Montrose Securities International
This is a Retail Brokerage Account Application. Please read it carefully, as you will select products and services, tell us how you want to communicate with us, and agree to certain provisions that will govern our relationship. When we accept it, this Application and all accompanying or supplemental documents form the entire Agreement between us for this account.
Unless otherwise indicated in this Application, the words "you," "your," "yourself," and "yours" mean the applicant(s). The words "we," "us," and "our" mean 44 Montgomery St, Ste 3350 San Francisco, CA 94104 and our branches, subsidiaries, and affiliates.
Please complete and sign this Application, along with any required supplemental forms identified through this application process. In order to complete this Application, you will need some or all of the following information:
The above information helps us comply with various securities regulations and rules and the USA PATRIOT Act, a Federal law that requires all securities firms to obtain, verify, and record information that identifies each applicant. The information also helps us more fully understand your investment profile and identify what types of investments or strategies may be suitable for you. Please note: if we cannot verify the information you provide, we may be required to restrict or deny your account.
Please remember to notify us if you experience a significant life change, such as the birth of a child, marriage, divorce, death of a spouse, loss of a job, change in financial situation, etc.
Do you have other accounts with us?
Are you:
Are you currently:
All applicants please provide the information below. Non-resident aliens, also include a completed W-8BEN.
Are you, your spouse, or any other immediate family members, including parents, in-laws, siblings and dependents:
Employed by or associated with the securities industry (for example, a sole proprietor, partner, officer, director, branch manager, registered representative or other associated person of a broker-dealer firm) or a financial services regulator?
If yes, please specify entity below. If this entity requires its approval for you to open this account, please provide a copy of the required authorization letter.
An officer, director or 10% (or more) shareholder in a publicly-owned company?
A senior military, governmental or political official in a non-US country?
Please tell us your best estimate as to:
The ability to quickly and easily convert to cash all or a portion of the investments in this account without experiencing significant loss in value...
1 Annual income includes income from sources such as employment, alimony, social security, investment income, etc.
2 Net worth is the value of your assets minus your liabilities. For purposes of this application, assets include stocks, bonds, mutual funds, other securities, bank accounts, and other personal property. Do not include your primary residence among your assets.
3 Liquid net worth is your net worth minus assets that cannot be converted quickly and easily into cash.
4 Annual expenses might include mortgage payments, rent, long-term debts, utilities, alimony or child support payments, etc.
5 Special expenses might include a home purchase, remodeling a home, a car purchase, education, medical expenses, etc.
Investing involves risk. Different investment products and strategies involve different degrees of risk. The higher the expected returns of a product or strategy, the greater the risk that you could lose most of your investment.
Please select the degree of risk you (and any co-applicants, if applicable) are willing to take with the assets in this account.
We are collecting the information below to better understand your investment experience.
6 May include structured products, hedge funds, etc.
Please provide us with additional information about your other investments to help us more fully understand your investment profile.
The more we know about you and your goals for this account, the better we can serve you.
Please provide us with any additional information not requested above that you believe will help us.
You will have a "cash account," unless you choose to have a "margin loan account" (customarily known as a "margin account"). To help you decide whether a margin loan account is right for you, please read this information, the Margin Loan Agreement and the Margin Disclosure Statement.
In a cash account, you pay for your securities in full by the settlement date of the purchase (generally three business days from the purchase). In a margin loan account, we may lend you a portion of the purchase price. This is called buying securities "on margin."
If you borrow funds in your margin loan account and the value of your holdings declines below the firm's and/or regulatory maintenance margin requirement, you may be subject to a "margin call."
Note: If you do not check any box above, by default you will have a cash account.
Sometimes there is cash in your account that hasn't been invested. We will automatically place—or "sweep"—that cash into one of the cash management programs listed below.
Unless you choose otherwise, we will use postal mail to send you any communications. As an alternative, you may choose to be notified by email when certain communications are available for you to access online.
By signing this Application, you affirm that you have received and read this Application and any supplemental documents governing this relationship. You affirm that the information you have provided is accurate and you agree to notify us of any changes in the information provided.
Please check all boxes that apply, and sign and date below.
U.S. Person: Under penalty of perjury, I certify that: (1) I am a U.S. citizen, U.S. resident alien or other U.S. person, and the Social Security Number or Taxpayer Identification Number provided in this Application is correct (or I am waiting for a number to be issued to me); and (2) I am not subject to backup withholding.
Non-Resident Alien: I certify that I am not a U.S. citizen, U.S. resident alien, or other U.S. person for U.S. tax purposes, and I am submitting the applicable Form W-8 with this form.
The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.
