New Client Profile
PRIMARY ACCOUNT OWNER
Name
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your mailing address a PO Box?
*
Yes
No
If yes, please provide legal physical address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home
Please enter a valid phone number.
Work
Please enter a valid phone number.
Cell
Please enter a valid phone number.
Fax
Please enter a valid phone number.
E-mail
example@example.com
Are you a U.S. Citizen?
*
Yes
No
If No, List Country:
Gender:
*
Male
Female
Number of dependents:
Home Ownership:
*
Own
Rent
Marital Status
*
Please Select
Single
Married
Divorced
Widowed
Domestic Partner
Employment
Employment Status
*
Please Select
Employed
Retired
Student
Minor
Self Employed
Not Currently Employed
Employer's Name
*
Employer's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nature of Business
Occupation
*
Years Employed:
Suitability Information
Annual Income
*
Please Select
Under 25,000
25,000 – 39,999
40,000 – 49,999
50,000 – 64,999
65,000 – 124,999
125,000 – 499,999
500,000 – 999,999
over 1 Million
Net Worth
*
Please Select
Under 10,000
10,000 - 24,999
25,000 – 49,999
50,000 – 199,999
200,000 – 499,999
500,000 – 999,999
1,000,000 – 4,999,999
over 5,000,000
(Assets - Liabilities = Net Worth)
Other Investments
*
Please Select
Under 10,000
10,000 – 24,999
25,000 – 49,999
50,000 – 199,999
200,000 – 499,999
over 500,000
(Investments that will not be held at Baird)
Tax Bracket
*
Please Select
0%
10%
12%
22%
24%
32%
35%
37%
Unsure
Investment Experience (years)
*
Less than 1
1 to 5
5+
Stocks
Bonds
Options
Mutual Funds
Annuities
Securities Industry & Other Affiliations
Is client, spouse/domestic partner, or dependents employed by Baird or affiliate?
*
Yes
No
Does client have immediate family member who is employed by Baird or an affiliate?
*
Yes
No
Does client or immediate family member control a publicly-traded company?
*
Yes
No
Is the client or immediate family member employed by or affiliated with a securities firm other than Baird?
*
Yes
No
Is the client or immediate family member employed by a securities regulator?
*
Yes
No
Trusted Contact
Optional - 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.
Decline to Provide
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone
E-mail
example@example.com
Have you given trading authorization and/or Power of Attorney to another individual?
Yes
No
If yes, list the authorized person/Power of Attorney:
Beneficiaries
Beneficiary Name
Spouse (Y/N)
Per Stirpes (Y/N)
Primary or Contingent
Share (%)
1
2
3
4
5
6
Account Investment Information
Account Investment Information
Investment Objective:
*
A - Capital Preservation (Target 0-10% Equities)
B - Conservative Income (Target 10-30% Equities)
C - Income with Growth (Target 30-50% Equities)
D - Growth with Income (Target 50-70% Equities)
E - Capital Growth (Target 70-90% Equities)
F - All Growth (Target 90-100% Equities)
Investment Time Horizon:
*
A - Short-term (0 to 3 years)
B - Intermediate-Term (4 to 6 years)
C - Long-Term (7 or more years)
Liquidity Needs:
*
Low
Medium
High
Submit
Should be Empty: