15052 Gleason Path, Ste 105 Apple Valley, MN 55124-7199
Your Local Branch Office:
(952) 431-6333, 1-877-455-1980
Primary Applicant / Organization Information
Depending on account type, this may be the minor, protected person, or organization (trust, corporation, partnership, etc.).
Individual / Organization Name
for individuals, list first, middle and last names
1350 HIGH SITE DR
no P.O. boxes or mail receiving / incorporation services
account notices will be sent here
Primary Physical Address
optional - if a mailing address is not provided, account notices will be sent to the primary physical address
Date of Birth / Effective Date Social Security / Tax ID # Account Type
Funding Method for this Account:
Electronic funds transfer
For additional information, visit www.scottrade.com/funding Referral / Promo Code
Transfer from another brokerage
Deposit check or physical stock certificates
Transfer from another Scottrade account
Investment / Trading Experience
To best match your needs with our solutions, please share how you plan to use this account:
Timely investing, trading infrequently when I see opportunity in the market
Relatively frequent trading based on market movement
Actively trading on a daily basis
During the past year, how many trades were placed across all of your investment accounts?
25 - 120 trades (3 - 10 per month)
0 - 24 trades (0 - 2 per month)
121 - 249 trades (11 - 20 per month)
Unsure; I am new to investing
250+ trades (21+ per month)
What is the approximate value of all investable assets - excluding real estate - that you currently hold: stocks, bonds, 401(k), cash, etc.?
$0 - $24,999
$25,000 - $49,999
$50,000 - $249,999
$250,000 - $499,999
Individual, Joint & Retirement Account Applicants - complete the section below
All Other Account Types - skip to Page 2
Are You a U.S. Citizen?
No - provide citizenship & residency information
Are you a permanent
Country of citizenship:
Yes - skip to Employment
Yes - Alien Registration Number:
No - visa type:
silicon staff it services
1350 High Site Dr , Apt #309 Eagan, MN 55121
1. Are you employed by / affiliated with a securities firm, exchange or FINRA?
2. Are you a control person / affiliate of a public company as defined by the SEC? This generally includes 10% shareholders, members of the Board of Directors, and policy-making officers.
3. Are you or your immediate family member / business associate a senior foreign political official?
If you will be in the U.S. 183 days or less, contact our International Department.
Yes - provide organization name & compliance department address below in
Yes - provide company name & CUSIP / symbol below.
03/02/2015 08:46 PM ET
03/02/2015 08:54 PM ET
Complete Page 2 of this Application
Page 1 of 2
Co-Applicant / Authorized Person Information
Depending on the account type, this may be a custodian, trustee, guardian, trading officer/partner, or other authorized representative.
For multiple co-applicants: make additional copies of this page to complete for each co-applicant; all pages must be submitted together with page 1 of this Application.
Name of Individual
Phone Numbers check preferred
Date of Birth