internal checklist for putnam tax...

33
Please make sure all forms are COMPLETED FULLY, SIGNED AND DATED BY THE CLIENT, and SIGNED AND DATED BY THE ADVISOR. Incomplete forms cannot be processed. Forms Client Profile Tax Account Annual Fee Agreement Tax Account Automatic Contribution Agreement Client Disclosure Form Putnam Mutual Fund Account Application Putnam Checkwriting Privilege Form* New LPL Account Application and Agreement Form (F1-BN) Risk Profile Checks Checklist for Putnam Tax Accounts Voided Check Based on the following schedule. Please circle one: JAN: $88. 00 FEB: $80. 00 MAR: $72. 00 APR: $64. 00 MAY: $56. 00 JUN: $48. 00 JUL: $40. 00 AUG: $32. 00 SEP: $24. 00 OCT: $16. 00 NOV: $8. 00 DEC: $96. 00 Other Copy of client’s Driver’s License Package revised on 1/31/2020 “Realty Benefits Services” fee will be drafted

Upload: others

Post on 11-Apr-2020

3 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

Please make sure all forms are COMPLETED FULLY, SIGNED AND DATED BY THE CLIENT, and SIGNED AND DATED BY THE ADVISOR. Incomplete forms cannot be processed.

FormsClient Profile

Tax Account Annual Fee Agreement

Tax Account Automatic Contribution Agreement

Client Disclosure Form

Putnam Mutual Fund Account Application

Putnam Checkwriting Privilege Form*

New LPL Account Application and Agreement Form (F1-BN)

Risk Profile

Checks

Checklist for Putnam Tax Accounts

Voided Check

Based on the following schedule. Please circle one:

JAN: $88.00 FEB: $80.00 MAR: $72.00 APR: $64.00 MAY: $56.00 JUN: $48.00

JUL: $40.00 AUG: $32.00 SEP: $24.00 OCT: $16.00 NOV: $8.00 DEC: $96.00

OtherCopy of client’s Driver’s License

Package revised on 1/31/2020

“Realty Benefits Services” fee will be drafted

Page 2: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

Putnam Tax AccountAnswer the following questions in order to complete the paperworkrequired for the Putnam Tax Account

Client’s Name (First, Middile initial, Last)

Client’s Date of Birth Client’s Social Security Number

Client’s Home CityClient’s Home StateClient’s Home Zip CodeNumber of Dependents

Client’s Occupation IndustryRealty Company NameRealty Company Office NameOffice Street AddressOffice City, State, and Zip Code

Client’s Home PhoneClient’s Work PhoneClient’s Fax NumberClient’s Cell PhoneClient’s Email Address

Branch NumberDealer NumberRep’s 70/30 Split IDRep’s Email AddressOffice Phone Number

Office StateOffice City

Office Zip Code

Office Street AddressRepresentative’s FirmAXA Rep Name

ID Expiration DateID Issuance DateID NumberPlace of Issuance

Client’s Country of CitizenshipID Type

CRD Number

Client’s Home Street Address

Page 3: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

PRINT FP NAME: ID #: DATE:

New Update

1. Background Information

Client/Owner

*First Name *Last Name

*SSN/TIN

*DOB

*Street Address

*City *State *Zip

Please complete previous address if changed within last 12 months

Street Address

City State Zip

*Citizenship: US Resident Alien Non-Resident

If non-US, specify:

Daytime Phone:

Mobile Phone:

Email:

*Status: Employed Self-Employed Retired Unemployed

*Occupation:

Employer Name:

Employer Address:

No. of Years:

Education: HS Assoc. BA/BS Masters/Ph.D.

Joint Client/Owner. Check the Box if N/A and add Spousal Information if applicable

First Name Last Name

SSN/TIN

DOB

Street Address

City State Zip

Please complete previous address if changed within last 12 months

Street Address

City State Zip

Citizenship: US Resident Alien Non-Resident

If non-US, specify:

Daytime Phone: Mobile Phone:

Email:

Status: Employed Self-Employed Retired Unemployed

Occupation:

Employer Name:

Employer Address:

No. of Years:

Education: HS Assoc. BA/BS Masters/Ph.D.

*Marital Status: Single Married Divorced Widowed Domestic Partner

*# of Dependents: Age(s)

Name(s)

Name(s)

CLIENT PROFILE

Realtor

Page 1 X02855_core_1 (02/20)

AXA Advisors, LLC (member FINRA, SIPC) 1290 Avenue of the Americas

New York, NY 10104

Page 4: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

AXA Advisors, LLC (member FINRA, SIPC) Page 2 1290 Avenue of the Americas X02855_core_1 (02/20)

New York, NY 10104

1. BackgroundInformation (Continued)

Client/OwnerProfileforEntitiesOnly—donotcompleteiftheclientisanindividual

Corporation(completeA-D) Trust(completeA-D) Partnership(completeA-C) Estate(completeA-C) GroupPlan(completeA-H)

A. *Name: *TIN #:

B. Authorized Person(s) to transact business:

*Name: *Title/Trustee:

Name: Title/Trustee:

AuthorizedPersonFormofIdentification (Pleasecheckone.) Valid Driver’s License Passport State Issued ID

Identification Number State/Country Issue Date Exp. Date

C. *StreetAddress: *City,State,Zip:

D. *Assets. Cash & Cash Equivalents: (CDs, Money Market, etc.) Stocks: Bonds:

Annuities: Mutual Funds: Other: Combined Total Assets:

E. TrustorIncorporationDate: StateorCountryofIncorporationorTrustAgreement:

F. *TypeofBusiness:

G. *EmployerName: *No.ofEmployees: <10 10-25 26-50 51-75 76-100 >100

H. *TypeofPlan: Startup/New Business Takeover/Rollover Amount: $

The Plan is: Profit Sharing/Money Purchase Pension Profit Sharing with 401k feature 401k Other:

Type of Funding: Exclusive Employer Funding Partial (Split) Funding

I. Important Considerations (includes existing insurance coverage, etc.):

Page 5: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

AXA Advisors, LLC (member FINRA, SIPC) Page 3 1290 Avenue of the Americas X02855_core_1 (02/20)

New York, NY 10104

2. USAPatriotActInformation

OwnerFormofIdentification(Pleasecheckone.) Valid Driver’s License Passport State Issued ID

IdentificationNumber State/Country IssueDate Exp.Date

JointOwnerFormofIdentification(Pleasecheckone.) Valid Driver’s License Passport State Issued ID

IdentificationNumber State/Country IssueDate Exp.Date

DEFINITION OF TRUSTED CONTACT: The trusted contact person is intended to be a resource for AXA in administering your account and protecting assets in connection with possible financial exploitation or diminished capacity. The Trusted Contact Person must be 18 years of age or older. AXA may disclose information about your policy to the Trusted Contact to confirm the specifics of your current contact information, health status, and the identity of any legal guardian, executor, trustee or holder of a power of attorney, and as otherwise permitted by applicable law. The Trusted Contact will not be authorized to transact business on your behalf.

