Application Form

1. Account Registration Details

Registered Account Name:*

Transferring from an existing broker to Gray Financial Capital?:*

Yes

No

This Account Will Trade:*

Equities

Funds

Bonds

Currencies

Account Management:*

Fully Managed

Broker Assisted

Self Managed

Currencies

2. Personal Information (Primary Account Holder)

First Name:*

Middle Name:*

Surname:*

Date of Birth:

Current Address:*

Address 2:*

City / State:*

Preferred E-Mail Address:*

Alternative E-Mail Address:

Preferred Contact Phone #:*

Current Employment Status:*

Employed (full/part time)

Self-Employed

Retired

Other

Alternative Phone #:

Employment Industry/ Sector:*

Annual Income (USD):

Less than $25,000

$25,001 - $99,999

$100,000 - $499,999

$500,000 +

Your Trading Experience:

Novice

Semi-Experienced

Experienced

Advanced

Read Disclosure Agreement

Accept:

By checking this box and by typing my/our signature(s) below and forwarding this application form to Gray Financial Capital via the Internet, I/we acknowledge, understand and agree to the Disclosure Agreement as set forth above and verify that all information submitted in this application to be true and correct. Further, I/we understand and agree that my/our electronic signature(s) is/are the equivalent of a manual signature and that Gray Financial Capital may rely upon it/them as such.

Primary Account Holder:

Secondary Account Holder:

Use the option below to upload a copy of your Passport.

Passport Upload

Upload Image

Use the option below to upload a a scan of a recent utility bill (dated within the last six months)

Utility Bill Upload

Upload Image

Your content has been submitted

An error occurred. Try again later

Documents can be sent via email to info@grayfinancialcapital.com