NEW ACCOUNT APPLICATION FORM PACUS UK LIMITED
Please fill out as much as possible.
Name of Primary Account Holder:
First Name
Last Name
Primary Address: (PO Boxes are not permitted)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Residential Phone Number: (Please include Country Code & Area Code)
Mobile Phone Number: (Please include Country Code & Area Code)
Direct Email Address:
example@example.com
D.O.B:
-
Month
-
Day
Year
Date of birth.
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Occupation:
Occupation.
Nationality:
Nationality.
Secondary Account Holder Name: (If Applicable)
First Name
Last Name
Relationship To Primary Holder:
Relationship to primary holder.
Secondary Account Holder Address: (Please Write Below in Street Address "AS ABOVE", If The Address is The Same)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address:
example@example.com
Secondary Account Holder Mobile Phone Number: (Please include Country Code & Area Code)
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FINANCIAL INFORMATION:
Yearly Income:
50-75K
75-100K
100-150K
150-300K
300-500K
500-1,000.000
1,000.000 +
USD
Net Worth: (Not Including Primary Residence)
100-300K
300-500K
500-750K
-1M
1-3M
3-5M
5-10M
10M+
USD
Liquid Net Worth:
100-300K
300-500K
500-750K
750-1M
1-3M
3-5M
5-10M
10M+
USD
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NEW INVESTORS:
This is my first investment with Pacus UK Limited.
Yes
No
Please list your investment objectives:
Long term growth with safety (long term capital appreciation with relative safety of principle)
Short term growth with high risk (appreciation with acceptance of principal)
Speculative (investment value increased – High Risk)
Income (proceeds of trades as income source)
Growth and income (preserves as much capital as possible)
Long term growth with greater risk – Aggressive growth (trades made on volatile terms)
EXPERIENCED INVESTORS:
I currently hold investments and have been actively trading for
blank
Year's.
I am investing in (please indicate the relevant box's or leave blank if not applicable)
Options
Stocks
Bonds
Commodities
Futures
FX
Angel Investor
Are you or your spouse exchange members or registered with the commodity futures Trading Commission (CFTC) or the Securities Exchange Commission(SEC) in any capacity?
Yes
No
NON-US CITIZENS: If the below box is clicked, then I am a Non-US Citizen and Non-US resident, and nor have I been, and do not plan to be in U.S. for more than 183 days in any calendar year, I am not engaged, and do not plan to be engaged during this year in a U.S. Business that effectively connected gains from broker transaction or my Country of Citizenship has a Tax Treaty with the U.S. that exempts transactions from the U.S.
Please Check This Box If You Agree To The Above Statement.
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Name of Primary Account Holder:
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Signature
Submit
Should be Empty: