| 1.What is your total estimated annual income? |
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| 2.Risk Capital, including initial deposit in this accountRisk Capital--if lost would not change your lifestyle.) |
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| 3.What is your total net worth?(Excluding residence)? |
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| 4.What is your liquid net worth? |
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| 5.Will any other person(s) guarantee, or have financial interest in this account?
NO
YES |
| If Yes please provide Name: |
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| 6.Will any person other than Client control, manage, or direct the trading in this account?
NO
YES |
| 7.Do you have or have you ever had any other account(s) with Ikon Capital
NO
YES |