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Open An Account

In order to establish an account with ALLIANCE PRECIOUS METALS GROUP, all information requested on this application must be provided. All information to ALLIANCE PRECIOUS METALS GROUP. shall be treated in accordance with applicable confidentiality laws, if any.

TYPE OF ACCOUNT TO BE OPENED







Please select the Type of Account to be Opened

Customer Information

Please Enter your Full Name
NAME

Please Enter your Address
ADDRESS

Enter City

Enter State

Enter Zip

Enter Country
CITY
STATE
ZIP
COUNTRY

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TELEPHONE/BUSINESS
FACSIMILE

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TELEPHONE/RESIDENTIAL
FACSIMILE

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Enter Valid Email
TELEPHONE/MOBILE
EMAIL

Please Enter your Date of Birth

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DATE OF BIRTH
NUMBER OF DEPENDANTS
MARITAL STATUS
Money Laundering Regulations

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DRIVERS LICENSE NUMBER
SOCIAL SECURITY NUMBER

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OCCUPATION

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EMPLOYERS NAME

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EMPLOYERS ADDRESS

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TYPE OF BUSINESS

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IF SELF EMPLOYED, BRIEFLY DESCRIBE YOUR BUSINESS

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UNIVERSITY / POST GRADUATE EDUCATION

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YRS COMPLETED
PROFESSIONAL QUALIFICATIONS
Financial Details

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ANNUAL SALARY $

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OTHER INCOME $
NET WORTH $

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EQUITY IN PRINCIPAL RESIDENCE $

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LIQUID ASSETS $
Trading Experience

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HAVE YOU TRADED COMMODITIES BEFORE?
NUMBER OF YEARS

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NAME OF FIRM

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HAVE YOU TRADED SECURITIES BEFORE?
NUMBER OF YEARS

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NAME OF FIRM

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Have you ever filed, or do you have pending litigation, disputed accounts, claims or other unresolved matters with commodity or securities brokers at this time?

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IF YES, BRIEFLY DESCRIBE


that I have read the RISK FACTORS AND DISCLOSURE STATEMENT Document.
Please Check Agree Box

I hereby represent and warrant that the foregoing information is true and correct. I hereby agree to notify ALLIANCE PRECIOUS METALS GROUP, in writing, of any changes, to the foregoing information. ALLIANCE PRECIOUS METALS GROUP, reserves the right, but has no duty, to verify the accuracy of the information provided herein.

Please Print your Name
SIGNATURE

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SIGNATURE

Please Enter Today's Date
DATE