Joint Account Application Form

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Individual Account Application Form [December 2015]

Dealing in margined products such as financial spread bets, financial spread trades and CFDs involves a high level of risk and you can rapidly lose more than your initial investment. Please ensure that you fully understand the risks involved and seek professional advice if necessary. For a full risk disclaimer, please see www.capitalindex.com. Capital Index (UK) Limited is authorised and regulated by the Financial Conduct Authority (registration number 709693).

Joint Account Application Form

Capital Index (UK) Limited is authorised and regulated by the Financial Conduct Authority (registration number 709693).

If you have any questions regarding the completion of this application form or any of the terms included within it, please contact our Client Services team on 0044 (0) 20 7060 5120 or at [email protected].

Once you have completed and signed the Joint Account Application Form, you can submit it via one of the following two options; scanned by email to [email protected] or by post to:

Client Services at Capital Index (UK) Limited

Salisbury House, London Wall, London, EC2M 5QQ, United Kingdom

ACCOUNT HOLDER 1

Personal and Address Details

Title and Full Name Date of Birth Gender Nationality

Full Home Address*

Country

*this address should be where your bank and utility accounts are registered How long have you been resident at this address? More than 3 months Less than 3 months

Contact Details

Telephone (primary) Telephone (secondary) Email

Would you like to receive marketing and promotional material from Capital Index?

Please see our Privacy Statement for how we treat your personal data. Yes No

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Trading Experience

1. In the last 3 years, how often have you traded the following products?

Shares and Bonds: Frequently Sometimes Rarely / Never

CFDs and Spreads: Frequently Sometimes Rarely / Never

FX: Frequently Sometimes Rarely / Never

Futures and Options: Frequently Sometimes Rarely / Never

2. How do you usually trade?

Make my own decisions Use managed funds Use advisory services

Not applicable – I have not traded these products before

3. Do you have any relevant experience or qualifications?

Work in a financial institution Attend seminars / webinars

Studying for or hold a professional qualification None

Financial Status

Current Employment Status Industry of Employment Occupation

Annual Income

Savings and Investments Main source of funds

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Declarations

Before opening an account, it is important to read and understand our risk and legal documentation.

- I confirm that the information provided here is true and correct.

- I understand that stop losses are not guaranteed.

- I understand that I may be required to deposit substantial additional margin, at short notice, to keep positions open, otherwise my open positions could be automatically closed out.

- I have read and understood the Risk Declaration.

- I have read and understood the Terms and Conditions.

- I accept that Capital Index (UK) Ltd is authorised and regulated by the Financial Conduct Authority that your arrangements with the Company are governed by the laws of the United Kingdom. In the event that the Company is subject to the laws of another country, I acknowledge that it is the Company’s sole responsibility to ensure that participation in the services offered by Capital Index (UK) Limited does not infringe any laws (in particular those of the USA).

- I consent to:

Capital Index (UK) Limited accepting trading instructions from any joint account holder;

Capital Index (UK) Limited sending trade confirmations to all joint account holders;

and Capital Index (UK) Limited processing withdrawal requests made by any joint account holder to their requested destination.

- I agree that all joint account holders can operate the account individually and that I am individually and jointly liable for all amounts owed to Capital Index (UK) Limited on this account and any sub account.

- I agree that all account statements will be sent to all joint account holders unless one account holder requests that statements not be sent to them.

Signature: Print Name:

Date:

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