Common use of Confidentiality and Security Clause in Contracts

Confidentiality and Security. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic and procedural safeguards that are designed to protect your nonpublic information. FOR OFFICE USE ONLY Review Date New Account Update IB Approval FOR OFFICE USE ONLY Office / Sales Code / Account Number Commission ACCOUNT APPLICATION (Please type, or print legibly and fully in ink) Legal Account Name: Social Security / Fed. ID # Account Owner(s): Date of Birth or formation of business entity: # of Dependents: Permanent street address is required (no P.O. Boxes): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxx E-mail Mailing Address (if different from above): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxxxxx Phone: Home Phone: Fax Phone: Daytime E-mail: Marital Status: Married Single Divorced Are you a: Speculator Xxxxxx U. S. Citizen: Yes No Type of Account: Individual/Joint General Partnership Limited Partnership Corporate Trust Discretionary XXX LLC LLP Name and address of Employer: Occupation/Position: Nature of Business: (If retired, please so indicate and list prior occupation) Name of Broker/Contact who solicited you for this application: FINANCIALS Annual Income: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No $25,000 - $50,000 $50,000 - $100,000 $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Does any other person have authority to trade this account? Yes No For Corporations: Attach a copy of most recent audited financial statement. If under $25,000, Give amount & source: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. No Yes Company: Liquid Net Worth (excluding equity in home): Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X. X. X’Xxxxx? Yes No $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $250,000 - $500,000 $100,000 - $250,000 $500,000 - $1,000,000 If yes, please list $1,000,000 - $2,000,000 $2,000,000 and Over Total Net Worth: Does this account owner control or have a financial interest in any other account with this firm? Yes No If yes, please list: $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $500,000 - $1,000,000 $2,000,000 and Over Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No Current Banking Information: Bank: City If yes, please list reason and date cleared: Acct. # Have you ever been in a legal dispute or involved in arbitration proceedings, arising from a commodities or securities dispute? Investment Experience: Yes No Futures Yes No # of years: Commodity Options Yes No # of years: Do You Understand: Commodity Funds Yes No # of years: Basics of Futures Trading? Yes No Stocks/Bonds Yes No # of years: Risks of Loss and the Possibility If yes, please list: of Incurring a Debit? Yes No Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable for you? Yes No Do You Have an Existing Securities Account? Yes No Brokerage Firm: Account Number:: X Customer Signature Date FOR OFFICE USE ONLY Review Date New Account Update Is this a Joint Account? Yes No (If YES, complete next section) Type of Account: Joint Tenants With Rights of Survivorship (JTWROS) Joint Tenants in Common (JTIC) For Individual of Joint Account:‌ Name: Net Worth Excluding Equity in Home: Date of Birth: Social Security # $5,000 - $25,000 Occupation: $50,000 - $100,000 $25,000 - $50,000 $100,000 - $250,000 Employer Name and Address: $250,000 - $500,000 $500,000 - $1,000,000 Nature of Business or Industry: Home Telephone: Business Telephone: $1,000,000 - $2,000,000 Annual Income: $25,000 - $50,000 $2,000,000 and over $50,000 - $100,000 Facsimile Number: $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Marital Status: Married Single Divorced Total Net Worth: Number of Dependents: $5,000 - $25,000 $50,000 - $100,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $25,000 - $50,000 $100,000 - $250,000 $500,000 - $1,000,000 $2,000,000 and over Investment Experience: Do You Understand: Futures: Yes No # of Years Basics of Futures Trading? Yes No Commodity Options: Yes No # of Years Risks of Loss and the Possibility of Commodity Funds: Yes No # of Years Incurring a Debit Balance? Yes No Stocks and Bonds: Yes No # of Years If yes, please list: Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable For You? Yes No Current Banking Information: Bank: City: Account Number: Do you have an Existing Securities Account? Yes No Brokerage Firm: Account Number: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No If yes, please list: Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X.X. X’Xxxxx? Yes No If yes, please list: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. Yes No Company: Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No If yes, please list reason and date cleared: Have you ever been in a legal dispute or involved in an arbitration proceeding arising from a commodities or securities dispute? Yes No X Customer Signature Date NOTICE TO CLIENTS This Agreement Is a Legal Contract, Please Read It Carefully. This is a legal contract between X.X. X’Xxxxx Foreign Exchange, Inc. (“RJO”) and the undersigned party or parties (“Client”) executing this document. In connection with opening an account to purchase and sell cash or spot foreign currency and options thereon through the OTC foreign exchange markets (hereinafter referred to as “FX”) with RJO, Client acknowledges that Client has been advised and understands the following factors concerning trading FX, in addition to those contained in the Risk Warning Statement which has been provided to Client.

