Application Form

Execution Only Account

Individual & Joint Applicants

Important Information

Please read this Application Form carefully. The Application Form, together with our Terms of Business and Schedule of Charges, will constitute a legal agreement between you and Dowgate Wealth. If you are unsure about how to complete any section of this form, please contact us.

It is important that you provide as much relevant detail as possible and check the information before you send the form back to us. If you need to add more information – for example additional residential addresses or information regarding additional dependents – please use the additional notes section at the end of this form. Non-UK nationals should also refer to Appendix I and II

We will review all the information you give us. Once we are satisfied we have all the information we need to comply with our legal and regulatory requirements, we will be able to provide our services to you. Any gaps in the information may result in us being unable to offer our services.

This form is for Individual and Joint Accounts, as well as accounts where a representative is making decisions on behalf of another person, like a minor or situations requiring Power of Attorney. See below for more information.

REPRESENTATIVES

Before completing this form, it's important to understand the different types of representatives and what they do.

Nominated Representative: this type of representative is chosen by the account holder to make investment decisions on their behalf in certain situations. These include.

Joint accounts: One person makes decisions for both people.
Family arrangements: A third party handles the investment decisions for the account holder(s).
Minors: A parent, grandparent, or guardian makes decisions for someone under 18.

Legal Representative:: is appointed through formal legal documents and can include:

Enduring Power of Attorney (EPA)
Lasting Power of Attorney (LPA)
Deputy Court Order (DCO)

A legal representative must be listed on most pages of the account form, except a few specific ones. We will need to see the original or a certified copy of these legal documents

The representative (either nominated or legal) will be responsible for receiving communications from us. If a representative is involved, their details should be entered as the “Second Applicant” on the forms, with the main account holder’s details included where needed.

SERVICE TYPE

Type of account:

Execution Only

Please note that Dowgate Wealth is only responsible for executing the trades as requested by you. We will not offer any investment advice or recommendations as part of this account service.

Is this a Joint Account application?

Yes

FIRST APPLICANT - PERSONAL INFORMATION

This section is to be completed by the sole applicant of an individual account or the first applicant of a joint account

Title:

Forename(s)

Surname

Date of Birth

Country of Birth

Town of Birth

CURRENT PERMANENT RESIDENTIAL ADDRESS

Address line 1:

Address line 2:

Town/City:

County:

Postcode:

Country:

Have you lived at this address for more than 3 years?

CONTACT DETAILS

Mobile Number

Home Number

Business Number

Email Address

NATIONALITY & TAX STATUS

Nationality

National Client Identifier (NI No if UK)

Click here for help with your NCI

Are you a dual national?

Dual Nationality

Tax residency and citizenship (if more than one, provide all countries)

Country	Tax Resident	Citizen	Tax ID Number

Are you a US Person?

SECOND APPLICANT - PERSONAL INFORMATION

This section is to be completed by second applicant of a joint account, OR the person acting as the Nominated or Legal Representative.

Title:

Forename(s)

Surname

Date of Birth

Country of Birth

Town of Birth

CURRENT PERMANENT RESIDENTIAL ADDRESS

Address line 1:

Address line 2:

Town/City:

County:

Postcode:

Country:

Have you lived at this address for more than 3 years?

CONTACT DETAILS

Mobile Number

Home Number

Business Number

Email Address

NATIONALITY & TAX STATUS

Nationality

National Client Identifier (NI No if UK)

Are you a dual national?

Dual Nationality

Tax residency and citizenship (if more than one, provide all countries)

Country	Tax Resident	Citizen	Tax ID Number

Are you a US Person?

SOURCE OF WEALTH & FUNDS

In very simple terms, source of wealth is about how you earned your wealth over time, while source of funds is about where the money you’ll be using to invest comes from. These requirements are part of the UK’s broader anti-money laundering regulations and help ensure the integrity of the financial system.

If a joint account, please clearly state source of wealth/funds for each individual applicant.

Source Type

Please select all applicable and provide details:

Employment or Business

Source of Wealth detail (including country where wealth is/was generated)

Source of Funds detail (including country where funds are/were generated)

Savings & Investments

Source of Wealth detail

Source of Funds detail

Inheritance or Gifts

Source of Wealth detail

Source of Funds detail

Property Sale

Source of Wealth detail

Source of Funds detail

Other

Source of Wealth detail

Source of Funds detail

HEALTH

This section is to be completed by the first applicant OR Legal Representatives should complete on behalf of their client OR Nominated Representatives for a minor should complete where applicable with the minor’s details.

How is your general state of health:

Do you have any upcoming operation in the next 12 months, or are you currently recovering from one?

Do you have any other health conditions that we should be aware of that may impact your financial planning or risk profile?

ACCOUNT TYPE & USAGE

It’s important for us to understand exactly what sort of account you require and also your expectations regarding funding and withdrawals to and from your portfolio. This is a regulatory requirement and additional protection for you if, for example, we observe any unusual activity.

This section is to be completed by the first applicant if an individual account, or both applicants should complete the section together with a combined response if a joint account.

What account type(s) do you require?

General investment account

A regular investment account which doesn’t have any special tax benefits, so you might need to pay taxes on any profits you make.

