Client Account Information (CAI) Natural Persons and Entities Securian Financial Services, Inc. CRI Securities, LLC 400 Robert Street rth St. Paul, Minnesota 55101-2098 1-800-820-4205 abc Required Use - The following must be completed and on file for each registration type: Natural Persons Parts A, C, D and E Entities Parts B, C, D and E Broker-Dealer Securian CRI Return To: A5-2016 1. Status New Client Existing Client with New Account Existing Client Update 3. Client Information Primary Owner Minor First name of birth PART A CLIENT INFORMATION for NATURAL PERSONS 2. Registration Type Individual Joint Custodial Guardian/Conservatorship For existing clients with current Part A & C information on file (Rev 6-2012 or newer), Check here and complete Name of Client(s) and SSN below, and indicate Client Signature date of current CAI. A new Part D and Part E is ALWAYS required with each new account. Middle initial Last name Social Security number Gender M F Street address (no P.O. Box) Client #1 Employer name Citizen of: U.S. Resident Alien: country of citizenship n-resident Alien: country of citizenship ID # Issue : Exp. : ID issuer: of US Government Photo ID Provided: U.S Driver s License Greencard U.S Passport /Federal Issued ID Representative viewed ID? Self employed - nature of business: Occupation Homemaker* Retired* Student* Unemployed* *Please provide source of income: 4. Joint Client Information Joint Owner Custodian Guardian First name of birth Middle initial Last name Social Security number Gender M F Street address (no P.O. Box) Check here if address is same as Client #1 Client #2 Employer name Citizen of: U.S. Resident Alien: country of citizenship n-resident Alien: country of citizenship ID # Issue : Exp. : ID issuer: of US Government Photo ID Provided: U.S Driver s License Greencard U.S Passport /Federal Issued ID Representative viewed ID? Self employed - nature of business: Occupation Homemaker* Retired* Student* Unemployed* *Please provide source of income: Page 1 of 5
PART A CLIENT INFORMATION for NATURAL PERSONS (continued) 5. Financial Information Individual Household Approximate annual Income (from all sources) Estimated net worth (excluding primary residence) Estimated liquid net worth (cash & cash equivalents) Federal tax range 0-15 32.1-50 15.1-32 50.1+ Number of Dependents PART B CLIENT INFORMATION for ENTITIES 1. Status New Client Existing Client with New Account Existing Client Update 2. Registration Type Trust Estate Corporation Partnership n-profit Organization Limited Liability Company Sole Proprietorship For existing clients with current Part B & C information on file (Rev 6-2012 or newer), Check here and complete Entity Name and TIN below, and indicate Client Signature date of current CAI. A new Part D and Part E is ALWAYS required with each new account. 3. Entity Information Entity name Tax ID Street address (no P.O. Box) Nature of business 4. Additional Entity Information Is the account owner a state or local government, an agency or instrumentality of a state or local government (i.e. municipality, city, fire, police, utility, etc.)? - Complete the Political Contribution Report form (F74110) and submit with the initial application to the Home Office. - further action is required. PART C CLIENT INFORMATION for ALL 1. Mailing Address (P.O. Box accepted) All correspondence will be sent to this address. If blank, correspondence will go to street address listed in Part A or Part B. Address 2. Total Investments (Natural Person or Entity) provide approximate amounts Individual Household Annuities - Fixed/Indexed Mutual Funds Annuities - Variable Options Commodities and Futures Precious Metals Equities Investment Real Estate/REITS Exchange Traded Funds Unit Investment Trusts Fixed Income Cash Insurance (cash value) Other: Optional comments on large discrepancy between total investments and estimated net worth in Part A #5: Page 2 of 5
3. Investment Knowledge and Experience of Client (Natural Persons) or Trustee/Legal Representative (Entity) a. Years of Investment Experience (required): b. General Investment Knowledge (required): ne Limited Moderate Extensive c. Specific Investment Knowledge (default is ne if information is not provided) 1. Annuities Fixed/Indexed 1. ne Limited Moderate Extensive 2. Annuities Variable 2. ne Limited Moderate Extensive 3. Commodities and Futures 3. ne Limited Moderate Extensive 4. Equities 4. ne Limited Moderate Extensive 5. Exchange Traded Funds 5. ne Limited Moderate Extensive 6. Fixed Income 6. ne Limited Moderate Extensive 7. Insurance 7. ne Limited Moderate Extensive 8. Mutual Funds 8. ne Limited Moderate Extensive 9. Options 9. ne Limited Moderate Extensive 10. Precious Metals 10. ne Limited Moderate Extensive 11. Investment Real Estate/REITS 11. ne Limited Moderate Extensive 12. Unit Investment Trust 12. ne Limited Moderate Extensive 13. Other 13. ne Limited Moderate Extensive 4. Broker-Dealer/FINRA/Stock Exchange/Publicly Traded Company Affiliations If yes, name of account owner or authorized person* Name of company: Symbol or CUSIP: b. Is any account owner or authorized person* (POA, trustee, custodian, or officer) on this account (MUST COMPLETE ALL QUESTIONS BELOW): * Authorized Person means POA, trustee, custodian or officer. PART C CLIENT INFORMATION for ALL (continued) a. Is any account owner or authorized person* (POA, trustee, custodian, or