Appears in 3 contracts

Samples: mcmtrader.com, www.mcmtrader.com, www.mcmtrader.com

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Confidentiality and Security. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic and procedural safeguards that are designed to protect your nonpublic information. FOR OFFICE USE ONLY Review Date New Account Update IB Approval FOR OFFICE USE ONLY Office / Sales Code / Account Number Commission ACCOUNT APPLICATION (Please type, or print legibly and fully in ink) Legal Account Name: Social Security / Fed. ID # Account Owner(s): Date of Birth or formation of business entity: # of Dependents: Permanent street address is required (no P.O. Boxes): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxx E-mail Mailing Address (if different from above): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxxxxx Phone: Home Phone: Fax Phone: Daytime E-mail: Marital Status: Married Single Divorced Are you a: Speculator Xxxxxx U. S. Citizen: Yes No Type of Account: Individual/Joint General Partnership Limited Partnership Corporate Trust Discretionary XXX LLC LLP Name and address of Employer: Occupation/Position: Nature of Business: (If retired, please so indicate and list prior occupation) Name of Broker/Contact who solicited you for this application: FINANCIALS Annual Income: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No $25,000 - $50,000 $50,000 - $100,000 $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Does any other person have authority to trade this account? Yes No For Corporations: Attach a copy of most recent audited financial statement. If under $25,000, Give amount & source: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. No Yes Company: Liquid Net Worth (excluding equity in home): Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X. X. X’Xxxxx? Yes No $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $250,000 - $500,000 $100,000 - $250,000 $500,000 - $1,000,000 If yes, please list $1,000,000 - $2,000,000 $2,000,000 and Over Total Net Worth: Does this account owner control or have a financial interest in any other account with this firm? Yes No If yes, please list: $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $500,000 - $1,000,000 $2,000,000 and Over Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No Current Banking Information: Bank: City If yes, please list reason and date cleared: Acct. # Have you ever been in a legal dispute or involved in arbitration proceedings, arising from a commodities or securities dispute? Investment Experience: Yes No Futures Yes No # of years: Commodity Options Yes No # of years: Do You Understand: Commodity Funds Yes No # of years: Basics of Futures Trading? Yes No Stocks/Bonds Yes No # of years: Risks of Loss and the Possibility If yes, please list: of Incurring a Debit? Yes No Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable for you? Yes No Do You Have an Existing Securities Account? Yes No Brokerage Firm: Account Number:: X Customer Signature Date FOR OFFICE USE ONLY Review Date New Account Update Is this a Joint Account? Yes No (If YES, complete next section) Type of Account: Joint Tenants With Rights of Survivorship (JTWROS) Joint Tenants in Common (JTIC) For Individual of Joint Account:‌ Name: Net Worth Excluding Equity in Home: Date of Birth: Social Security # $5,000 - $25,000 Occupation: $50,000 - $100,000 $25,000 - $50,000 $100,000 - $250,000 Employer Name and Address: $250,000 - $500,000 $500,000 - $1,000,000 Nature of Business or Industry: Home Telephone: Business Telephone: $1,000,000 - $2,000,000 Annual Income: $25,000 - $50,000 $2,000,000 and over $50,000 - $100,000 Facsimile Number: $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Marital Status: Married Single Divorced Total Net Worth: Number of Dependents: $5,000 - $25,000 $50,000 - $100,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $25,000 - $50,000 $100,000 - $250,000 $500,000 - $1,000,000 $2,000,000 and over Investment Experience: Do You Understand: Futures: Yes No # of Years Basics of Futures Trading? Yes No Commodity Options: Yes No # of Years Risks of Loss and the Possibility of Commodity Funds: Yes No # of Years Incurring a Debit Balance? Yes No Stocks and Bonds: Yes No # of Years If yes, please list: Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable For You? Yes No Current Banking Information: Bank: City: Account Number: Do you have an Existing Securities Account? Yes No Brokerage Firm: Account Number: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No If yes, please list: Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X.X. X’Xxxxx? Yes No If yes, please list: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. Yes No Company: Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No If yes, please list reason and date cleared: Have you ever been in a legal dispute or involved in an arbitration proceeding arising from a commodities or securities dispute? Yes No X Customer Signature Date NOTICE TO CLIENTS This Agreement Is a Legal Contract, Please Read It Carefully. This is a legal contract between X.X. X’Xxxxx Foreign Exchange, Inc. (“RJO”) and the undersigned party or parties (“Client”) executing this document. In connection with opening an account to purchase and sell cash or spot foreign currency and options thereon through the OTC foreign exchange markets (hereinafter referred to as “FX”) with RJO, Client acknowledges that Client has been advised and understands the following factors concerning trading FX, in addition to those contained in the Risk Warning Statement which has been provided to Client.PARTNERSHIP INDIVIDUAL GENERAL PARTNER INFORMATION

