Primary Account Holder. Minor (if Uniform Gift / Transfer to Minors Account) / Trustee / Authorized Signatory Name (first, middle, last) Social Security Number Date of Birth (mm/dd/yyyy) Legal Street Address City State Zip Mailing Street Address City State Zip Email Address Phone Number Please indicate if you are a: ☐ U.S. Citizen ☐ Resident Alien ☐ Non-Resident Alien Country of Citizenship if non-U.S. Citizen (A completed applicable Form W-8 is required for subscription) Please specify if you are a Fidelity employee/officer/director/trustee/affiliate (required): ☐ Fidelity Employee ☐ Fidelity or Fidelity Fund Officer or Directors/Trustees ☐ Immediate Family Member of Fidelity Officer or Directors/Trustees ☐ Fidelity Affiliate ☐ Not Applicable
Primary Account Holder. Minor (if Uniform Gift / Transfer to Minors Account) / Trustee / Authorized Signatory (Natural Persons) Name (first, middle, last) Social Security Number Date of Birth (mm/dd/yyyy) Legal Street Address City State Zip Mailing Street Address City State Zip Email Address Phone Number Please indicate if you are a: ☐ U.S. Citizen ☐ Resident Alien ☐ Non-Resident Alien Country of Citizenship if non-U.S. Citizen (A completed applicable Form W-8 is required for subscription) Please specify if you are a Fidelity employee/officer/director/trustee/affiliate (required): ☐ Fidelity Officer or Director/Trustee3 ☐ Fidelity Employee4 ☐ Fidelity Fund Officer or Director/Trustee5 ☐ Immediate Family Member of Fidelity Officer or Director/Trustee ☐ Not Applicable 3 “Fidelity Officer or Director/Trustee” includes any independent director/trustee, interested director/trustee, president, vice president, secretary, or treasurer of Fidelity, or any other officer of Fidelity customarily performing functions similar to those performed by any of the above designated directors/trustees and officers. 4 “Fidelity Employee” includes any employee of Fidelity. 5 “Fidelity Fund Officer or Director/Trustee” includes any independent director/trustee, interested director/trustee, president, vice president, secretary, or treasurer of a Fidelity registered investment company, business development company, or privately offered investment vehicle, or any other officer customarily performing functions similar to those performed by any of the above designated directors/trustees and officers.
Primary Account Holder. If I am the Primary Account Holder, I represent that I am authorized to accept this Agreement on behalf of the owners of the Accounts under my Household. If I instruct Personal Capital Advisors to open a Joint Account, I represent that I am authorized by all joint owners to open and provide data and instructions to Personal Capital Advisors for that Joint Account. I understand that Personal Capital Advisors and Broker/Custodian may also rely on data and instructions from other Joint Account Holders or require combined instructions from all Joint Account holders to carry out some types of instructions. If I instruct Personal Capital Advisors to open an Account for a minor, trust, company, or retirement plan, I certify that I am authorized to sign this Agreement for the minor, trust, company, or retirement plan. In addition to my understanding of the above, if there is a Secondary Account Holder for my Household, I grant a Limited Power of Attorney (“LPOA”) to the Secondary Account Holder to act as my authorized agent and attorney-in-fact for all my Accounts, including any Joint Accounts (as defined below), with authority to make investment decisions on my behalf. I understand that I may revoke this LPOA at any time by providing Personal Capital Advisors with instructions to terminate the LPOA. If this LPOA is terminated, I may have to create a separate Dashboard in order to facilitate my Personal Capital Advisors transactions. I understand that all decisions, information, and instructions provided by the Secondary Account Holder are binding on me, and I hereby ratify those instructions. (Initial Here) I further understand that if I do not want an Account to be included within the Household, for example, if it is an ERISA or XXX Account (as defined in Section 4 below), I will notify Personal Capital Advisors and make sure it is not included under this Dashboard and will establish such an Account under a separate Dashboard. I also understand that unless I instruct Personal Capital Advisors otherwise, Personal Capital Advisors will hold Joint Accounts involving accounts of spouses in community property jurisdictions in the name of both spouses as community property. Personal Capital Advisors will have no liability for any loss that may arise due to or taking instructions from one spouse or requiring instructions from both spouses.
Primary Account Holder. Minor (if Uniform Gift / Transfer to Minors Account) / Trustee / Authorized Signatory Name (first, middle, last) Social Security Number Date of Birth (mm/dd/yyyy) Legal Street Address City State Zip Mailing Street Address City State Zip Email Address Phone Number Please indicate if you are a: ☐ U.S. Citizen ☐ Resident Alien ☐ Non-Resident Alien Country of Citizenship if non-U.S. Citizen (A completed applicable Form W-8 is required for subscription)
