CUSTOMER ACCOUNT APPLICATION

The following information is being provided by the undersigned for the purpose of opening an account at Hudson Global Capital Ltd. (HGC) I represent that the information is true and correct and that I will promptly notify you in writing of any material changes.

Ownership of Account :

           To operate Singly
           To operate Joint Account as
                     Joint tenants with right of survivorship
                     Tenants-in-common

GENERAL INFORMATION - Please Print or Type

1. Customer's Name (in full) 2. Spouse's Name
 

3. I/D No. / Passport Number

4. Date Of Birth
 
5. Citizenship : 6. Residence Phone
 
7. Mobile # / Pager # 8. E-Mail Address / Fax #
 
9. Residence Address

10. MAILING INFORMATION FOR STATEMENTS (Check one or more of the following)

Mandatory by Mail, address(es) as follows:
 
 
 
 
  By Fax
 
By E-Mail
 

EMPLOYMENT INFORMATION (LAST TWO YEARS)

11. Employer's Name 12. Nature of Business
 

13. Employer's Address

14. Position Held & Years There

COMPLETE QUESTIONS 15 TO 18 IF YOU HAVE BEEN WITH YOUR CURRENT EMPLOYER FOR LESS THAN TWO YEARS

15. Previous Employer's Name

16. Nature of Business
 

17. Previous Employer's Address

18. Position Held & Years There

FINANCIAL INFORMATION

19. Annual Income US$15,000 - US$25,000 US$25,000 - US$50,000 US$50,000 - US$100,000 more than US$100,000
         
20. Net Worth less than US$50,000 US$50,000 - US$100,000 US$100,000 - US$200,000 more than US$200,000

21. Approximate risk capital available : $ _______________ 22. Initial Deposit : Cash ____________ Collateral ____________

23. Do you own any property?  
      No Yes, Please specify: __________________________

BANK REFERENCES

24. Name of Bank & specify the branch office 25. Type of Account(s) Current Savings Other
 

26. Address

27. Account No.



 

By confirming my application for the above and by signing below, I:-

1. confirm that all information provided by me in this application is true and I have not witheld any material information;
2. agree to enclose true copies of my income substantiation documents and other documents as may be require by HGC, which documents
shall thereby become and remain HGC's properties;
3. authorise HGC to conduct credit checks and verify information given in this application with any person without prior reference to me.
4. authorised and give consent to HGC to disclose or release any information relating to me and/or my account with HGC at any time to
any party that HGC may deem fit;
5. agree that I shall execute such forms, agreements and where applicable, legal and security documents as may be required by HGC
before HGC officer designated above upon being notified that my application has been approved by HGC;
6. agree that opening an account with HGC, I shall be deemed to have read, accepted and be bound by HGC Term and Conditions
(as may be amended by HGC from time to time), copies of which are available at HGC and current copies of which I hereby
acknowledge receipt;
7. declare that I am not bankrupt and no Statutory Demand has been served on me.
8. acknowledge that HGC has the absolute right to reject or approve my application without assigning any reason.

 

___________________________
Signature of Customer

Date: ______________________

For Internal Use Only

Account No: ___________________________________

Authorised Officer: _____________  Date: ____________