Spi_individual Account Application Form

INDIVIDUAL ACCOUNT APPLICATION

STANDARD ACCOUNTS To open a standard account, a minimum margin deposit GBP £5,000 OR its USD/EURO equivalent is required. Wire transfer, bank check, money order, certified check, or personal check. Personal checks may take up to ten business days to clear depending on the bank, state of origin, and amount. Leverage for standard accounts is 200:1 MINI ACCOUNTS To open a Mini account, a minimum margin deposit of GBP £2,500 OR its USD/EURO equivalent is required. Wire transfer, bank check, money order, certified check, or personal check. Personal checks may take up to ten business days to clear depending on the bank, state of origin, and amount. Leverage for Mini accounts is 200:1 Deposit of Margin Funds Initial Deposit (submit funds ONLY after the Account Application has been approved) Interbankps requires 2 forms of identification for each individual listed on the account, one must be a photo ID. Acceptable forms of Identification are: A copy of an unexpired/valid picture drivers license A copy of an unexpired/valid passport A copy of a state issued picture ID Section 1. Customer Information (* = Required Field) Customer Information and Identification: As a government regulated futures commission merchant, Interbankps, is required to obtain certain customer information to verify your identity in accordance with the anti-money laundering procedures required by the USA/UK Patriots Act and set forth in the regulations promulgated by the National Futures Association. In order to approve and open your account, please provide complete information in response to the following application.

* First Name: * Last Name: * Day Phone: Mobile Phone: * Date Of Birth: * No. of Dependants: * Marital Single Married Status: Passport #: Physical Street Address (P.O. Box cannot be accepted) * Address 1: Address 2: * City: * Country:

* Primary Email: * Re-type Prim. Email: * Evening Phone: Fax: * Gender: Male Female * Country of Citizenship:

Driver's License #:

Address 3: * State/Province: * Zip/Postal Code:

Employment Information Employment Status:

* Bus. Addr. 1: Address 2: * City: * Country:

* Nature of Business: Apt/Suite: Address 3: * State/Province: * Zip/Postal Code:

* Bus. Phone: Bus. Email:

* Your Position: * Years Employed:

* Bus. Name:

CUSTOMER CONTRACT ALL OF THE ABOVE INFORMATION IS COMPLETE, CORRECT AND PROVIDED TO SPI: INTERBANK PAYMENT SERVICE FOR THE PURPOSE OF INSTRUCTING SPI: INTERBANK PAYMENT SERVICE TO TRANSMIT A FUNDS TRANSFER. SPI: INTERBANK PAYMENT SERVICE ACCEPTANCE AND EXECUTION OF THE FUNDS TRANSFER IS SUBJECT TO THE TERMS AND CONDITIONS OF INTERNATIONAL REMITTANCE. MY SIGNATURE BELOW INDICATES THAT I HAVE RECEIVED A COMPLETED COPY OF THIS FUNDS TRANSFER REQUEST.

Customer Signature:

Date: