ACCT # REP #

ACCOUNT WORKSHEET
INDIVIDUAL JOINT ENTITY IRA ROTH IRA ESTATE TRUST
(complete 2 sheets) (complete entity section) (complete beneficiary information) (death cert, (trust agreement)
testamentary, affidavit)

ACCOUNT TITLE: _________________________________________ ________________ ______________

RESIDENTIAL ADDRESS: ____________________________________________________ ______________

(must be legal address)
MAILING ADDRESS: ________________________________________________________ _________

OCCUPATION: ___________________________________________________________ ______________

EMPLOYER NAME & ADDRESS: (If retired list previous employer – Retired clients require compliance approval prior to opening)

_________________________________________________________________ _____________________

WORK PHONE: __ HOME PHONE: CELL PHONE:

EMAIL: FAX:

MARITAL STATUS: # OF DEPENDENTS: YEARS AS INVESTOR:

DOB: S.S. # / TAX ID #:

ANNUAL INCOME: LIQUID NET WORTH: NET WORTH:

Less than $50,000 Less than $100,000 Less than $100,000
$50,000 - $99,999 $100,000 - $249,999 $100,000 - $249,999
$100,000 - $199,999 $250,000 - $499,999 $250,000 - $499,999
$200,000 - $299,999 $500,000 - $999,999 $500,000 - $999,999
$300,000 - $399,999 $1,000,000 - $2,999,999 $1,000,000 - $2,999,999
$400,000 - $499,999 $3,000,000+ $3,000,000+
$500,000 - $749,999
$750,000 - $999,999
$1,000,000+

TAX BRACKET: 0-10% 11-15% 16-25% 26-28% 29-33% 33+%

INVESTMENT EXPERIENCE: (please check the products/strategies that best reflect investment experience to date.)
None Mutual Funds Stocks
Bonds Margin Annuities
Options Exchange Traded Funds Inverse/Leveraged Products
Alternative Investments Futures Active Short-Term Trading

INVESTMENT DECISIONS: (How involved is the client in making investment decisions?)

I make my own investment decisions and/or consult with someone other than my Financial Advisor.
I discuss investment decisions with my Financial Advisor, but I also consult other sources of financial information and/or discuss
with other parties.
I rely on the guidance of my Financial Advisor most of the time.
I follow the recommendations of my Financial Advisor all of the time.
This is my first investment account other than my employer sponsored retirement program.

CLIENT ASSOCIATED OR EMPLOYED BY A BROKER DEALER? NO YES Firm:

CLIENT IN CONROL POSITION? NO YES Position:
CLIENT RELATED TO AN EMPLOYEE? NO YES Employee:
CLIENT US CITIZEN / PERMANENT RESIDENT? NO YES CURRENT CITIZENSHIP:
CITIZENSHIP AT BIRTH: DUAL CITIZENSHIP:

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INVESTMENT OBJECTIVES: (check one - must coincide with Risk Tolerance below)
Preservation of Principal/Income – Focus is on preserving principal and generating current income. (Minimal Risk, Low Risk)
Balanced Growth – Focus is on generating current income and/or long-term capital growth. (Minimal Risk, Low Risk, Moderate Risk)
Growth – Focus is on generating long-term capital growth. (Low Risk, Moderate Risk, High Risk)
Aggressive Growth/Aggressive Income – Focus is on generating growth and/or income at greater than market rates.
(Moderate Risk, High Risk, Maximum Risk)
Speculation – Focus is on generating maximum possible returns. (High Risk, Maximum Risk)

RISK TOLERANCE: Please indicate your risk tolerance specific to the investments in this account. (check one)
Minimal Risk - even if that means my investment does not generate significant income or returns and may not keep pace with inflation.
Low Risk - including low volatility, and understand I could lose a modest amount of my investment.
Moderate Risk - including some volatility, to seek higher returns and understand I could lose a portion of my investment.
High Risk - including high volatility, and understand I could lose a substantial amount of my investment.
Maximum Risk - I could lose all of my investment.

INVESTMENT TIME HORIZON: When do you expect to cease accumulating assets in this account, and begin withdrawing significantly
from the principal? (check one)
< 1 year 1 to 3 years 4 to 6 years 7 to 8 years 9 to 11 years 12+ years

LIQUIDITY NEEDS: On an annual basis, what are your expected withdrawal needs from this account? (check one)
Less than $1,000 $10,000 - $49,999 $100,000 - $249,999
$1,000 - $9,999 $50,000 - $99,999 $250,000 +

SOURCE OF FUNDS: Business / Self-Employed Sale of Asset Wages/Income

Gift/Inheritance Savings
Investment Income Settlement

SOURCE OF CLIENT: Client Referral Existing Client RBC Referral

Cold Call New Rep Transfer Seminar
E-Commerce Personal Acquaintance Walk In/Call In

INITIAL TRANSACTION:

ENTITY ACCOUNT/TYPE OF BUSINESS:

NAME & ADDRESS:

COUNTRY OF ORGANIZATION: COUNTRY OF HEADQUARTERS:

LEGAL STRUCTURE:
LLC C-Corp S-Corp Publicly Traded Pink Sheet Closely Held

TAX ID #: # OF EMPLOYEES: FINANCIAL ENTITY? YES / NO

*JOINT ACCOUNT OWNER: Please complete an additional account worksheet

I further certify that based on my knowledge gained in my professional capacity through the means of conversation, with the
intended account holder, that the above information is accurate and complete.

OPENING RR: Date:

RR(s) Servicing Account (if applicable): Date:

RR(s) Servicing Account (if applicable): Date:

Manager Approval: Date:

Escalated Approval: Date:

**This worksheet must be completed in its entirety. If there is missing or inaccurate information the worksheet will be returned to
you which will delay the account from being opened.
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 TRUSTED CONTACT
TRUSTED CONTACT:
NAME:
ADDRESS:
PHONE: EMAIL:
RELATIONSHIP: AGE:
Client declined to provide a trusted contact; I have made a reasonable effort to obtain this information.

INITALS

IRA BENEFICIARY INFORMATION

IRA BENEFICIARY #1:
NAME & ADDRESS:
DOB: SS#:
RELATIONSHIP: PERCENTAGE:
PRIMARY OR CONTINGENT

IRA BENEFICIARY #2:

NAME & ADDRESS:
DOB: SS#:
RELATIONSHIP: PERCENTAGE:
PRIMARY OR CONTINGENT

IRA BENEFICIARY #3:

NAME & ADDRESS:
DOB: SS#:
RELATIONSHIP: PERCENTAGE:
PRIMARY OR CONTINGENT

IRA BENEFICIARY #4:

NAME & ADDRESS:
DOB: SS#:
RELATIONSHIP: PERCENTAGE:
PRIMARY OR CONTINGENT

3 revised 02.08.18