NOTE:TheTrustedContactinformationbelowsupersedesanypreviouslynamedTrustedContactPerson.ToremoveaTrustedContactwithout designatingareplacement,pleasechecktheboxindicatingyoudonotwanttodesignateaTrustedContact.

TRUSTEDCONTACTPERSON

TrustedContactPersonInformation:Check this box if you DO NOT want to designate a Trusted Contact

To designate a Trusted Contact, please complete the following fields

First Name Last Name

Mailing Address Number and Street

City State Zip

Phone Number

Email Address

Relationship to Owner

TrustedContactPersonInformation:Check this box if you DO NOT want to designate a Trusted Contact

Check this box if you want to designate the same Trusted Contact as Owner #1. If checked, the fields below do not need to be completed

To designate a Trusted Contact, please complete the following fields

First Name Last Name

Mailing Address Number and Street

City State Zip

Phone Number

Email Address

Relationship to Owner

Page 6: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

AXA Advisors, LLC (member FINRA, SIPC) Page 4 1290 Avenue of the Americas X02855_core_1 (02/20)

New York, NY 10104

4. InsuranceCoverage (Not Applicable for Annuity, Brokerage and AXA Network Sales)

Indicate issuer and policy coverage:

Client/Owner Joint Client/Owner or Spouse

Life Insurance

Disability Insurance

Long-Term Care Insurance

When was the last time your Life Insurance portfolio was reviewed? Date:

Do you have sufficient life insurance coverage to address your family’s needs? Yes No

Do you have a need for long-term care protection? Yes No

Comments:

3. FinancialHousehold(HH)Information

Client/Owner Gross HH Income (all sources): $

Joint Client/Owner Gross HH Income (if separate HH): $

=*Est.GrossAnnualHHIncome(s): $

*Est.MonthlyFixedHHExpenses: $

*Fed.MarginalTaxBracket: 10% 12% 22% 24% 32% 35% 37%

*INVESTMENTEXPERIENCE(INYEARS)

None <1 1−4 5+

a) *CDs

b) *Stocks

c) *Bonds

d) *Annuities

e) *MutualFunds

*CURRENTHOLDINGSCompleteallthatapply(a-h)

a) Cash & Cash Equivalents: (CDs, Money Market, etc.) $

b) Stocks: $

c) Bonds: $

d) Annuities: $

e) Mutual Funds: $

f) Other Property(ies) Net Equity: (excludesprimary residence) $

g) Retirement Accounts (401(k), 403(b), IRA): $

h) Other (529 plans, life policy cash values,alternative investments, etc.): $

=i)*TotalAssets(above): $

*NetWorth(modified:allassetsminusdebts;excludesprimaryresidenceandassociateddebt):$

*LiquidNetWorth $

Page 7: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

AXA Advisors, LLC (member FINRA, SIPC) Page 5 1290 Avenue of the Americas X02855_core_1 (02/20)

New York, NY 10104

5. Goals&Objectives

*Whatistheprimarypurposeofthisinvestment/insurancerecommendation?(SelectOnlyOne)

Education Large Purchase (new home or other large investments) Liquidity (near-term) Tax Deferral/Relief

Retirement (accumulation/deferred/immediate) Protection Other (business planning/estate preservation/charitable/inheritance-legacy)

*Whatbestdescribesyourinvestment/insuranceobjective?(SelectOnlyOne)

Safety of Principal - only available for EQUI-VEST ® (Income with Capital Preservation for LPL) and Fixed Annuities Income (Income Moderate Growth for LPL)

Growth & Income Growth Aggressive Growth Trading/Speculation (brokerage only) N/A for Fixed Life * UL/WL/Term

*Arelifetimeincomeorprincipalguaranteesimportanttoyou?(SelectOnlyOne)

Yes No N/A for (Brokerage, Advisory Accounts, ADV-SCS, Life Products Fixed and Variable)

*Inmakinginvestment/insurancedecisions,whatconcernsyoumostthatyour FinancialProfessionalcanhelpyouwith?(SelectOnlyOne)

Making emotional investment decisions Not meeting my financial goals Outliving my investment assets or the income from my investment

Outspending my investment assets Tax consequences Family protection/Estate planning Other (use section 7)

*Whatprimaryriskdoyouwantaddressedwiththisinvestment/insurance?(SelectOnlyOne)

Capitalization (large/mid/small) Concentration (under diversification) Inflation/Purchasing Power Interest Rate Liquidity

Market Risk Volatility (includes fixed income markets) Income replacement/insuring assets against debt/final expenses

*HowdoyoupreferinteractingwithyourFinancialProfessional?(SelectOnlyOne)

N/A for Life Products Fixed and Variable Ongoing advice and service for fee (applicable only to advisory accounts) Periodic consultation and service (applicable to brokerage, annuity, direct mutual fund accounts etc.)

* IacknowledgethatmyFinancialProfessionalwillbecompensatedfortheadvice,recommendationandserviceprovided.

* Iacknowledgemyfinancialprofessionalwillbecompensatedfortheadvice/recommendation/serviceheorsheprovides.Thetypeofcompensationhasbeenexplainedandprovidedviaofferingmaterialandprospectusifapplicable.I’mawareandcomfortablewiththearrangement.

