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Account Selection

Account Type

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Account Information * = Required Fields

Account Owner

 E-Mail Address:* Primary Account Holder Name * Address * City *
State * Zip * LEGAL address if different City
State Zip MAIL TO (Check One) * Home Business P.O. Box
 MARRIED * Single (S) Married (M) Divorced (D) Widowed (W)
 Citizenship *
SS or TIN# * Drivers License or Passport# * Drivers License Issue Date* Drivers License Expiry Date* State or Country * Daytime Phone# * Your birth date * No. of your dependents * Spouse's name ( if applicable )

Joint Account Owner (IF ANY)

 E-Mail Address: Joint Name Joint Address City
State Zip LEGAL address if different City
State Zip MAIL TO (Check One) Home Business P.O. Box
 MARRIED Single (S) Married (M) Divorced (D) Widowed (W)
 Citizenship
SS# Drivers License or Passport # Drivers License Issue Date Drivers License Expiry Date State or Country Phone# Your Joint Holder Birthdate No. of your spouse's dependents Spouse's name ( if applicable )

Trusted Contact Information

Please add a Trusted Contact, we require this information. Under FINRA Rule 4512 Clearing Firm or Broker-Dealer is required to disclose to you (the customer) that Clearing Firm or Broker-Dealer or an associated person of Clearing Firm or Broker-Dealer is authorized to contact the trusted contact person and disclose information about the customer’s account to address possible financial exploitation, to confirm the specifics of the customer’s current contact information, health status, or the identity of any legal guardian, executor, trustee or holder of a power of attorney, or as otherwise permitted by FINRA Rule 2165.

Trusted Contact Name:
Address:
Phone#:  Email Address:

Please provide a bank reference

Bank Name *

Bank Address *
City: *
State: *
Zip: *

Account Holder Affiliations

Is the account maintained for a current or former Politically Exposed Person Official (includes U.S. and foreign Individuals)? *
Yes / No
If yes, Please provide the names of the official immediate family members (including former spouses) Official and Immediate Family Members
Is the account maintained for a Foreign Financial Institution as defined by Title 30 of the Code of Federal Regulations?. If yes, please complete the "Foreign Financial Institution Due Diligence Questionnaire" form. *
Yes / No
Is this account Foreign Bank organized under foreign law and located outside of the United States as defined by Title 31 of the Code of Federal Regulations?. If yes, please ensure the "Certification Regarding Correspondent Accounts" is complete (in addition to the "Foreign Financial Institution Due Diligence Questionnaire" form). *

NOTE: Broker-dealers are prohibited from establishing, maintaining, administering or managing correspondent account in the United States for foreign shell banks that are regulated affiliates.
Yes / No
If yes, please list U.S. Agent for service of process.
 
Are you or the joint owner an employee of this firm?
Yes   No
Are you or the joint owner related to an employee of this firm ? If YES, give the name of the employee and relationship to you ?
Yes  No
Are you or the joint owner a senior officer, director or large shareholder of a public company ? If YES, give the name of the company?
Yes  No
Are you or the joint owner or any member of your immediate families affiliated with or employed by a member of a stock exchange or Financial Industry Regulatory Authority? If YES, what is the affiliation ?
Yes  No
Are you or the joint owner maintaining any other brokerage accounts?   If YES, with what firms?
Yes  No
HAVE YOU GRANTED TRADING AUTHORIZATION TO ANOTHER PARTY?If yes, request Trading Authorization From and provide name of agent :   
Yes  No
Is the account holder a control person of a publicly traded company ? (Director, Officer or 10% Stock Owner)
If yes, please list the name of the company(S) and the stock ticker symbol. I (We) promise to notify you of any change :   
Yes  No

Investment Profile

INVESTMENT OBJECTIVE *
Speculation (06) For Autotrading - Choose Speculation Only
Income (04)
Growth (03)
Capital Preservation (05)
Other (08)
INVESTMENT EXPERIENCE *
None (00)
Limited (01)
Good (02)
Extensive (03)
ANNUAL INCOME (from all sources) *
Under $25,000 (01)
$25,001 to $50,000 (02)
$50,001 to $100,000 (03)
$100,001 to $200,000 (23)
$200,001 to $300,000 (24)
$300,001 to $500,000 (25)
$500,001 to $1,200,000 (26)
over $1,200,001 (27)
LIQUID NET WORTH (cash&liquid investments only)*
Under $50,000 (01)
$50,001 to $100,000 (02)
$100,001 to $200,000 (22)
$200,001 to $500,000 (23)
$500,001 to $1,000,000 (24)
$1,000,001 to $5,000,000 (25)
over $5,000,000 (26)
TOTAL NET WORTH (excluding residence) *
Under $50,000 (01)
$50,001 to $100,000 (02)
$100,001 to $200,000 (22)
$200,001 to $500,000 (23)
$500,001 to $1,000,000 (24)
$1,000,001 to $5,000,000 (25)
over $5,000,000 (26)
RISK TOLERANCE *
Low (01)
Medium (02)
High (03)

