
NEW JOINT BROKERAGE ACCOUNT APPLICATION
* indicates a required entry
1. Account Registration
Account Type Select one:
Joint Tenants with Rights of Survivorship (JTWROS)			Ownership of assets by two or more individuals. In the event of the death of one party, the survivor(s) receive total ownership.
Joint Tenants in Common (JTIC)			Ownership of assets by two or more individuals. A specific ownership percentage is assigned to each individual. In the event of the death of one party, the deceased's interest passes to their estate and not to the surviving tenant(s).
2. Applicant Information
Primary Applicant This section gathers basic information on the primary applicant.
First Name	*
Middle Initial
Last Name	*
Social Sec. No. / Tax ID	*		(###-##-#### or ##-#######)
Birth Date	*		(MM/DD/YYYY)
Home Phone	*		(###-###-####)
Business Phone			(###-###-####)
Gender	*	FemaleMale
Personal Identification Confirmation This information is newly required as part of our identity confirmation process.
Driver's License Number
State Issued
Date Issued
Expiration Date
or
Passport Number
Country Issued
Date Issued
Expiration Date
Internet Access This information is necessary to establish internet access for your account.
E-mail Address	*
Mother's Maiden Name	*
Mailing Address If using a PO Box as the mailing address, please provide your legal/physical address in the next address section.
Mailing Address	*
City	*
State	*		Must have a US address in Mailing OR Legal/Physical Address.
ZIP Code	*		(##### or #####-####)
Legal/Physical Address If your legal/physical address is different from your mailing address, or if your mailing address is a PO Box, fill out this section.
Street Address
City
State			Must have a US address in Mailing OR Legal/Physical Address.
ZIP Code			(##### or #####-####)
Citizenship
Nationality		U.S.Other
Country			(Required if not a U.S. Citizen)
Status		Resident Non-Resident
Employment Information
Employment Status		Employed Retired Not Employed
Occupation			(Required if you are employed)
Employer			(Required if you are employed)
City			(Required if you are employed)
State			(Required if you are employed)
Retired or Not Employed? If you are retired or currently not employed, specify the amount and source of your annual income:
Amount			($#,###,###)
Source
Financial Institution Information on your financial institution is required for suitability.
Financial Institution Name	*
City	*
State	*
Suitability - Financial Information Combine if filing Jointly. Exclude personal residence, automobiles, and household furnishings.
Annual Income	*		($#,###,###)
Net Worth	*		($#,###,###)
Liquid Net Worth	*		($#,###,###) Excluding all real estate
Investment Objective	*	Income Long Term Growth Short Term Growth Short Term Trading Speculation
Risk Exposure	*	Low Moderate High
Investment Experience	*	Minimal Moderate Extensive
Federal Tax Bracket	*	15% 28% 33% Other
Other Amount			(Required if Other) (##)
Joint Applicant 1 This section gathers basic information on any additional applicants.
First Name	*
Middle Initial
Last Name	*
Social Sec. No. / Tax ID	*		(###-##-#### or ##-#######)
Birth Date	*		(MM/DD/YYYY)
Personal Identification Confirmation This information is newly required as part of our identity confirmation process.
Driver's License Number
State Issued
Date Issued
Expiration Date
or
Passport Number
Country Issued
Date Issued
Expiration Date
Citizenship
Nationality		U.S.Other
Country			(Required if not a U.S. Citizen)
Status		Resident Non-Resident
Employment Information
Employment Status		Employed Retired Not Employed
Occupation			(Required if you are employed)
Employer			(Required if you are employed)
City			(Required if you are employed)
State			(Required if you are employed)
Financial Institution Information on your financial institution is required for suitability.
Financial Institution Name	*
City	*
State	*
Joint Applicant 2 This section gathers basic information on any additional applicants.
First Name	*
Middle Initial
Last Name	*
Social Sec. No. / Tax ID	*		(###-##-#### or ##-#######)
Birth Date	*		(MM/DD/YYYY)
Personal Identification Confirmation This information is newly required as part of our identity confirmation process.
Driver's License Number
State Issued
Date Issued
Expiration Date
or
Passport Number
Country Issued
Date Issued
Expiration Date
Citizenship
Nationality		U.S.Other
Country			(Required if not a U.S. Citizen)
Status		Resident Non-Resident
Employment Information
Employment Status		Employed Retired Not Employed
Occupation			(Required if you are employed)
Employer			(Required if you are employed)
City			(Required if you are employed)
State			(Required if you are employed)
Financial Institution Information on your financial institution is required for suitability.
Financial Institution Name	*
City	*
State	*

3. Interested Party
Fill out this section if another party should receive duplicate statements and/or confirmations. For example: accountants or attorneys.
Should another party receive duplicate statements and or confirmations?		Yes No
Name
Street Address
City
State
ZIP Code			(##### or #####-####)

4. Account Service Instructions
For your convenience, all securities will be held in your brokerage account. Purchase requirements and sales proceeds will be electronically transferred to/from your credit union account.
Financial Institution Name
Account Number			Checking or Savings (DDA)
Account Type		Checking Savings
ABA Routing/Transit Number			This is the first nine digits on the bottom left of your check.
City
State
5. Tenants in Common (If Applicable)
Only fill out this section if you chose a TEN COM account registration. In the event of the death of either or any of the undersigned, the interests in the tenancy shall be equal unless otherwise specified immediately below. If interests are not to be equal, designate the percentage interest of each tenant:
Tenant 1
Name
Percent			(##)
Tenant 2
Name
Percent			(##)
Tenant 3
Name
Percent			(##)

6. Affiliations and Acknowledgments (If Applicable)
Fill out this section if you are affiliated with, or work for a stock exchange or a member firm of an exchange or the NASD. Notification of your intent to open an account will be sent to your employer in accordance with current regulation.
I am affiliated with, or work for a stock exchange or a member firm of an exchange or the NASD		Yes No
Name of Firm
Street Address
City
State
ZIP Code			(##### or #####-####)
I am a		Director 10% Shareholder Policymaking Executive Officer of a publicly traded company

7. Information Release
		Credit Union Information Release
In order to provide me with information about financial products and services during the next twelve (12) months, I authorize BestVest Investments, Ltd. and my credit union and its affiliates to mutually share personal and financial account information. By giving the above authorization, I understand that information about me will not be disclosed to any unaffiliated third party without my permission and further, that the sharing of this information will be for the limited stated purpose of providing me information about financial products and services

8. Backup Withholding
Taxpayer Identification and Certification-Substitute Internal Revenue Service Form W-9
Under penalties of perjury, I certify (1) that the number shown on this form is my correct social security of taxpayer identification num ber and (2) that I am not subject to backup withholding because I am exempt from backup withholding or I have not been notified by the In ternal Revenue Service that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the IRS h as notified me that I am no longer subject to backup withholding and (3) I am a U.S. person (including a U.S. resident alien.) I must click the button in item 2b below if I have been notified by the IRS that I am currently subject to backup withholding because I have fai led to report all interest and dividends on my tax return. 2b. I am subject to backup withholding.
Click the button below to proceed.