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STOCKCROSS
F I N A N C I A L S E RV I C E S
M e m ber N YSE SIPC Established 1973
Certification of Trusteeship and Investment Power
In order to open a trust account at StockCross, please complete a New Account Application and sign all applicable agreements, then complete Steps 1 through 5 on this form. To
re-register an existing StockCross Account in the name of your trut, see Step 6 for additional instructions. If you require assistance with this form, please contact our New Accounts
Department at (800) 225-6196.
Step 1: Trust Information
Name of Trust Date of Trust Governed by the law of which state? Wyoming
Social Security #
Please indicate whether the trust is: Irrevocable Revocable and/or amendable. If so, by whom?
Please list all beneficiaries:
Step 2: Trustee Name(s)
Please list all current trustees.
Note: Under the terms of the Agreement set forth below, any of the following co-trustees, acting alone, will be authorized to instruct StockCross in the investment and withdrawal of
trust assets. It is the responsibility of the trustees to inform each other of any actions taken in the trust account. StockCross cannot be held liable for honoring instructions issued by
any one trustee, whether acting alone or in concert with other trustees.
Trustee Name(s) 1. Social Security Number(s) 1.
2. 2.
3. 3.
4. 4.
5. 5.
Step 3: Trading Authorization
❑ If the trustees are authorized by the trust agreement to appoint a third party, such as an investment advisor, to enter buy and sell orders for securities in the trust account, and
wish to do so, please check here, and include a completed Trading Authorization Form.
Step 4: Trustee Powers
Please check below all the certifications of trustee powers that apply, and indicate the page number(s) of the trust agreement where that power is granted to the trustee.
The undersigned trustee(s) request(s) that StockCross open a trust account for the following types of securities transactions. (Check all that apply):
❑ CASH ACCOUNT TRANSACTIONS. Buying and selling common and preferred stocks, rights, warrants, corporate bonds and other equity securities available through StockCross.
The authority to engage in CASH transactions is granted to the trustee(s) on the following page of the trust agreement: ____________________
❑ MARGIN TRANSACTIONS. Borrowing funds for the purpose of buying or carrying securities on margin, and/or borrowing securities for the purpose of selling short.
The authority to engage in MARGIN transactions is granted to the trustee(s) on the following page of the trust agreement: ____________________
OPTION TRANSACTIONS (Check all that apply)
❑ Selling covered calls. ❑ Buying puts and calls. ❑ Spreading puts and calls.
❑ Selling uncovered puts and calls. (Note: This type of option transaction may require that a full copy of the trust agreement be submitted to StockCross for review.)
The authority to engage in the selected OPTION transactions is granted to the trustee(s) on the following page of the trust agreement: ____________________
SX-0609w
Step 5: Certification, Agreement, Indemnification and Signature(s)
CERTIFICATION. The undersigned certify that all current trustees have been named above, that the securities transactions requested above are fully authorized by the trust agreement,
and that the trustees are empowered to execute documents on behalf of the trust and to instruct StockCross in the disposition and withdrawal of trust assets. The undersigned
further certify that all other information provided above is complete and accurate, and that the trust agreement is in full force and effect.
AGREEMENT. The trustees agree to refrain from placing orders and other instructions which have not been authorized by the trust agreement. The trustees also agree to notify
StockCross immediately and in writing of any change in the trusteeship or of any amendment, revocation, or other modification to the trust agreement that affects the certifications
made above. The trustees agree to provide additional documentation (such as a death certificate, letter of resignation, or appointment, and a newly executed customer agreement, etc.)
that StockCross may request in the event of a change in trusteeship. StockCross also reserves the right to request, and the trustees agree to provide, a full copy of the trust agreement
if StockCross in its sole discretion determines that circumstances warrant such a request. The trustees authorize StockCross to accept orders and instructions on behalf of the trust
from any one trustee acting alone, whether the trust agreement authorizes the trustees to act independently or not, and they agree to accept full responsibility for advising each other of
any actions so taken. The trustees acknowledge that any notice or demand provided by StockCross to one trustee shall be regarded as notice to all. If an existing StockCross Account is
being re-registered in trust name, the trustees agree as successors to the account to be bound by the terms of all agreements previously executed by the predecessor Account Owner(s).
INDEMNIFICATION. The trustees, jointly and severally, agree to indemnify StockCross and to hold StockCross harmless for any liability or claim arising from transactions undertaken
at the instruction of the trustees.
All current trustees must sign below.
Signature of Trustee Date
Signature of Trustee Date
Signature of Trustee Date
Signature of Trustee Date
Step 6: Re-register an Existing StockCross Account into Trust Name
If you have an existing StockCross Account, it may be possible to re-register that account in the name of your trust if the following apply:
The existing StockCross Account and the trust have the identical Social Security Number or Federal Tax ID,
All Account Owners of the existing StockCross Account are willing to relinquish their ownership rights in favor of the trust,
All securities in the existing account are held at StockCross in street name, and
The existing account is a cash account. (If the existing account is a margin and/or option account, please contact our New Accounts Department for assistance.)
If these four conditions are met, and you wish to re-register your existing StockCross Account into trust name, please complete everything above, then the following:
The existing StockCross Account number is:
The Social Security Number or Federal Tax ID of the existing account is:
The owner(s) of the existing StockCross Account are: (Please list all Account Owners.)
Step 7: Relinquishment of Ownership and Request to Re-Register Assets into Trust Name
I am the/an owner of the existing StockCross Account described above. I request that StockCross re-register the assets currently held in this account under the trust name shown
above. I understand that in so requesting, I relinquish ownership rights in the favor of the trust. I further understand that if my name does not appear above as trustee, I also relinquish
all rights to control the investment of these assets and to withdraw them from the account.
All Account Owners of the existing StockCross account must sign.
Signature of Existing Account Owner Date
Signature of Existing Joint Tenant (if any) Date
NOTARIZATION. If you are an Account Owner of the existing StockCross account and your name does NOT appear in Step 2 of this form as a trustee, your signature
must be notarized.
State of ______________________________, County of ______________________________.
On this _____ day of ______________________, in the year ______, before me personally appeared __________________________________________________,
personally known to me (or proven on the basis of satisfactory evidence) to be the person described in and who executed the foregoing instrument, and duly acknowledged to me that
he/she/they executed it.
_____________________________________________
(Notary Public)
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