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Please complete this customer profile by providing the relevant details where requested and ticking the boxes
where appropriate. We need the information that is requested from you in this form prior to opening your
account. Failure to provide sufficient information may lead to a delay in processing your application to open an
account and/or a delay in providing the relevant services for you.
Please ensure that this form is signed in accordance with your Account Mandate by the duly authorized
signatories.
1. Account information
Title/ Name of account ____ATKINS MARTIN ERIC__________________________
Contact details
Telephone (daytime): __972 52 6930066______________ (evening): ___972 46549044_________________
Email : _ATKINS.MARTIN@GMAIL.COM__
2. Type of Account
Securities
We offer both advisory dealing/advisory managing services and execution-only services for Securities
products
Please tick the relevant products that you are experienced with:
X
Equities…………………………………………………………………
X
Bonds…………………………………………………………………..
X
Structured Notes………………………………………………………..
X
Mutual Funds /Unit Trusts……………………………………………..
Derivatives……………………………………………………………..
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Please indicate which type of services you require for Securities:
Please tick the box against
the service required
Advisory Services
Advisory Managed: We will monitor your portfolio and on our own initiative X
provide you with investment advice in accordance with your investment
objectives, in the context of your portfolio of investments. No transaction will
be entered into without your prior consent.
Execution-only
If you wish to make execution-only investments in unregulated collective investment schemes (hedge
funds, private equity funds, property funds, etc), we are obliged to assess your ability to make your own
investment decisions and to understand the risks involved.
Yes No
____________________________________________________________________________
____________________________________________________________________________
Yes No
B. Derivatives (This section need only be completed by if you intend to trade in the Derivatives Market)
Financials Financials
Commodities Commodities
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Advisory Managed: We will monitor your portfolio and on our own initiative
provide you with investment advice in accordance with your investment objectives, X
Execution-only
Sections 4 to 9 should be completed by all clients i.e. Advisory clients and Execution-only clients.
4. Investment details
What additional funds might be added over the next twelve months: _N.A.______
Balanced income & capital growth: X Bonds and convertible bonds – where income is fixed and
is linked to the underlying shares or funds, which
are specifically identified as such.
_____________________________________________
Please indicate your risk tolerance (you should bear in mind that higher return expectations entail a
commensurate level of investment volatility):
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6. Time Horizon
7. Restrictions/Preferences
Please list below any restrictions or preferences you may have, which you wish us to take account of.
These might be for example, geographical areas or specific markets, types of investment, the size of
individual investment units or classes of investments. If you do not give us details of restrictions, we
will assume that there are none.
______________________________________________________________________________
______________________________________________________________________________
_______________________________________________________________________________
We are best able to give you suitable advice when we have a complete picture of the manner in which
our services fit into your overall financial plan. Your net worth profile should reflect your financial position
accurately. If you do not complete this step, your application may be delayed and we may be unable to open
your Account. If your financial circumstances change, please notify us as soon as possible.
Please indicate the current distribution of your overall financial assets (% of Total Assets)
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9. Trading experience and knowledge
Securities
How long have you had an account trading these investments? ___________________________________
What is the approximate size of the average deal you traded? ___________________________________
Derivatives
How long have you had an account trading these investments? ________________________________
What is the approximate size of the average deal you traded? ________________________________
If you are resident outside the United Kingdom and you do not wish to receive confirmations, please notify us in writing.
Note however, that we recommend that you receive and retain all confirmations.
We shall send you periodic statements as well as (where appropriate) a statement of valuation and composition of your
Portfolio either 15 Business Days after the end of a calendar month or 15 Business Days after the end of each Quarter as
defined in our Terms of Business.
Quarterly Monthly X
Custody services
We will appoint a third party to act as Custodian of your assets which we may from time to time safeguard
and administer under this Agreement. Details of our Custodians are available on request.
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11. Acknowledgement and signature
• The information I have given on this form is true and complete. I will inform you immediately in writing of
any material changes to the information that has been provided by me on this form.
– classify me correctly as a “retail” customer for the purposes of the Financial Services and Markets Act
2000 and the rules of the Financial Services Authority;
– identify properly and recommend suitable investments to me in the case that I request any advisory
services from you; and
– in respect of execution-only services, such information may be used so that you can if necessary query the
appropriateness of a transaction.
• I have read and understand and agree to be bound by the terms and conditions set out in:
– the Terms of Business (including the risk warnings as to derivatives, warrants, penny shares and
stabilisation (as applicable) and the policies relating to older execution and conflicts of interest);
• I consent to the use, processing and disclosures of my personal details (including sensitive personal data) as
set in the Data Protection Notice (incorporated in the Terms of Business).
Date: ______________________________________
If you have any questions, please feel free to contact our Compliance Department on +44 (0) 20 7280 9526 or
Private Banking Manager 0207 280 9529.
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