4. FOR ANY QUESTIONS REGARDING THIS APPLICATION FORM OR THE AGREEMENT YOU MAY CONTACT US AT OR PAGE 1 INITIALS:...
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1 NATURAL PERSON INSTRUCTIONS AS TO HOW TO COMPLETE THIS FORM 1. BEFORE COMPLETING THIS APPLICATION FORM, YOU SHOULD MAKE SURE YOU HAVE READ AND UNDERSTOOD ALL INFORMATION IN THE FOLLOWING DOCUMENTS: CLIENT AGREEMENT, SERVICES, CLIENT CATEGORISATION, INVESTOR COMPENSATION FUND, RISKS DISCLOSURES AND ACKNOWLEDGEMENTS, POLICY TO ACT IN THE BEST INTEREST OF THE CLIENT,AND THE CONFLICTS OF INTEREST POLICY. 2. PLEASE COMPLETE ALL INFORMATION BELOW IN THIS APPLICATION FORM AS ACCURATELY AS POSSIBLE IN BLOCK CAPITAL LETTERS WITH A BLACK OR BLUE PEN OR TYPE. 3. YOU MAY SUBMIT THIS APPLICATION FORM EITHER: A) BY POST SEND TO US AT MEGA EQUITY SECURITIES & FINANCIAL SERVICES PUBLIC LTD GRIVA DIGENIS 1080 NICOSIA CYPRUS, OR B) BY FAX AT , OR C) SCAN AND SEND TO US BY AT INFO@MEGAEQUITY.COM 4. FOR ANY QUESTIONS REGARDING THIS APPLICATION FORM OR THE AGREEMENT YOU MAY CONTACT US AT OR INFO@MEGAEQUITY.COM A.CONTACT DETAILS 1. TITLE (MR./MRS.): 2. FIRST NAME: 3. SURNAME: PAGE 1 INITIALS:...
2 4. FATHER S FIRST NAME: 5. ADDRESS: 6. CONFIRM 7. MOBILE TELEPHONE: 8. INCLUDE FREE OF CHARGE MOBILE SMS UPDATES: YES NO THANKS 9. NATIONALITY: 10. DATE OF BIRTH: 11. COUNTRY OF RESIDENCE: 12. LANDLINE: 13. ADDRESS LINE 1: 14. ADDRESS LINE 2: 15. TOWN/CITY: 16. POSTCODE: 17. ARE YOU REFERRED BY AN AGENT?: YES NO 18. IF YES TO THE ABOVE, YOUR AGENTS NAME: B.CURRENT SITUATION 1. EMPLOYMENT STATUS: EMPLOYED SELF-EMPLOYED PENSIONER / RETIRED STUDENT UNEMPLOYED 2. APPROXIMATE ANNUAL INCOME (IN EUR): 0-25,000 25,001-50,000 50,001-75,000 75, , , ,000 >200,000 PAGE 2 INITIALS:...
3 3. SOURCE OF ANNUAL INCOME: COMPENSATION FOR PERSONAL SERVICES PENSIONS INTEREST / DIVIDENDS ALIMONY REAL PROPERTY INCOME COMMISSIONS ROYALTIES GRANTS / PRIZES AND AWARDS 4. APPROXIMATE MONTHLY DISPOSABLE INCOME: 5. APPROXIMATE SAVINGS AND INVESTMENTS: 6. SOURCE OF SAVINGS AND INVESTMENTS: INCOME INHERITANCE GIFT LOANS 7. HAVE YOU TRADED FOREIGN EXCHANGE IN THE LAST 12 MONTHS: YES NO 8. HAVE YOU TRADED CFD'S, SHARES, OR FUTURES IN THE PAST 12 MONTHS: YES NO 9. EDUCATION PROFILE: HIGH SCHOOL TECHNICAL/VOCATIONAL TRAINING BACHELORS DEGREE MASTER / DIPLOMA / PROFESSIONAL TITLE PhD 10. MARITAL STATUS: UNMARRIED MARRIED 11. NUMBER OF DEPENDANTS: 12. DO YOU CURRENTLY (OR DURING THE LAST 12 MONTHS) HOLD A POLITICAL OFFICE, OR HAVE TIES TO A POLITICALLY ACTIVE PERSON: YES NO C.BANK DETAILS PLEASE NOTE THAT,AT THIS POINT IN TIME, MEGA EQUITY SECURITIES & FINANCIAL SERVICES PUBLIC LTD. ONLY ACCEPTS FUNDS RECEIVED BY BANK TRANSFER, BECAUSE OF THE STRICT POLICY TO COMPLY WITH THE PREVENTION AND SUPPRESSION OF MONEY LAUNDERING ACTIVITIES LAW 188(I)2007. THESE DEPOSITS MUST BE TRANSFERRED FROM A REFERENCE ACCOUNT UNDER YOUR NAME. THIS IS OCCURING FOR THE SAFETY OF BOTH, THE COMPANY AND THE CLIENT. PAGE 3 INITIALS:...
