Ab UBS Financial Services Inc. - Wealth Management USA

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RESETabUBS Financial Services Inc.Account NumberTIN ÅÅçìåí ééäáÅ íáçå åÇ ÖêÉÉãÉåí Ñçê lêÖ åáò íáçåë åÇ ìëáåÉëëÉëAccount OwnershipSelect the Organization/Business Structure:Is this entity/organization abusiness that provides commercial goods or services(i.e., an operating entity)?YesNoIf no, specify the beneficialowner(s) of the organization/business on page 9.Any changes or correctionsto the information on thisapplication must be initialed by you.CorporationFed Charter-Credit UnionGovt Agency-Local EntCorp-Subchapter ‘S’State Charter-S&L BankGovt Agency-StateLimited Liability Company (LLC)State Charter-Savings BankFoundationLimited Liability Partnership (LLP)State Charter-Comm BankEndowmentLimited Liability-LimitedPartnership (LLLP)State Charter-Trust Co.Sole ProprietorshipState Charter-Indust LoanPartnership-GeneralFed Charter-Savings AssocPartnership-LimitedFed Charter-Nat’l BankAssociationFed Charter-Trust Co.Partnership-Invest ClubGovt Agency-FederalState Charter-Credit UnionInvest Club MembershipAccount Owner InformationBasic InformationOrganization/Business Name:This section should becompleted with theOrganization/Businessinformation.If address is a P.O. Box orthere are additionaladdresses please fill out theadditional address information on page 8.Date of Incorporation/EstablishmentTax ID Number (TIN)Location of Address:Business-PrimaryOrganization/Business is:1)Incorporated2)For ProfitUnincorporatedNot For ProfitOther (specify):Address Line 1Address Line 2Is the Organization/Business publicly listed?NoYes, specifyCityExchange (NYSE, AMEX, or NASDAQ)Business Phone 1:Ticker SymbolStateZipBusiness Phone 2:Industry Group (i.e., Construction, Service, etc.)(optional)Place of Formation/Incorporation:USA (if incorporated, specify State):Business Fax:Other: (specify)(optional)Do you consent to electronic delivery of your Agreementsand Disclosures booklet and other disclosures?NoYes If yes provide email address below,Tax Bracket (optional)E-mail address001601110CL-AC-BSA (Rev. AOEAIIGCCOMIIOMAEKMCAAIKAMMGCIKMEAIIMCOMEEMOIMGK 2010 UBS Financial Services Inc. All rights reserved. Member SIPC.1

RESETabUBS Financial Services Inc.Account NumberTINFinancial InformationFiscal Year-End: (indicate month)Annual Income: Investment Experience (in years):Liquid Assets: EquitiesNet Worth: BondsOptions-BuyDo you receive a substantial amount of revenue (over50%) (trade/export) from a country outside of the UnitedStates?NoYes If yes specify:FuturesOptions-SellDoes the organization/business own at least 10% of theshares of any publicly traded company?NoYes, specify company and %:%Country(ies)Secretary InformationComplete only forSecretary ofCorporation orCorporation SubChapter S.NameAddress:Address Line 1TitleAddress Line 2Authorized to give instructions?YesNoCityStateZipPhone Number:Officer/Owner/Member/Partner InformationComplete this section forthe Principal Officer/Ownerfor an Organization,Beneficial Owner/orMember of an LLC, Partnerfor a Partnership. Additionalnames can be added onpage 7.If applying for the UBS VisaSignature credit card, thePrincipal Officer/Ownermust complete the UBSResource Card Program section on page 4.If you answer “yes” to theNYSE Rule 407 question, aletter of authorization fromthe firm specified must beobtained before theaccount can be opened.Name:E-mail address (optional)Are any of the business owners, directors/principal officers, or any of their immediate family members a controlperson of any publicly traded corporation (examples ofcontrol persons are policy making officers, directors or10% shareholders)?NoYes, specify:SS#:Citizenship:USAOther: (specify)Passport/CedulaFirm(If non-U.S. and no Social Security Number specified)Location of Address:Home-Legal ResidenceOther: (specify)Business PrimaryAre any of the business owners, directors/principal officers, or any spouse affiliated with any securities firm,excluding UBS and its affiliates, broker-dealer subsidiaryof