officer) an officer, director, or 10 shareholder of a publicly traded company? Beneficial Interest 1. An employee or registered person of SFS/CRI? 2. Related to** an employee or registered person of SFS/CRI? Name of Account Owner or Authorized Person*: Name of Account Owner or Authorized Person*: Name of employee or registered person: Relationship: Spouse Domestic Partner Minor Child Other relative for whom you provide material support: 3. An employee or registered person of another broker/dealer? Outside broker/dealer name: Outside broker/dealer address: Outside Affiliation 4. Related to** employee or registered person of another broker/dealer? Outside B/D employee or registered person: Outside broker/dealer name: Outside broker/dealer address: Relationship: Spouse Domestic Partner Minor Child Other relative for whom you provide material support: 5. An employee or related to** employee of FINRA or a stock exchange? Name of stock exchange or FINRA: ** Related to means an immediate family member (spouse, domestic partner or minor children) or other relative for whom you provide material support. Page 3 of 5
PART D PROFILE INFORMATION for this ACCOUNT ALWAYS Required New Account Application Existing Account Update Account # (required): 1. Platform Type Broker/Dealer Product (includes insurance/annuities) Investment Advisory Program 2. Sponsor Name Pershing Minnesota Life Other: 3. Beneficial Interest Is any RR or IAR a primary or contingent beneficiary/tod on this account? Name of RR or IAR: 4. Application Type Brokerage Account Annuity - Variable Life Insurance - Variable Other: Direct Mutual Funds Annuity - Indexed Life Insurance - Indexed 529 Plan Annuity - Fixed Investment Advisory Account 5. Account Type Traditional/Rollover IRA Individual (n-qualified) Corporation ERISA 403(b) Trust Roth IRA Joint Partnership n-erisa 403(b) Estate SIMPLE IRA Custodial n-profit Organization Health Savings Account Life Insurance - SEP IRA Guardian LLC 529 Plan - Name of insured: Education IRA Conservatorship Sole Proprietorship Name of beneficiary: 6. Investment Profile for this Account a. Investment objective (check one) Must match Model Portfolio on Investment Management Agreement or outside company account application Capital Preservation Income Income & Growth Conservative Growth Growth Aggressive Growth b. Risk tolerance (check one) Conservative/Low Moderate Aggressive/High c. Time horizon for this account (check one) 3 years or less 4-8 years 9-11 years 12+ years d. Liquidity needs (check one) Low (funds needed in 9+ years) Medium (funds needed in 4-8 years) High (funds needed in <3 years) If high, describe need (i.e., RMD, etc.) 7. Email address for this account (optional) : PART E SIGNATURES ALWAYS Required I believe the information provided is true and accurate to the best of my knowledge. This document contains a pre-dispute arbitration clause which appears on the fifth page, item E and a tification of Identity Verification. I HAVE READ, AGREE WITH, AND HAVE RECEIVED A COPY OF THE STATEMENTS AND DISCLOSURES ON THE FIFTH PAGE. Owner/custodian or trustee/legal representative signature Joint owner or co-trustee/legal representative signature of transaction I believe the information provided is true and accurate to the best of my knowledge. Primary representative name (print) Representative signature Representative name (print) Representative name (print) Home office principal signature Page 4 of 5
A. GENERAL I understand I will receive and am advised to read a current copy of the prospectus/offering memorandum for any investment at or prior to investing. (t applicable to secondary equity offerings.) I have been informed of all charges and expenses associated with my investment, including, if applicable, any charges for transactions processed through our clearing firm. I have received and reviewed the schedule of fees to be charged to me for all proposed investment activities. I realize that an investment intended as long-term should be held for a number of years. Due in part to the sales charges involved, selling or surrendering in the short-term may result in a loss. I am aware there is no assurance that the initial objective/s of any investment will be achieved. Thus, when I ultimately sell or surrender the investment, I may receive more or less than the amount I invested. I realize that the element of risk is inherent in any investment, what varies is the degree of risk. Generally, the greater the potential return, the greater the risk I must be willing to assume. If I am transferring assets from another mutual fund, annuity or advisory account into this new investment, I understand that sales charges may have been incurred under the prior investment and that I may incur a sales charge on the current investment as well. I will only make payment by check payable to the entity listed on the application or in the prospectus and never payable directly to a representative or an entity through which the representative may gain access to my funds. I will not loan to nor borrow from a representative any monies or securities. It will be my responsibility to inform my representative/advisor of any changes in my personal profile/circumstances. I understand that if I purchase an insurance or investment product or service through Securian Financial Services, Inc. or CRI Securities, LLC ( the firms ), my representative/advisor