Checklist for opening a Royal West Indies Brokers trading account 1. Fill in the opening forms and sign them 2. A copy of your passport or identity card (front and backside) 3. Proof of your residential address Please send ONE of the following documents are considered proof of your residential address: a bank account statement (not an online printout) (less than 6 months old) a credit card statement (not an online printout) (less than 6 weeks old) an electricity, gas or water bill (not an online printout) (less than 6 months old) a phone bill (not mobile and not an online printout) (less than 6 months old) a household or property insurance bill (less than 6 months old) mortgage statement (less than 6 months old) a government issued tax bill for personal or property tax (less than 6 months old) signed letter issued by a bank or government (Less than 6 months old) confirmation from the local authorities or house bank (less than 6 months old.) page 1 of 5
ROYAL WEST INDIES BROKERS N.V. NEW ACCOUNT FORM 1. Personalia Account Holder Surname: Given Name(s): Date of Birth: (dd) (mm) (yyyy) Residential Address Sex: Male Female Marital status: Single Married Divorced Master Bachelor Secondary Widowed Email: Highest Level of Education: 2. Professional Information Profession: Employer details: Number of people relying on your income: page 2 of 5
3. Tax information Country(ies) of Tax Residency (or a nonresident taxpayer) Tax Reference Number 1. 2. 3. 4. Bank Account Bankname: Bank Address: Bank place: Account Holder: Account number: (IBAN/BIC/SWIFT) Initial deposit: (the minimum initial deposit is US$ 2,500. ) 5. Base Currency If you answered Other, Royal West Indies Brokers will contact you. Base Currency: US Dollar (USD ) Euro (EUR) British Pound (GBP) page 3 van 5 Other
6. 7. Trading Experience Years of Experience Amount of Transactions per year Stocks: Options: Futures: Bonds: Currency: Level of Knowledge Stocks: Options: Futures: Bonds: Currency: 8. Regulatory Information Are you, or any immediate family member who resides in the same household, registered as a brokerdealer or an employee, director or owner of a securities or commodities brokerage firm? Have you ever been the subject of, or initiated litigation, arbitration No No or any other type of dispute or settlement procedure with another broker or dealer? If yes, why? Are you a director, a % shareholder or do you exercise effective control of any publicly traded company? Do you exercise control over the trading or the profits of any other Interactive Brokers account? No No page 4 of 5
9. Financial Background (in US$) Net Worth (w/o residence) <.000.000 35.000 35.000 75.000 Net Worth (incl. residence) < 0.000 0.000 250.000 250.000 400.000 > 400.000 Liquid Net Worth <.000.000 35.000 35.000 75.000 Estimated Annual Income < 30.000 30.000 40.000 40.000 75.000. Signature By signing this agreement, the Client confirms that: the Client has received the document Basic Client Agreement (IB Accounts), has read its content and has understood and accepted it. The Client explicitly agrees that any amendments made to this document will henceforth be sent to the Client by electronic means; the Client has read, understood and agreed to the contractual conditions of Interactive Brokers (IB) regarding the service it offers to the Client (The IB Customer Agreement ); the Client thoroughly examined and answered the information and questions on this form to the best of the Client s knowledge and beliefs, especially questions regarding the investment objective, trading experience and financial background. (date), (city), (signature) (name) page 5 of 5