N/A

N/A

N/A

dsoto
Line
dsoto
Line
dsoto
Line
Page 8: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

AXA Advisors, LLC (member FINRA, SIPC) Page 6 1290 Avenue of the Americas X02855_core_1 (02/20)

New York, NY 10104

5. Goals&Objectives (Continued)

AccountsandProductsGrid

ThefollowingisbasedonPrimaryInvestment/InsuranceGoals

Education LargePurchase Liquidity(nearterm)

TaxDeferral/Relief

Retirement/Income/WealthPreservationManagingRiskAccumulation

Other

IndexedUniversal/Term/Universal/WholeLife

Depends on Strategy

Not

RecommendedDepends on

Strategy

LifeVariable Depends on Strategy

Not

RecommendedDepends on

Strategy

CorporateOwnedLifeInsurance

Depends onStrategy

Depends on

Strategy

GroupRetirementAccount

NotRecommended

NotRecommended

NotRecommended

Brokerage

BrokerageIRA NotRecommended

Depends OnTime Horizon

Depends OnTime Horizon

MutualFund/MutualFundOnlyAccount

529Plan Not

RecommendedNot

RecommendedNot

RecommendedNot

RecommendedNot

Recommended

Equities/Exchange-TradedFunds/FixedIncome

Depends on Strategy

AdvisoryAccounts

NotRecommended

Depends on Response

Depends onResponse

ThirdPartyAssetManagement

NotRecommended

Depends on Response

Depends onResponse

Fixed/ImmediateAnnuities

NotRecommended

Depends on Strategy Time

Horizon

NotRecommended

Variable/Indexed Annuities

NotRecommended

Depends on Strategy Time

Horizon

NotRecommended

Alternative Investments

NotRecommended

Depends on Strategy Time

Horizon

NotRecommended

*ClientAcknowledgment(SelectOnlyOne)

I wish to follow the personal investment strategy and product recommendations outlined in the Account and Products Grid.

I appreciate the care provided by AXA Advisors and my Financial Professional to help me determine a personal investment strategy along with product recommendation(s) pursuant to the Account and Products Grid. However, I prefer to employ my own strategy and product decisions understanding that they may be considered non-recommended and/or counter to the advice given.

The Accounts and Products Grid may not apply to all entities and depending upon unique client circumstances valid exceptions may apply.

N/A

dsoto
Line
Page 9: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

AXA Advisors, LLC (member FINRA, SIPC) Page 7 1290 Avenue of the Americas X02855_core_1 (02/20)

New York, NY 10104

5. Goals&Objectives (Continued)

RiskTolerance

Your Risk Tolerance is a function of your investment time horizon and appetite for risk. If you are not comfortable selecting a Risk Tolerance using the descriptions below, ask your Financial Professional to help you complete a separate Risk Tolerance Questionnaire.

The Conservative investor is generally very sensitive to short term losses. The Conservative investor’s aversion to short-term losses could compel him or herto sell their investment and hold a zero risk investment if losses occur. The Conservative investor would accept lower long-term returns in exchange for smaller and less frequent changes in portfolio value.

The Conservative-Plus investor is generally sensitive to short-term losses. The Conservative-Plus investor’s aversion to losses could compel him or her to shiftinto a more stable investment if significant short-term losses occur. The Conservative-Plus investor is usually willing to accept somewhat lower returns in order to assure greater safety of his or her investment.

The Moderate investor is somewhat concerned with short-term losses and may shift to a more stable option in the event of significant losses. The safety ofinvestment and return are typically of equal importance to the Moderate investor.

The Moderate-Plus investor is generally willing to accept high risk and chance of loss in order to achieve higher returns on his or her investment. Significantlosses over an extended period may prompt the Moderate-Plus investor to shift to a less risky investment.

The Aggressive investor generally aims to maximize long-term expected returns rather than to minimize possible short-term losses. An Aggressive investorvalues high returns and can tolerate both large and frequent fluctuations in portfolio value in exchange for a higher return over the long run.

*WhichRiskTolerancebestdescribesyou?Note to Financial Professional: If the client used a firm-approved risk profile determination tool, the results must be properly mapped per firm guidance.

(SelectOnlyOne)

Conservative Conservative Plus Moderate Moderate Plus Aggressive N/A for Fixed Life * UL/WL/Term

*Whatisyourexpectedinvestmenttimehorizon(inyears) for this recommendation?Time horizon applies to all products including fixed insurance - NOTE: the time horizon applies to the point of sale and maintaining the account/contract/policy.

(SelectOnlyOne)

1 2 3 4 5 6 7 8 9 10 >10

Note to Financial Professional: Please make sure the Client’s Investment Objective is in line with his/her stated Risk Tolerance.

Safety of Principal/Income with Capital

Preservation

Income/Income Moderate Growth

Growth & Income Growth Aggressive Growth Trading/Speculation

Conservative Conservative Conservative Plus Moderate Moderate Plus Aggressive

Conservative Plus Moderate Moderate Plus Aggressive Aggressive Plus

Moderate Plus Aggressive

Page 10: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

AXA Advisors, LLC (member FINRA, SIPC) Page 8 1290 Avenue of the Americas X02855_core_1 (02/20)

New York, NY 10104

6. ProductPurchase*Product: *TaxType(Qual/NQ/IRA/403(b)/457Plan): *Amount/FaceAmount:$(e.g. Retirement Cornerstone)

AXA Network and Association Individual Purchases Only.

This section is completed for the client’s purchase of:

AXA Network non-proprietary group annuity / 401k product:Other:

Branch Manager Signature for AXA Network group annuities / 401K Products / I am familiar with this product and approve the suitability of this transaction

BranchManager(BM)Signature: Print Name: Date:

Branch Manager signature is NOT required for Association 300+ Series, AXA Network Variable Life and Annuity, AXA Network Indexed Life and Annuity, AXA Network Fixed Deferred and Immediate Annuity and AXA Equitable Fixed Annuity sales.

*SourceofFundsforthispurchase: (Check box and circle sub-item(s)). If more than one box is checked, provide % breakdown. (Must add up to 100%)

Cash: Death Claim, Gift, Inheritance, Checking, Savings, Money Market, Payroll Deduction, CDs: %

Borrowing: Mortgage (including Reverse Mortgage), Personal Loan, Credit: %NQAnnuityorLifeInsurance: (Replacement, Surrender/Exchange, Policy Loan, Dividend, Withdrawal): %

TermConversion-Partial: % TermConversion-Full: %QualifiedAnnuity: (Replacement, Surrender/Exchange, Policy Loan, Dividend, Withdrawal): %401K,PensionPlans,OtherGroupRetirementPlans: %

NQ: Brokerage, Investment Advisory Assets, Mutual Fund Shares, UIT Shares, Stocks or Bonds: %

Qualified: Brokerage, ERISA Plan, Investment Advisory Assets, Mutual Funds Shares, UIT Shares, Stocks or Bonds: %

EmployerContribution: %

Other: Sale of Car, Home, Business, or Other Asset (specify: ),

Legal Settlement, Lottery/Gaming Proceeds, Other: : %

*[CaliforniaOnly]Do you intend to apply for means-tested government benefits, including, but not limited to, Medi-Cal or the veterans’ aid and attendance benefit?