Appears in 1 contract

Samples: www.mcmtrader.com

Confidentiality and Security. We restrict access to nonpublic personal Contractor must maintain and protect any information about you to those employees who need to know that information to provide products or services to you. We maintain physicalit receives, electronic and procedural safeguards that are designed to protect your nonpublic information. FOR OFFICE USE ONLY Review Date New Account Update IB Approval FOR OFFICE USE ONLY Office / Sales Code / Account Number Commission ACCOUNT APPLICATION (Please typecompiles, or print legibly creates as a result of the Contract in accordance with any federal, state, or local laws and fully regulations that apply. Contractor must establish a method to secure the confidentiality of records and other information relating to the TWDB in ink) Legal Account accordance with applicable federal and state laws, rules, and regulations. of the policies immediately upon request. EXECUTION OF PROPOSAL Company Name: Social Security / FedAddress: Phone Number: E-Mail: I, , am the above-referenced company’s representative and I am authorized to submit this response and sign future contract documents. ID # Account Owner(s): Date of Birth or formation of business entity: # of Dependents: Permanent street By signing below, the representative certifies that if a Texas address is required (no P.O. Boxes): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxx E-mail Mailing Address (if different from above): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxxxxx Phone: Home Phone: Fax Phone: Daytime E-mail: Marital Status: Married Single Divorced Are you a: Speculator Xxxxxx U. S. Citizen: Yes No Type of Account: Individual/Joint General Partnership Limited Partnership Corporate Trust Discretionary XXX LLC LLP Name and address of Employer: Occupation/Position: Nature of Business: (If retiredshown as the address, please so indicate and list prior occupation) Name of Broker/Contact who solicited you for this application: FINANCIALS Annual Income: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No $25,000 - $50,000 $50,000 - $100,000 $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Does any other person have authority to trade this account? Yes No For Corporations: Attach the respondent qualifies as a copy of most recent audited financial statement. If under $25,000, Give amount & source: Are you a “control person” or “affiliate” of a public company Texas Bidder as defined in SEC 34 TAC Rule 144? This would include20.32(68). Authorized Signature Date Title: CONTENT ITEM 2 COMPANY PROFILE SUMMARY AND HISTORY (To be provided by Respondent) CONTENT ITEM 3 RESUMES OF INDIVIDUALS (to be provided by Respondent) CONTENT ITEM 4 – OWNERSHIP OF BUSINESS ENTITY Name(s) and Social Security Number(s) of Each Person with at least 25 Percent Ownership of the Business Entity Submitting the RFO (if applicable) Name Social Security Number Name Social Security Number Name Social Security Number Name Social Security Number CONTENT ITEM 5 – EXPERIENCE AND KNOWLEDGE (To be provide by Respondent) CONTENT ITEM 6 – PRICE (To be provide by Respondent) EXHIBIT B Contractor’s Proposal TWDB Contract 1800012297 Exhibit B, but is not necessarily limited toPage 1 of 18 Texas Water Development Board REQUEST FOR OFFERS NO. 580-18-RFO0075 WEBCASTING SERVICES July 25, 10% shareholders2018 To Whom It May Concern: Texas Admin has more than 18 years experience working with various state agencies to webcast regulatory and board meetings. Our expertise in this area has allowed us to understand the extensive technological needs of state agencies. We have a proven process that includes eliminating points of failure and customized personalized technical assistance. We produce high quality video with various additional elements, policy-making executivessuch as closed captioning and transcriptions of the spoken words. We have read and understand the RFO, and members specifically the Scope of the Board of Directors. No Yes Company: Liquid Net Worth (excluding equity in home): Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X. X. X’Xxxxx? Yes No $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $250,000 - $500,000 $100,000 - $250,000 $500,000 - $1,000,000 If yes, please list $1,000,000 - $2,000,000 $2,000,000 and Over Total Net Worth: Does this account owner control or have a financial interest in any other account with this firm? Yes No If yes, please list: $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $500,000 - $1,000,000 $2,000,000 and Over Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No Current Banking Information: Bank: City If yes, please list reason and date cleared: Acct. # Have you ever been in a legal dispute or involved in arbitration proceedings, arising from a commodities or securities dispute? Investment Experience: Yes No Futures Yes No # of years: Commodity Options Yes No # of years: Do You Understand: Commodity Funds Yes No # of years: Basics of Futures Trading? Yes No Stocks/Bonds Yes No # of years: Risks of Loss and the Possibility If yes, please list: of Incurring a Debit? Yes No Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable for you? Yes No Do You Have an Existing Securities Account? Yes No Brokerage Firm: Account Number:: X Customer Signature Date FOR OFFICE USE ONLY Review Date New Account Update Is this a Joint Account? Yes No (If YES, complete next section) Type of Account: Joint Tenants With Rights of Survivorship (JTWROS) Joint Tenants in Common (JTIC) For Individual of Joint Account:‌ Name: Net Worth Excluding Equity in Home: Date of Birth: Social Security # $5,000 - $25,000 Occupation: $50,000 - $100,000 $25,000 - $50,000 $100,000 - $250,000 Employer Name and Address: $250,000 - $500,000 $500,000 - $1,000,000 Nature of Business or Industry: Home Telephone: Business Telephone: $1,000,000 - $2,000,000 Annual Income: $25,000 - $50,000 $2,000,000 and over $50,000 - $100,000 Facsimile Number: $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Marital Status: Married Single Divorced Total Net Worth: Number of Dependents: $5,000 - $25,000 $50,000 - $100,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $25,000 - $50,000 $100,000 - $250,000 $500,000 - $1,000,000 $2,000,000 and over Investment Experience: Do You Understand: Futures: Yes No # of Years Basics of Futures Trading? Yes No Commodity Options: Yes No # of Years Risks of Loss and the Possibility of Commodity Funds: Yes No # of Years Incurring a Debit Balance? Yes No Stocks and Bonds: Yes No # of Years If yes, please list: Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable For You? Yes No Current Banking Information: Bank: City: Account Number: Do you have an Existing Securities Account? Yes No Brokerage Firm: Account Number: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No If yes, please list: Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X.X. X’Xxxxx? Yes No If yes, please list: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executivesWork, and members of we are able to comply with the Board of Directorsspecifications laid out in the RFO. Yes No Company: Have We appreciate the opportunity to submit this proposal and look forward to hearing from you ever been subject to bankruptcy proceedingssoon. Best regards, receivership or similar actions, voluntarily or involuntarily? Yes No If yes, please list reason and date cleared: Have you ever been in a legal dispute or involved in an arbitration proceeding arising from a commodities or securities dispute? Yes No X Customer Signature Date NOTICE TO CLIENTS This Agreement Is a Legal Contract, Please Read It Carefully. This is a legal contract between X.X. X’Xxxxx Foreign ExchangeXxxx Xxxxxxx GM/COO XxxxxXxxxx.xxx, Inc. (“RJO”) AdminMonitor, Inc. Texas Water Development Board REQUEST FOR OFFERS NO. 580-18-RFO0075 WEBCASTING SERVICES Table of Contents 1. Content Item 1: Signed/Dated Execution of Proposal 2. Content Item 2: Company Profile Summary and the undersigned party or parties (“Client”) executing this document. In connection with opening an account to purchase and sell cash or spot foreign currency and options thereon through the OTC foreign exchange markets (hereinafter referred to as “FX”) with RJO, Client acknowledges that Client has been advised and understands the following factors concerning trading FX, in addition to those contained in the Risk Warning Statement which has been provided to Client.History

