LOGIN User Pass Confidential Account Application Please print legibly and completely, designating N/A for those spaces that do not apply (Click Here For Printable Version) * (Check Only One) Individual     ___ Sole Proprietorship   ___ Joint Tenants (JTWROS) ___ Corporation ___ General Partnership  ___ CUSTOMER INFORMATION Account Owner Name: _______________________________________ Date of Birth: __________________ Account Owner Name: _______________________________________ Date of Birth: __________________ Address: _________________________________________________________________________________ Mailing Address for all Notices and Statements (No PO Box for FedEx) City: _____________________ State: _____________________ Zip Code: _____________________ Telephone: ________________ Office: ____________________ Fax: _________________________ Employer's Name: ___________________________ Position: _____________________________________ Employer's Address: ________________________________________________________________________ City: ______________________ State: _____________________ Zip: __________________________ Social Security # or Tax I.D. #: __________________________ Citizenship: __________________________ Country of Residence: _____________________________ E-Mail Address: ____________________________________________________________________________ FINANCIAL INFORMATION Bank Name: _______________________________ Branch Location: ______________________________ Annual Income : ___ $100,000-$250,000 ___ $250,000-$500,000 ___ $500,000-$1,000,000 ___ Over $1,000,000 Net Worth : ___ $100,000-$250,000 ___ $250,000-$500,000 ___ $500,000-$1,000,000 ___ Over $1,000,000 Liquid Net Worth: ___ $100,000-$250,000 ___ $250,000-$500,000 ___ $500,000-$1,000,000 ___ Over $1,000,000 Investment Objectives: ___ Growth ___ Speculation ___ Income ___ Hedge ___ Conservation of Capital Investment Experience: Number of Years ________________ The undersigned hereby attest(s) and certifies to be sophisticated financial institution and/or sophisticated participant and attest(s) the above information is complete and accurate. The undersigned hereby authorizes LAM to verify any or all of the foregoing information. Account Owner Signature: _____________________________________ Date: ______________________________ Account Owner Signature: _____________________________________ Date: ______________________________ This Document and Signature received by either, facsimile and/or mail shall be deemed to be an original executed application. FINWORLD INC. CANADA 130, Kingstreet, suite 1800, Toronto, Ontario, M5X 1E3, Canada +1 416 860 6213 info@finworld-inc.com Business hour - Monday to Friday - from 8:00 AM to 2:00 PM - Eastern Time Copyright 2006, Finworld Inc., All right reserved.