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Application for opening of managed account

Please select account type:

Private account

Company account

Customer data

Salutation:		Profession:
Firstname:		Position:
Lastname:		Employer:
Address:		Branch:
ZIP Code, City:		Former profession:
Country:
Phone #:		Marital status:
Tel.# business:		# of Dependents:
Fax #:		Identification:
Tel.# cell:		ID #:
E-Mail:		Issued at:
Date of birth:		Valid to:
Place of birth:		Issuing authority:

The following information's are nessesary for corporate accounts:

Name of company:		Contact, Firstname:
Address:		Contact, Lastname:
ZIP Code, City:

Product selection:

Securities

CFDs/Spread Trading

Options

Futures

Forex

Declaration of assets:

Liquid Net. Assets (= Cash, Bonds, Stocks etc.)	Annual Income (average of last 5 years)	Risk Capital (which loss of capital you can take?)

Are you investing your own funds?	Are you dealing on credit basis?	Origin of funds:

Monthly spending: Euro

Account information:

Planned depositary capital:		Password for account:
		Investor password:
Account currency: USD EUR CHF		Phone password:

Investment Experience:

	Funds	Stocks	Certificates
Number of years
	CFDs/Spread Trading	Options	Futures
Number of years
	Forex
Number of years

Knowledge of function and risk:

Funds	Stocks	Certificates	CFDs/Spread Trading

Options	Futures	Forex

Managed Account

Who is going to make the trading decisions?		System provider name
If "autom. system": Name of autom. system		System provider contact person
System provider contact phone		System provider email

Investor Profile:

Risk group 6	Profile	Investment horizon	Investment Objective	Financial Instrument
	Speculative high profit expectations, high risk willingness, high losses are acceptable, total loss likely.limited retention.	< 1 Year	utilization of price movements by buying of Stocks and Future Options	Options

Risk group 7	Profile	Investment horizon	Investment Objective	Financial Instrument
	Highly speculative very high profit expectation, very high risk willingness, total loss very likely. leverage effect, reserve liability and limited retention.	< 1 Year	Speculative, High return of short-term price movements on the derivatives markets	Futures, Forex, Options, Currencies

Auf die vPE WertpapierhandelsBank AG bin ich aufmerksam geworden durch:

Recommendation of friends

via Internet

Your Partner FXM Financial GmbH 17070 has been recommendet

Your Partner FXM Financial GmbH 17070 has contacted me


Please send the New Account Application Form

Want you to receive information by your e-mail?		Yes
For internal
Referee name:

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Verification code

The above mentioned person declares and confirms that all information speficied above is complete and true. The above-mentioned person authorizes FXM Financial Group to verify the authenticity of this information.

I have read and understood the risc warning and agree with it.