Appears in 1 contract

Samples: Webcasting Services

Confidentiality and Security. We restrict access THE LENDER RESTRICTS ACCESS TO NONPUBLIC PERSONAL INFORMATION ABOUT THE TRUST AND THE INSURED TO THOSE EMPLOYEES AND AGENTS WHO NEED TO KNOW THAT INFORMATION TO PROVIDE PRODUCTS OR SERVICES TO THE TRUST OR THE INSURED, AND AS ALLOWED BY APPLICABLE LAW OR REGULATION, AND DOES NOT PERMIT IT TO BE SHARED OR USED FOR ANY OTHER PURPOSE. THE LENDER MAINTAINS PHYSICAL, ELECTRONIC, AND PROCEDURAL SAFEGUARDS TO GUARD THE NONPUBLIC PERSONAL INFORMATION OF THE TRUST AND THE INSURED. 27 Notifier Name Notifier Address Notifier City, State, Zip Notifier Phone Number Dear : A company called Imperial Premium Finance, LLC has allowed me to nonpublic personal information about buy an insurance policy with me as the insured by lending to me money to pay the premium on the Policy. As a condition to the loan and as a part of the on-going obligations thereunder, I am asking you to those employees who need notify Imperial Premium Finance, LLC of my passing. Please contact Imperial Premium Finance, LLC, Attention: General Counsel at 000 Xxxx xx Xxxxxxxx Xxxxxxxxx, Xxx. 000, Xxxx Xxxxx, Xxxxxxx 00000, telephone number (000) 000-0000 immediately upon my death. Thank you in advance for assisting me in this process. Sincerely, [INSURED] Insurance Company: [INSURER] Policy #: [POLICY-NUMBER] LIMITED SPECIFIC POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that [INSURED] hereinafter called “Principal” does hereby make, constitute, and appoint IMPERIAL PREMIUM FINANCE, LLC, a Florida limited liability company hereinafter called “Agent”, my true and lawful attorney-in-fact, for me and in my name and on my behalf, giving and granting onto the Agent full power and authority to know that information act as to provide products or services limited matters stated below pertaining to youthe loan and trust documents herein described and no others. We maintain physical, electronic and procedural safeguards that are designed to protect your nonpublic information. FOR OFFICE USE ONLY Review Date New Account Update IB Approval FOR OFFICE USE ONLY Office / Sales Code / Account Number Commission ACCOUNT APPLICATION (Please type, or print legibly and fully in ink) Legal Account Name: Social Security / Fed. ID # Account Owner(s): Date of Birth or formation of business entity: # of Dependents: Permanent street address is required (no P.O. Boxes): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxx E-mail Mailing Address (if different from above): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxxxxx Phone: Home Phone: Fax Phone: Daytime E-mail: Marital Status: Married Single Divorced Are you a: Speculator Xxxxxx U. S. Citizen: Yes No Type of Account: Individual/Joint General Partnership Limited Partnership Corporate Trust Discretionary XXX LLC LLP Name and address of Employer: Occupation/Position: Nature of Business: (If retired, please so indicate and list prior occupation) Name of Broker/Contact who solicited you for this applicationLender: FINANCIALS Annual IncomeIMPERIAL PREMIUM FINANCE, LLC Name of Life Insurance Trust: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No $25,000 - $50,000 $50,000 - $100,000 $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Does any other person have authority to trade this account? Yes No For Corporations[TRUST-NAME] Name of Trustee: Attach a copy [TRUSTEE-NAME] Name of most recent audited financial statement. If under $25,000, Give amount & sourceBorrower: Are you a “control person” or “affiliate” [TRUST-NAME] Name of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. No Yes CompanyGrantor: Liquid Net Worth (excluding equity in home): Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X. X. X’Xxxxx? Yes No $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $250,000 - $500,000 $100,000 - $250,000 $500,000 - $1,000,000 If yes, please list $1,000,000 - $2,000,000 $2,000,000 and Over Total Net Worth: Does this account owner control or have a financial interest in any other account with this firm? Yes No If yes, please list: $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $500,000 - $1,000,000 $2,000,000 and Over Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No Current Banking Information: Bank: City If yes, please list reason and date cleared: Acct. # Have you ever been in a legal dispute or involved in arbitration proceedings, arising from a commodities or securities dispute? Investment Experience: Yes No Futures Yes No # of years: Commodity Options Yes No # of years: Do You Understand: Commodity Funds Yes No # of years: Basics of Futures Trading? Yes No Stocks/Bonds Yes No # of years: Risks of Loss and the Possibility If yes, please list: of Incurring a Debit? Yes No Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable for you? Yes No Do You Have an Existing Securities Account? Yes No Brokerage Firm: Account Number:: X Customer Signature Date FOR OFFICE USE ONLY Review Date New Account Update Is this a Joint Account? Yes No (If YES, complete next section) Type of Account: Joint Tenants With Rights of Survivorship (JTWROS) Joint Tenants in Common (JTIC) For Individual of Joint Account:‌ Name: Net Worth Excluding Equity in Home: Date of Birth: Social Security # $5,000 - $25,000 Occupation: $50,000 - $100,000 $25,000 - $50,000 $100,000 - $250,000 Employer Name and Address: $250,000 - $500,000 $500,000 - $1,000,000 Nature of Business or Industry: Home Telephone: Business Telephone: $1,000,000 - $2,000,000 Annual Income: $25,000 - $50,000 $2,000,000 and over $50,000 - $100,000 Facsimile Number: $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Marital Status: Married Single Divorced Total Net Worth: Number of Dependents: $5,000 - $25,000 $50,000 - $100,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $25,000 - $50,000 $100,000 - $250,000 $500,000 - $1,000,000 $2,000,000 and over Investment Experience: Do You Understand: Futures: Yes No # of Years Basics of Futures Trading? Yes No Commodity Options: Yes No # of Years Risks of Loss and the Possibility of Commodity Funds: Yes No # of Years Incurring a Debit Balance? Yes No Stocks and Bonds: Yes No # of Years If yes, please list: Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable For You? Yes No Current Banking Information: Bank: City: Account Number: Do you have an Existing Securities Account? Yes No Brokerage Firm: Account Number: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No If yes, please list: Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X.X. X’Xxxxx? Yes No If yes, please list: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. Yes No Company: Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No If yes, please list reason and date cleared: Have you ever been in a legal dispute or involved in an arbitration proceeding arising from a commodities or securities dispute? Yes No X Customer Signature Date NOTICE TO CLIENTS This Agreement Is a Legal Contract, Please Read It Carefully. This is a legal contract between X.X. X’Xxxxx Foreign Exchange, Inc. (“RJO”) and the undersigned party or parties (“Client”) executing this document. In connection with opening an account to purchase and sell cash or spot foreign currency and options thereon through the OTC foreign exchange markets (hereinafter referred to as “FX”) with RJO, Client acknowledges that Client has been advised and understands the following factors concerning trading FX, in addition to those contained in the Risk Warning Statement which has been provided to Client.[INSURED]

Appears in 1 contract

Samples: Financing Agreement (Imperial Holdings, LLC)