a financial institution, securities or commoditiesexchange, self-regulatory organization or the UBS auditor(currently Ernst & Young)? (NYSE Rule 407)NoAddress Line 1%Yes, specify:FirmAddress Line 2Home PhoneAre any of the business owners, directors/principal officers, or any of their immediate family members, anemployee of UBS AG, its subsidiaries or affiliates (e.g.,UBS Financial Services Inc., UBS Securities LLC)?NoYes, specify:Date of Birth:Affiliate/SubsidiaryCityStateZipEmployee Name/SS#001601110CL-AC-BSA (Rev. AOEAIIGCCOMIIMOCEIMCAAIKAIECEGKMMIAAOEGEIOGMEGAK 2010 UBS Financial Services Inc. All rights reserved. Member SIPC.2

RESETabUBS Financial Services Inc.Account NumberSS#/TINAccount InformationAccount Investment ObjectivesAggressive/Speculative:Seeks the potential forsignificant appreciation;willing to accept a highdegree of loss of principal.Moderate: Seeks potentialreturns with a lower risk ofloss of principal.Conservative: Seekssecurities that are mostlikely to preserve principalwith low risk.Return Objective: (select one)Capital Appreciation: Investments seeking growth of principal rather than the generation of income.Current Income and Capital Appreciation: Investments seeking both the generation of income and the growth ofprincipal.Current Income: Investments seeking the generation of income.Primary Risk Profile: (select ndary Risk Profile: (Optional, this may be applicable if you intend to engage in options Senior Political AffiliationI) Are you, any authorized signatories, beneficial owners, trustees, power of attorneys or other individuals withauthority to effect transactions,a current U.S. political official (as defined in section I-B on page 8)?YesNo If yes, complete additional information on page 8.II) Are you, any authorized signatories, beneficial owners, trustees, power of attorneys or other individuals withauthority to effect transactions, or any of their immediate family members or close associates a current or formerSenior non-U.S. political official, or Senior/Influential representative of a major non-US political party or stateowned enterprise of national importance ?YesNo If yes, complete additional information on page 8.Source of FundsIf funds are frominvestments transferredfrom another firm, pleaseindicate the source offunds to purchase theinitial investments.Please indicate the source of funds in the account: (Check all that apply.)Income from the business/organizationInvestors/Venture CapitalInheritance – from whom:Gifts – from whom:Sale of Real Estate – location:Legal SettlementSale of Business – name:Other – specify:UBS Bank USA Deposit Account Sweep Program - For Sole Proprietors and Government AgenciesUninvested cash balances in Business Services Account BSA , with some exceptions, will be automatically deposited intothe UBS Bank USA Deposit Accounts. Please see the Client Relationship Agreement and the Agreements and Disclosuresbooklet for important information related to the Deposit Account Program.CAP ELECTIONThe cap minimum is 100,000 for individualaccounts or 200,000 forjoint accounts, in eachcase on a per accountbasis.ALTERNATIVES TO THEDEPOSIT ACCOUNT2,3Check here to cap the amount of uninvested cash that will sweep into the Deposit Account, and select a secondarysweep option below:1RMA Money Market PortfolioNew York Municipal FundNew Jersey Municipal FundCalifornia Municipal FundTax-Free FundU.S. Government PortfolioPuerto Rico Short Term Investment Fund, Inc. (For Puerto Rico residents only)4If you do not want to sweep into the Deposit Account you can select one of the sweep options below:New York Municipal FundNew Jersey Municipal FundCalifornia Municipal FundTax-Free FundPuerto Rico Short Term Investment Fund, Inc. (For Puerto Rico residents only)4Non-Deposit Account Sweep of Uninvested Cash Balances2,3 - For All Other Businesses/Organizations and Managed ProgramsRMA Money Market PortfolioNew York Municipal FundNew Jersey Municipal FundCalifornia Municipal FundTax-Free FundU.S. Government PortfolioPuerto Rico Short Term Investment