Account Application

To create an account, all that is required is a few straightforward procedures.

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1Account Application Form

ACCOUNT(s) DETAILS.

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First Applicant

Title:

Mr.
Mrs.
Ms.
Other

Other (write in full)

First Name: *

Last Name: *

Previous Name:

(If applicable)

Date of Birth: *

Place of Birth:

Nationality: *

Current Residential Address and Postcode: *

Write in full. (Please note C/O or P.O. Box is not acceptable)

Country:

Home Telephone Number:

Mobile Telephone Number: *

Email: *

Second Applicant (If applicable)

Title:

Mr.
Mrs.
Ms.
Other

Other (write in full)

First Name:

Last Name:

Previous Name:

(If applicable)

Date of Birth:

Place of Birth:

Nationality:

Current Residential Address and Postcode::

Write in full. (Please note C/O or P.O. Box is not acceptable)

Country:

Home Telephone Number:

Mobile Telephone Number:

Relationship to First Applicant:

Email:

CORRESPONDENCE DETAILS.

Please note that any correspondence we are required to send to you will be sent to the address you provide here. If no correspondence address is provided, we will use the current residential address of the first applicant.

Address and postcode for correspondence:

Is this address for:

YOU
A FRIEND
A FAMILY MEMBER
YOUR FINANCIAL ADVISER
YOUR WORK
OTHER

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First Applicant

Employer Name: *

Employer Address:

Nature of Employer Business:

Occupation: *

Job Title: *

Length of Service: *

Annual Gross Salary:

Please include currency symbol

If Retired or Unemployed:

Please provide details of your last employment before retirement or unemployment.

Second Applicant (If applicable)

Employer Name:

Employer Address:

Nature of Employer Business:

Occupation:

Job Title:

Length of Service:

Annual Gross Salary:

Please include currency symbol

If Retired or Unemployed:

Please provide details of your last employment before retirement or unemployment.

INVESTMENT PORTFOLIO DETAILS.

FINANCIAL PROFILE:

A. Approximate Annual Income (USD): *

Less Than - $25,000
$26,000 - $100,000
$101,000 - $250,000
$251,000- $500,000
$501,000 - $1,000,000
$1,001,000- $3,000,000
$3,001,000 +

B. Tax Bracket Status:

15%
20%
25%
30%
35%
40% +

C. Approximate Net Worth (USD): *

Less Than - $25,000
$26,000 - $100,000
$101,000 - $250,000
$251,000- $500,000
$501,000 - $1,000,000
$1,001,000- $3,000,000
$3,001,000 +

D. Liquid Net Worth – Cash, Stocks, Bonds, etc. (USD): *

Less Than - $25,000
$26,000 - $100,000
$101,000 - $250,000
$251,000- $500,000
$501,000 - $1,000,000
$1,001,000- $3,000,000
$3,001,000 +

OTHER INVESTMENTS:

Please provide us with additional information about your other investments to help us more fully understand your investment profile and identify what types of investments or strategies may be suitable for you.

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Type of Investment:

Firm Holding the Investment :

Amount (USD) $:

Account(s) and Ridgewood & Company Advisory Declaration.

I/We confirm that I/we have the necessary powers to take out this Client Portfolio Account and enter into a relationship with Ridgewood & Company Limited.

My/Our signature(s) below confirm(s) that: I/We declare that the information supplied in this application is complete and correct to the best of my/our knowledge and belief at the time of this declaration.

I/We agree to provide Ridgewood & Company Limited with any further information as may be required.

I/We agree to notify Ridgewood & Company of any material changes in the information provided in this application including but not limited to, changes in personal details, which may occur after the date of this application.

I/We agree/disagree to Ridgewood & Company Limited using my/our personal information for marketing purposes. You may change your mind at any time about receiving marketing messages by contacting us as described in the Ridgewood & Company Limited Terms and Conditions.

I/We confirm that I/we have read and understood the Ridgewood & Company Limited Terms and Conditions.

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First Applicant

Signature

Date:

Second Applicant (If applicable)

Signature

Date:

UPLOAD REQUIRED DOCUMENTATION:

A) Valid government ID (i.e., passport main page, or driver license front and back)
B) Utility bill dated within the last 3 months (i.e., water, electric, mobile phone bill, bank statement)

UPLOAD REQUIRED DOCUMENTATION:

Click or drag files to this area to upload. You can upload up to 4 files.

Please upload related photographs and documents in the following formats (DOC, DOCX, JPG, PNG, PDF) with 20MB each.