Joint Account Holder / Co-Trustee / Authorized Signatory Sample Clauses

Joint Account Holder / Co-Trustee / Authorized Signatory. (Natural Persons) Name (first, middle, last) Social Security Number Date of Birth (mm/dd/yyyy) Legal Street Address City State Zip Mailing Street Address City State Zip Email Address Phone Number Please indicate if you are a: ☐ U.S. Citizen ☐ Resident Alien ☐ Non-Resident Alien Country of Citizenship if non-U.S. Citizen (A completed applicable Form W-8 is required for subscription) Please specify if you are a Fidelity employee/officer/director/trustee/affiliate (required): ☐ Fidelity Officer or Director/Trustee ☐ Fidelity Employee ☐ Fidelity Fund Officer or Director/Trustee ☐ Immediate Family Member of Fidelity Officer or Director/Trustee ☐ Not Applicable