SIPP Account Application Form

SIPP

Account

Application Form

Effective Date: 24 February 2016

APPLICATION INSTRUCTIONS

The following supporting documentation must accompany the SIPP’s completed Account Application Form:

-

For the SIPP trustees to provide on the initial set up of the SIPP Scheme at LMAX Exchange. If the SIPP Trustee is

aware that the up-to-date trust deed and any supplemental deed of the Scheme has been provided previously, then

there is no need to provide these again.



SIPP Scheme Trust Deed and any supplementary Trust Deeds.



Evidence of registration of the Scheme with Pensions Regulator or HMRC.

-

For the SIPP Member (beneficiary) , which may also be a Co (Second) -Trustee



A copy of your valid and signed passport, driving license etc.



Proof of residency, such as a copy of your bank statement or utility bill (e.g. gas, water, electricity, land

line phone, internet and cable TV connections) issued in your name in the previous 3 months.

- Limited Power of Attorney (“LPOA”), which is attached.

We are unable to open SIPP accounts without this documentation.

SIPP Account Application Form

Complete the following form to open a SIPP account. Please complete all sections in full and using

BLOCK CAPITALS (any section left incomplete will delay the processing of your application).

Please call +44 20 3192 2555 should you have any questions.

Details of SIPP Scheme

Scheme Name:

Address of SIPP Scheme, if different, to SIPP Trustee

Town:

Address Line 1:

County:

Address Line 2:

Post code:

Country:

Business tel. no:

HMRC ref:

SIPP Plan ref:

Designated SIPP A/C name for this application:

SIPP Trustee Details

SIPP Trustee name:

Registered company number of the SIPP Trustee:

FCA Firm Reference no (FRN) of the SIPP Trustee:

Legal Entity Identifier Code (LEI):

Is SIPP Member (beneficiary) acting as a co (second) trustee: YES / NO

Primary Contact at the SIPP Trustee

Title: Mr  Mrs  Ms  Miss  Dr  Other  Please specify:

First name:

Surname:

Mobile tel. no:

Email address:

Registered Company Address of the SIPP Trustee

Address Line 1:

Town:

Address Line 2:

County:

Address Line 3:

Post code:

Country:

Business tel. no:

Correspondence Address of the SIPP Trustee

Same as registered address (tick) 

Address Line 1:

Town:

Address Line 2:

County:

Address Line 3:

Post code:

SIPP Bank Details

Bank Name:

Bank Address:

Postcode:

Country

Account Name:

Account No:

Sort code:

—

—

Or IBAN

BIC

Approx. SIPP funds available for the purposes of trading with LMAX: £

Account and Security Details

Proposed Username:

(Memorable word between 6-20 characters in length)

Account Base Currency: GBP EUR USD AUD

_{CAD JPY CHF SEK SGD HKD}

Mother’s Maiden Name:

Father’s first name:

SIPP Member (Beneficiary) Details

Title: Mr  Mrs  Ms  Miss  Dr  Other  Please specify:

First name:

Surname:

Date of Birth:

Nationality:

Address Line 1:

Town:

Address Line 2:

County:

Address Line 3:

Post code:

Country of Residence:

Email address

Primary phone number:

(mobile preferred)

Secondary phone number:

(landline)

Trading Experience (Excludes trades for which you received financial advice)

The trading experience of SIPP Member (beneficiary)

Have you traded FX in the past 12 months?

No 

Yes averaging:

1-4 trades per month  5-10 trades per month  11-20 trades per month  20+ trades per month 

Have you traded CFDs or Futures in

the past 12 months?

No 

Yes averaging:

1-4 trades per month  5-10 trades per month  11-20 trades per month  20+ trades per month 

Do you have a relevant education or professional qualification that you consider would you assist your

If trading is to be carried out by the SIPP Trustee, then the below should indicate the experience of the officer who is

an authorised manager or supervisor of trading activities

Have you traded FX in the past 12 months?

No 

Yes averaging:

1-4 trades per month  5-10 trades per month  11-20 trades per month  20+ trades per month 

Have you traded CFDs or Futures in the past 12

months?

No 

Yes averaging:

1-4 trades per month  5-10 trades per month  11-20 trades per month  20+ trades per month 

Do you have a relevant education or professional qualification that you consider would you assist your

understanding of CFDs/Forex or leveraged products?

Yes  No 

If trading is to be carried out by the SIPP Trustee, details of persons authorised to do so:

Signature:

Date

D

D

M

M

Y

Y

Y

Y

Full name:

Position:

Signature:

Date

D

D

M

M

Y

Y

Y

Y

Full name:

Position:

SIPP Trustee Declaration

In signing and returning this form we confirm for the SIPP Scheme that:



We have full power and authority to enter into the LMAX Agreement which is described in bullet point 3 below with LMAX

on behalf of the SIPP Scheme and all trustees and authorised signatories of the SIPP Scheme are over 18 years of age;



We declare that the information we have provided as part of this application process is true, accurate and complete and,

should there be any subsequent changes to this information, We will inform LMAX immediately in writing;



We have read and understood and agree to be bound by the LMAX Agreement that is comprised of the current versions

published on the website of (a) the Terms of Business, (b) Product Information Schedules, (c) the Risk Warning Notice,

(d) the Trading Manual, (e) Instrument Information, (f) the Order Execution Policy, (g) (where applicable) the API

agreement, and (h) the SIPP Margin and Miscellaneous Schedule. We acknowledge that all of the documents that

constitute the LMAX Agreement and supplementary documents as available from the website including, but not limited to,

our Privacy Policy and Summary Conflicts of Interest Policy, or any other document that may form part of your agreement

with us, may be amended from time to time as permitted by the terms of the Terms of Business and that any later

versions will govern my trading relationship with LMAX from the effective dates set out in the Terms of Business;