Fund, Inc. (For Puerto Rico residents only)41If you have multiple accounts in the same insurable capacity (for purposes of the FDIC insurance rules) at UBS, or if you hold other deposits including Certificates of Deposit at UBS Bank USA, youmay exceed FDIC insurance limits even if you have placed a limit on the amount of cash that will be swept from those account into UBS Bank USA Deposit Accounts. UBS will not be responsible forany insured or uninsured portion of the Deposit Accounts. (Refer to the Deposit Account Sweep Program disclosure statement in the Agreements and Disclosures booklet for more details.) 2Money4market funds are sold by prospectus only, are NOT FDIC-INSURED, NOT BANK GUARANTEED, AND MAY LOSE VALUE. 3State municipal funds are designed for residents of those states, respectively. PuertoRico Short Term Investment Fund, Inc. is offered exclusively to Puerto Rico residents as defined in the Fund’s prospectus. The Fund is not a money market fund registered under the U.S. InvestmentCompany Act of 1940, does not comply with rules applicable to U.S. registered funds and presents a higher degree of risk than those funds. The Fund is sold by prospectus only, is NOT FDIC-INSURED, NOTBANK GUARANTEED, AND MAY LOSE VALUE. For Puerto Rico residents holding accounts with UBS Financial Services Incorporated of Puerto Rico only.001601110CL-AC-BSA (Rev. AOEAIIGCCOMIIMOAGKMCAAIKAMIKCCIMMMMICGEIGKAEMGGK 2010 UBS Financial Services Inc. All rights reserved. Member SIPC.3

RESETabUBS Financial Services Inc.Account NumberSS#/TINGeneral Account FeaturesMARGIN1Accounts automatically come with margin unless they are Retirement, UGMA/UTMA, Estate, 529 Plan, or certainother accounts. Most managed programs cannot have margin.Check here if you do not want margin. If the account will have margin, answer the following questions:1 Do you intend to engage in “pattern day trading” as defined by NYSE Rule 431?2Yes2 Do you have any other margin accounts with UBS Financial Services Inc.?No If yes, complete:Account NumberAccount NumberYesNoAccount NumberAccount NumberDUPLICATE PARTIESIf you would like duplicate trade confirmations and statements sent to additional individuals, complete the duplicateparty information on page 7.1Margin is not suitable for all clients. Please review UBS Financial Services’ Loan Disclosure Statement carefully for information on the risks involved with using margin. 2Day tradingmeans purchasing and selling or selling and purchasing the same security in the same day in a margin account. “Pattern day trading” means executing four or more day trades withinfive business days if the number of day trades exceeds six percent of the total trades during that period.Business Services Account BSA Features The following features are automatically included in each Business Services Account BSA : UBS UBS American Express Card, Check Writing,and Electronic Funds Transfer and Bill Payment services. Please fill in the information below to complete enrollment in these features. To apply for the UBS Visa Signature Credit Card, the Principal Officer/Owner must complete the UBS Visa Signature credit card section below.This account may be subject to an annual fee as described in the Agreements and Disclosures booklet.UBS American Express Card2UBS RESOURCE CARDPROGRAM1Indicate the person’s name(s) that should appear on the Card(s):Indicate the card level forthe account:Name 1 (not exceeding 26 characters)Select Level (default) Includes a UBS AmericanExpress Card and UBS VisaSignature credit card3.Name 2 (not exceeding 26 characters)UBS Visa Signature Credit Card3Premier Level - Includes aUBS American Express Cardand UBS Visa Signaturecredit card3 and providesadditional rewards and benefits. 350 additional annualupgrade fee applies. See theAgreements andDisclosures booklet for further details.Indicate the person’s name(s) that should appear on the Card(s):Applicant Name (not exceeding 26 characters),. 