Additional Risk Disclosure
Dear Sir or Madam,
This information on your account application indicates that you do not meet [Brand-Name] guidelines for a margined spot foreign currency or precious metals accounts. One or more of the following reason(s) is/are cited:
Although the reason(s) cited above do not preclude you from opening an account, the following risk disclosure documentmust be read, understood, and signedfor you to open an accountwith [Brand-Name].
RISKDISCLOSURE
Based on your personal information and/or investment experience, trading in margined Foreign Exchange or Precious Metals might be too risky of an investment product for you. Because of the high degree of leverage obtainable in trading margined Foreign Exchange or Precious Metals with [Brand-Name], the loss in trading spot foreign currencies or Precious Metals can be substantial with the possibility that you could lose more than your initial investment. You should, therefore, carefully consider whether such trading is suitable for you in light of your circumstances and financialresources.
DesiredLeverage to be changed
| Leverage 100:1 | Leverage 200:1 | Leverage 300:1 | Leverage 400:1 |
ACKNOWLEDGEMENT
I understand that I do not meet the minimum guidelines to open an account as set forth by [Brand-Name]. However, I have considered the financial risks involved in trading margined Foreign Exchange and/or Precious Metalswith regardto my personalsituation, and I wish to proceedwith openingan account.
| PRINT NAME: | DATE: |
| SIGNATURE: |
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