TAX BRACKET: %
Investment Experience and Objectives
Stocks *  Years of Experience
Average Shares Per Trade * 
# of Trades Per Year * 
ETFs *  Years of Experience
Average Shares Per Trade * 
# of Trades Per Year * 
Options *  Years of Experience
Average Shares Per Trade * 
# of Trades Per Year * 
Bonds *  Years of Experience
Average Shares Per Trade * 
# of Trades Per Year * 
Mutual Funds* Years of Experience
Average Shares Per Trade * 
# of Trades Per Year * 
Knowledge Level (Limited, Good, Extensive)
StocksLimited  Good  Extensive
ETFsLimited  Good  Extensive
OptionsLimited  Good  Extensive
BondsLimited  Good  Extensive
Mutual FundsLimited  Good  Extensive

Suitability Information

TIME HORIZON
The number of years planned to invest to achieve a particular financial goal.
LIQUIDITY NEEDS
The ability to quickly and easily convert all or a portion of the account assets into cash without experiencing significant loss.
Short (Less than 3 Years) (01)      Longest (8 years or more) (03)
Average (4 to 7 Years) (02)
Very Important (01)      Not Important (03)
Somewhat Important (02)

Online Investing Background

Current Brokerage Experience *
Are you satisfied with your current discount broker? *
How long have you used the internet? *
Years
Are you using IE, Safari, Google Chrome, Firefox (v8.0 or above)? *
Were you referred to us? By whom? *
What is your initial cash deposit amount or transaction amount? *
Will you be transferring an account? If so, from where? *

Tell Us About Your Job                       

Your Occupation * Years Employed * Employer's Name * Type of Business * Employer's Address * Your Annual Income * $ Other Income: * $
Joint Owner's Occupation Years Employed Joint Owner's Employer's Name Type of business Employer's Address Joint Owner's Annual Income $ Joint Owner's Other Income: $

Please Certify Your Social Security or Tax ID Number

Under penalty of perjury I certify that:
(1) The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me) and
(2) I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (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 notified me that I am no longer subject to backup withholding (does not apply to real estate transactions, mortgage interest paid, the acquisition or abandonment of secured property, contributions to an individual retirement account (IRA), and payments other than interest and dividends).
(3) I am a U.S. person (including a U.S. resident alien).
Certification Instructions -- You must cross out item (2) above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.
(4) The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Definition of a U.S. person. For federal tax return purposes, you are considered a U.S. person if you are: An individual who is a U.S. citizen or U.S. resident alien, A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, An estate (other than a foreign estate), or A domestic trust (as defined in Regulations section 301.7701-7). The Internal Revenue Service does not require your consent to any provisions of this document other than the certifications required to avoid backup withholding.
 Current Tax Status: Low Medium High
Tax Bracket : %

Need Help? Call Us - 1-800-847-8495

Letter of Authorization

Letter of Authorization: Charge Fees to my Brokerage Account

Dear AutoShares:


This letter of authorization and the account application in general serves as authorization to charge my account fees, including commissions, routing, execution, venue, software, and/or data fees. I understand that the fees will be charged to my online brokerage account accordingly.

Note: I understand I will be billed for the aforementioned fees until I close my account, and may contact AutoShares at 1-800-847-8495 with any questions.

Choose Account Service:

(Select service for your Brokerage account) *

Autotrade Newsletter Alerts

Select if Autotrading Newsletter Publisher Trade Alerts. Customers are provided with a Web Based Online Brokerage Account.

Autotrade - Trade Leader Services

Select if using Trade Leader Autotrade Services. Customers are provided with a Web Based Online Brokerage Account.

 

Automated Trading - Collective2

Select if Connecting Collective2 to AutoShares. Customers are provided with a Web Based Online Brokerage Account.

Automatic Investing Services

Select if scheduling automatic investments. Customers are provided with a Web Based Online Brokerage Account.

