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Current time:Feb 29, 2020 7:54:10 AM
Individual Account
Account Type
Individual
Joint
Account Information
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Ms
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Adml
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WCmd
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Date Of Birth
day*
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month*
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Identification Type*
National ID Card
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Are you a U.S. Citizen/Resident for tax purposes?
Are you a U.S. Citizen/Resident for tax purposes?*
Yes
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Residential Address
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ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
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AZERBAIJAN
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BRIT -PROTECTED PERS
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BRITISH NATIONAL OVERSEAS
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CHAD
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CONGO
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CROATIA
CYPRUS
CZECH REPUBLIC
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DENMARK
DJIBOUTI
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EAST GERMANY
EAST TIMOR
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
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ETA TEST
ETHIOPIA
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Please enter your Residence Address
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Court
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Drive
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Place
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Road
Street
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Access
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Alleyway
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Bridge
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Dale
Dell
Dip
Driveway
Distributor
Deviation
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End
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Expressway
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Formation
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Gully
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Loop
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Contact Details
一
一
一
EMPLOYMENT AND FINANCIAL DETAILS
(The following questions are collected for compliance with AML/CTF requirements.)
*Employment Status
Employed
Self Employed
Retired
Unemployed
*Approximate Net Worth
$0 - $50,000
$50,001 - $100,000
$100,001 - $500,000
> $500,000
*Source/Destination of Funds
Gift
Savings from employment income
Company sale or sale of interest in company
Share sale
Maturing Investments
Inheritance
Property sale
*Nationality
Australian
American
New Zealander
British
Chinese
Singaporean
Indonesian
Malaysian
Afghan
Aland Islander
Albanian
Algerian
American Samoan
Andorran
Angolan
Anguilla
Antarctican
Antiguan And Barbudan
Argentinian
Armenian
Aruban
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Belarusian
Belgian
Belizean
Beninese
Bermudian
Bhutanese
Bolivian
Bosnian And Herzegovinan
Batswana
Bouvet Islander
Brazilian
British Indian Ocean Territory
Bruneian
Bulgarian
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Burundian
Cambodian
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Canadian
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Central African
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Chilean
Christmas Islanders
Cocos Islandian
Colombian
Comorian
Congolese
North Korean
Cook Islander
Costa Rican
Cuban
Ivorian
Croatian
Cypriot
Czech
Danish
Djiboutian
Dominican
Ecuadorian
Egyptian
Salvadoran
Equatorial Guinean
Eritrean
Estonian
Ethiopian
Falkland Islander
Faroese
Fijian
Finnish
French
French Guianese
French Polynesian
French Southern Territories
Gabonese
Gambian
Georgian
German
Ghanaian
Gibraltar
Greek
Greenlander
Grenadian
Guadeloupean
Guamanian
Guatemalan
Guernsey
Guinean
Guinea-Bissau
Guyanese
Haitian
Heard Island And Mcdonald Islander
Honduran
Hong Konger
Hungarian
Icelander
Indian
Iranian
Iraqi
Irish
Manx
Israeli
Italian
Japanese
Jamaican
Jersey
Jordanian
Kazakh
Kenyan
I-Kiribati
South Korean
Kuwaiti
Kyrgyzstani
Laotian
Latvian
Lebanese
Mosotho
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macanese
Macedonian
Malagasy
Malawian
Maldivian
Malian
Maltese
Marshallese
Martiniquais
Mauritanian
Mauritian
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Mexican
Micronesian
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Moroccan
Mozambican
Myanmar
Namibian
Nauruan
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Dutch
Dutch Antillean
New Caledonians
Nicaraguan
Nigerien
Nigerian
Niuean
Norfolk Islander
Northern Mariana Islander
Norwegian
Omani
Pakistani
Palauan
Palestinian
Panamanian
Papua New Guinean
Paraguayan
Peruvian
Filipino
Pitcairn Islanders
Polish
Portuguese
Puerto Rican
Qatari
Republic of South Sudan
Republic of Sudan
Reunionese
Romanian
Russian
Rwandan
Barthélemois
Saint Helenian
Kittitian
Saint Lucian
St. Martiner
Saint-Pierrais Miquelonnais
Vincentian
Samoan
Sammarinese
Sao Tomean
Saudi
Senegalese
Serbian
Seychellois
Sierra Leonean
Slovakian
Slovanian
Solomon Islander
Somalian
South African
South Georgia And The South Sandwich Islander
Spanish
Sri Lankan
Surinamese
Svalbard And Jan Mayen islander
Swazi
Swedish
Swiss
Syrian
Taiwanese
Tajik
Tanzanian
Thai
East Timorese
Togolese
Tokelauan
Tongan
Trinidadian
Tunisian
Turkish
Turkmen
Turks And Caicos Islander
Tuvaluan
Ugandan
Ukrainian
Emirati
Uruguayan
Uzbek
Vanuatuan
Vatican City State
Venezuelan
Vietnamese
Virgin Islander
U.S. Virgin Islander
Wallisian Futunan
Western Saharan
Yemeni
Zambian
Zimbabweans
Chamorro
Botswana
Saint Vincentian
British Virgin Islander
Kosovar
Alandic
Channel Islander
Saint Barthelemy
Sint Maarten
Saint Martin
Svalbard And Jan Mayen islander
Dominicans
Investment Experience
In the previous 12 months:
You traded Securities or Bonds*
Never
Daily
Weekly
Monthly
Quarterly
Semi-Annually
You traded Derivatives (Eg. futures and options)*
Never
Daily
Weekly
Monthly
Quarterly
Semi-Annually
You traded leveraged FX, CFDs*
Never
Daily
Weekly
Monthly
Quarterly
Semi-Annually
Your approximate trading value was ($USD)*
$0 - $50,000
$50,001 - $100,000
$100,001 - $500,000
$500,001 and more
Intended number of weekly trades*
1 - 15 Trades
16 - 30 Trades
31 - 50 Trades
Intended value of weekly trades ($USD)*
1 - 1,000 USD
1,001 - 2500 USD
2,501 USD and more