0 0Requested Revolving Credit Line(optional) For UBS Visa Signaturecredit card onlyAdditional Card Member (if applicable) (not exceeding 26 characters)Does the Principal Officer/Owner own or rent their home?OwnRentCode Name letters only(For identity verification purposes)Check here to enroll UBS Rewards4Delivery:Standard (default)Overnight (Fees may apply)1Only account owners can be issued cards in this section. Other individuals must be designated on the Authorized Agent/Dual Signor Addendum on pages 1516. 2Transactions with your UBS American Express Card are deducted automatically from your Business Services Account BSA account. See the Agreementsand Disclosures booklet for details. Names provided below will appear on the cards in addition to the organization/business name provided on page 1. TheUBS American Express Card for Business Services Account BSA is not an American Express Corporate Card or American Express Business Card. 3You can alsoapply for a UBS Visa Signature credit card by completing the information above. Transactions with the UBS Visa Signature credit card are billed separately fromthe Business Services Account BSA unless you request an automatic payment plan. Names provided below will appear on the cards in addition to theorganization/business name provided on page 1. Issuance of the UBS Visa Signature credit card is subject to review and approval by Barclays Bank Delaware.Please see the UBS Visa Signature credit card Terms and Conditions for rate, fee and other cost information. 4UBS Rewards program allows you to earn pointstoward merchandise, travel and gift certificates. An annual 50 enrollment fee will be charged to this account at the end of the month following enrollment.001601110CL-AC-BSA (Rev. AOEAIIGCCOMIIMMCGIMCAAIKAMAGKCMEEEIIIOMKMIGAICAK 2010 UBS Financial Services Inc. All rights reserved. Member SIPC.4

RESETabUBS Financial Services Inc.Account NumberTINBusiness Services Account BSA Features continuedCHECK WRITINGWallet* (free) (default)3-page desk3-page businessOtherSelect a check style (select one):To request dual signature checks complete the Authorized Agent/Dual Signor Addendum on pages 15-16.Delivery:Overnight (Fees may apply)Standard (default)Name/Address toappear on checksAlternate Mailing Address for Cards and ChecksClient NameCheck here if thesame as Name andMailingaddress on theaccount .Address Line 1 - P.O. Box not permitted for cardsAddress Line 2CityStateZip*Wallet checks are free; all other check styles involve a fee.BILL PAYMENT SERVICECityZipPlease indicate your access preference for each: (select one for each service)Online (web)ResourceLineSM (phone) - If ResourceLine, complete pages 11-12ELECTRONIC FUNDSTRANSFER (EFT) SERVICEOnline (web)ResourceLineSM (phone) - Complete pages 13-14UBS ONLINE SERVICESCheck here for online access to account information.CL-AC-BSA (Rev. JHCLK001601110 AOEAIIGCCOMIIMMAEKMCAAIKAMMCCKIMMAMEEAAEIMECAOAK 2010 UBS Financial Services Inc. All rights reserved. Member SIPC. 5

RESETabUBS Financial Services Inc.Account NumberTINAccount AgreementU.S. Federal law requires us to obtain, verify and record information that identifies each person or entity that opens an Account with us. When youopen an Account, we will ask for your name, a street address, date of birth, and a tax identification number, such as a social security number. We mayalso ask to see a driver’s license or other identifying documents that will allow us to identify you.BY SIGNING BELOW AND DEPOSITING CASH OR SECURITIES IN THEACCOUNT, I UNDERSTAND, ACKNOWLEDGE AND AGREE ON BEHALF OFTHE ORGANIZATION THAT:A. I have supplied all of the information requested in this Account Applicationand I declare it to be true and accurate. I have received and read a copy of theAccount Application and Agreement and the attached Client RelationshipAgreement, and agree to be bound by the terms and conditions therein.Additionally, I will review the Agreements and Disclosures booklet upon receipt(or that I previously received) for additional terms and conditions. The ClientRelationship Agreement together with all other agreements and disclosuresthat UBS Financial Services