Confidentiality and Security. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic and procedural safeguards that are designed to guard your personal account information. To further protect your nonpublic informationprivacy, we restrict access to your personal and financial data to authorized Xxxxxx associates who have a need for these records. FOR OFFICE USE ONLY Review Date New Account Update IB Approval FOR OFFICE USE ONLY Office / Sales Code / Account Number Commission ACCOUNT APPLICATION We require all nonaffiliated organizations to conform to our privacy standards and are contractually obligated to keep the information provided confidential and used as requested. Furthermore, we will continue to adhere to the privacy policies and practices described in this notice even after your account is closed or becomes inactive. ADV OFFER: ADV OFFER: Should you wish to receive an updated copy of Sprott Asset Management USA, Inc.’s Form ADV, please contact Xxxxxxx Xxxxxx at (Please type000) 000-0000 or via email at xxxxxxx@xxxxxxxxxxxx.xxx. Appendix B RESOURCE EXPLORATION AND DEVELOPMENT PRIVATE PLACEMENT, LP ADDITIONAL SUBSCRIPTION FORM To: Resource Exploration and Development Private Placement, LP c/o Sprott US GenPar LLC 0000 Xxxxxxx Xxxxx Xxx, Xxxxx 000 Xxxxxxxx, Xxxxxxxxxx 00000 Attn: Xxx Xxxxxxxxxxx Email: xxxxxxxxxxxx@xxxxxxxxxxxx.xxx Phone: (000) 000-0000 (Investor Name) The undersigned hereby wishes to contribute additional capital to increase its subscription in Resource Exploration and Development Private Placement, LP (the “Partnership”) by the amount set forth below. The undersigned shall contribute such capital by making a payment by wire in the manner indicated on the attached payment information sheet. Total Additional Subscription Amount: US$ (Minimum of US$250,000) Desired Subscription Date: (Effective the 1st Business Day of the fiscal quarter, or print legibly and fully in inkas otherwise determined by the General Partner, immediately following acceptance of additional subscription by the Partnership) Legal Account Name: Social Security / Fed. ID # Account Owner(s): Date of Birth or formation of business entity: # of Dependents: Permanent street address is required (no P.O. Boxes): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxx E-mail Mailing Address (if different from above): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxxxxx Phone: Home Phone: Fax Phone: Daytime E-mail: Marital Status: Married Single Divorced Are you a: Speculator Xxxxxx U. S. Citizen: Yes No Type of Account: Individual/Joint General Partnership Limited Partnership Corporate Trust Discretionary XXX LLC LLP Name and address of Employer: Occupation/Position: Nature of BusinessThe undersigned hereby: (If retired, please so indicate and list prior occupationi) Name of Broker/Contact who solicited you for this application: FINANCIALS Annual Income: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No $25,000 - $50,000 $50,000 - $100,000 $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Does any other person have authority to trade this account? Yes No For Corporations: Attach a copy of most recent audited financial statement. If under $25,000, Give amount & source: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but acknowledges that the undersigned is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. No Yes Company: Liquid Net Worth (excluding equity in home): Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X. X. X’Xxxxx? Yes No $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $250,000 - $500,000 $100,000 - $250,000 $500,000 - $1,000,000 If yes, please list $1,000,000 - $2,000,000 $2,000,000 and Over Total Net Worth: Does this account owner control or have a financial increasing its interest in any other account with this firm? Yes No If yes, please list: $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $500,000 - $1,000,000 $2,000,000 the Partnership on the terms and Over Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No Current Banking Information: Bank: City If yes, please list reason and date cleared: Acct. # Have you ever been in a legal dispute or involved in arbitration proceedings, arising from a commodities or securities dispute? Investment Experience: Yes No Futures Yes No # of years: Commodity Options Yes No # of years: Do You Understand: Commodity Funds Yes No # of years: Basics of Futures Trading? Yes No Stocks/Bonds Yes No # of years: Risks of Loss and the Possibility If yes, please list: of Incurring a Debit? Yes No Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable for you? Yes No Do You Have an Existing Securities Account? Yes No Brokerage Firm: Account Number:: X Customer Signature Date FOR OFFICE USE ONLY Review Date New Account Update Is this a Joint Account? Yes No (If YES, complete next section) Type of Account: Joint Tenants With Rights of Survivorship (JTWROS) Joint Tenants in Common (JTIC) For Individual of Joint Account:‌ Name: Net Worth Excluding Equity in Home: Date of Birth: Social Security # $5,000 - $25,000 Occupation: $50,000 - $100,000 $25,000 - $50,000 $100,000 - $250,000 Employer Name and Address: $250,000 - $500,000 $500,000 - $1,000,000 Nature of Business or Industry: Home Telephone: Business Telephone: $1,000,000 - $2,000,000 Annual Income: $25,000 - $50,000 $2,000,000 and over $50,000 - $100,000 Facsimile Number: $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Marital Status: Married Single Divorced Total Net Worth: Number of Dependents: $5,000 - $25,000 $50,000 - $100,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $25,000 - $50,000 $100,000 - $250,000 $500,000 - $1,000,000 $2,000,000 and over Investment Experience: Do You Understand: Futures: Yes No # of Years Basics of Futures Trading? Yes No Commodity Options: Yes No # of Years Risks of Loss and the Possibility of Commodity Funds: Yes No # of Years Incurring a Debit Balance? Yes No Stocks and Bonds: Yes No # of Years If yes, please list: Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable For You? Yes No Current Banking Information: Bank: City: Account Number: Do you have an Existing Securities Account? Yes No Brokerage Firm: Account Number: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No If yes, please list: Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X.X. X’Xxxxx? Yes No If yes, please list: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. Yes No Company: Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No If yes, please list reason and date cleared: Have you ever been in a legal dispute or involved in an arbitration proceeding arising from a commodities or securities dispute? Yes No X Customer Signature Date NOTICE TO CLIENTS This Agreement Is a Legal Contract, Please Read It Carefully. This is a legal contract between X.X. X’Xxxxx Foreign Exchange, Inc. (“RJO”) and the undersigned party or parties (“Client”) executing this document. In connection with opening an account to purchase and sell cash or spot foreign currency and options thereon through the OTC foreign exchange markets (hereinafter referred to as “FX”) with RJO, Client acknowledges that Client has been advised and understands the following factors concerning trading FX, in addition to those conditions contained in the Risk Warning Statement which has been provided Partnership’s Amended and Restated Amended and Restated Agreement of Limited Partnership and Confidential Private Placement Memorandum, each as amended and supplemented from time to Client.time, and the Subscription Agreement previously executed by the undersigned and accepted by the Partnership (the “Subscription Agreement”), and (ii) restates all of the representations and warranties of the undersigned contained in the Subscription Agreement, and certifies that the same remain true and correct in all material respects as of the date set forth below. THE UNDERSIGNED AGREES TO IMMEDIATELY NOTIFY THE GENERAL PARTNER SHOULD ANY OF THE FOREGOING INFORMATION CHANGE OR BECOME UNTRUE. Dated: , For Corporation, Fund, Trust or Other Entity Shareholders: For Individual Shareholders: (Print Name of Entity) Print Name: (Signature) (If any Joint Limited Partners) By: Print Print Name: Name: Title: (Signature)

