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Access your Account | Request a User ID | Reset your PIN # | Apply for an Account | Account Management

Apply for a New Account

If you are interested in opening an account but do not wish to do so on-line call us at (315) 655-2964 or (800) 659-8044 and we'll take your information over the phone.

Important Information About Procedures for Opening a New Account

To Help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means to you: When you open an account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may ask to see your driver's license or other identifying documents.

New Account Application

First Name: Middle Name: Last Name:
Social Security or Tax ID Number: Date of Birth:

Joint Tenant (Minor, if Custodial Account)
First Name: Middle Name: Last Name:
Social Security or Tax ID Number: Date of Birth:

If this is a joint account, it is the express intention of the undersigned that ownership of this account be vested in them as (check one):

Joint Tenants with rights of survivorship and not as tenants in common or as tenants by the entirety. In the event of the death of either or any of the undersigned the entire interest in the Joint Account shall be vested in the survivor or survivors on the same terms and conditions as therefore held, without in any manner releasing the undersigned or their estates from the liability provided for in this Agreement.
Tenants in Common. In the event of the death of either or any of the undersigned, the interests in the tenancy shall be equal unless otherwise specified immediately below.

If interests are not to be equal, designate the percentage interest of each tenant.

Name	%	Name	%	Name	%

*If you do not choose, the account will be registered as Joint Tenants with Rights of Survivorship.

Please indicate your investment objectives:
Capital Appreciation Preservation of Capital Income Speculation
Other: (specify)

Registration
Individual Joint Custodian Trust Estate
Other (please specify)

Type of Account
Cash Margin Option

* Additional paperwork required. Will be forwarded by mail

Customer

Street:
City:	State: Zip:
*(if using a P.O. Box you must indicate your legal address below)

Street:
City:	State: Zip:

Email Address:

Telephone Numbers
Daytime: ( ) Evening: ( )

Citizenship
U.S. Resident Alien Non-Resident Alien
If Non-resident Alien, indicate Country and Passport Number

Employment

Employer:
Type of Business:
Position/Title:
Address:
City:	State: Zip:

If you are not currently employed, please provide the amount and source of your annual income here:
Income: Source:

Bank Reference

Name of Bank:
Account Number:
Branch:
City:	State: Zip:

Joint Tenant

Street:
City:	State: Zip:
*(if using a P.O. Box you must indicate your legal address below)

Street:
City:	State: Zip:

Email Address:

Telephone Numbers
Daytime: ( ) Evening: ( )

Citizenship
U.S. Resident Alien Non-Resident Alien
If Non-resident Alien, indicate Country and Passport Number

Employment

Employer:
Type of Business:
Position/Title:
Address:
City:	State: Zip:

If you are not currently employed, please provide the amount and source of your annual income here:
Income: Source:

Bank Reference

Name of Bank:
Account Number:
Branch:
City:	State: Zip:

Annual Income

Approximate annual income from all sources: (for joint account check your combined income)
Under $25,000 (please specify amount )
$25,000-$50,000 $50,000-$100,000 Over $100,000

Net Worth: (exclusive of home and farm)
Under $50,000 (please specify amount )
$50,000-$100,000 $100,000-$500,000 Over $500,000

Liquid Net Worth: (including cash and securities)
Under $50,000 (please specify amount )
$50,000-$100,000 $100,000-$500,000 Over $500,000

Tax Bracket
15% 28% Over 28%

Affiliations and Acknowledgments

I am affiliated with, or work for a stock exchange or a member firm of an exchange or the NASD

(Please indicate name of firm)

(Notification of your intent to open an account will be sent to your employer in accordance with current regulations)
I am aDirector 10% Shareholder Policymaking executive officer of a publicly traded company
(If so, provide name of company)

If you have checked any of the above, please supply account number(s) of other accounts you have with us.

Power of Attorney
Have you granted trading authorization to someone other than the account owner(s)?
Yes No
If so, you will need to supply the trading authorization.

Please indicate the relationship between you and your agent (e.g. investment advisor, trustee, family member, etc.)

Account Service Instructions

Purchases	Sales	Dividends and Interest

Hold securities	Hold proceeds in brokerage account	Pay all dividends and interest in cash and send me a monthly check

Send me certificates	Send me proceeds	Pay all dividends and interest in cash and reinvest my mutual fund dividends

		Pay all dividends and interest in cash and hold them in my account