Account Ownership and Activity Questionnaire

Instructions: Please complete this form as indicated in each section. Remember to be as detailed as possible. All applicable fields must be completed in their entirety.

Enter 5 to 30 characters

Basic Information

Enter 2 to 30 characters
Enter 2 to 30 characters
Format: DD/MM/YYYY
This includes any social media (i.e. Facebook, Twitter, LinkedIn, etc.) sites.
Enter 8 to 50 characters

Ownership

Has the company been under the same ownership for the past five (5) years?
You must identify an ownership structure. Please determine if your company is publicly owned, government owned, or privately owned.
Enter 3 to 50 characters
Enter 10 to 300 characters.
Does your company have the ability to designate Nominee Owners &/or Directors?
Enter 10 to 300 characters.

If yes, please provide the name and street address of a person who resides in the United States and is authorized and has agreed to be an agent to accept service of legal process for records regarding this account.

Enter 5 to 50 characters.
Enter 5 to 50 characters.
Enter 5 to 50 characters.
Enter 5 to 50 characters.
Enter 3 to 50 characters.

Activities

Enter 10 to 300 characters.
Enter 10 to 300 characters.
Are the funds to be deposited in your FXCM Trading Account being invested on behalf of non-disclosed third parties, clients of the business, limited partners, non-voting shareholders, or any other third parties?
Enter 5 to 300 characters.
Does your Company clear for or offer correspondent accounts to other financial institutions?
Enter 5 to 300 characters.
Are you an institutional investor whose main activity is to invest in Financial Instruments?
Does your company have a designated Compliance or Anti Money Laundering Officer?
Enter 5 to 50 characters.
Enter 5 to 50 characters.
Enter 5 to 50 characters.
Enter 5 to 50 characters.
Enter 3 to 50 characters.

Regulatory Registration

Enter 5 to 50 characters.
Enter 5 to 50 characters.
Format: DD/MM/YYYY
Enter 5 to 50 characters.
Enter 3 to 50 characters.
Enter 3 to 50 characters.

Directors & Key Management

Please list your Director(s) and Key Management's name, title and location.

Enter 5 to 50 characters.
Enter 5 to 50 characters.
Enter 5 to 50 characters.
Do you want to add another director or manager? You cannot add any more directors.

Authorization and Signature

Thank You

Your information has been received and will be processed shortly. Please allow 1-2 business days for your form to be reviewed.

Reminder: Additional information and/or documents may be required in order to complete your application. Once we have reviewed your submitted document(s), you will be contacted regarding the next steps of the application process.