Client Profile

Name *

First Name Middle Name Last Name

Email *

someone@example.com

Date of Birth *

Month Day Year

Social Security Number

If you prefer not to share your Social Security Number via this form, please contact our Client Service Team at 1-877-566-9468. Thank you!

Mother's Maiden Name

If you prefer not to share your Mother's Maiden Name via this form, please contact our Client Service Team at 1-877-566-9468. Thank you!

Physical Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Mailing Address (If different than physical address)

PO Box

Street Address Line 2

City State / Province

Postal / Zip Code

Primary Phone Number *

Please enter a valid phone number.

Type of Phone *

Mobile Home Work

Secondary Phone Number

Please enter a valid phone number.

Type of Phone

Mobile Home Work

Marital Status *

Married Single Divorced Widowed Civil Union Domestic Partnership

Employment Status *

Employed Self-Employed Retired Unemployed Homemaker Student

Occupation *

Employer Name *

Employer Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

If not employed, source of income is: (select all that apply)

Alimony Unemployment Social Security Disability Retirement Income Investments Other

U.S. Citizen *

U.S. Citizen Other

Gross Annual Income (from all sources) *

Estimated Net Worth (excluding primary residence) *

Under $50,000 $700,001 - 1,000,000 $50,000 - 100,000 $1,000,001 - 2,000,000 $100,001 - 200,000 $2,000,001 - $4,000,000 $200,001 - 400,000 Over $4,000,000 $400,001 - 700,000

Marginal Tax Bracket *

0-15% 16-29% 30-50% Over 50%

Please provide your investment knowledge of each type of investment product below. If you wish to disclose your outside investment holdings, please complete the Holdings column in the form below, or upload statements of your current investments.

Produce Knowledge and Experience *

	None	Limited	Moderate	Extensive	Value
Equities/Stocks
Exchange Traded Funds
Fixed Annuities
Fixed Income / Bonds
Illiquid Alternative Investments
Insurance
Investment Real Estate
Mutual Funds
Options
Unit Investment Trusts
Variable Annuities

If you wish for us to consider your other investments, please upload statement(s) below, provide to your Advisor

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Are you an associated person with Lincoln Investment? *

Yes No

Does an associated person with Lincoln Investment have a beneficial financial interest in, control trading in or have authority to make investment decisions as they relate to this account? *

Yes No

Are you related* to an associated person with Lincoln Investment? *

Yes No

Are you an associated person with, or related* to an associated person of another B/D? *

Yes No

Does an employee of FINRA, a Stock Exchange, or a state or federal securities regulatory organization have a beneficial financial interest in, control trading in or have authority to make investment decisions as they relate to this account? *

Yes No

Name of Associated Person *

Relationship to Associated Person (if applicable) *

Name of Broker/Dealer *

Address of Broker/Dealer *

*Related Person—is defined as the 1) spouse, 2) child and child’s spouse (if residing in the same household as, or is financially dependent on the associated person), 3) any related individual over whose account the associated person has control, or 4) any individual over whose account the associated person has control or contributes material financial support.

Important Note: If you are an "Associated Person" please submit a letter authorizing the opening of this account from your broker/dealer or employer with submission of this paperwork.

Are you, or anyone with an interest in this account, a Politically Exposed Person? For purposes of this question, this includes current or former: (1) senior military, governmental, or political officials; (2) his/her immediate family members; (3) his/her close associates. *

Yes No

If yes, indicate country type. *

U.S. Non-U.S.

Name of the Official *

Position Held *

Country (if non-U.S.) *