International Client Application Form

BROKERAGE ACCOUNT APPLICATION FORM

    Account Information

    Account Registration

    Select the type of registration you want on your Account



    Account Holder

    Mr
    Mrs
    Ms
    Dr

    Securities industry regulations require that we request the following information:

    Employed
    Self-Employed
    Retired
    Unemployed
    Marital Status Single
    Married
    Divorced

    Additional Account Holder (If applicable)

    Mr
    Mrs
    Ms
    Dr

    Securities industry regulations require that we request the following information:

    Employed
    Self-Employed
    Retired
    Unemployed
    Marital Status Single
    Married
    Divorced
    Is any member of your household a control person (Example: A person who can exercise power or has a controlling interest in a company) in a publicly traded corporation?
    Yes
    No

    Investment Profile

    Account Holder

    Investment Knowledge

    None
    Good
    Limited
    Extensive

    Investment Experience

    None
    Limited
    Good
    Excellent

    Common Shares

    None
    Limited
    Good
    Excellent

    Preferred Shares

    None
    Limited
    Good
    Excellent

    Bonds

    None
    Limited
    Good
    Excellent

    Money Market

    None
    Limited
    Good
    Excellent

    New Issues

    None
    Limited
    Good
    Excellent

    Mutual Funds

    None
    Limited
    Good
    Excellent

    Options

    None
    Limited
    Good
    Excellent

    Commodities/Futures

    None
    Limited
    Good
    Excellent

    Venture Situations

    None
    Limited
    Good
    Excellent

    Trading Experience (years):

    Additional Account Holder

    Investment Knowledge

    None
    Good
    Limited
    Extensive

    Investment Experience

    None
    Limited
    Good
    Excellent

    Common Shares

    None
    Limited
    Good
    Excellent

    Preferred Shares

    None
    Limited
    Good
    Excellent

    Bonds

    None
    Limited
    Good
    Excellent

    Money Market

    None
    Limited
    Good
    Excellent

    New Issues

    None
    Limited
    Good
    Excellent

    Mutual Funds

    None
    Limited
    Good
    Excellent

    Options

    None
    Limited
    Good
    Excellent

    Commodities/Futures

    None
    Limited
    Good
    Excellent

    Venture Situations

    None
    Limited
    Good
    Excellent

    Trading Experience (years):

    Investment Goal

    Capital Preservation
    Income
    Growth
    Speculation
    Investment Objective Definitions: Capital preservation: The objective of capital preservation is to protect your initial investment by choosing investments that minimize the potential of any loss of principal. The long-term risk of capital preservation is that the returns may not be adequate to offset inflation. Income: The primary objective of an income strategy is to provide current income rather than long-term growth of principal. Growth: The objective of a growth strategy is to increase the value of your investment over time with recognizing a high likelihood of volatility. Speculation: A speculator's objective is to assume a higher risk of loss in anticipation of potentially higher than average gain by taking advantage of expected price changes

    Does anyone other than the account holder(s) have trading authorization over the account?

    Yes
    No

    If yes, please complete and mail Power of Attorney form to add an individual as having trading authority
    I /We am/are of legal age to enter in this agreement. I hereby request that Alden Graff open an account in the name(s) listed as account holder(s) on this application. I/We the undersigned agree to provide instructions as an authorized signatory to Alden Graff via phone, fax, email or any other method deemed appropriate by Alden Graff without instructions being duly confirmed in writing. Therefore, this signed document allows Alden Graff to process transactions sent via any of the above mentioned mediums without liability in any form to Alden Graff or its employees.
     
    I understand there are fees associated with establishing, maintaining, engaging in transactions, and transferring assets out of this account. I further acknowledge that securities products purchased or sold in a transaction with Alden Graff are subject to investment risks, including possible loss of the principal invested. I understand that Alden Graff does not provide tax, legal or accounting advice.

    Signature of Primary Account Owner


    Signature of Co-Account Owner

    ID Document


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