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Your Situation
Pre-Retirees & Retirees
Business Owner-Manager
Corporate Executive
Accounting Professionals
Health Care Professional
Multi-Generational Business Shareholder
Windfall Recipient
Sports And Entertainment Professional
Services
Financial Planning
Investment Management
Portfolio Review
Individual Pension Plan
EIM Partners Fund
About
About Us
Our Fees & Process
Our Team
Careers
Our YouTube Channel
Clients
Client Area
EIM Partners Fund
Knowledge Library
Tools
Book a Consultation
Know Your Client Form for Individuals
"
*
" indicates required fields
Investor Information - Client 1
Title - Client 1
*
Name - Client 1
*
First
Last
Date Of Birth - Client 1
*
MM slash DD slash YYYY
Email - Client 1
*
Home Phone - Client 1
*
Cell Phone - Client 1
*
Occupation - Client 1
*
Maritial Status - Client 1
*
Please Select
Single
Married
Employer Name - Client 1
*
Citizenship - Client 1
*
Please Select
Canadian
USA
IND
GBR
Other
Employer Address
*
Sin - Client 1
*
Annual Income - Client 1
*
If US resident, TIN,SSN - Client 1
Investor Information - Client 2
Name - Client 2
*
Spouse DOB - Client 2
*
MM slash DD slash YYYY
Email - Client 2
*
Home Phone - Client 2
*
Cell Phone - Client 2
*
Occupation - Client 2
*
Sin - Client 2
*
Employer - Client 2
*
Employer Address - Client 2
*
Annual Income - Client 2
*
Citizenship - Client 2
*
If US resident, TIN,SSN - Client 2
Address Information - Client 1
Mailing address same as legal address? - Client 1
*
Yes
No
Legal Address - Client 1
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Address Information - Client 2
Mailing address same as legal address? - Client 2
*
Yes
No
Address (if different) - Client 2
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Verification of Identity - Client 1
Driver’s License No. - Client 1
Passport No. - Client 1
Citizenship Card No. - Client 1
Health Card - Client 1
Other ID - Client 1
Reference Number - Client 1
Place Of Issue - Client 1
Client 2 Verification of Identity
Driver’s License No. - Client 2
Passport No. - Client 2
Health Card - Client 2
Citizenship Card No. - Client 2
Reference Number - Client 2
Other ID - Client 2
Place Of Issue - Client 2
Investment Profile - Client 1
Investment Knowledge - Client 1
*
Professional
Sophisticated
Good
Limited
Risk Tolerance - Client 1
*
Speculative
High Risk
Medium
Low
Investment Objectives - Client 1
*
Growth
Balanced
Capital Preservation
Cash Management
Investment Profile - Client 2
Risk Tolerance - Client 2
*
Speculative
High Risk
Medium
Low
Investment Knowledge - Client 2
*
Professional
Sophisticated
Good
Limited
Investment Objectives - Client 2
*
Growth
Balanced
Capital Preservation
Cash Management
Client Assets - 1
Principal Residence - Client 1
*
Cottage - Client 1
Other Real Estate - Client 1
Private Company - Client 1
Stocks - Client 1
*
Bonds - Client 1
*
Insurance - Client 1
*
Other Assets - Client 1
Total Assets - Client 1
Client Assets - 2
Principal Residence - Client 2
*
Cottage - Client 2
Other Real Estate - Client 2
Private Company - Client 2
Stocks - Client 2
*
Bonds - Client 2
*
Insurance - Client 2
Other Assets - Client 2
Total Assets - Client 2
Liabilities - Client 1
Mortgages - Client 1
*
Loans - Client 1
Lines Of Credit - Client 1
Other Liabilities - Client 1
Total Liabilities - Client 1
Net Worth - Client 1
Notes - Client 1
Liabilities - Client 2
Mortgages - Client 2
*
Loans - Client 2
Lines Of Credit - Client 2
Other Liabilities - Client 2
Total Liabilities - Client 2
Net Worth - Client 2
Notes - Client 2
Net Investable Assets - Client 1
Net Investable Assets - Client 1
*
Over 1,000,000
Under 1,000,000
Net Assets - Client 1
*
0 - 1,000,000
1,000,000 - 5,000,000
5,000,000 +
Time Horizon - Client 1
*
Short Term (under 1 yr)
Medium Term (1-5yrs)
Long Term (5yrs +)
Net Investable Assets - Client 2
Net Investable Assets - Client 2
*
Over 1,000,000
Under 1,000,000
Net Assets - Client 2
*
0 - 1,000,000
1,000,000 - 5,000,000
5,000,000 +
Time Horizon - Client 2
*
Short Term (under 1 yr)
Medium Term (1-5yrs)
Long Term (5yrs +)
Liquidity Requirements - Client 1
Do you require any regular withdrawals? - Client 1
*
Yes
No
Do you expect any large, lump sum withdrawals in the next 24 months? - Client 1
*
Yes
No
Limp Sum Withdrawals (IF Yes) - Client 1
Are you an 'insider' of a public company? (Are you a director or officer of a public company? Do you control more than 10% of the voting rights of a public company?) - Client 1
*
Please Select
Yes
No
PEP? - Client 1
*
Please Select
Yes
No
In opening this account, are you acting on the instructions of or on behalf of a third party? - Client 1
Please Select
Yes
No
Are you or anyone you know the Head of an International Organization (HIO) or close associate of an HIO? - Client 1
Please Select
Yes
No
(If YES to any of the above please provide details here): - Client 1
Liquidity Requirements - Client 2
Do you require any regular withdrawals? - Client 2
*
Yes
No
Do you expect any large, lump sum withdrawals in the next 24 months? - Client 2
*
Yes
No
Limp Sum Withdrawals (IF Yes) - Client 2
Do you expect any large, lump sum withdrawals in the next 24 months? - Client 2
*
Yes
No
Are you an 'insider' of a public company? (Are you a director or officer of a public company? Do you control more than 10% of the voting rights of a public company?) - Client 2
Please Select
Yes
No
PEP? - Client 2
*
Please Select
Yes
No
In opening this account, are you acting on the instructions of or on behalf of a third party? - Client 2
Please Select
Yes
No
Are you or anyone you know the Head of an International Organization (HIO) or close associate of an HIO? - Client 2
*
Please Select
Yes
No
(If YES to any of the above please provide details here): - Client 2
Investment Restrictions
Investment Restrictions:
*
Please Select
Yes
No
Investment Restrictions Comments: (If YES to any of the above please provide details here):
Emergency Contact Information - Client 1
Emergency Contact Name - Client 1
*
First
Last
Emergency Contact Relationship - Client 1
*
Emergency Contact Email - Client 1
*
Emergency Contact Home Phone - Client 1
Emergency Contact Cell Phone - Client 1
*
Emergency Contact Address - Client 1
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Emergency Contact Information - Client 2
Emergency Contact Name - Client 2
*
First
Last
Emergency Contact Relationship - Client 2
*
Emergency Contact Email - Client 2
*
Emergency Contact Home Phone - Client 2
*
Emergency Contact Cell Phone - Client 2
*
Emergency Contact Address - Client 2
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Exponent Investment Management Inc. Statement Delivery - Client 1
Receive one consolidated family account statement each quarter? - Client 1
*
Please Select
Yes
No
Online Access? - Client 1
*
Please Select
Yes
No
Exponent Investment Management Inc. Statement Delivery - Client 2
Receive one consolidated family account statement each quarter? - Client 2
*
Please Select
Yes
No
Online Access? - Client 2
*
Please Select
Yes
No