Yes N/A for Life Products Fixed and Variable No

7. AdditionalClientNotesandImportantConsiderations(Inheritance/windfall, planned retirement date, special care needs, wills,trusts, etc.)

Putnam Government Money Market NQ

100

Page 11: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

AXA Advisors, LLC (member FINRA, SIPC) Page 9 1290 Avenue of the Americas X02855_core_1 (02/20)

New York, NY 10104

8. AdditionalInformation/Acknowledgments

Yes No *IstheClient/Owner/AuthorizedPersonassociatedorregisteredwithoremployedbyamemberofFINRA?

If yes, name of member:

Yes No AreyouaPoliticallyExposedPerson?

If Yes, please provide position and country:

Yes No N/A TheplansponsoracknowledgesreceiptoftheERISASection408(b)(2)feedisclosureanddescription of servicesreasonablyinadvanceofopeningthisaccount.

I acknowledgereceiptandreviewofapplicableprospectusesand/orADV’spriortothepurchaseofandinsurance/investmentintherecommendedstrategies,tools,andproducts.Further,IagreethatifthestrategyselectedisforretirementincomepurposesthatIunderstandthatwithdrawalsofincomethatexceeddividendandorsimilaramounts,orinthecaseoflifeinsurancecostbasis,orinthecaseofcertaintypesofannuities,theannualroll-uporwithdrawalbenefitthatsuchwithdrawalsconstituteandaggressivemethodofobtainingincomeandcouldcausegreaterlikelihoodandriskofdepletingtheinvestmentasset.

Yes No IstheClient/Owner/AuthorizedPersonwithaninterestintheaccounteither(1)aseniormilitary,governmentalorpoliticalofficialinaNon-U.S.countryor(2)closelyassociatedwithoranimmediatefamilymemberofsuchofficial?Ifyes,identifytheofficial,officeheldandcountry.

Yes No *HasafinancialplanbeenpreparedbyAXAAdvisorsforthisrecommendationinthelast12months? (OnlycheckforNaviPlanLevel2non-feeandfee-basedplans.)Ifyes,plan#ortoolname:Client/Owner/AuthorizedPerson. By signing below, I acknowledge that the above information is true and correct. Fordeferredvariableandfixedannuitypurchasesonly: I understand that the annuity for which I am applying may have surrender charges and/or marketvalue adjustment (MVA) charges and that taxes may apply if I withdraw money. Fordeferredorimmediatevariableorfixedannuitypurchases:I did receive a copy of the NAIC Buyer’s Guide, if state required. Fordeferredvariableannuities: I did receive a copy of theAXA Advisors annuities disclosure brochure and reviewed it with my Financial Professional. I understand that if this purchase is for a qualified retirement plan account, any tax deferral features do not provide additional benefit and that my purchase is for the product’s features and/or benefits other than tax deferral. I also understand that if I am purchasing an AXA Equitable variable annuity any checks accompanying my application should be made payable to ‘‘AXA Equitable’’. AXA Equitable will hold the funds for my benefit in a non-interest bearing ‘‘Special Bank Account for the Exclusive Benefit of Customers’’ until my application is approved, not approved or returned by AXA Advisors. I may request the full return of my payment at any time prior to the issuance of the contract by contacting my Financial Professional. ForIRAOwners/PlanSponsors: I acknowledge receipt of the Disclosure Notice in accordance with relevantguidance from federal and/or state regulations.

Client/Owner/Authorized Person Signature: Date:

IstheJointClient/Owner/AuthorizedPersonwithaninterestintheaccounteither(1)aseniormilitary,governmentalorpoliticalofficialinaNon-U.S.countryor(2)closelyassociatedwithoranimmediatefamilymemberofsuchofficial?

Yes No Ifyes,identifytheofficial,officeheldandcountry.

Joint Client/Owner/Authorized Person Signature: Date:

FinancialProfessional:I have reviewed all sections of the Client Profile with the Client/Owner, if applicable the Joint Client/Owner and acknowledge the information is accurate and current. This includes information collected at the initial point of sale and any subsequent sales. I am familiar with the product(s) being sold and have determined proper suitability. The client received an NAIC Buyer’s Guide, if state required. Fordeferredvariableannuitypurchasesonly: I have reasonablegrounds for believing that the recommendations for this customer to purchase/exchange an annuity is suitable on the basis of the facts disclosed by the customer as to his/her investments, insurance products and financial situation and needs. I have provided the client with all required Federal, State and Standards of Care disclosures.

Forindividuals, I have verified the identity of the client/owner(s) by reviewing the driver’s license/passport or if taken via themail, a copy of the driver’s license is in the file. I have also confirmed how the client/owner(s) acquired or accumulated the funds used to make this purchase. Forentities, I have verified the identity of the client/owner by reviewing certifiedarticles of incorporation, business license, partnership agreement or trust agreement and also determined the source of funds. I understand that I have primary responsibility for customer identity verification for non-natural owners, and retained a copy of the documentary proof of the entity’s existence and authorized persons in the client’s file as required by the AXA Advisors Compliance Manual.

Financial Professional Signature: Date:

AXA Advisors, LLC (NY, NY 212-314-4600), member FINRA, SIPC, AXA Equitable Life Insurance Company (NY, NY), and AXA Network, LLC (AXA Network Insurance Agency of California, LLC in CA; AXA Network Insurance Agency of Utah, LLC, in UT; AXA Network of Puerto Rico, Inc. in PR) are affiliated companies and do not provide tax or legal advice or services.

Page 12: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

PLEASE READ CAREFULLY. BY SIGNING BELOW, YOU AGREE TO HAVING READ AND UNDERSTOOD THE FOLLOWING:

I hereby authorize Realty Benefit Services to access the checking or savings account provided below solely for the purpose of paying automatic contribution service fees rendered for my tax account.

I understand that the initial fee of $__________ will be deducted from the account provided below. I fur-

year from the account provided below and that I shall incur additional charges in the event any payment

to notify two weeks in advance of a change in accounts. This would include changes in account numbers that would cause a returned item.The annual fee is subject to change.

NotificationsI agree to provide written notice at least two weeks in advance in the event I wish to close my tax account or stop automatic contributions from my commissions. I further agree to indemnify and hold Realty Benefit Servicesfor services rendered. I agree to notify Realty Benefit Services in writing of any changes to my bank account, this notice will be at least two weeks in advance of any debits. I understand that these services are being provided solely through arrangements with Realty Benefit Services

9

In the event I leave my real estate firm, I will notify Realty Benefit Services prior to December of my termination to avoid any further service fees from being deducted in January.

NAME

SIGNATURE

Revised 7/31/2018

DATE

Tax Account Annual Fee Agreement

Attach a Voided Check

AXA PRODUCER NAME

DATE

SOCIAL SECURITY # EMAIL

HOME PHONE CELL PHONE

REALTY COMPANY OFFICE LOCATION

Agent ID #

Page 13: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

NAME

SIGNATURE DATE

CITYHOME ADDRESS

STATE DATE OF BIRTHZIP

Tax Account Automatic Contribution Agreement

REALTY COMPANY OFFICE LOCATION

SOCIAL SECURITY #

Please check one: This is a new account

I am changing the contribution percentage to my current account

Choose Your Contribution Percentage

Please deduct from my commissions the following percentage: (please circle)

5% 10% 15% 20% 25%

30% 35% %

PLEASE READ CAREFULLY. BY SIGNING BELOW, YOU AGREE TO HAVING READ AND UNDERSTOOD THE FOLLOWING:

ACCOUNT #

Account Information

FINANCIAL PROFESSIONAL’S NAME

This form is not issued or us ed by AXA Advisors, LLC or its affiliates. It r epresents an agreement between you and your real estate company only.

Revised 2/12/2019

available withheld from my commissions to my tax account at least once a month.

Agent ID #

Page 14: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

� � �

Client Disclosure Form

I, ____________________________________________, am currently acting in the capacity of a registered

representative of AXAAdvisors, LLC and an agent of AXA Network (“AXAAdvisors”) While you may be

aware that I also provide third party administration services, those services are wholly independent

IURP�DQ\�DIÀOLDWLRQ�,�KDYH�ZLWK�$;$$GYLVRUV�RU�LWV�VXEVLGLDULHV��,�GR�QRW�UHSUHVHQW�$;$$GYLVRUV�ZKHQ�

SURYLGLQJ�WKLUG�SDUW\�DGPLQLVWUDWLRQ�VHUYLFHV��

You should also know that while I typically provide third party administration services based on

a separate fee agreement, when I offer you life insurance, annuities, mutual funds or other security

products as an AXAAdvisors Associate, I may receive commissions directly from the provider of

WKHVH�SURGXFWV�

3OHDVH�VLJQ�EHORZ�WR�LQGLFDWH�\RXU�DFNQRZOHGJH�WKDW�\RX�KDYH�UHDG�DQG�XQGHUVWDQG�WKH�DERYH�VWDWHPHQW� %\�VLJQLQJ�WKLV�\RX�DOVR�DFNQRZOHGJH�WKDW�\RX�KDYH�UHDG�DQG�XQGHUVWDQG�WKH�DERYH�VWDWHPHQW��%\ signing this, you also acknowledge that you understand that AXAAdvisors is in no way responsible

for the supervision of or control over any third party administration services that have been or will be

UHQGHUHG�WR�\RX�

7KDQN�\RX��DQG�,�ORRN�IRUZDUG�WR�GRLQJ�EXVLQHVV�ZLWK�\RX�

CLIENT’S NAME

CLIENT’S SIGNATURE DATE

Revised 2/7/2012

Page 15: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

FM503 01/19 1 of 8

Putnam mutual fund account application guideFor more information: Putnam Investments 1-800-225-1581 www.putnam.com

Please complete the Putnam mutual fund account application to establish one of the registration types below. A separate application is required for each additional registration. To establish an account registered to a legal entity such as a corporation, partnership, limited liability company, or non-profit foundation, please contact Putnam Investor Services for the correct form(s).

Available registration types and considerations

Individual/Joint RegistrationsIndividual: An account registered in the legal name of one owner

Joint tenants with rights of survivorship: An account with two or more parties (not an entity) with equal interest in the account• Upon the death of a tenant, the account goes to the surviving tenants. Upon the death of all tenants, the account goes to the estate of the last surviving tenant.

• This type of registration is not available for residents of Louisiana.

Tenants in common: An account registered to two or more parties (individuals or entities); all entity types are eligible• Equal divisible interest in the account is determined by the number of tenants. Upon death, the deceased tenant’s interest is distributed per the terms of his or

her estate; the surviving tenants must transfer their remaining interest to a new registration.

Community property: An account registered between spouses where each spouse has one-half interest• Upon death, the deceased spouse’s half is distributed per the terms of his or her estate and is taxable; the surviving spouse must transfer his or her remaining

interest to a new registration.

• Joint community property registrations are only available in the following states: Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington,and Wisconsin.

Custodial/Fiduciary RegistrationsConservator/Guardian: An account for a court-appointed individual who is responsible for, or administers the property of, a minor or incapacitated adult

• You must provide a copy of the Letter of Appointment of conservator or guardian (certified by the clerk of the issuing court within 120 days) which lists thepowers of the appointed party as well as any and all restrictions.

Uniform Transfers to Minors Act (UTMA)/Uniform Gifts to Minors Act (UGMA): An account that represents an irrevocable gift that belongs solely to a minor• Complete Section 1B to provide a donor state (required) and to designate a successor custodian in the event of the custodian’s resignation, disability or death.

Trust/Estate RegistrationsTrust: An account set up as a legal entity managed by a trustee for the benefit of a beneficiary

• The trustor (creator of the trust, also called a grantor or settlor) appoints the trustee via a trust agreement to manage and distribute funds while the trustor isstill alive or after his death.

• You must provide an excerpt of the trust, including the first page, all signed pages, and the designation of trustees, certified within 120 days. Please provide acopy of IRS Employee Identification Number (EIN) assignment letter, if applicable.