Online Trading Account - No Autotrade Service

Select if No Autotrade Service is Required. Customers are provided a Web Based Online Brokerage Account for investing in Stocks, Options, and ETFs.

 

Developer Account

Select if you are a developer requiring a developer account. Customers are provided with API Access and a Web Based Online Brokerage Account.

Choose Account Platform:

(click checkbox to indicate platform choice)

WebTrader Account with Autotrade Execution

Investor account includes:

Basic Quote Services

Research Tools
Options Chains
Streaming News
Order Management

Streaming account

API/Developer Access

Select if connecting a third party platform to AutoShares.

Pricing Plan:

Self-Directed Online Investing Accounts + AutoTrade Platform
($5000 Minimum Account Size)


Base Charges:

Stocks and Options - $4.95 per order (minimum)

Options add + $.75 cents per contract


**Regulatory, Exchange, Routing, and Venue Fees are debited per each transaction in your account.

*Rate changes must be approved by AutoShares. Rates do not automatically adjust and are not retroactive. No rebates are given for past trade activity.

Developer Access (for developers only)

Service Instructions

SWEEP: Cash Margin

SPECIFY:
FDIC
Retail Money Market Portfolio-domestic customer fund(236)
Daily Dollar International-foreign customer fund(229)
WHEN SECURITIES ARE SOLD Hold Proceeds (7) Send Proceeds (8)

WHEN SECURITIES ARE PURCHASED, THEY WILL BE HELD IN FIRM NAME
DIVIDENDS * Hold (2) Send (1)

Contact your broker for frequency of "Send".

* In conjunction with "Hold Dividends," by selecting "Sweep" your credit balances will automatically be money market swept. Other alternatives for dividend distribution or requests for physical certificate delivery may available. Contact your investment representative.

Enhanced Account Features

Free Householding Service
The householding service combines mailings of account statements, tax-related statements, proxies, prospectuses, annual reports, and other eligible documents for accounts within your household into one envelope.
Free Dividend Reinvestment
Select whether or not you would like to have your dividends reinvested on all eligible securities. You can always change your selection later by calling your investment representative.
Please select one of the following options:
I want to utilize the householding service. (This option requires a Householding Authorization form to be completed.)
I do not want to household this new account with any of my other accounts.
Please select one of the following options:
Reinvest dividends on ALL eligible securities.
Please do not reinvest any dividends. Pay dividends in cash to my money market account.

E-Documents EnrollmentWhen you enroll your account in E-Docs, you will receive trade confirmations, account statements, tax-related documents, proxies, prospectuses, annual reports, and all other eligible account documents electronically. An e-mail notification will be sent to the Account Owner's e-mail address on the same day electronic documents become available. Just log into your account to access E-Docs and view, print or download your electronic documents.

Yes
No

Rule 14b-1(c) of the Securities Exchange Act, unless you object, requires us to disclose to an issuer, upon its request, the names, addresses, and securities positions of our customers who are beneficial owners of the issuer's securities held by us in nominee name. The issuer would be permitted to use your name and other related information for corporation communication only.
 Yes, I do object to the disclosure of such information.
 No, I do not object to the disclosure of such information.
Please see your Investment representative for enrollment information.

Upload Drivers License - Front and Back

 

We Require a Valid ID Matching the Applicants Address to Issue an Account Number.

You will have 30 days from the date of your Application to Submit the Required Documents.
You can use a smart phone to make clear copies of your id and upload these documents.

 

Upload FRONT & BACK OF YOUR DRIVERS LICENSE using the BROWSE/UPLOAD buttons.

To Submit Your ID's Later, Click Next Step to Complete Your New Account Application.

 

I Have Read and Agree with the Following:
Customer Agreement including Pre-Dispute Arbitration Clause
Web Site Access and Online Delivery Consent
Anti Money-Laundering Policies
Letter of Authorization
AutoTrade Program Authorization


Risk Disclosures:
Privacy Statement , Margin Disclosure Document , Day Trading Risk, Extended Hours Trading,
Order Flow Payments, Penny Stocks, Traders Responsibilities, Risks of Options, AutoShares Business Continuity Plan
I Have Read, Understand, and Agree With All Of The Account Documents Covered by this Signature Page

Draw Signature with Mouse or Finger. Press CONFIRM SIGNATURE after you draw your signature to confirm your signature.
To sign later, you may skip this section and sign manually.

Customer's signature  X 

Dated : 

Joint owner signature  X 

Dated : 

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