Appears in 1 contract

Samples: Subscription Agreement

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Confidentiality and Security. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic and procedural safeguards that are designed to protect your nonpublic information. FOR OFFICE USE ONLY Review Date New Account Update IB Approval FOR OFFICE USE ONLY Office / Sales Code / Account Number Commission ACCOUNT APPLICATION (Please type, or print legibly and fully in ink) Legal Account Name: Social Security / Fed. ID # Account Owner(s): Date of Birth or formation of business entity: # of Dependents: Permanent street address is required (no P.O. Boxes): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxx E-mail Mailing Address (if different from above): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxxxxx Phone: Home Phone: Fax Phone: Daytime E-mail: Marital Status: Married Single Divorced Are you a: Speculator Xxxxxx U. S. Citizen: Yes No Type of Account: Individual/Joint General Partnership Limited Partnership Corporate Trust Discretionary XXX IRA LLC LLP Name and address of Employer: Occupation/Position: Nature of Business: (If retired, please so indicate and list prior occupation) Name of BrokerXxxxxx/Contact who solicited you for this application: FINANCIALS Annual Income: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No $25,000 - $50,000 $50,000 - $100,000 $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Does any other person have authority to trade this account? Yes No For Corporations: Attach a copy of most recent audited financial statement. If under $25,000, Give amount & source: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. No Yes Company: Liquid Net Worth (excluding equity in home): Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X. X. X’Xxxxx? Yes No $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $250,000 - $500,000 $100,000 - $250,000 $500,000 - $1,000,000 If yes, please list $1,000,000 - $2,000,000 $2,000,000 and Over Total Net Worth: Does this account owner control or have a financial interest in any other account with this firm? Yes No If yes, please list: $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $500,000 - $1,000,000 $2,000,000 and Over Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No Current Banking Information: Bank: City If yes, please list reason and date cleared: Acct. # Have you ever been in a legal dispute or involved in arbitration proceedings, arising from a commodities or securities dispute? Investment Experience: Yes No Futures Yes No # of years: Commodity Options Yes No # of years: Do You Understand: Commodity Funds Yes No # of years: Basics of Futures Trading? Yes No Stocks/Bonds Yes No # of years: Risks of Loss and the Possibility If yes, please list: of Incurring a Debit? Yes No Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable for you? Yes No Do You Have an Existing Securities Account? Yes No Brokerage Firm: Account Number:: X Customer Signature Date FOR OFFICE USE ONLY Review Date New Account Update Is this a Joint Account? Yes No (If YES, complete next section) Type of Account: Joint Tenants With Rights of Survivorship (JTWROS) Joint Tenants in Common (JTIC) For Individual of Joint Account:‌ Name: Net Worth Excluding Equity in Home: Date of Birth: Social Security # $5,000 - $25,000 Occupation: $50,000 - $100,000 $25,000 - $50,000 $100,000 - $250,000 Employer Name and Address: $250,000 - $500,000 $500,000 - $1,000,000 Nature of Business or Industry: Home Telephone: Business Telephone: $1,000,000 - $2,000,000 Annual Income: $25,000 - $50,000 $2,000,000 and over $50,000 - $100,000 Facsimile Number: $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Marital Status: Married Single Divorced Total Net Worth: Number of Dependents: $5,000 - $25,000 $50,000 - $100,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $25,000 - $50,000 $100,000 - $250,000 $500,000 - $1,000,000 $2,000,000 and over Investment Experience: Do You Understand: Futures: Yes No # of Years Basics of Futures Trading? Yes No Commodity Options: Yes No # of Years Risks of Loss and the Possibility of Commodity Funds: Yes No # of Years Incurring a Debit Balance? Yes No Stocks and Bonds: Yes No # of Years If yes, please list: Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable For You? Yes No Current Banking Information: Bank: City: Account Number: Do you have an Existing Securities Account? Yes No Brokerage Firm: Account Number: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No If yes, please list: Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X.X. X’Xxxxx? Yes No If yes, please list: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. Yes No Company: Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No If yes, please list reason and date cleared: Have you ever been in a legal dispute or involved in an arbitration proceeding arising from a commodities or securities dispute? Yes No X Customer Signature Date NOTICE TO CLIENTS This Agreement Is a Legal Contract, Please Read It Carefully. This is a legal contract between X.X. X’Xxxxx Foreign Exchange, Inc. (“RJO”) and the undersigned party or parties (“Client”) executing this document. In connection with opening an account to purchase and sell cash or spot foreign currency and options thereon through the OTC foreign exchange markets (hereinafter referred to as “FX”) with RJO, Client acknowledges that Client has been advised and understands the following factors concerning trading FX, in addition to those contained in the Risk Warning Statement which has been provided to Client.PARTNERSHIP INDIVIDUAL GENERAL PARTNER INFORMATION

