Buckingham Capital Singapore - Account Opening Form

Name

Email Address

Phone Number

Do you have an online account?

Yes No

Do you track your investments you made online?

Yes No

What are your financial requirements?

What type of an investor are you?

What is your time frame for your investments?

up to 1 YEAR 1-3 years 3-5 years 5 years and above

What is your investment experience?

None Some Experience Good Extensive Investment Experience

What forms of investments do you now have?

Your Net Income

Net Worth

0 – 100,000 100,000 – 500,000 500,000 – 1 Million and above 5 Million and above

Do travel overseas on a regular basis?

Yes No

What are the destinations that you frequent? (if applicable)

Are you a CEO or a director of a publicly traded company?

Yes No

If yes, what is the name of the company?

BANKING INSTRUCTIONS: Note that we will send you a separate banking letter after your application has been received. This is done for security reasons.

Account Declaration

I hereby confirm that the information that I have entered here in this account form is true, complete, accurate, and correct. I also confirm that I will inform Buckingham Capital Pte Ltd in writing for any change in the contact details that I have included in the said form above.