAL OWNER (OR AM AUTHORIZED TO SIGN FOR THE BENEFICIAL OWNER) OF ALL THE INCOME TO WHICH THIS FORM RELATES); 2) THE BENEFICIAL OWNER IS NOT A U.S. PERSON; 3) THE INCOME TO WHICH THIS FORM RELATES IS NOT EFFECTIVELY CONNECTED WITH THE CONDUCT OF A TRADE OR BUSINESS IN THE UNITED STATES OR IS EFFECTIVELY CONNECTED BUT IS NOT SUBJECT TO TAX UNDER A N INCOME TAX TREATY; AND 4) FOR BROKER TRANSACTIONS OR BARTER EXCHANGES, THE BENEFICIAL OWNER IS A N EXEMPT FOREIGN PERSON AS DEFINED IN THE INSTRUCTIONS. FURTHERMORE, I AUTHORIZE THIS FORM TO BE PROVIDED TO ANY WITHHOLDING AGENT THAT HAS CONTROL, RECEIPT, OR CUSTODY OF THE INCOME OF WHICH I AM THE BENEFICIAL OWNER OR ANY WITHHOLDING AGENT THAT CAN DISBURSE OR MAKE PAYMENTS OF THE INCOME OF WHICH I AM THE BENEFICIAL OWNER. NOTE: THE INTERNAL REVENUE SERVICE DOES NOT REQUIRE YOUR CONSENT TO ANY PROVISIONS OF THIS DOCUMENT OTHER THAN THE CERTIFICATIONS REQUIRED TO ESTABLISH YOUR STATUS AS A N O N - U.S. PERSON AND, IF APPLICABLE, OBTAIN A REDUCED RATE OF WITHHOLDING.
ACCOUNT TRANSFER: IF CUSTOMER HAS PROVIDED INFORMATION REQUESTING THAT ANOTHER BROKER TRANSFER ASSETS A N D / OR CASH TO INTERACTIVE BROKERS, CUSTOMER HEREBY REQUESTS SUCH TRANSFER PURSUANT TO THE TERMS AND CONDITIONS SPECIFIED BELOW IN THE SECTION: "FUND YOUR ACCOUNT/TRANSFER FROM ANOTHER BROKER"
THE INTERACTIVE BROKERS CUSTOMER AGREEMENT CONTAINS A N ARBITRATION CLAUSE REQUIRING BOTH PARTIES TO ARBITRATE ANY DISPUTES BETWEEN CUSTOMER AND INTERACTIVE BROKERS LLC REGARDING SECURITIES TRADING OR CUSTOMER'S SECURITIES ACCOUNT. CUSTOMER MUST BE AWARE THAT: ARBITRATION IS FINAL AND BINDING ON THE PARTIES. THE PARTIES ARE WAIVING THEIR RIGHT TO SEEK REMEDIES IN COURT, INCLUDING THE RIGHT TO JURY TRIAL. PRE-ARBITRATION DISCOVERY IS GENERALLY MORE LIMITED THAN AND DIFFERENT FROM COURT PROCEEDINGS. THE ARBITRATORS'S AWARD IS NOT REQUIRED TO INCLUDE FACTUAL FINDINGS OR LEGAL REASONING AND ANY PARTY'S RIGHT TO APPEAL OR TO SEEK MODIFICATION OF RULINGS BY THE ARBITRATORS IS STRICTLY LIMITED. THE PANEL OF ARBITRATORS WILL TYPICALLY INCLUDE A MINORITY OF ARBITRATORS WHO WERE OR ARE AFFILIATED WITH THE SECURITIES INDUSTRY.
Date
Date
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Agreement Limiting Interactive Brokers' Liability for Decisions and Actions of Your Independent Financial Advisor.
