MAS Consulting Financial Market Client Form

Monetary Authority of Singapore

Consulting Financial Market Client Form

FINANCIAL ADVISERS (AMENDMENT NO. X) REGULATIONS 2013 IN EXERCISE OF THE POWERS CONFERRED BY SECTIONS 23(4), 100(1) AND 104 OF THE FINANCIAL ADVISERS ACT, THE MONETARY AUTHORITY OF SINGAPORE HEREBY MAKES THE FOLLOWING REGULATIONS

A. IDENTITY DETAILS 1. Name of the Applicant: 2. Father's/ Spouse Name: 3. Gender:

Male Female B. Marital Status: Single Married

C. Date of Birth: 4. Nationality: B. Status:

Resident Individual Non Resident Foreign National

5. Identity Proof No. (if any): 6. Specify the Proof of Identity Submitted:

B. ADDRESS DETAILS 1. Residence Address: City/ Town/ Village: PIN Code: State: Country: 2. Contact Details: Telephone Number (Res): Mobile Number: Email ID: 3. Specify the Proof of Address Submitted for Residence Address: 4. Permanent Address:

5. SUBSCRIPTION A. Selected Package: B. Current Capital: C. Trading Platform: D. Trading Experience: E. Trading Losses: F. How Do You Know About Our Company? H. Past Company Adviser Comments: