Personal Details
Title *
Mr
Mrs
Miss
Ms
Dr
Rev
First Name *
Middle Name
Last Name *
Daytime Phone *
Mobile Phone *
Date of Birth - Mth *
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day *
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
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24
25
26
27
28
29
30
31
Year *
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
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1971
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1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Email Address *
Nationality *
Residential Contact Information
Residential Address *
City *
Post Code *
Country *
Select...
UNITED STATES
UNITED KINGDOM
CANADA
AUSTRALIA
NEW ZEALAND
IRELAND
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Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo {Democratic Rep}
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland {Republic}
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar, {Burma}
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Postal Address (if different from above)
Will you be using an automated trading system or Expert Advisor?
Yes
No
Do all persons associated with this application understand the nature and risks of margined (or geared) investments?
Yes
No
Do all persons associated with this application have experience trading in Margined Contracts?
Yes
No
If yes, what instruments do they have experience trading with?
Do the persons associated with this application have any other investment experience other than that outlined above?
Are any of the persons associated with this application related to an existing account holder with AxiCorp?This includes existing AxiCorp account holders who are your relatives (including step-relatives or in-laws) as well as business associates.
Yes
No
If yes, please provide details:
Have any of the persons/partners associated with this account application been subject to any bankruptcy proceedings?
Yes
No
If yes, please provide details:
Financial Information
Are you trading as an Individual or a Sole Trader?
Individual
Sole Trader
Average ANNUAL gross income over the last three years
Select a value
$0 - $30,000
$30,001 - $60,000
$60,001 - $150,000
$150,001 and above..
Individual Financial Information
* The information provided below relates to the individual business/partnership whose details are listed above. Failure to provide this information may prevent us from processing your account.
Net Assets
Select a value
$0 - $100,000
$100,001 - $500,000
$500,001 - $5,000,000
$5,000,001 and above
Net Liabilities
Select a value
$0 - $100,000
$100,001 - $500,000
$500,001 - $5,000,000
$5,000,001 and above
Net Value (Net Assets - Net Liabilities)
Select a value
$0 - $100,000
$100,001 - $500,000
$500,001 - $5,000,000
$5,000,001 and above
Approx amount of funds available for your trading with us as equity
Select a value
$0 - $30,000
$30,001 - $60,000
$60,001 - $150,000
$150,001 and above
Legal Information and Identification * The purpose of this section is so that you (the Applicant) can review and save all the relevant legal documents that you are required to read.You can also review the identification section in preparation for completing the application. Please download and review the Client Agreement and PDS below before completing this section.Download the client agreement here Download the PDS here Download the FSG here
I have read, understood and agree to the terms of the Client Agreement
I have read and understood the Product Disclosure Statement
I have read and understood the Financial Services Guide
Identification Requirements Following 9/11, governments internationally have tightened banking rules to prevent money laundering. In December 2007, The Australian Government introduced its Anti Money Laundering and Counter-Terrorism Financing Act. To comply with this Act, AxiCorp Financial Services Pty Ltd, needs to formally identify you.
To do this we need to see the completed application form as well as a copy of the identification documents (ID) for the account holder or one of the partners.
The documents that you provide must be valid and clearly show your name and your residential address. PLUS Your signature and your photograph (as applicable to the document type). PRIMARY ID WITH PHOTO AND SIGNATURE (one only required) Current Australian/Foreign PassportExpired Australian Passport (less than two years old) Current Government-issue National ID Current Australian Driver LicencePLUS SECONDARY ID (one only required) Australian utilities provider bill/letter of service (less than three months old) ATO notice of assessment (less than one year old) Australian Local Government notice (less than one year old) Current Australian Driver Licence (only if not used as Primary ID above)Thank you for your understanding in working with us in compliance of this new legislation.
Banking Details (Optional)
Bank Name
Branch Address
City/Town
Country
Post Code
Account Holder (Must be the same as Account Application Name)
BSB Number
Account Number
IBAN/SWIFT Code (Int'l Clients)
Final Step
Please submit the form using the button below.