Please review each of the statements below and then: 1) initial each statement if you agree, and then: 2) sign the agreement at the bottom In consideration for maintaining a brokerage account at Interactive Brokers, Customer agrees:
1 . I u n d e r s t a n d t h a t m y financial advisor is i n d e p e n d e n t f r o m interactive b r o k e r s ("IB") a n d is n o t a n e m p l o y e e o r a n a g e n t of IB. I agree that Interactive Brokers i s n o t liable for t h e trading d e c i s i o n s or actions o f m y advisor a n d I agree n o t t o bring lawsuits or claims o f a n y k i n d against IB for actions or trading d e c i s i o n s o f m y advisor. AGREED BY: INITIALS 2 . I u n d e r s t a n d t h a t Interactive Brokers' only role is t o execute t r a d e s o r d e r e d b y m y advisor a n d h o l d m y p o s i t i o n s i n a n IB account. I a g r e e t h a t since IB d o e s n o t r e c o m m e n d t r a d e s o r give advice, IB will n o t c o n d u c t a n y "suitability" review t o m a k e s u r e t h a t m y advisor's t r a d i n g decisions a r e suitable f o r m y c i r c u m s t a n c e s a n d objectives. AGREED BY: INITIALS 3 . I selected m y advisor personally. I u n d e r s t a n d t h a t Interactive Brokers d o e s n o t r e s e a r c h o r r e c o m m e n d particular financial advisors. I u n d e r s t a n d t h a t IB h a s n o t r e c o m m e n d e d o r investigated m y advisor. AGREED BY: INITIALS 4 . Since Interactive Brokers is n o t providing a n y advice t o m e , if m y a c c o u n t g e n e r a t e s profits, I will n o t have t o s h a r e t h e p r o f i t s w i t h IB. Likewise I agree that if m y account s u f f e r s l o s s e s , Interactive Brokers will n o t r e p a y or b e responsible for m y l o s s e s . AGREED BY: INITIALS 5 . I a g r e e t h a t Interactive Brokers d o e s n o t s e e m y advisor's c o m m u n i c a t i o n s t o m e a n d is n o t r e s p o n s i b l e f o r s t a t e m e n t s o r i n f o r m a t i o n c o m i n g t o m e f r o m m y advisor. I a g r e e t o login t o t h e IB website o r t o c o n t a c t IB if I w a n t t o verify a n y a c c o u n t o r p r o f i t /l o s s i n f o r m a t i o n given t o m e b y m y advisor. AGREED BY: INITIALS
Date:
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Instructions for Check Deposits: So that we may process your check as quickly as possible, please enter check information in the spaces provided above. If you are not sure what to enter, please see the example below:
Please make your check payable to "Interactive Brokers LLC" and make sure the names of all account holders are written on the check (use the Memo line if necessary). Please enclose your check with this completed application. If you are faxing or e-mailing us your completed application and you want to mail the check separately, send it to: Interactive Brokers 8 Greenwich Office Park Greenwich, CT 06831-0504 Attn: IBCD
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Free of Payment (FOP) Request: Complete this section only if you want to initially fund your account with a wire transfer: This form authorizes the transfer of assets held at a third-party broker to be moved to Interactive Brokers. You must contact your third-party broker to initiate the transfer. Your Account Name, Tax Identification Number, and Customer Type (i.e. individual, joint, Roth IRA) for your Interactive Brokers Account should match the third-party broker account in order for the transfer to take place. Please note that Interactive Brokers accepts only products that it makes available for trading. Certain products, such as Mutual Funds and Limited Partnership units cannot be held in your Interactive Brokers account. Please Note: You should confirm with your sending broker their DTC Participant # so as not to delay the processing of your Free of Payment delivery. Third-party Broker Account Name
Account Number:
Date
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Wire Transfer: Complete this section only if you want to initially fund your account with a wire transfer: Amount of wire transfer Currency of wire transfer (for example: U.S. dollars)
