Page 8 of 10 TDA 186 A 02/20
If I am a U.S. person for tax purposes:
Under penalties of perjury, I certify that: (1) the number shown on this form is my correct taxpayer identication number; (2) I
am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notied by the
Internal Revenue Services (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends,
or (c) the IRS has notied me that I am no longer subject to backup withholding; (3) I am a U.S. citizen or other U.S. person; and
(4) the FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
If I have been notied by the IRS that I am subject to backup withholding because I have failed to report all interest and dividends
on my tax return, I must cross out (2) in this certication.
If I am not a U.S. Person for tax purposes:
I am submitting the applicable Form W-8 with this form to certify my foreign status.
The IRS does not require your consent
to any provision of this document
other than the certications required
to avoid backup withholding.
The Client Agreement applicable to this brokerage account contains a predispute
arbitration clause. By signing this agreement, the parties agree to be bound by the terms
of the Client Agreement, including the arbitration agreement located in Section 12 of the
Client Agreement on page 8.
fonts are not
For UTMA/UGMA Accounts:
Important information about procedures for opening a new account:
To help the government ght the funding of terrorism and money laundering activities, federal law requires all nancial
institutions to obtain, verify, and record information that identies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that
will allow us to identify you. We may also utilize a third-party information provider for verication purposes and/or ask for a copy
of your driver’s license or other identifying documents. By my signature below, I attest that I am of legal age to contract, and I
certify, to the best of my knowledge that the information provided on this application is complete and correct.
If this is a Joint account, all Account Owners must sign.