Inc. ("UBS") makes available to me, including anyamendments, form the entire Agreement between me and UBS.B. As more fully described in the Client Relationship Agreement, theAgreement applies to all of my accounts at UBS, including accounts I may openin the future ("Accounts"). With some exceptions, I will be able to open additional accounts or take advantage of services and account features in thefuture without signing additional documents. I will not receive another copyof the Client Relationship Agreement or the Agreements and Disclosuresunless there are updates and amendments, or if UBS requires my signature onthis Agreement when I open Accounts in another capacity.C. If I am opening an account for a Sole Proprietorship, I certify that I am doingbusiness under the Organization/Business name listed on page 1, and I am thesole owner of said business and said business is not organized as any form ofcorporation, partnership or limited liability company. I authorize UBS to acceptany checks or other negotiable instruments payable to me and signed in thename of said business for deposit to the credit of my individual account(s)(including accounts for which I am a joint tenant, custodian or trustee) without limit as to amount, or further inquiry and without liability on the part ofUBS. I agree to notify UBS immediately in the event I change the name underwhich said business is carried out or if said business is discontinued.D. If I am opening an account for an LLC that is disregarded for income taxpurposes, I have provided the tax identification of the beneficial owner onpage 2;E. When I use margin privileges, UBS will hold the securities in my Account ascollateral against the amounts I borrow. I agree to keep sufficient positions andmargin in my Account to meet any margin calls UBS may be required to issue.By signing below, I agree that the Margin Agreement in the Client RelationshipAgreement applies to all of my accounts, including any accounts that I mayopen in the future. Note, however, that UBS does not extend margin for certain types of accounts (e.g., IRA and ERISA Plan accounts, Coverdell EducationSavings Accounts, 403(b)(7) Accounts, UGMA/UTMA, Estate or 529 PlanAccounts). Likewise, I acknowledge and agree that certain securities in myaccount, including any account I may open in the future, may be loaned to UBSor to other persons or entities as described in the Margin Agreement.F. As described in the last paragraph of the Client RelationshipAgreement entitled "Arbitration," I am agreeing in advance to arbitrateany controversies in accordance with the terms therein;G. UBS does not provide legal or tax advice;H. If I have requested the UBS American Express Card or have applied for aUBS Visa Signature credit card, I agree to be bound by the terms and conditions of their respective cardholder agreements in the Agreements andDisclosures booklet.W-9 Form CertificationUnder penalties of perjury, by signing the first signature line below, I certifythat: (1) the number shown on this form is my correct taxpayer identificationnumber (or I am waiting for a number to be issued to me), and (2) I am notsubject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS)that I am subject to backup withholding as a result of a failure to report allinterest or dividends, or (c) the IRS has notified me that I am no longer subjectto backup withholding, and (3) I am a U.S. citizen or other U.S. person (definedin the instructions).Certification Instruction: You must cross out item (2) above if you have beennotified by the IRS that you are currently subject to backup withholdingbecause you have failed to report all interest or dividends on your tax return.The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoidbackup withholding.The Client Relationship Agreement contains a predispute arbitration on page 27.Sign HereSignature and W-9 CertificationPrint NameDateAdditional Party SignaturePrint NameDateAdditional Party SignaturePrint NameDateAdditional Party SignaturePrint NameDateUBS Financial Services