Account Application

First name

Last name

Email

Select Phone Type Mobile Home Business

Phone Number

Phone Country Code

Residential Address I

Residential Address II

Select Country Argentina Brazil Canada

Select State None

Zip

Date of Birth

Social Security or ITIN

Marital Status Select Single Married Divorced Widowed Partnered

Number of Dependents

Occupation Select Accounting, Auditing Actuary Administrative Advertising/PR Aerospace, Defense, Aviation Architect Artist, Entertainer, Media Athlete Automotives Banking, Mortgage Broker Builders/General Contractors Business Owner Civil Service Clergy Construction Consultant Customer Service, Call Center Dentist Designer Doctors & Other Health Professionals Educator, Training Energy & Natural Resources Engineer Environmentalist Farming Finance, Real-Estate, Financial Expert Firefighter Forensics Healthcare Homemaker Human Resources Information Technology Insurance Law Enforcement, Security Lawyers/Law Firms Machinist Management, Professional Military Nurse Oil & Gas Professional Others Politics Research Resturant, Food Retail, Sales Retired Scientist Self-Employed Social, Public Servant Student Therapist Transporter Securities & Investment Venture Capitalist Warehouse

Industry Select Accounting Advertising/PR Aerospace, Defense Contractors Agriculture Air Transport Alchoholic Beverages Architectural Services Attorneys/Law Firms Auto Dealers Auto Manufacturers Automotives Banking, Mortgage Banking, Commercial Books, Magazines & Newspapers Broadcasters, Radio/TV Builders/General Contractors Builders/Residential Business Services Casinos/Gambling Cattle Ranchers/Livestock Chemical & Related Manufacturing Clothing Manufacturing Communication/Electronics Computer Software Construction Consultancy Credit Unions Dentists Doctors & Other Health Professionals Drug Manufacturers Education Energy & Natural Resources Environment Farming Finance Finance, Insurance & Real Estate Food & Beverage Forensics Funeral Services Health Information Technology Insurance Lawyers/Law Firms Manufacturing Marine Transport Mining Music Production Nurses Oil & Gas Others Securities & Investment Venture Capital Waste Management

Annual Income (Combine if joint) Select $0 - $15,000 $15,001 - $25,000 $25,001 - $50,000 $50,001 - $100,000 $100,001 - $200,000 $200,000+

Liquid Net Worth Select $0 - $15,000 $15,001 - $25,000 $25,001 - $50,000 $50,001 - $100,000 $100,001 - $200,000 $200,000 - $500,000 $500,001 - $100,000,000 $1,000,000+

Total Net Worth Select $0 - $15,000 $15,001 - $25,000 $25,001 - $50,000 $50,001 - $100,000 $100,001 - $200,000 $200,000 - $500,000 $500,001 - $100,000,000 $1,000,000+

What describes your investment experience? Select None Limited Good Excellent

What is the objective of this investment account? Select Speculation Growth Income Capital Preservation

Where will the assets to fund this account come from? Select Employment Income Gift / Inheritance / Trust Fund Insurance / Legal Settlement Investments / Capital Gains Lottery / Gaming Pension / IRA / Retirement Real-Estate Proceeds Savings Spousal / Child Support Unemployment / Disability Payments

What is the purpose and expected use of this account? Select Investment account with frequent transfers Long-term investment with occassional transfers Investing for estate planning Investing for tax planning Investing for college / minor Investing for retirement Investing of Pooled Assets Active / Day Trading Learning how to invest

Options for Uninvested Cash Astro Financial* Extended Insurance Sweep Deposit Account (Recommended) Cash Account Balance Program

Advanced Trading Features (Subject to Approval) Add Margin Trading Add Futures Trading

Power of Attorney (Check to receive form via email) I will like to grant authority of this account over to another individual

Add Trusted Contact Person (If applicable)

By choosing to provide information about a trusted contact person, you authorize Astro Finance to contact and to disclose information about your account to that person in the following circumstances: to address possible financial exploitation, to confirm the specifics of your current contact information, health status, or the identity of any legal guardian, executor, trustee or holder of a power of attorney, or as otherwise permitted by applicable law.

By clicking on "Next" I agree to the Terms, Privacy and Risks associated with Astro Finance, a subsidiary company of Astro Finance PTY LTD.