EFTA Document EFTA01436009

Structured Products Agreement and Approval Form Please Complete All Sections Account Number Account Name Account Type Individual Other (specify): NOTE: IRA and ERISA accounts are prohibited from purchasing Structured Products. Account and Owner Information: Provide requested information for each beneficial account owner ("Client"). If more than one owner exists, the Structured Products Agreement and Approval Supplementary Form to this Agreement may be required. Entity Name, or First