NATIONAL COMMODITIES CORP. INC.
CUSTOMER ACCOUNT APPLICATION

SINGLE STOCK FUTURES


CUSTOMER 1 CUSTOMER 2   (COMPLETE FOR JOINT, PARTNER ACCOUNTS)

_NAME____________________________S.S.# OR TAX I.D.#________________

_ADDRESS_________________________________________________________

_CITY_____________________________STATE_____ZIP___________________

_EMPLOYER_______________________OCCUPATION____________________

_ADDRESS_________________________________________________________

_CITY_____________________________STATE_____ ZIP__________________

_HOME PHONE____________________BUS. PHONE_____________________

_CELLULAR/BEEPER_______________FAX_____________________________

_DATE OF BIRTH___________________CITIZENSHIP_____________________

_NO OF DEPENDENT_______________MARITAL STATUS_________________

_NAME____________________________S.S.# OR TAX I.D.#________________

_ADDRESS_________________________________________________________

_CITY_____________________________STATE_____ZIP___________________

_EMPLOYER_______________________OCCUPATION____________________

_ADDRESS_________________________________________________________

_CITY_____________________________STATE_____ ZIP__________________

_HOME PHONE____________________BUS. PHONE_____________________

_CELLULAR/BEEPER_______________FAX_____________________________

_DATE OF BIRTH___________________CITIZENSHIP_____________________

_NO OF DEPENDENT_______________MARITAL STATUS_________________
   
 WOULD YOU PREFER RECEIVING YOUR DAILY & MONTHLY STATEMENTS BY:

E-mail                   Regular Mail                   Fax
If Fax or E-mail, please provide # and/or address in the line below

________________________________________________________________________

ANNUAL INCOME

$_______________________

NET WORTH (EXCLUSIVE OF RESIDENCE)

$_______________________

LIQUID NET WORTH

$_______________________

ANNUAL INCOME

$_______________________

NET WORTH (EXCLUSIVE OF RESIDENCE)

$_______________________

LIQUID NET WORTH

$_______________________

 
  • Single Stock Futures Trading Objective        __ Speculation     __Hedging
    Affiliations: ______________________________________________________________________________________
  • Are you affiliated with or employed by a futures or securities exchange, NFA, NASD, a member firm of either of those entities.
    __ Yes    __ No
  • Are you a "control person" or affiliate of a public company as defined in SEC Rule 144? This would include, but is not necessarilly limited to, 10% shareholders, policy making executives, and members of the Board of Directors.
    __ Yes, Trading Symbol _____________________________________________________________
    __ No


SIGNATURE CUSTOMER 1

____________________________ Date: ______________

SIGNATURE CUSTOMER 2

_____________________________ Date: ______________


APPROVAL OF BRANCH OFFICE MANAGER OR I.B.

_____________________________ Date: ______________

APPROVAL OF NCCI

_____________________________ Date: ______________


ALL NATIONAL COMMODITIES CORP. INC CUSTOMERS ARE REQUESTED TO SUBMIT NEW FINANCIAL INFORMATION EVERY CALENDAR YEAR, OR UPON ANY SIGNIFICANT CHANGE IN FINANCIAL CONDITION

PAGE 4 [1][2][3][5][6][7][8][9][10][11][12][13][14][15][16][17][ALL][TRENDEX]