New Client Profile

Securities Industry & Other Affiliations
Is client, spouse/domestic partner, or dependents employed by Baird or affiliate?*

YesNo
Does client have immediate family member who is employed by Baird or an affiliate?*

YesNo
Does client or immediate family member control a publicly-traded company?*

YesNo
Is the client or immediate family member employed by or affiliated with a securities firm other than Baird?*

YesNo
Is the client or immediate family member employed by a securities regulator?*

YesNo
Trusted Contact

Trusted Contacts would only be contacted if Baird has questions or concerns about a client’s whereabouts, health status or in the event Baird has a reasonable belief that the client may be a victim of fraud or exploitation. This should not be yourself.
Decline to Provide
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
E-mail
example@example.com
Have you given trading authorization and/or Power of Attorney to another individual?

YesNo
If yes, list the authorized person/Power of Attorney:
Beneficiaries

Who do you want to receive assets in the case of your death?

Rows	Beneficiary Name	Spouse (Y/N)	Does this person have children? (Y/N)	Primary or Contingent	Share (%)
1
2
3
4
5
6

WE WILL COLLECT THE TRUST TAX ID, YOUR SOCIAL SECURITY NUMBER AND DATE OF BIRTH THROUGH OUR SECURE DOCUSIGN SYSTEM WHEN COMPLETING PAPERWORK.
Should be Empty:

PRIMARY ACCOUNT OWNER