4 FOR YOUR OWN ACCOUNT SAFETY PLEASE SPECIFY AT LEAST ONE REFERENCE ACCOUNT AS A BANK ACCOUNT FOR FUTURE PAYOUTS. YOU WILL BE ABLE TO CHANGE THE ACCOUNTS LATER VIA OUR WEBSITE, DOWNLOADING THE CHANGE OF BANK DETAILS FORM. 1. NAME OF BANK: 2. ACCOUNT HOLDER: 3. IBAN: 4. SWIFT/BIC: TRADING ACCOUNT INFORMATION 1. BASE CURRENCY: EUR GBP CHF USD 2. PLEASE SPECIFY FOR WHAT PURPOSE YOU WISH TO USE THE BROKERAGE SERVICES OF MEGA EQUITY SECURITIES & FINANCIAL SERVICES PUBLIC LTD.: LONG-TERM INVESTMENTS SHORT-TERM INVESTMENTS SPECULATION HEDGING 3. ANTICIPATED TRADES PER MONTH: >100 INVESTMENT & TRADING EXPERIENCE 1. WHICH OF THE FOLLOWING FINANCIAL INSTRUMENTS DO YOU HAVE ADEQUATE EXPERIENCE IN: FX (FOREIGN EXCHANGE) SHARES FUTURES CONTRACTS FOR DIFFERENCE (CFD'S) BONDS WARRANTS FUNDS 2. HAVE YOU EXECUTED A SIGNIFICANT LEVEL OF TRANSACTIONS IN ONE PARTICULAR FINANCIAL MARKET WITH AN AVERAGE FREQUENCY OF TEN TRADES PER QUARTER WITHIN THE LAST (4) QUARTERS: YES NO 3. DOES THE VAULE OF YOUR PORTFOLIO (CASH PLUS FINANCIAL INSTRUMENTS) EXCEED 500,000 EUROS: YES NO PAGE 4 INITIALS:...
5 4. DO YOU WORK OR HAVE WORKED IN THE FINANCIAL SECTOR FOR AT LEAST ONE YEAR IN A PROFESSIONAL PROSITION: YES NO *ACCOUNT TYPE WE PROVIDE A LARGE VARIETY OF MARKETS TO CLIENTS, PLEASE SPECIFY THE ACCOUNT TYPE YOU WISH TO OPEN. 1. **ACCOUNT TYPE (CHOOSE ALL THAT APPLY): SHARE TRADING ACCOUNT CFD / FX TRADING ACCOUNT FUTURES TRADING ACCOUNT *All account types include online trading access, broker-assisted sales and trading services, daily technical and weekly commentaries, as well as other value added services. **Share Trading and Futures Trading Accounts require additional documentation. Please see or contact your account executive for further information. PAGE 5 INITIALS:...
6 APPLICANT S DECLARATION, AUTHORISATION AND SIGNATURE I HEREBY REQUEST AND AUTHORISE MEGA EQUITY SECURITIES & FINANCIAL SERVICES PUBLIC LTD, Reg. No , under licence from Cysec with licence no. 011/03 dated 12 th May 2003 (HEREINAFTER, MEGA EQUITY SECURITIES & FINANCIAL SERVICES PUBLIC LTD TO PROVIDE ME WITH ALL THE ACCOUNTS AND SERVICES I WILL REQUEST. I HEREBY CONFIRM THAT I HAVE BEEN INFORMED AND ACCEPT ALL THE TERMS AND CONDITIONS WHICH GOVERN THE PROVISION OF THE REQUESTED ACCOUNTS AND SERVICES. THE INFORMATION DISCLOSED ABOVE IS TRUE AND ACCURATE AND I WILL PROMPTLY NOTIFY MEGA EQUITY SECURITIES & FINANCIAL SERVICES PUBLIC LTD IF ANY OF THE ABOVE PARTICULARS CHANGE OR CEASE TO BE TRUE AND ACCURATE. I ALSO UNDERTAKE TO SUPPLY ANY OTHER INFORMATION THAT MAY BE REQUIRED IN THE FUTURE AND I HEREBY SUBMIT TRUE COPIES OF THE RELEVANT ORIGINAL DOCUMENTS. FURTHERMORE I UNDERSTAND AND AGREE THAT THE INFORMATION A BOVE AND ANY OTHER INFORMATION CONTAINED IN THIS DOCUMENT CAN AND MAY BE DISCLOSED BY MEGA EQUITY SECURITIES & FINANCIAL SERVICES PUBLIC LTD FOR REGULATORY PURPOSES OR BECAUSE OF OTHER STATUTORY OBLIGATIONS AND TO OTHER ENTITIES OF THE MEGA EQUITY SECURITIES & FINANCIAL SERVICES PUBLIC GROUP. APPLICANT S SIGNATURE DATE FOR MEGA EQUITY SECURITIES & FINANCIAL SERVICES PUBLIC LTD USE ONLY RECEIVED BY: NAME DATE: / / SIGNATURE CHECKED BY: DATE : / / NAME SIGNATURE COMMENTS: PAGE 6 INITIALS:...
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