Appears in 1 contract

Samples: www.mcmtrader.com

Confidentiality and Security. We restrict access to nonpublic personal Personal Information collected on this website, and private information about you which can be accessed through this website, to those of our employees who need to know that information to provide products or services applicable Fund information to you. We maintain physical, electronic electronic, and procedural safeguards that are designed comply with applicable state and/or federal regulations to protect guard your nonpublic Personal Information and other private information. FOR OFFICE USE ONLY Review Date New Account Update IB Approval FOR OFFICE USE ONLY Office / Sales Code / Account Number Commission ACCOUNT APPLICATION (Please typeWe do not rent, sell to, or print legibly share Personal Information or other private information about you with other people or companies except the third-party vendors who perform services on the Funds’ behalf. • Health Insurance Portability and fully Accountability Act of 1996, as amended (“HIPAA”). The Iron Workers’ Locals No. 15 and 424 Extended Benefit Fund (the “EB Fund”) is regulated by another federal law, known as HIPAA, and it requires the EB Fund to take various extra precautions when it handles or utilizes your individually identifiable health information, including eligibility information (known as “protected health information”). For additional information about HIPAA, and a copy of the EB Fund’s Notice of Privacy Practices (2021 Restatement) please refer to pages 100, and 114 through 120, respectively, of the EB Fund’s Summary Plan Description. • How We Notify You About Privacy Policy Changes. We may revise and update this Privacy Policy if we change our practices, add new website features, or change existing website features. To the extent possible we will post a notice to this website of any substantive changes to our Privacy Policy. Your use of this website following any such change constitutes your agreement with regard to any Personal Information collected from you in ink) Legal Account Name: Social Security / Fedthe past and/or in the future. ID # Account Owner(s): Date of Birth or formation of business entity: # of Dependents: Permanent street address is required (no P.O. Boxes): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxx E-mail Mailing Address (if different from above): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxxxxx Phone: Home Phone: Fax Phone: Daytime E-mail: Marital Status: Married Single Divorced Are you a: Speculator Xxxxxx U. S. Citizen: Yes No Type of Account: Individual/Joint General Partnership Limited Partnership Corporate Trust Discretionary XXX LLC LLP Name and address of Employer: Occupation/Position: Nature of Business: (***************************************************************************** If retired, please so indicate and list prior occupation) Name of Broker/Contact who solicited you for this application: FINANCIALS Annual Income: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No $25,000 - $50,000 $50,000 - $100,000 $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Does any other person have authority to trade this account? Yes No For Corporations: Attach a copy questions about the Terms of most recent audited financial statement. If under $25,000, Give amount & source: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. No Yes Company: Liquid Net Worth (excluding equity in home): Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X. X. X’Xxxxx? Yes No $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $250,000 - $500,000 $100,000 - $250,000 $500,000 - $1,000,000 If yesUse / User Agreement and/or Privacy Policy, please list $1,000,000 - $2,000,000 $2,000,000 contact the Funds' Executive Director, Xx. Xxxxxx Xxxxxx, by telephone at 000-000-0000, or via email at: xxxxxx@xxxxxxxxxxxxx.xxx. The Funds' mailing address is as follows: Iron Workers’ Locals No. 15 and Over Total Net Worth: Does this account owner control or have a financial interest in any other account with this firm? Yes No If yes424 Benefit Funds 000 Xxxx Xx, please list: $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $500,000 - $1,000,000 $2,000,000 and Over Have you ever been subject to bankruptcy proceedingsXxxxxxxx 0, receivership or similar actions, voluntarily or involuntarily? Yes No Current Banking Information: Bank: City If yes, please list reason and date cleared: Acct. # Have you ever been in a legal dispute or involved in arbitration proceedings, arising from a commodities or securities dispute? Investment Experience: Yes No Futures Yes No # of years: Commodity Options Yes No # of years: Do You Understand: Commodity Funds Yes No # of years: Basics of Futures Trading? Yes No Stocks/Bonds Yes No # of years: Risks of Loss and the Possibility If yes, please list: of Incurring a Debit? Yes No Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable for you? Yes No Do You Have an Existing Securities Account? Yes No Brokerage Firm: Account Number:: X Customer Signature Date FOR OFFICE USE ONLY Review Date New Account Update Is this a Joint Account? Yes No (If YES, complete next section) Type of Account: Joint Tenants With Rights of Survivorship (JTWROS) Joint Tenants in Common (JTIC) For Individual of Joint Account:‌ Name: Net Worth Excluding Equity in Home: Date of Birth: Social Security # $5,000 - $25,000 Occupation: $50,000 - $100,000 $25,000 - $50,000 $100,000 - $250,000 Employer Name and Address: $250,000 - $500,000 $500,000 - $1,000,000 Nature of Business or Industry: Home Telephone: Business Telephone: $1,000,000 - $2,000,000 Annual Income: $25,000 - $50,000 $2,000,000 and over $50,000 - $100,000 Facsimile Number: $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Marital Status: Married Single Divorced Total Net Worth: Number of Dependents: $5,000 - $25,000 $50,000 - $100,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $25,000 - $50,000 $100,000 - $250,000 $500,000 - $1,000,000 $2,000,000 and over Investment Experience: Do You Understand: Futures: Yes No # of Years Basics of Futures Trading? Yes No Commodity Options: Yes No # of Years Risks of Loss and the Possibility of Commodity Funds: Yes No # of Years Incurring a Debit Balance? Yes No Stocks and Bonds: Yes No # of Years If yes, please list: Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable For You? Yes No Current Banking Information: Bank: City: Account Number: Do you have an Existing Securities Account? Yes No Brokerage Firm: Account Number: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No If yes, please list: Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X.X. X’Xxxxx? Yes No If yes, please list: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. Yes No Company: Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No If yes, please list reason and date cleared: Have you ever been in a legal dispute or involved in an arbitration proceeding arising from a commodities or securities dispute? Yes No X Customer Signature Date NOTICE TO CLIENTS This Agreement Is a Legal Contract, Please Read It Carefully. This is a legal contract between X.X. X’Xxxxx Foreign Exchange, Inc. (“RJO”) and the undersigned party or parties (“Client”) executing this document. In connection with opening an account to purchase and sell cash or spot foreign currency and options thereon through the OTC foreign exchange markets (hereinafter referred to as “FX”) with RJO, Client acknowledges that Client has been advised and understands the following factors concerning trading FX, in addition to those contained in the Risk Warning Statement which has been provided to Client.Xxxxx X