Instructions for Wire Transfer: You must notify your bank to send a wire. All incoming wires must have the account holder's name (both names if a joint account). Depending on your bank, please allow one to four business days for your funds to be received. For security reasons, incoming funds are held for ten business days before you can withdraw the funds. Use the chart below to determine where to have your bank send the wire transfer, based on the currency of the funds being sent. For wires originating in the same country as the receiving bank listed below, please instruct your bank to send funds via the in-country payment system(s). For wires originating outside the country of the receiving bank, instruct your bank to send funds via SWIFT. Line 59 of the SWIFT message should include Interactive Brokers LLC Bank Account Number at Citibank and Line 70 of the SWIFT message should include your name (IB Account Holder's Name). Currency Receiving Bank Name and Address Receiving Bank Codes Receiving Bank Account Name and Number Interactive Brokers LLC Bank Account No. 40806826 For further credit to: [Insert All Account Holder Name(s)] Interactive Brokers LLC Bank Account No. 15344028 For further credit to: [Insert All Account Holder Name(s)] Interactive Brokers LLC Bank Account No. 095911034289 Royal Bank of Canada (RBC) 180 Wellington St. W. Toronto, ON M5J1J1 Canada SWIFT BIC Code: ROYCCAT2 Transit: 09591 Institution: 0003 Wire Beneficiary Address: Interactive Brokers, 1 Pickwick Plaza, Greenwich, CT, 06831 United States For further credit to: [Insert All Account Holder Name(s)] Interactive Brokers LLC Bank Account No. 10569674 Sort Code: 185008 SWIFT BIC Code: CITI GB 2L Int'l Bank Acct No. (IBAN): GB35CITI18500810569674 For further credit to: [Insert All Account Holder Name(s)] Interactive Brokers LLC Bank Account No. 08774544 Sort Code: 185008 SWIFT BIC Code: CITI GB 2L Int'l Bank Acct No. (IBAN): GB70CITI18500808774544 For further credit to: [Insert All Account Holder Name(s)] Interactive Brokers LLC Bank Account No. 0119754038 BLZ No.: 50210900 SWIFT BIC Code: CITI DE FF Int'l Bank Acct No. (IBAN): DE21502109000119754038 For further credit to: [Insert All Account Holder Name(s)] CHATS Code: 006/391 Interactive Brokers LLC Bank Account No. 17739993
Citibank, N.A. (New York Branch) Wall Street New York, NY 10043 United States of America
Bank of America, N.A. (Sydney Branch) Level 64, MLC Centre, 19 Martin Place, SYDNEY NSW AUSTRALIA 2000
Citibank, N.A. (London Branch) Citigroup Centre, Canary Wharf 33 Canada Square London, England (E14 LB) United Kingdom
Citibank, N.A. (London Branch) Citigroup Centre, Canary Wharf, 33 Canada Square London, England (E14 LB) United Kingdom
Citigroup Global Markets Deutschland AG & Co. KGaA. REUTERWEG 16 60323 FRANKFURT AM MAIN GERMANY FRANKFURT AM MAIN
Citibank, N.A. (Hong Kong Branch) 9/F Two Harbourfront 22 Tak Fung Street
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Hunghom Hong Kong Citibank Japan (Ltd.) Honten Branch Citigroup Center 2-3-14 Higashi Shinagawa Shinagawa-ku, Tokyo Japan zip-code: 140-8639 Banco Nacional de Mexico, S.A. Mexico Location: 3er Piso Torre Norte Act. Roberto Medellin No. 800 Col. Santa Fe, Mexico, D.F. 01210 Tampa Location: Citigroup Global Transaction Services 3800 Citigroup Center Tampa FL Skandinaviska Enskilda Banken AB SKANDINAVSKA ENSKILDA BANKEN KUNGSTRDGRDSGATAN 8 106 40 STOCKHOLM
For further credit to: [Insert All Account Holder Name(s)] Interactive Brokers LLC Bank Account No. 0159170403
SWIFT BIC Code: CITI JP JT For further credit to: [Insert All Account Holder Name(s)]
Interactive Brokers LLC Bank Account No. at SWIFT BIC Code: CITIUS33MER * For further credit to: [Insert All Account Holder Name(s)] Banamex: 231440011**
Interactive Brokers LLC Bank Account No. at S-E Banken: SE8850000000055558500891 For further credit to: [Insert All Account Holder Name(s)] Interactive Brokers LLC Bank Account No.: 312840003254901 For further credit to: [Insert All Account Holder Name(s)] Interactive Brokers LLC Bank Account No.: 312840003254901 For further credit to: [Insert All Account Holder Name(s)]
Citibank, N.A. (Auckland) 23 Customs Street East Level II, Citibank Centre, Auckland, New Zealand
Citibank, N.A. (Auckland) 23 Customs Street East Level II, Citibank Centre, Auckland, New Zealand
Account Transfer from Another Brokerage Firm (ACATS/ATON): Complete this section only if you want to initially fund your account through a transfer of assets and/or cash from a U.S. securities broker (ACATS) or a Canadian securities broker (ATON):
Please note: The Account Name, Tax Identification Number, and Account Type (i.e. individual, joint, Roth IRA) for your Interactive Brokers account must exactly match the brokerage account from which you are transferring assets in order for the transfer to take place. Also, please note that Interactive Brokers accepts transfers only of assets that IB makes available for trading. Certain products, such as mutual funds and limited partnership units cannot be transferred to or held in your Interactive Brokers account. Name of brokerage firm that transfer is coming from Account number of account being transferred
Do you have a margin loan in the account being transferred? Yes No Are there options positions in the account being transferred? Yes No
Do you have any short positions in the account being transferred? Yes No Are you transferring all assets from the account or just some assets? Full Transfer Partial Transfer