We consent to the Order Execution Policy and for any orders to be executed outside a regulated market or a multilateral

trading facility;



We consent to any unexecuted limit order not to be made public;



The SIPP Scheme is properly constituted and validly exist under the laws of its jurisdiction and has the authority to

conduct its business;



The SIPP Member (beneficiary) may trade in the investment types / instruments (Permitted Investments) listed in the

SIPP Margin and Miscellaneous Schedule and that by doing so the SIPP Member (beneficiary) will not be in breach of

any laws or regulations nor the provisions in the SIPP Trust Deed;



We understand that, in order to comply with anti-money laundering legislation, LMAX, in relation to the SIPP Trustee or

their representatives and SIPP Member, may use information held in any database or in other electronic format;



The SIPP Trustee have obtained the consent of each of the authorised signatories and SIPP Member to the electronic

identity verification searches or to provide the required documentation;



We are aware that the trading service provided by LMAX carries a high level of risk and can result in losses that exceed

the balance of cash held on the account at any time; and



You are not permitted to reduce the Margin requirement described in your SIPP Margin and Miscellaneous Schedule without

our prior approval. This restriction on reducing the Margin requirement is imposed to assist us in meeting HMRC’s

Agreement

By signing this form we represent that all the information contained herein is true, complete and accurate and we agree on

behalf of the SIPP Scheme to be bound by the Agreement.

SIPP Margin and Miscellaneous Schedule

Margin requirements:

FX: 10%

CFDs on Spot Gold and Silver: 20%

CFDs on Commodities: 10%

CFDs on Indices: 10%

Permitted Investments:

Spot FX

Rolling Spot FX

Spot Gold and Silver

Rolling Spot Gold and Silver

CFDs on Commodities

CFDs on Indices

Miscellaneous Terms:

Limited Power of Attorney for a SIPP Account

The “Account Holder” with LMAX Trader

The “Attorney”

Name of SIPP Trust

Name

Name of Trustee (1)

Name of Co-Trustee (2)

(if there is a second trustee i.e:

member / beneficiary)

Full address of Attorney

Full address of SIPP Trust

Email of Attorney

Email of SIPP Trust

Phone number(s)

AUTHORITY

BY THIS POWER OF ATTORNEY made by way of deed, the Account Holder hereby appoints the

Attorney (with no power of substitution) and in the Account Holder's name or otherwise and on his

behalf, as from the date of signature of this Power of Attorney:

a) to give instructions to trade and to give investment orders on behalf of the Account Holder

in connection with all funds and other assets in the Account Holder’s account(s) listed above

under LMAX Account Number(s) (the “Accounts”); and

b) to give such instructions and orders freely and repeatedly and without limitation, thereby

increasing or diminishing the funds or other assets in the Accounts.

LIMITATION

The Attorney is not authorized to withdraw or pledge funds or other assets from any of the Accounts or

transfer funds or other assets between the Accounts. The Attorney is not authorized to make

payments into the Accounts other than from the Account Holder’s own credit card or bank accounts.

The Attorney shall only be authorized to the extent that the Account Holder provides him with the login

details and passwords of the Accounts.

REVOCATION

a) a written notice of revocation from the Account Holder; or

b) valid documentary evidence of the death, presumed death, bankruptcy or loss of legal

or mental capacity of either the Account Holder or the Attorney.

Any revocation or termination of the Power of Attorney pursuant to a) or b) above shall not affect the

validity, ratification or indemnity in respect of any instructions/orders given or transactions begun prior

to LMAX Limited receiving such notice or evidence.

RATIFICATION

The Account Holder hereby ratifies and confirms whatever the Attorney does or purports to do in the

exercise of any power conferred by this Power of Attorney.

This Power of Attorney in no way affects any and all rights* conferred to LMAX Limited under any

agreements between the Account Holder and LMAX Limited.

INDEMNITY

The Account Holder will fully indemnify and hold harmless LMAX Limited, and its successors and

assigns, against all claims, losses, costs, expenses, damages or liability which the Account Holder or

LMAX Limited sustain or incur as a result of any act or omission of the Attorney (including any cost

incurred in enforcing this indemnity).

GOVERNING LAW AND JURISDICTION

This Power of Attorney (and any dispute, controversy, proceedings or claim of whatever nature arising

out of or in any way relating to this Power of Attorney or its formation or any act performed or claimed

to be performed under it) shall be governed by and construed in accordance with English law and the

Courts of England shall have exclusive jurisdiction to hear and decide any suit, action or proceedings

and/or settle any disputes which may arise in connection with this Power of Attorney or its formation or

any act performed or claimed to be performed under it.

SIGNATURES

IN WITNESS whereof this Power of Attorney has been executed and delivered as a deed on the

following date.

Executed as a deed by the Account Holder

Trustee name:

……… ………..

Insert name of company

acting by:

……… ……….

Insert name of first director Signature of first director

……… ……….

Insert name of second director / secretary Signature of second director / secretary

Witness name

Trustee name:

………. ………..

Insert name of individual Signature of Individual

In the presence of

Witness name:

………. ………..

Insert name of individual Signature of Individual

Full Address of witness

Occupation of witness

Attorney

I hereby acknowledge receipt of the power described above and accept my appointment as agent and

attorney-in-fact for the Account Holder.

Signature

*IMPORTANT NOTE*