Confidential Client Questionnaire

1. Driver's license or passport
2. Work address and phone number
3. Approximate household income and net worth
4. Trust document if applicable
5. Optional: latest tax return

• Please answer only those questions which apply to you or your spouse/partner. Leave the rest blank.
• Required fields are denoted with an asterisk (*) next to the field name.
• NAMES: Consider entering the name you typically use such as on bank accounts, investment accounts, and driver's license.

Note: When we open your account, we will include the title, trustee(s), and effective date in the account registration. If you are unsure of the proper title of your trust, you should consult with your attorney.

Example of a proper Trust title:

The Doe Family Trust, John A. Doe OR Jane B. Doe TTEES, UA 1/1/2001

A Trusted Contact Person is a resource whom we at Coherent, or your custodian (e.g. Schwab) may contact on your behalf if necessary, to attempt to address issues related to your accounts. Trusted Contact information provided on this form will replace all those currently on file.

For multiple-party (e.g. joint) accounts, each party can name separate Trusted Contacts. If this applies to you, please let us know. Otherwise the Trusted Contact information on this form will apply to all parties.

A Trusted Contact will not be able to view your account information, execute transactions, or inquire about account activity, unless that person has authority through another role on the account, such as a trustee or power of attorney.

A Trusted Contact must be at least 18 years old.