Instructions for Account Transfer from Another Broker: Customer requests that transferring broker transfer to Interactive Brokers the specified assets in the third-party brokerage account specified above. Customer understands that to the extent any assets are not readily transferable, with or without penalties; such assets may not be transferred within the time frames required by the NYSE Rule 412 or similar rule of NASD or other designated examining body. Unless otherwise indicated, customer authorizes the transferring broker to liquidate any non-transferable proprietary money market fund assets that are part of the account and to transfer the resulting credit balance to Interactive Brokers. Customer authorizes transferring broker to deduct any outstanding fees due from the credit balance in the account. If the account does not contain a credit balance, or if the credit balance is insufficient to satisfy any outstanding fees due, Customer authorizes transferring broker to liquidate the assets in the account necessary to satisfy any obligation. Full Transfer: If you are transferring ALL the assets from another brokerage account into your Interactive Brokers account (full transfer), you do n o t need to complete the form below.
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Partial Transfer: If you are transferring only SOME of the assets from another brokerage account into your Interactive Brokers account (partial transfer), you must list all: 1) stock; 2) options; and 3) cash that you want to transfer. Use the form below and attach additional pages if necessary. Partial Account Transfer Form (use only if you are opening your account by transferring only part of an account with another brokerage firm to Interactive Brokers). Use the lines below and attach additional pages if necessary: Positions: Stocks: Symbol Number Shares Long/Short Long Short Long Short Long Short Long Short Long Short O p t i o n s (Please note, this is not available for ATON Underlying Symbol Number of Contracts Strike Price Expiration (yyyy/ mm/dd) Put/Call Long/Short Long Short Put Call Long Short Put Call Long Short Put Call Long Short Put Call Long Short C a s h - ACATS are available for USD accounts only. ATONs are available for USD and CAD accounts Amount Positive Cash Balance or Margin Loan? Cash balance Margin Loan
Put
Call
If your broker requires a paper ACAT signature form for transfer, you must send a signed copy of the ACAT portion of your application to your broker. Signature of Account Holder Signature of Joint Account Holder
Date
Date
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VIII. RETURN YOUR COMPLETED APPLICATION (ALONG WITH REQUIRED DOCUMENTS) TO YOUR ADVISOR OR TO INTERACTIVE BROKERS
Please complete all information required in this application, provide all required signatures for each account holder, and return the entire application to your Financial Advisor or directly to Interactive Brokers. Please make sure to include your required proof of identity and address documents for each account holder. If your advisor has instructed you to send your application directly to Interactive Brokers, you may use any of the methods below:
Scan and Email (This is the fastest method)
newaccounts.uk@interactivebrokers.co.uk
Please note: The scanning and emailing option is typically the most efficient method, and will make account review quicker. Please be aware of the following guidelines and limitations when sending us e-mails or scanned document attachments. Please send emails as text rather than HTML format. If possible, users of Microsoft Outlook emailer should disable RFT (rich-text format) encoding. Only the following attachment types are accepted: .gif .tiff .tif .jpeg .jpg .png .bmp .pdf. Please limit the size attachment to 10MB. Please limit the size of e-mail text to 2,000 characters. Emails longer than that will be truncated. When sending a document by email, please only include your account number in the Subject line of your email. This will allow the Interactive Brokers system to automatically post your email (with any attachments) to your application.
Courier/Overnight Service (e.g. Fed Ex) Mailing your documentation via overnight carrier is also a choice, but please keep in mind that the processing time for approval of the account may take longer than if sending by email or fax. Fax
Interactive Brokers (U.K.) Limited Attn: Document Processing Gotthardstrasse 3 6301 Zug Switzerland +41-41-726-9500
+(41-41) 726-9599 Please note: Scanning and emailing required documents or sending documents by Courier/Overnight service are the best methods of sending documents. If you prefer to send documents via fax, please observe the following guidelines: Please enlarge documents to at least 125% of the normal size (up to 3/4 page-size) so we can read the document. Please lighten the documents by one or two increments when copying or faxing. As a general rule, before faxing, please make sure that all text is large and clear, and legible.