Estate: An account set up by the court appointed fiduciary that consists of the testamentary assets attributable to a deceased individual• You must provide a copy of the appointment of the executor, administrator, or personal representative (certified by the clerk of the issuing court within 120

days). Please provide a copy of IRS Employee Identification Number (EIN) assignment letter, if applicable.

Additional notes• If you wish to make beneficiary designations on an individual or joint with rights of survivorship registration then Putnam’s Transfer on death designation form

is also required.

• Additional joint registration options may be available depending on your state of residence. Speak to your financial advisor to determine eligibility rules andrequirements.

Page 16: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 17: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 18: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 19: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 20: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 21: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 22: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 23: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 24: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 25: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 26: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 27: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork
Page 28: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

A1

Page 1 of 6

Account Application Non-Retirement

Section I: Account Information

Account Type (choose only one)1.

Each account holder must receive, read and understand the contents of the applicable Account Packet (Account Packet - AXA Master). This separatepacket contains the Account Agreement and any Program Brochures that detail the relationship between you, your financial professional, AXA Advisors,LLC, LPL Financial and other related parties as applicable to your account.

Brokerage Direct Business

No Yes (Attach the Broker/Dealer Change Form F21-AXA)Is this a new account for a broker/dealer change?

Registration Type (choose only one)2.

*Additional documentation required. Financial professional should refer to the detailed procedures for the registration type on the resource center.

Account updates required by LPL Operations

AXA Advisors, LLC • A Registered Investment Advisor LPL Financial LLC A Registered Investment Advisor • Member FINRA/SIPC

Guardianship/Conservatorship*

Limited Liability Company*

Individual

Custodian for Minor Non-Profit Organization*Personal Trust*

Community Property

Other (Please specify):

Tenants in Common

Corporate*

Joint Tenants With Right of Survivorship

Partnership*Coverdell ESA*

Estate*

529 Plan (Direct Business Only)

U.S. Citizen

Fill in your current residency status: (choose only one)

Resident Alien (copy of Resident Alien card required)

Social Security Number or Tax ID

Country of Citizenship

Mailing Address

Home Phone Mobile Phone

Account Registration

Business Phone Fax Number

Registration Information3.

Is this account for a Government Entity? NoYes

1. If yes, is this account for a municipal entity? NoYes

a) If “no”, this municipal account does not hold nor will it hold proceeds of municipal securities or municipal escrow investments. Please listbelow the source of funds that will be invested in this account:

Answer the question below only if you answered “yes” this is a municipal entity – If you answered “No” this is not a municipal entity, you may skip and move to the next question.

2. Will this municipal account contain proceeds of municipal securities or municipal escrow investments? NoYes

Yes

Yes

Other (Please specify):

F1BN-AXA Revised 1119

Rep ID

Account Number

Page 29: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

A1

Page 2 of 6

Registration Information (continued)3.

Section I: Account Information (continued)

Is your account holder considered an “institutional account” based on one or more of the following definitions per FINRA Rule 4512(c):1. A bank, savings and loan association, insurance company or registered investment company;2. An investment adviser registered either with the SEC under Section 203 of the Investment Advisers Act or with a state securities

commission (or any agency or office performing like functions); or3. Any other person (whether a natural person, corporation, partnership, trust or otherwise) with total assets of at least $50 million

NoYes

Section II: Investment Objective and Associated Risk

A. Income with Capital Preservation. Emphasis is placed on generation of current income with capital loss prevention. With little to no focus ongrowth, this account may suit investors with a conservative risk tolerance and short time horizon. Account risks are mostly related to not generatingsignificant income or returns and not keeping track with inflation.

B. Income with Moderate Growth. Emphasis is placed on generation of current income with secondary focus on moderate capital growth. Withadded moderate growth focus, this account may suit investors with a conservative to conservative-plus risk tolerance and short to intermediate timehorizon. Account risks are mostly related to the quality of the issuer and fluctuating interest rates.

C. Growth with Income. Emphasis is placed on modest capital growth with some focus on generation of current income. With a growth focus, thisaccount may suit investors with a conservative-plus, moderate or moderate-plus risk tolerance and intermediate time horizon. Account risks aremostly related to market volatility and the size of market capitalization.

D. Growth. Emphasis is placed on achieving growth through and capital appreciation. There is little to no focus on generation of current income. Thisaccount may suit investors with a moderate, moderate-plus or aggressive risk tolerance and an intermediate to long-term time horizon. Account risksare mostly related to market volatility and the size of market capitalization.

E. Aggressive Growth. Emphasis is placed on aggressive growth and maximum capital appreciation. There is no focus on generation of currentincome. This account may suit investors with a moderate plus to aggressive risk tolerance and a long time horizon. Account risks are mostly related tomarket volatility, size of market capitalization and other risks as applicable.

Attention: If you select an objective and cross it out to choose another, the change must be initialed by all account holders.

Select the one Investment Objective below that most accurately reflects your primary goal for this account. An Investment Objective identifies theattributes associated with an investment or investment strategy that, in association with its level of risk, will be used to help achieve your goal. There is noguarantee that the investment objective will be achieved.

Investment Objective Selection1.

F. Trading. Emphasis is placed on speculative transaction activity. This objective represents acceptance of an extremely high level risk.

Section III: Account Holder Information

For corporate, LLC, non-profit organization, partnership, and investment club accounts, this section is NOT required. Complete the appropriate supplementary documentation instead. For additional account holders, complete the Supplemental Account Application (F1C-AXA).

Primary Information1.

Primary Account Holder/Trustee/Minor/Decedent/529 Owner

ID verified? NoYes

Occupation (former if retired or unemployed)

Social Security Number Date of Birth No. of Dependents Industry (former if retired) ID Place of Issuance

Residence Address (no P. O. Boxes) Same as mailing address

Country of Citizenship

Employment Address (no P.O. boxes)

Employer Name Mark here if retired or unemployed ID Number

ID Type (Ex: Driver's License, Passport, etc.)

ID Issuance Date ID Expiration Date

Home Phone Mobile Phone Fax NumberBusiness Phone

Is this account for the benefit of a Politically Exposed Person (PEP)*? NoYes

If yes, define PEP position:

*A Politically Exposed Person (PEP) is defined as: 1. A current or former senior foreign (non-U.S.) political figure; 2. His/her immediate family members (e.g., parents, spouse, sibling, children, in-laws);  3. Close associates - People who are widely and publicly known to maintain a close relationship with the PEP, including people who are in a position to conduct substantial financial transactions on behalf of the PEP; 4. Any corporation, business or other entity that has been formed by, or for the benefit of, the PEP.