will receive a commission or other remuneration from the firms as a result of the purchase. B. MUTUAL FUNDS INVESTORS I have been informed of the ways to reduce the sales charges, namely, the breakpoint discounts, the Letter of Intent and Rights of Accumulation. If I have purchased a fund which offers multiple classes of shares, the charges and expenses of each class have been explained to me so I am comfortable that I have made the appropriate choice. C. NOTIFICATION OF IDENTITY VERIFICATION I understand that my identity may be verified by the Company in accordance with USA PATRIOT Act of 2001. This verification may include, but is not limited to, contact with financial institutions, consumer reporting agencies and government agencies. D. ADDRESS All communication will be sent to the mailing address I have provided on page 2 of this form. If no mailing address is provided, I understand the street address will be deemed the mailing address. CLIENT ACCOUNT INFORMATION FORM ments and Disclosures CLIENTS SHOULD RETAIN A COPY OF THIS PAGE FOR THEIR RECORDS. E. ARBITRATION DISCLOSURES This agreement contains a predispute arbitration clause. By signing an arbitration agreement the parties agree as follows: I. 1) All parties to this agreement are giving up the right to sue each other in court, including the right to a trial by jury, except as provided by the rules of the arbitration forum in which a claim is filed. J. 2) Arbitration awards are generally final and binding; a party s ability to have a court reverse or modify an arbitration award is very limited. 3) The ability of the parties to obtain documents, witness statements and other discovery is generally more limited in arbitration than in court proceedings. 4) The arbitrators do not have to explain the reason(s) for their award, unless, in an eligible case, a joint request for an explained decision has been submitted by all parties to the panel at least 20 days prior to the first scheduled hearing date. 5) The panel of arbitrators will typically include a minority of arbitrators who were or are affiliated with the securities industry. Page 5 of 5 F. Client s Copy 6) The rules of some arbitration forums may impose time limits for bringing a claim in arbitration. In some cases, a claim that is ineligible for arbitration may be brought in court. 7) The rules of the arbitration forum in which the claim is filed, and any amendments thereto, shall be incorporated into this agreement. AGREEMENT TO ARBITRATE CONTROVERSIES It is agreed that any controversy between us arising out of your business or this agreement, shall be submitted to arbitration conducted before the Financial Industry Regulatory Authority and in accordance with its rules. Arbitration must be commenced by service upon the other party of a written demand for arbitration or a written notice of intention to arbitrate. person shall bring a putative or certified class action to arbitration, nor seek to enforce any predispute arbitration agreement against any person who has initiated in court a putative class action; or who has not opted out of the class with respect to any claims encompassed by the putative class action until: (i) the class certification is denied; or (ii) the class is decertified; or (iii) the customer is excluded from the class by the court. Such forbearance to enforce an agreement to arbitrate shall not constitute a waiver of any rights under this agreement except to the extent stated herein. DISCREPANCIES Reports of the execution of transactions and statements of the account of the undersigned shall be conclusive if not objected to in writing as follows: For transactions in a brokerage account, discrepancies must be reported within 30 days of the trade date. For all other transactions, discrepancies must be reported within 30 days after receipt of the initial confirmation or, if none, the statement of the account by the undersigned. Any inaccuracy or discrepancy in an account must be reported promptly, and all oral communications should be re-confirmed in writing to protect rights under the Securities Investor Protection Act (SIPA). tice of a discrepancy should be sent to the address below. G. INVESTOR EDUCATION AND PROTECTION You may obtain information about Securities Investor Protection Corporation (SIPC), including the SIPC brochure, by contacting SIPC at 202-371-8300 or their website at www.sipc.org. An investor brochure that includes information describing FINRA BrokerCheck may be obtained from FINRA. The FINRA BrokerCheck hotline number is 800-289-9999. The FINRA website address is www.finra.org. H. COMPLAINTS Complaints may be directed to: Securian Financial Services, Inc. - or - CRI Securities, LLC ATTN: A5-7779 400 Robert Street rth St. Paul, MN 55101 1-800-820-4205, option 2 sfsservicecenter@securian.com BUSINESS CONTINUITY PLAN (BCP) Information on our BCP can be found at www.securianfinancial.com or by calling 1-800-820-4205, option 2. HANDLING OF CUSTOMER CHECKS Please be aware that any check provided to a representative of Securian Financial Services, Inc. or CRI Securities, LLC ( the firms ) for insurance products or investment accounts may be delayed for several days before it is deposited by the product provider. This delay is necessary to allow the firms adequate time to perform a suitability review and other necessary reviews related to the transaction.