Inc. Branch Use OnlyCheck here to certify that the client has been informed of all possible sweep options.I attest that the client has been issued all required disclosure documents.Is the FA registered in both the client’s state of residence and mailing address?YesWhat was the initial transaction for this account?BuySellDepositInitial Trade Information: Security Name:Security Symbol:How was the account obtained?Interest/Dividends:MonthlyAccount Settles:Sweep Fund:Walk-In/Call-In /Mail-InSeminar-CEFS/Adv SvcsWeeklyHold in AccountAssets in AccountBank Code:NoTransfer of AccountsValue: Equity DVPPlan Code:Government DVPAssoc Code:Existing Clientor Shares:Referral:Transfer/ShipManaged Account Code:Family of Account Code:001601110CL-AC-BSA (Rev. AOEAIIGCCOMIIMMAEIMCAAIKAEEGOIKMEEAMGOACCCAEMMGK 2010 UBS Financial Services Inc. All rights reserved. Member SIPC.6

abUBS Financial Services Inc.RESETAccount NumberTIN ÅÅçìåí fåÑçêã íáçå ÇÇÉåÇìãComplete for each additional principal officer Attach an additional sheet if necessary.Principal Officer Name:If applying for the UBS VisaSignature credit card, thePrincipal Officer/Ownermust complete the UBSResource Card Program section on page 4.E-mail address (optional)Are any of the business owners, directors/principal officers, or any of their immediate family members a controlperson of any publicly traded corporation (examples ofcontrol persons are policy making officers, directors or10% shareholders)?NoYes, specify:SS#:Citizenship:USAOther: (specify)FirmPassport/Cedula%(If non-U.S. and no Social Security Number specified)If you answer “yes” to theNYSE Rule 407 question, aletter of authorization fromthe firm specified must beobtained before theaccount can be opened.Location of Address:Home-Legal ResidenceOther: (specify)Business PrimaryAre any of the business owners, directors/principal officers, or any spouse affiliated with any securities firm,excluding UBS and its affiliates, broker/dealer subsidiaryof a financial institution, securities or commoditiesexchange, self-regulatory organization or the UBS auditor(currently Ernst & Young)? (NYSE Rule 407)NoAddress Line 1Yes, specify:FirmAddress Line 2Home PhoneAre any of the business owners, directors/principal officers, or any of their immediate family members, anemployee of UBS AG, its subsidiaries or affiliates (e.g.,UBS Financial Services Inc., UBS Securities LLC)?NoYes, specify:Date of Birth:Affiliate/SubsidiaryCityStateZipEmployee Name/SS#Complete for each duplicate partyCheck all that apply:Trade Confirmation RecipientStatement RecipientCheck all that apply:Trade Confirmation RecipientStatement RecipientInternal Location Code (UBS Financial Services Use Only):Internal Location Code (UBS Financial Services Use Only):Name of Duplicate PartyName of Duplicate PartyAddress Line 1Address Line 1Address Line 2Address Line 2CityCitizenship:USAStateOther: (specify)ZipCityCitizenship:USAStateOther: (specify)001601110CL-AC-BSA (Rev. K 2010 UBS Financial Services Inc. All rights reserved. Member SIPC.7

RESETabUBS Financial Services Inc.Account NumberTIN ÅÅçìåí fåÑçêã íáçå ÇÇÉåÇìãComplete for each additional addressClient NameClient NameAddress Line 1Address Line 1Address Line 2Address Line 2CityStateLocation of Address:Home:Legal ResidenceBusiness:PrimaryOther: (specify)ZipCityStateLocation of Address:Home:Legal ResidenceBusiness:PrimaryOther: nior Political Affiliation Additional InformationI) If you answered yes to section I on page 3, complete the information below:A) Political Official’s Name:B) Current Position:PresidentVice PresidentUS Cabinet MemberMember of the House of RepresentativesSupreme Court JusticeChairman of the Joint Chiefs of StaffGovernorSenatorC) Relationship to Client(s):SelfImmediate family memberAssociated with business or trustClose associateII) If you answered yes to section II on page 3, complete the information below:Official’s/Organization’s Name:Current or Former Position (include country name):Relationship to Client(s):SelfImmediate family memberAssociated with business or trustClose associate001601110CL-AC-BSA (Rev. AOEAIIGCCOMIIOKAGIMCAAIKAIACMEOMEEAAGIOOCOIKGECK 2010 UBS Financial Services Inc. All rights reserved. Member SIPC.8