Realtor

F1BN-AXA Revised 1119 Account Number

Real Estate

Page 30: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

A1

Page 3 of 6

Section III: Account Holder Information (continued)

Primary Information (continued)1.

Mark here and complete the below information if a FINRA employee or person associated with a broker/dealer or municipal securities dealer has a financial interest in, controls trading in, or has discretionary authority over this account (e.g., accounts for minor children). This includes situations where you are employed by FINRA or associated with a broker/dealer or municipal securities dealer. This also includes situations where your spouse, domestic partner, or other immediate family member is employed by FINRA or associated with a broker/dealer or municipal securities dealer.

Mark here if you or any member of your immediate family has been a corporate officer, director, or owner of 10% or more of any public corporation within the past three months.

Full Name of Person Associated with Firm or FINRA Name of Associated Firm (if FINRA, list FINRA)

LPL will notify FINRA, the broker/dealer, or the municipal securities dealer regarding this account and may transmit duplicate statements, confirmations and other information concerning the account. By completing and signing this new account application, you authorize LPL to provide transactional data as listed above to FINRA, the broker/dealer, or municipal securities dealer as applicable.

Relationship to Account Holder of Person Associated with Firm or FINRA

Name of Corporation(s)

Address of Person Associated with Firm or FINRA Corporate Compliance Mailing Address of Firm

The trusted contact person is intended to be a resource for LPL and/or AXA in administering your accounts and protecting your assets in connection with possible financial exploitation or diminished capacity (refer to account packet/agreement for more details). LPL and/or AXA may disclose information about your account(s) to the Trusted Contact to confirm the specifics of your current contact information, health status, and the identity of any legal guardian, executor, trustee or holder of a power of attorney, and as otherwise permitted by applicable law. Note: Your trusted contact person must be age 18 or older, and would not be able to conduct transactions in your account.

Trusted Contact Name Trusted Contact Email

Trusted Contact Address

Secondary Information2.

Secondary Account Holder/Trustee/Custodian/529 Beneficiary

ID verified? NoYes

Occupation (former if retired or unemployed)

Social Security Number Date of Birth No. of Dependents Industry (former if retired) ID Place of Issuance

Residence Address (no P. O. Boxes) Same as mailing address

Employment Address (no P.O. boxes)

Employer Name Mark here if retired or unemployed ID Number

ID Type (Ex: Driver's License, Passport, etc.)

ID Issuance Date ID Expiration Date

Country of Citizenship

Home Phone Business PhoneMobile Phone Fax Number

I decline to provide a trusted contact person at this time.

Is this account for the benefit of a Politically Exposed Person (PEP)*?

If yes, define PEP position:

*A Politically Exposed Person (PEP) is defined as: 1. A current or former senior foreign (non-U.S.) political figure; 2. His/her immediate family members (e.g., parents, spouse, sibling, children, in-laws);  3. Close associates - People who are widely and publicly known to maintain a close relationship with the PEP, including people who are in a position to conduct substantial financial transactions on behalf of the PEP; 4. Any corporation, business or other entity that has been formed by, or for the benefit of, the PEP.

NoYes

Trusted Contact Primary Phone Relationship to Account Holder (Spouse, Relative, Friend, Professional Relationship, Other)

F1BN-AXA Revised 1119 Account Number

Page 31: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

A1

Page 4 of 6

Mark here if you or any member of your immediate family has been a corporate officer, director, or owner of 10% or more of any public corporation within the past three months.

Full Name of Person Associated with Firm or FINRA Name of Associated Firm (if FINRA, list FINRA)

Mark here and complete the below information if a FINRA employee or person associated with a broker/dealer or municipal securities dealer has a financial interest in, controls trading in, or has discretionary authority over this account (e.g., accounts for minor children). This includes situations where you are employed by FINRA or associated with a broker/dealer or municipal securities dealer. This also includes situations where your spouse, domestic partner, or other immediate family member is employed by FINRA or associated with a broker/dealer or municipal securities dealer.

LPL will notify FINRA, the broker/dealer, or the municipal securities dealer regarding this account and may transmit duplicate statements, confirmations and other information concerning the account. By completing and signing this new account application, you authorize LPL to provide transactional data as listed above to FINRA, the broker/dealer, or municipal securities dealer as applicable.

Relationship to Account Holder of Person Associated with Firm or FINRA

Name of Corporation(s)

Address of Person Associated with Firm or FINRA Corporate Compliance Mailing Address of Firm

The trusted contact person is intended to be a resource for LPL and/or AXA in administering your accounts and protecting your assets in connection with possible financial exploitation or diminished capacity (refer to account packet/agreement for more details). LPL and/or AXA may disclose information about your account(s) to the Trusted Contact to confirm the specifics of your current contact information, health status, and the identity of any legal guardian, executor, trustee or holder of a power of attorney, and as otherwise permitted by applicable law. Note: Your trusted contact person must be age 18 or older, and would not be able to conduct transactions in your account.

Trusted Contact Name Trusted Contact Email

Trusted Contact Address

Section III: Account Holder Information (continued)

Secondary Information (continued)2

Section IV: Financial Information and Experience

Enter the letter that corresponds to the correct range:

1.

Annual income? Liquid net worth?* Net worth? (exclusive of primary residence) Approximate account value?**

Annuities

Investment Experience (total number of years):

Stocks OptionsBondsMargin

Other (please specify):

Mutual Funds Partnerships

Federal income tax bracket? (%)Specify the exact source of Account Holder Wealth and Income (e.g. Inheritance, employment salary, sale of real estate, etc.)

A. $1 - $24,999 B. $25,000 - $49,999 C. $50,000 - $99,999 D. $100,000 - $249,999

F. $500,000 - $749,999E. $250,000 - $499,999 G. $750,000 - $999,999 H. $1,000,000 and over

Investment Information

Indicate the number of years of experience for each investment type:

I decline to provide a trusted contact person at this time.

Relationship to Account Holder (Spouse, Relative, Friend, Professional Relationship, Other)Trusted Contact Primary Phone

F1BN-AXA Revised 1119 Account Number

Page 32: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

A1

Page 5 of 6

Section VI: Acknowledgment and Execution

Section V: Margin Agreement

Margin Disclosure Statement Information (not all account types are eligible to have margin, ask your financial professional for details)1.

