Common use of Account Registration Clause in Contracts

Account Registration. ☐ Individual Account ☐ Trust ☐ Corporation, Partnership, ☐ Joint Registration ☐ Individual Retirement LLC, Pension or Profit- * If no box below is checked, we will issue the Account (IRA) Sharing Plan. Association, securities as JTWROS. or other Entity ☐ Joint Tenants with Rights of Survivorship * ☐ Tenants in Common ☐ Tenants in Entirety ☐ Community Property PLEASE PUT A CHECK NEXT TO EACH SOCIAL SECURITY NUMBER OR TAX ID NUMBER THAT IS RESPONSIBLE FOR TAXES. WE WILL REPORT THIS NUMBER TO THE IRS. ☐ Name of INVESTOR (Individual, Entity, Custodian, Trust or Beneficiary) Date of Birth Soc. Sec. / Tax ID # ☐ Name of SIGNER (Signer for Entity, Trust. Name of IRA Participant) Date of Birth Soc. Sec. / Tax ID # ☐ Name of JOINT INVESTOR or CO- TRUSTEE (if applicable) Date of Birth Soc. Sec. / Tax ID # Marital Status (please check one): ☐ Single ☐ Married ☐ Other $______________________Total Investment Amount HOME ADDRESS ☐ USE THIS ADDRESS FOR MAILING Street Address Apt / Suite / Unit # City State Zip Home Phone Fax Email BUSINESS ADDRESS ☐ USE THIS ADDRESS FOR MAILING Street Address Apt / Suite / Unit # City State Zip Business Phone Fax Email

Account Registration. ☐ ¨ Individual Account ☐ ¨ Trust ☐ Corporation, Partnership, ☐ ¨ Corporation ¨ Joint Registration ☐ ¨ Individual ¨ Partnership Retirement LLC, Pension or Profit- Account (IRA) * If no box below is checked, we will issue the Account (IRA) Sharing Plan. Association, securities as JTWROS. or other Entity ☐ ¨ Limited Liability Company ¨ Estate o Joint Tenants with Rights of Survivorship * ☐ ¨ Foundation o Tenants in Common ☐ ¨ Charitable Remainder o Tenants in Entirety ☐ Trust o Community Property ¨ Other PLEASE PUT A CHECK NEXT TO EACH SOCIAL SECURITY NUMBER OR TAX ID NUMBER THAT IS RESPONSIBLE FOR TAXES. WE WILL REPORT THIS NUMBER TO THE IRS. ☐ ¨ Name of INVESTOR (Individual, Entity, Custodian, Trust or Beneficiary) Date of Birth Soc. Sec. / Tax ID # ☐ ¨ Name of SIGNER (Signer for Entity, Trust. Name of IRA Participant) Date of Birth Soc. Sec. / Tax ID # ☐ ¨ Name of JOINT INVESTOR or CO- TRUSTEE (if applicable) Date of Birth Soc. Sec. / Tax ID # Marital Status (please check one): ☐ ¨ Single ☐ ¨ Married ☐ ¨ Other $______________________$ Total Investment Amount HOME ADDRESS ☐ ¨ USE THIS ADDRESS FOR MAILING Street Address Apt / Suite / Unit # City State Zip Home Phone Fax Email BUSINESS ADDRESS ☐ ¨ USE THIS ADDRESS FOR MAILING Street Address Apt / Suite / Unit # City State Zip Business Phone Fax Email

Account Registration. ☐ Individual Account ☐ Trust ☐ Corporation, Partnership, LLC, ☐ Joint Registration ☐ Individual Retirement LLC, Account (IRA) Pension or Profit- Profit-Sharing Plan. Association, or other Entity * If no box below is checked, we will issue the Account (IRA) Sharing Plan. Association, securities as JTWROS. or other Entity ☐ Joint Tenants with Rights of Survivorship * ☐ Tenants in Common ☐ Tenants in Entirety ☐ Community Property PLEASE PUT A CHECK NEXT TO EACH SOCIAL SECURITY NUMBER OR TAX ID NUMBER THAT IS RESPONSIBLE FOR TAXES. WE WILL REPORT THIS NUMBER TO THE IRS. ☐ Name of INVESTOR (Individual, Entity, Custodian, Trust or Beneficiary) Date of Birth Soc. Sec. / Tax ID # ☐ Name of SIGNER (Signer for Entity, Trust. Name of IRA Participant) Date of Birth Soc. Sec. / Tax ID # ☐ Name of JOINT INVESTOR or CO- TRUSTEE (if applicable) Date of Birth Soc. Sec. / Tax ID # Marital Status (please check one): ☐ Single ☐ Married ☐ Other $______________________$ Total Investment Amount HOME ADDRESS ☐ USE THIS ADDRESS FOR MAILING Street Address Apt Xxxxxx Xxxxxxx Xxx / Suite Xxxxx / Unit Xxxx # City State Zip Xxxx Xxxxx Xxx Home Phone Fax Email BUSINESS ADDRESS ☐ USE THIS ADDRESS FOR MAILING Street Address Apt Xxxxxx Xxxxxxx Xxx / Suite Xxxxx / Unit Xxxx # City State Xxxx Xxxxx Zip Business Phone Fax Email

Account Registration. ☐ ¨ Individual Account ☐ Trust ☐ Corporation, Partnership, ☐ ¨ Joint Registration ☐ Individual Retirement LLC, Pension or Profit- * If no box below is checked, we will issue the Account (IRA) Sharing Plan. Association, securities as JTWROS. or other Entity ☐ ¨ Joint Tenants with Rights of Survivorship * ☐ ¨ Tenants in Common ☐ ¨ Tenants in Entirety ☐ ¨ Community Property ¨ Trust ¨ Individual Retirement Account (IRA) ¨ Corporation, Partnership, LLC, Pension or Profit-Sharing Plan. Association, or other Entity PLEASE PUT A CHECK NEXT TO EACH SOCIAL SECURITY NUMBER OR TAX ID NUMBER THAT IS RESPONSIBLE FOR TAXES. WE WILL REPORT THIS NUMBER TO THE IRS. ☐ ¨ Name of INVESTOR (Individual, Entity, Custodian, Trust or Beneficiary) Date of Birth Soc. Sec. / Tax ID # ☐ ¨ Name of SIGNER (Signer for Entity, Trust. Name of IRA Participant) Date of Birth Soc. Sec. / Tax ID # ☐ ¨ Name of JOINT INVESTOR or CO- TRUSTEE (if applicable) Date of Birth Soc. Sec. / Tax ID # Marital Status (please check one): ☐ ¨ Single ☐ ¨ Married ☐ ¨ Other $$ _______________________ Total Investment Amount HOME ADDRESS ☐ ¨ USE THIS ADDRESS FOR MAILING Street Address Apt / Suite / Unit # City State Zip Home Phone Fax Email BUSINESS ADDRESS ☐ ¨ USE THIS ADDRESS FOR MAILING Street Address Apt / Suite / Unit # City State Zip Business Phone Fax Email