Mail Mailing your documentation through the regular postal service is also a choice, but please keep in mind that the processing time for approval of the account may take longer than if sending by email or fax.
Interactive Brokers (U.K.) Limited Attn: Document Processing P.O. Box 254 6301 Zug Switzerland
Should you have any questions, please send us an email addressed to newaccounts.uk@interactivebrokers.co.uk or call: 00800-42-276537 (international toll free) or +41-41-726-9500 (direct dial).
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Form
Individual/Sole Proprietor
Corporation
Partnership
Limited liability company. Enter the tax classification: Other (see instructions)
Disregarded entity
Corporation
Partnership
Exempt Payee
Part I
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter.
alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is Employer identification number
Part II
Certification
Under penalties of perjury, I certify that: The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 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 Service (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 withholding, and I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the instructions on page 4.
Sign Here
Signature of U.S. person Date (MM-DD-YYYY)
Form
W - 9 (Rev. 10-2007)
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Form
W-8BEN
Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding
Section References are to the Internal Revenue Code. See separate instructions. Give this form to the withholding agent or payer. Do not send to the IRS.
OMB No. 1545-1621
Do not use this form for: A U.S. citizen or other U.S. person, including a resident alien individual................................................. A person claiming that income is effectively connected with the conduct of a trade or business in the United States.............................................................................................. A foreign partnership, a foreign simple trust, or a foreign grantor trust (see instructions for exceptions).... A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization,foreign private foundation, or government of a U.S. possession that received effectively connected income or that isclaiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) (see instructions)..................................................................................................................................... person exempt from backup withholding. A person acting as an intermediary..........................................................................................................
...............W-8ECI or W-8EXP
Note: These entities should use Form W-8BEN if they are claiming treaty benefits or are providing the form only to claim they are a foreign ..................................W-8IMY
Part I
Partnership
Simple trust
International organization
4 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.
Part II
a
9 I certify that (check all that apply): The beneficial owner is a resident of United States and that country. b c d If required, the U.S. taxpayer identification number is stated on line 6 (see instructions). The beneficial owner is not an individual, derives the item (or items) of income for which the treaty benefits are claimed, and, if applicable, meets the requirements of the treaty provision dealing with limitation on benefits (see instructions). The beneficial owner is not an individual, is claiming treaty benefits for dividends received from a foreign corporation or interest from a U.S. trade or business of a foreign corporation, and meets qualified resident status (see instructions). e The beneficial owner is related to the person obligated to pay the income within the meaning of section 267(b) or 707(b), and will file Form 8833 if the amount subject to withholding received during a calendar year exceeds, in the aggregate, $500,000.
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1 0Special rates and conditions (if applicablesee instructions): The beneficial owner is claiming the provisions of Article of the treaty identified on line 9a above to claim a type of income): . % rate of withholding on (specify
Explain the reasons the beneficial owner meets the terms of the treaty article:
Part III
11
I have provided or will provide a statement that identifies those notional principal contracts from which the income is not effectively connected with the conduct of a trade or business in the United States. I agree to update this statement as required.
Part IV
Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify under penalties of perjury that: I am the beneficial owner (or am authorized to sign for the beneficial owner) of all the income to which this form relates, The beneficial owner is not a U.S. person, The income to which this form relates is (a) not effectively connected with the conduct of a trade or business in the United States, (b) effectively connected but is not subject to tax under an income tax treaty, or (c) the partner's share of a partnership's effectively connected income, a n d For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions. Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner.
Sign Here
Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY) Capacity in which acting
Form
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Form
W-8ECI
Certificate of Foreign Persons Claim for Exemption From Withholding on Income Effectively Connected With the Conduct of a Trade or Business in the United States
Section References are to the Internal Revenue Code. See separate instructions. Give this form to the withholding agent or payer. Do not send to the IRS.