A margin account allows you to borrow against eligible securities or purchase securities on margin. Initial below if you want to establish a margin accountand to indicate that you have received the Margin Disclosure Statement, have read the margin disclosure section in the Account Packet referenced inSection I, and agree to the terms and conditions.

Date Margin Disclosure Statement provided: ALL account holders must initial.InitialsInitials

Delivery Preferences If you have provided your email address in this application, you may elect to receive documents from LPL electronically.1.

No, I do not want to receive documents from LPL electronically. Please send me paper copies of all communications related to my account. This is the default selection if "Yes" is not selected above.

Yes, I want to receive all documents from LPL electronically (including, but not limited to, communications, account statements, trade confirmations performance reports and legal and regulatory notices and disclosures), to the extent permitted by applicable law. I acknowledge that I need to (i) maintain an active email account to receive notifications from LPL when documents are available, (ii) login to Account View and accept its terms and conditions of use before I am able to view the documents electronically, and (iii) be responsible for certain costs associated with electronic access, such as Internet service fees. This preference for electronic delivery will remain in effect until revoked.

You may revoke your election to receive electronic documents or request paper copies of electronic documents at any time by logging into Account View or contacting your Financial Professional.

Email

InitialsInitials

1-3 years 3-5 years 5-10 years More than 10 years

Do you have liquidity needs from the funds in this account?

If yes, when do you need these funds?

What is your investment time horizon for this account?

More than 3 years0-3 years

Investment Time Horizon and Liquidity Needs2.

NoYes

*Liquid net worth is exclusive of real estate; only include assets that can be liquidated within 30 days. **Account minimums apply; see the applicable Account Packet for details or ask your financial professional.

What are your assets/investments (includes positions held outside and by LPL in this and other accounts)?  Please indicate percentage of assets exclusive ofprimary home (must equal 100%). Do not provide percentages in fractions or decimals.

Real Estate _____%

Insurance _____%

Mutual Funds _____%

Stocks _____%

Annuities _____%

Alternative Investments _____%

Checking / Savings _____%

Other _____%

Bonds _____%

If Other, please explain

Section IV: Financial Information and Experience (continued)

1. Investment Information (continued)

List any name differences that you are known by or commonly use in the space provided. By listing the names below and signing Section VI, you areauthorizing LPL to accept transactions and follow instructions under all names listed.

Name Differences/One and the Same Information (not to be used in lieu of court documentation for legal name changes)2.

F1BN-AXA Revised 1119 Account Number

Page 33: INTERNAL CHECKLIST FOR PUTNAM TAX ACCOUNTSdocs.agentbenefits.net/dergalis/ALL_Tax_Account_Forms...Putnam Tax Account Answer the following questions in order to complete the paperwork

A1

Page 6 of 6

Branch Use Only

I have reviewed this document for completeness, accuracy, suitability, and disclosures.

Financial Professional Signature Financial Professional Name (print) Date (required)Rep ID

4.

Under penalties of perjury, I hereby certify that: (1) The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and (2) I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, (3) I am a U.S. person (including a U.S. resident alien), and (4) I attest I am exempt from FATCA Reporting. (However, if you provide an IRS W-8 form, it will supersede this statement and you may be subject to FATCA Reporting.) (Cross out (2) if subject to backup withholding.) The Internal Revenue Service does not require my consent to any provision of this document other than the certifications required to avoid backup withholding.

Account Holder Signature Account Holder Name (print) Date (required)

Account Holder Signature Account Holder Name (print) Date (required)

This account is governed by and I acknowledge receipt of the predispute arbitration clause that is located in the last numbered section of the Account Agreement (included in the Account Packet specified in Section I), which is incorporated by reference into this Account Application.

I authorize LPL and/or AXA to contact my trusted contact person listed above. I understand that providing this information is optional and I may withdraw it at any time.

For IRA Owners/Plan Sponsors: I acknowledge receipt of the Disclosure Notice in accordance with relevant guidance from the Department of Labor.

Account Holder Signature Account Holder Name (print) Date (required)

Account Holder Signature Account Holder Name (print) Date (required)

Disclosure for Section 529 Plan Accounts only:

By signing this form, Account Holder acknowledges that Account Holder(s) understands that: Section 529 plans are offered by different states; that those plans generally provide unique benefits and features to state residents only; and that Account Holder has carefully considered the potential tax and other benefits of the Section 529 plan offered by Account Holder's state of residence as well as the potential tax and other benefits of the Section 529 plan(s) offered through AXA Advisors.

3. AcknowledgmentI acknowledge by signing below that I have received, read, understand and agree to the terms of this Account Application and the applicable AccountAgreement (included in the Account Packet specified in Section I). Additionally I certify the following:

• I acknowledge that my Financial Professional has explained the fees and charges associated with this account and any proposed transactions. If myaccount is being funded with proceeds from a prior investment, my Financial Professional has explained the rationale for using such proceeds in thismanner.

• I understand and agree to the terms of the Automatic Cash Sweep Program set out in the Account Agreement.• All of the information provided in this Account Application is true, correct, and complete and I agree to notify my financial professional of any changes to

the information.• I understand that LPL will supply my name to issuers of any securities held in my account so that I may receive important information regarding those

securities, unless I notify LPL in writing not to do so.• I acknowledge that proceeds from liquefied home equity on my primary residence will not be used to fund this account.• I have discussed with my financial professional the investment objective selected for the account in Section II of this Application.• I understand that investing through a brokerage account involves investment risk, including the risk of loss. I am prepared to bear the risks associated

with my investments.• I understand and agree that it is my responsibility to inform my financial professional any time I purchase class A shares of a mutual fund in the same fund

family as a fund that I own either individually or in related accounts, in order to ensure that I receive the appropriate commission discount.• I understand no portion of this account can be used as collateral without authorization of LPL Home Office which shall be obtained through the

completion of required LPL documentation.• In the event that I choose to pledge eligible LPL accounts as collateral to a lender for a loan or line of credit, I acknowledge that I cannot and will not use

the proceeds from any loan or line of credit to purchase securities.

Section VI: Acknowledgment and Execution (continued)

F1BN-AXA Revised 1119 Account Number