RESETabUBS Financial Services Inc.Account NumberTINÉåÉÑáÅá ä lïåÉê fåÑçêã íáçå ÇÇÉåÇìãEcçê åçåJçéÉê íáåÖ ÉåíáíáÉë çåäóFBasic/Personal InformationLocation of Address:Home-Legal ResidenceBusiness-PrimaryName:Complete this section forthe beneficial owner(s) ofnon-operating entity.Attach an additional sheet ifnecessary.If you completed theBeneficial OwnerInformation for an LLCon page 2, it is not necessary to complete thisaddendum.Note, Beneficial Owner isany person or entity thathas an ownership interest inan account, regardless ofthe account title or namedauthorized person(s).If address is a P.O. Box, orthere are additionaladdresses, complete theAdditional Address information on page 8.Country of Citizenship (individuals) /Place of Formation (trusts, estates and StateZipUSA (if organization is incorporated, specify State):Other: (specify):Date of Birth (individuals only):Location of Address:Home-Legal ResidenceBusiness-PrimaryName:Country of Citizenship (individuals) /Place of Formation (trusts, estates and organizations):AddressCityUSA (if organization is incorporated, specify State):Other: (specify):Date of Birth (individuals only):Location of Address:Home-Legal ResidenceBusiness-PrimaryName:Country of Citizenship (individuals) /Place of Formation (trusts, estates and organizations):AddressCityUSA (if organization is incorporated, specify State):Other: (specify):Date of Birth (individuals only):Location of Address:Home-Legal ResidenceBusiness-PrimaryName:Country of Citizenship (individuals) /Place of Formation (trusts, estates and organizations):AddressCityUSA (if organization is incorporated, specify State):Other: (specify):Date of Birth (individuals only):001601110CL-AC-BSA (Rev. AOEAIIGCCOMIIOICEKMCAAIKAAIKAKCEMIEEIEAAEAAAMKAK 2010 UBS Financial Services Inc. All rights reserved. Member SIPC.9

RESETUBS Financial Services Inc.Account NumberTINDTCC/COD InstructionsIf your account is set up to deliver securities and cash to a third party (i.e.deliver versus payment), please provide either DTCC or Fed Wire instructions.DTCC Clearing Number:Name of Delivering Institution:Internal Account Number:Additional Information:Del/RecNYGovernment Delivery InstructionsABA Number:Bank Name:Department:Third Party:Internal Account Number:Other Instructions:Physical Delivery:ID Confirm InstructionsInstitutional ID Number:Agent Bank/ID:Instructions Matrix:AID CID:Internal Account Number of Receiving Bank:Internal Account Number of Institution:Interested Party ID Number:Interested Party Internal Account Number:Interested Party ID Number:Interested Party Internal Account Number:Receive Physical Master Confirm: SID Indicator:YesNoYes (on SID)GHMRW35:No (Not on SID)Special Instructions:001601110CL-AC-BSA (Rev. AOEAIIGCCOMIIOMAEIMCAAIKAEIGKAEMEMEMECOKAOAAACCK 2010 UBS Financial Services Inc. All rights reserved. Member SIPC.10

RESETabUBS Financial Services Inc.Account NumberTINáää m óãÉåí pÉêîáÅÉThe Bill Payment Serviceallows you to pay yourbills and/or make paymentsto a third party vendorwithout writing and mailinga check. If paying bills viaResourceLineSM, completethe information.UBS Online Servicesclients can set upVendor/Payeeinformation online.*Please note that RMAIRMA and BusinessFAVENDOR/PAYEE 1VENDOR/PAYEE 2Name of Vendor/PayeeName of Vendor/PayeeVendor/Payee Account NumberVendor/Payee Account NumberVendor/Payee Street AddressVendor/Payee Street AddressCityStateCountryPostal CodeCityStatePostal Code ,Vendor/Payee Telephone NumberPlease attach a separatesheet to add moreVendors/Payees.On Demand Paymentsrequire the client’s verbalconsent for the branch toinitiate the paym

Business Phone 1: Business Phone 2: (optional) Business Fax: (optional) Do you consent to electronic delivery of your Agreements . Fed Charter-Credit Union State Charter-S&L Bank State Charter-Savings Bank State Charter-Comm Bank State Charter-Trust Co. State Charter-Credit Union