Note: Persons submitting this form must file an annual U.S. income tax return to report income claimed to be effectively connected with a U.S. trade or business (see instructions). Do not use this form for: beneficial owner solely claiming foreign status or treaty benefits...................................................................................... A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private foundation, or government of a U.S. possession claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443 (b).......................................................................................................................................................... A foreign partnership or a foreign trust (unless claiming an exemption from U.S. withholding on income effectively connected with the conduct of a trade or business in the United States).......................................................................... Note: See instructions for additional exceptions. ......................W-8BEN or W-8IMY ........................................W-8EXP Note: These entities should use Form W-8ECI if they received effectively connected income (e.g., income from commercial activities). Instead, use Form: ........................................W-8BEN
Part I
3 Type of beneficial owner: Partnership Government Private foundation Individual Simple trust or grantor trust International organization Corporation Complex trust Central bank of issue Disregarded entity Estate Tax-exempt organization
4 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.
9 Specify each item of income that is, or is expected to be, received from the payer that is effectively connected with the conduct of a trade or business in the United States
Part II
Certification
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Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify under penalties of perjury that: I am the beneficial owner (or I am authorized to sign for the beneficial owner) of all the income to which this form relates, The amounts for which this certification is provided are effectively connected with the conduct of a trade or business in the United States Sign and are includible in my gross income (or the beneficial owners gross income) for the taxable year, a n d The beneficial owner is not a U.S. person.. Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner.
Sign Here
Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY) Capacity in which acting
Form
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Form
W-8EXP
Certificate of Foreign Government or Other Foreign Organization for United States Tax Withholding
(For use by foreign governments, international organizations, foreign central banks of OMB No. 1545-1621 issue, foreign tax-exempt organizations, foreign private foundations, and governments of Department of the Treasury U.S. possessions.) Seciton References are to the Internal Revenue Code. See separate instructions. Give this form to the withholding agent or payer. Do not send to the IRS.
OMB No. 1545-1621
Do not use this form for: Any foreign government or other foreign organization that is not claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443 (b).......................................................................................................................................................... A beneficial owner solely claiming foreign status or treaty benefits................................................................................... A foreign partnership or a foreign trust.............................................................................................................................. A person claiming an exemption from U.S. withholding on income effectively connected with the conduct of a trade or business in the United States............................................................................................................................................
.........................................W-8ECI
Part I
1 Name of organization
3 Type of entity
Foreign government
International organization
Foreign central bank of issue not wholly owned by the foreign sovereign)
4 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box
Part II
a
Qualification Statement
9 For a foreign government: I certify that the entity identified in Part I is a foreign government within the meaning of section 892 and the payments are within the scope of the exemption granted by section 892. Check box 9b or box 9c, whichever applies: b The entity identified in Part I is an integral part of the government of
10
The entity identified in Part I is an international organization within the meaning of section 7701(a)(18) and The payments are within the scope of the exemption granted by section 892.
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11
For a foreign central bank of issue (not wholly owned by the foreign sovereign): I certify that:
The entity identified in Part I is a foreign central bank of issue, The entity identified in Part I does not hold obligations or bank deposits to which this form relates for use in connection with the conduct of a commercial banking function or other commercial activity, and The payments are within the scope of the exemption granted by section 895. 1 2 For a foreign tax-exempt organization, including foreign private foundations: If any of the income to which this certification relates constitutes income includible under section 512 in computing the entitys unrelated business taxable income, attach a statement identifying the amounts. Check either box 12a or box 12b: a I certify that the entity identified in Part I has been issued a determination letter by the IRS dated that is currently in effect and that concludes that it is an exempt organization described in section 501(c). b c I have attached to this form an opinion from U.S. counsel concluding that the entity identified in Part I is described insection 501(c). For section 501(c)(3) organizations only, check either box 12c or box 12d: If the determination letter or opinion of counsel concludes that the entity identified in Part I is described in section 501(c)(3), I certify that the organization is not a private foundation described in section 509. I have attached an affidavit of the organization setting forth sufficient facts for the IRS to determine that the organization is not a private foundation because it meets one of the exceptions described in section 509(a)(1), (2), (3), or (4). d If the determination letter or opinion of counsel concludes that the entity identified in Part I is described in section 501(c)(3), I certify that the organization is a private foundation described in section 509. For a government of a U.S. possession: I certify that the entity identified in Part I is a government of a possession of the United States, or is a political subdivision thereof, and is claiming the exemption granted by section 115(2).