Appears in 1 contract

Samples: User Agreement

Confidentiality and Security. We restrict access to nonpublic personal information about you our members to those employees who need to know that information to provide products or and services to you. We maintain physical, electronic electronic, and procedural safeguards that are designed comply with Federal standards to protect guard your nonpublic personal information. FOR OFFICE USE ONLY Review Date New Account Update IB Approval FOR OFFICE USE ONLY Office / Sales Code / Account Number Commission ACCOUNT APPLICATION It’s Your Choice! You can choose how you wish to learn about our products and services, including not receiving information from our affiliates and non-affiliates. To tell us your preferences, you may: • Visit any of our branches and request an “Opt Out” form. That form can then be mailed to Securityplus FCU, Attn: Marketing Department, P.O. Box 7560, Baltimore, MD 00000-0000. • Contact the Securityplus FCU Call Center at (Please type, 000) 000-0000 or print legibly and fully in ink) Legal Account Name: Social Security / Fed. ID # Account Owner(s): Date of Birth or formation of business entity: # of Dependents: Permanent street address is required (no P.O. Boxes): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxx E1-866-4SECPLUS • Send us an e-mail Mailing Address (if different from above): Xxxxxx Xxxxxxx Xxxx Xxxxx Xxx+0 Xxxxxxx Phoneat xxxxxxxx@xxxxxxxxxxxxxxx.xxx • Write us in care of the Securityplus Federal Credit Union, Attn: Home Phone: Fax Phone: Daytime EMarketing Department, P.O. Box 7560, Baltimore, MD 21207-mail: Marital Status: Married Single Divorced Are you a: Speculator Xxxxxx U. S. Citizen: Yes No Type of Account: Individual/Joint General Partnership Limited Partnership Corporate Trust Discretionary XXX LLC LLP Name and address of Employer: Occupation/Position: Nature of Business: (0560. Securityplus Federal Credit Union reserves the right to amend this disclosure at any time without prior notice. This disclosure amends any existing agreements Securityplus FCU has with you. WHAT TO DO IF YOU ARE A VICTIM OF IDENTITY THEFT If retired, please so indicate and list prior occupation) Name of Broker/Contact who solicited you for this application: FINANCIALS Annual Income: Do you have any unsatisfied debit balance(s) with RJO become a victim of identity theft, it is important that you take the following steps to xxxxxx a thorough investigation and quick resolution: • File a police report in the precinct in which the crime occurred. A copy of the report must be provided to the Credit Union so that we may conduct a full and complete investigation. • Stop by a branch to complete the ID Theft Affidavit form or with any other commodities/securities firm? Yes No $25,000 - $50,000 $50,000 - $100,000 $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Does any other person have authority call 000-000-0000 or 1-866-4SECPLUS to trade request this account? Yes No For Corporationsform. The completed form will need to be returned to: Attach Securityplus FCU, P.O. Box 7560, Baltimore, MD 21207. • We will contact each of the three main Credit Agencies and order a copy of most recent audited financial statementyour credit report. If under $25,000, Give amount & source: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy-making executives, and members of the Board of Directors. No Yes Company: Liquid Net Worth (excluding equity in home): Are you an employee or member of any futures or securities exchange, NFA, NASD; a member firm of either of those entities or an employee of X. X. X’Xxxxx? Yes No $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $250,000 - $500,000 $100,000 - $250,000 $500,000 - $1,000,000 If yes, please list $1,000,000 - $2,000,000 $2,000,000 and Over Total Net Worth: Does this account owner control or have a financial interest in You will be able to see if there are any other account with this firm? Yes No If yes, please list: $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $500,000 - $1,000,000 $2,000,000 and Over Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No Current Banking Information: Bank: City If yes, please list reason and date cleared: Acct. # Have you ever been in a legal dispute or involved in arbitration proceedings, arising from a commodities or securities dispute? Investment Experience: Yes No Futures Yes No # of years: Commodity Options Yes No # of years: Do You Understand: Commodity Funds Yes No # of years: Basics of Futures Trading? Yes No Stocks/Bonds Yes No # of years: Risks of Loss and the Possibility If yes, please list: of Incurring a Debit? Yes No Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable for you? Yes No Do You Have an Existing Securities Account? Yes No Brokerage Firm: Account Number:: X Customer Signature Date FOR OFFICE USE ONLY Review Date New Account Update Is this a Joint Account? Yes No (If YES, complete next section) Type of Account: Joint Tenants With Rights of Survivorship (JTWROS) Joint Tenants in Common (JTIC) For Individual of Joint Account:‌ Name: Net Worth Excluding Equity in Home: Date of Birth: Social Security # $5,000 - $25,000 Occupation: $50,000 - $100,000 $25,000 - $50,000 $100,000 - $250,000 Employer Name and Address: $250,000 - $500,000 $500,000 - $1,000,000 Nature of Business or Industry: Home Telephone: Business Telephone: $1,000,000 - $2,000,000 Annual Income: $25,000 - $50,000 $2,000,000 and over $50,000 - $100,000 Facsimile Number: $100,000 - $200,000 $200,000 - $1,000,000 over $1,000,000 Marital Status: Married Single Divorced Total Net Worth: Number of Dependents: $5,000 - $25,000 $50,000 - $100,000 $250,000 - $500,000 $1,000,000 - $2,000,000 $25,000 - $50,000 $100,000 - $250,000 $500,000 - $1,000,000 $2,000,000 and over Investment Experience: Do You Understand: Futures: Yes No # of Years Basics of Futures Trading? Yes No Commodity Options: Yes No # of Years Risks of Loss and the Possibility of Commodity Funds: Yes No # of Years Incurring a Debit Balance? Yes No Stocks and Bonds: Yes No # of Years If yes, please list: Firm Account Open Closed Firm Account Open Closed Is Foreign Exchange Trading Suitable For You? Yes No Current Banking Information: Bank: City: Account Number: Do accounts that you have an Existing Securities Account? Yes No Brokerage Firmnot authorized and can work with these agencies to get notifications of other unauthorized activity. Following is information on the three main Credit Agencies: Account NumberEquifax Experian TransUnion PO Box 740241 PO Box 2002 PO Box 1000 Atlanta, GA 30374 Allen, TX 75013 Chester, PA 19022 xxx.xxxxxxx.xxx xxx.xxxxxxxx.xxx xxx.xxxxxxxxxx.xxx Order a Credit Report: Do you have any unsatisfied debit balance(s) with RJO or with any other commodities/securities firm? Yes No If yes, please listOrder a Credit Report: Are you an employee or member of any futures or securities exchange, NFA, NASD; Order a member firm of either of those entities or an employee of X.X. X’Xxxxx? Yes No If yes, please listCredit Report: Are you a “control person” or “affiliate” of a public company as defined in SEC Rule 144? This would include, but is not necessarily limited to, 10% shareholders, policy000-making executives, and members of the Board of Directors. Yes No Company000-0000 000-000-0000 000-000-0000 Report Fraud: Have you ever been subject to bankruptcy proceedings, receivership or similar actions, voluntarily or involuntarily? Yes No If yes, please list reason and date clearedReport Fraud: Have you ever been in a legal dispute or involved in an arbitration proceeding arising from a commodities or securities dispute? Yes No X Customer Signature Date NOTICE TO CLIENTS This Agreement Is a Legal Contract, Please Read It Carefully. This is a legal contract between X.X. X’Xxxxx Foreign Exchange, Inc. (“RJO”) and the undersigned party or parties (“Client”) executing this document. In connection with opening an account to purchase and sell cash or spot foreign currency and options thereon through the OTC foreign exchange markets (hereinafter referred to as “FX”) with RJO, Client acknowledges that Client has been advised and understands the following factors concerning trading FX, in addition to those contained in the Risk Warning Statement which has been provided to Client.Report Fraud:

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