Portfolio Management Contract

Bohemian I

To fill out the following form, please have your identity card or passport, your tax identification number and your bank acount details/IBAN ready.

Your personal data will be stored in compliance with the legal requirements. Your data will be treated confidentially and will not be sold or marketed to third parties.

1

Basic data

2

Risk level, confirmations and trading account

Basic data (1/2)

Your data

Personal information

First name

Last name

Date of birth (Input sequence: Year-Month-Day):*

Country of birth

Street

Additional address details

Zip

City

Country

Citizenship

Phone (+xx-xxx-xxxx)

Fax (+xx-xxx-xxxx)

Email address

Identification document No.

Issue date (Input sequence: Year-Month-Day):*

Expiry date (Input sequence: Year-Month-Day):*

Tax residency

Tax ID

I am a politically exposed person Info

Education and profession

Profession

Other education level

Name and address of employer

Company name and address

Origin of the amount to be invested, your wealth, your income

Please select the origin of the amount to be invested at Van Sterling and enter the origin of your assets (eg. professional or business income, inheritance, etc.)

Do you transfer the amount from a bank in one of these countries: EU (incl. Germany, Austria), Liechtenstein, Switzerland?*
yesno

Bank account

From which bank / account do you transfer the amount?

Bank name

IBAN

Amount

Please enter the amount to be invested.

Amount (EUR):

to Step 2: Risk Profile