Part III
Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify under penalties of perjury that: The organization for which I am signing is the beneficial owner of the income to which this form relates, The beneficial owner is not a U.S. person, For a beneficial owner that is a controlled entity of a foreign sovereign (other than a central bank of issue wholly owned by a foreign sovereign), the beneficial owner is not engaged in commercial activities within or outside the United States, a n d For a beneficial owner that is a central bank of issue wholly owned by a foreign sovereign, the beneficial owner is not engaged in commercial activities within the United States. Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner.
Sign Here
Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY) Capacity in which acting
Form
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Form
W-8IMY
Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S. Branches for United States Tax Withholding
Seciton References are to the Internal Revenue Code. See separate instructions. Give this form to the withholding agent or payer. Do not send to the IRS.
Do not use this form for: A beneficial owner solely claiming foreign status or treaty benefits......................................................................... A hybrid entity claiming treaty benefits on its own behalf......................................................................................... A person claiming an exemption from U.S. withholding on income effectively connected with the conduct of a trade or business in the United States..................................................................................................................... A disregarded entity. Instead, the single foreign owner should use......................................................................... A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private foundation, or government of a U.S. possession claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443 (b)....................................................................................................................................
..................................................W-8BEN
..................................................W-8EXP
Part I
Identification of Entity
2 Country of incorporation or organization
3 Type of entitycheck the appropriate box: Qualified intermediary. Complete Part II. Nonqualified intermediary. Complete Part III. U.S. branch. Complete Part IV. Withholding foreign partnership. Complete Part V. Withholding foreign trust. Complete Part V. Nonwithholding foreign partnership. Complete Part VI. Nonwithholding foreign simple trust. Complete Part VI. Nonwithholding foreign grantor trust. Complete Part VI.
4 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box
Part II
9a
Qualification Intermediary
(All qualified intermediaries check here) I certify that the entity identified in Part I: Is a qualified intermediary and is not acting for its own account with respect to the account(s) identified on line 8 or in a withholding statement associated with this form and Has provided or will provide a withholding statement, as required.
(If applicable) I certify that the entity identified in Part I has assumed primary withholding responsibility under Chapter 3 of the Code with respect to the account(s) identified on this line 9b or in a withholding statement associated with this form
(If applicable) I certify that the entity identified in Part I has assumed primary Form 1099 reporting and backup withholding responsibility as authorized in its withholding agreement with the IRS with respect to the account(s) identified on this line 9c or in a
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Part III
10a b
Nonqualified Intermediary
(All nonqualified intermediaries check here) I certify that the entity identified in Part I is not a qualified intermediary and is not acting for its own account. (If applicable) I certify that the entity identified in Part I is using this form to transmit withholding certificates and/or other documentary evidence and has provided or will provide a withholding statement, as required.
Part IV
Note: You may use this Part if the entity identified in Part I is a U.S. branch of a foreign bank or insurance company and is subject to certain regulatory requirements (see instructions). 11 I certify that the entity identified in Part I is a U.S. branch and that the payments are not effectively connected with the conduct of a trade or business in the United States. Check box 12 or box 13, whichever applies: 12 13 I certify that the entity identified in Part I is using this form as evidence of its agreement with the withholding agent to be treated as a U.S. person with respect to any payments associated with this certificate. I certify that the entity identified in Part I: Is using this form to transmit withholding certificates or other documentary evidence for the persons for whom the branch receives a payment and Has provided or will provide a withholding statement, as required.
Part V
14
I certify that the entity identified in Part I: Is a withholding foreign partnership or a withhholding foreign trust and Has provided or will provide a withholding statement, as required.
Part VI
15
I certify that the entity identified in Part I: Is a nonwithholding foreign partnership, a nonwithholding foreign simple trust, or a nonwithholding foreign grantor trust and that the payments to which this certificate relates are not effectively connected, or are not treated as effectively connected, with the conduct of a trade or business in the United States a n d Is using this form to transmit withholding certificates and/or other documentary evidence and has provided or will provide a withholding statement, as required.
Part VII
Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income for which I am providing this form or any withholding agent that can disburse or make payments of the income for which I am providing this form.
Sign Here
Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY)
Form
U923307 - IB UK Account Application for Financial Advisor Clients (Individual/Joint) - Aug 16 2010
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