Self Managed Super Fund (SMSF)

Phone: +6 (0)2 8014 4280 Fax: +61 (0)2 8072 2120 E-mail: [email protected] Web: www.icmarkes.com

International Capital Markets Pty Ltd Level 2 / 2 Bligh Street

Sydney, NSW, 2000 For any assistance or queries with this form, please contact our Support

Team on +61 (0)2 8014 4280 , or email [email protected] or live chat with us.

Trust/Super Name: Trust/Super Type:

Postcode: Street No. & Name:

Suburb: State:

Self Managed Super Fund (SMSF)

Trust or Superannuation Details -

Phone Number: After Hours:

Fax: Email: Trust/Super No.: Country of Registration: Main Contact: Position:

Registered Address: (if different from above)

Contact Details :

Account

Leverage:

First Name: Last Name:

Street No. & Name:

Suburb:

State: Postcode:

Trustee Details (Corporate Trustees Only)

Trustee Details (Individual Trustees Only)

Self Managed Super Fund (SMSF)

Given Names: Date of Birth: Company Name: Company Type: ABN/ACN/ Company: Address Mobile: Email: Contact Details

Other Trustees

Street No. & Name:

Suburb:

State: Postcode:

Full Name:

Street No. & Name:

Suburb:

State: Postcode:

Beneficial Owner/Membership Class Details

Under part 1 of the Australian Anti-Money Laundering Counter Terrorism Financing Act 2006 we are required in the case of a Trust or Superannuation to obtain details of either the Beneficial Owners OR each Class of Membership. Name or Memb. Class:

Street No. & Name: Suburb:

State / Country: Postcode:

Address:

Self Managed Super Fund (SMSF)

Name or Memb. Class:

Street No. & Name: Suburb:

State / Country: Postcode:

Address:

Name or Memb. Class:

Street No. & Name: Suburb:

State / Country: Postcode:

Address:

Name or Memb. Class:

Street No. & Name: Suburb:

State / Country: Postcode:

Address:

Declaration

By ALL Trustees signing this application you declare to International Capital Markets Pty Ltd that:

 You confirm that you have read and understood the PDS including the terms and conditions of Contracts that form part of the PDS.

 You understand the risks associated with investing in the Contracts described in the PDS.

 You understand that Contracts are leveraged products. This means a small movement in the market can lead to a much larger movement in the value of your investment. This can work against you as well as for you. You acknowledge that you could sustain a loss greater than and not limited to the margin that you have deposited with us.

 You believe that, based on your review of the PDS, you are capable of assessing the merits of and under-standing the terms, conditions and risks of Contracts. Therefore, the Contracts are an appropriate product for you to invest in.

 That the information that you have provided in this application form is true and correct and you will notify International Capital Markets Pty Ltd in writing if any information provided changes or ceases to be correct.  This application form requires you to disclose personal information. The “Privacy’ section of the PDS explains

how we collect personal information and then how we maintain, use and disclose this information. By signing and returning this application form, you acknowledge having reviewed the ‘Privacy’ section of the PDS and you consent to us collecting, using and disclosing information about any person named in this application form for the purposes de- scribed in the “Privacy’ section of the PDS as permitted by the Privacy Act 1988.

Self Managed Super Fund (SMSF)

Have ALL Trustees read and understood the PDS ? Have ALL Trustees read and understood the FSG ?

Do ALL Trustees understand the nature and risks of margined products?

Signature Name Date

Signature Name Date

Secret Question and Answer

To ensure the safety of your account at all times IC Markets will ask you a secret question when dealing with us on the Phone, Live Chat or Email. This allows us to verify that you are the account owner when communicating with us. Please write a question of your choice and enter an answer. All nominated account holders must know the question and answer.

Self Managed Super Fund (SMSF)

Security Question:

Security Answer:

Introducing Broker

How did you hear about IC Markets ? If you are part of a trading group or were Introduced to IC Markets by someone please let us know the details:

* If ID is NOT in English it must be accompanied with a translation.

International Capital Markets Pty Ltd is required by the Australian Anti-Money Laundering and Counter Terrorism Fi-nancing Act 2006 to verify the identity of the Trust or Superannuation fund.

The identity requirements are as follows:

Trust Deed OR Certified Extract from the Trust Deed

Identity Requirements

Self Managed Super Fund (SMSF)

ID Required for Trust or Superannuation

If Trustee is a Company If Trustee is an Individual

Certificate of Company Incorporation

1 x Primary Photo ID (Passport, Driver’s Li- cense or Government Issued Photo ID)

1 x Secondary ID (Utility Bill - less than 3 months old, Notice from Government Tax Office - less than 3 months old)

+ ID For EACH Director

1 x Primary Photo ID (Passport, Driver’s Li- cense or Government Issued Photo ID)

1 x Secondary ID (Utility Bill - less than 3 months old, Notice from Government Tax Office - less than 3 months old)

Once you have completed this application form please submit to us via one of the following methods. Please allow up to two business days for your trading account to be approved and opened.

Risk Warning: Trading Derivatives carries a high level of risk to your capital and you should

only trade with money you can afford to lose. Trading Derivatives may not be suitable for all investors, so please ensure that you fully understand the risks involved, and seek independent advice if necessary. A Product Disclosure Statement (PDS) can be obtained either from this website or on request from our offices and should be considered before entering into a transaction with us. True ECN accounts offer spreads from 0.0 pips with a commission charge of AUD $3.50 per 100k traded. Standard account offer spreads from 1 pips with no additional commission charges. Spreads on CFD indices start at 0.4 points. The information on this site is not directed at residents in any country or jurisdiction where such distribution or use would be contrary to local law or regulation. International Capital Markets holds an Australian financial services licence (AFSL) to carry on a financial services business in Australia, limited to the financial services covered by its AFSL. International Capital Markets Pty Ltd. ACN 123 289 109. AFSL No. 335692.

For Any Assistance:

[email protected] Email:

+61 (0)2 8072 2120 Fax:

International Capital Markets Pty Ltd Level 2 / 2 Bligh Street,