Individual Savings Account

A tax-efficient savings or investment account available to UK residents. ISAs allow you to save or invest money without paying tax on the interest, dividends, or capital gains earned within the account.

If you’d like to open an ISA account we’ll need to send you a supplementary form which provides additional information and account specific questions.

Are regular withdrawals needed? For example, dividends paid out monthly or quarterly to your personal bank account

Is a significant capital withdrawal expected? For example, a property purchase is planned for next year

Is ongoing account funding expected? For example, transfer of funds from an annual bonus to your investment account

BANK ACCOUNT INFORMATION

Please note that payments will only be made to and accepted from your nominated bank account detailed below and that a certified copy of a bank statement will be required.

For joint accounts, a certified copy of a bank statement for one individual to the account will be required. For non-UK bank accounts, please provide IBAN, BIC / ABA numbers and the account currency.

Bank Name

Account Name

Sort Code

Account Number

IBAN Number (if relevant)

BIC / ABA Number (if relevant)

Account Currency (if relevant)

THIRD PARTY INFORMATION

In certain situations, it is useful to have copies of certain reports and documentation relating to your account(s) sent to third parties. For example a tax advisor for assessment and tax filing purposes, or a lawyer for estate planning. If you would like Dowgate Wealth to provide information regarding the account to a third-party individual, please provide the relevant details below.

Would you like to nominate a third party?

Title:

Surname

Forename(s)

Company name (if relevant)

Address

Postcode

Email address

Telephone number

Please detail the role of the third party:

Please detail what correspondence you wish to be provided to the third party:

None

Reporting

Online Access

Other (please specify)

ONLINE PORTAL SECURITY QUESTIONS

Our online portal gives you access to your investment portfolio, so you can see your holdings, the value of your investments and a history of all your transactions.

Would you like access to our online portal?

For security, we ask the main account holder to provide answers to four security questions. Additional access can be provided upon request for joint account holders or third parties.

Question (choose four) Answer

Make of first car

Favourite holiday destination

Name of your first pet

Name of the road you grew up in

Favourite colour

Mother’s maiden name

Father’s first name

DECLARATIONS

By signing under Part 10 (Signatures), the following declarations apply:

1. I/We have read and understood the nature and the risk of the product(s) that I/we intend to invest in through this account.
2. I/We act in my/our name(s) as specified on this application form and not on behalf of another party in respect of all matters related to this account. Accordingly, all funds to be deposited and transacted on the account are my/our own funds.
3. I/We am/are not aware of any health or other conditions that I/we may have that might affect the proper operation of the account.
4. I/We have provided true, accurate and complete information and undertake to update Dowgate Wealth of any changes to the information provided without delay.
5. I/We accept that in certain circumstances Dowgate Wealth will be obliged to share information with UK tax authorities, who may pass it on to other tax authorities.
6. I/We have received, read and understood the following:
- a. Dowgate Wealth Terms of Business - including the product risks disclosure (website link)
- b. Conflict of Interest Policy (website link)
- c. Schedule of Charges
- d. I/We have obtained the Dowgate Wealth Order Execution Policy (website link)
7. I/We consent to the Order Execution Policy and for any orders to be executed outside a regulated market or a multilateral trading facility.
8. I/We consent for any unexecuted limit orders not to be made public
9. I/We accept and agree to be bound by the terms provided above and consent to such terms and information including future updates to these be provided to me/us by way of posting on the websites indicated above.

EXPRESS CONSENT FOR RECEIVING INFORMATION ELECTRONICALLY

We are required by regulation to obtain your express consent to provide you with information in an electronic, durable medium that is not paper. For example, by email.

If you do not consent to us providing you with information electronically, we will be unable to offer you an account. For the avoidance of doubt, by consenting to receiving information via electronic means, you remain entitled to provide us with specific requests for information via a reasonable alternative form of durable medium.

I/We hereby consent to receive information from Dowgate Wealth via email, PDF document or by any other durable medium that is not paper

I/We hereby consent to receive information not personally addressed to me/us via the websites that you provide me/us notice of

I/We Accept (please tick this box):

DATA PROTECTION

Your data will be processed in line with the Dowgate Wealth Privacy Policy which can be found at: https://dowgatewealth.co.uk/privacy-policy/

MARKETING COMMUNICATION

We offer company news and market commentary which is emailed to the contact email address detailed in Section 1 and 2. If you would like to receive this, please tick this box:

	Company news and events	Market commentary and insights
Applicant 1
Applicant 2

CLIENT SIGNATURE(S)

FIRST APPLICANT

To be signed by the sole applicant of an individual account OR Nominated Representative (joint accounts, minors, family arrangements) OR Legal Representative

SECOND APPLICANT

To be signed by the second applicant of a joint account (NOT the Nominated Representative)

Docusign Document will be sent for signing directy to the second applicant's email address

APPENDIX I - ACCOMPANYING DOCUMENTATION FOR NON-UK CLIENTS

Please provide certified copies of the following in respect of each applicant:

Passport or other government issued ID

Proof of address (e.g. utility bill)

Evidence of Source of Wealth

Employment Income: Payslip, salary records, tax docs
Savings: Bank statement, source docs
Property Sale: Sale contract, title deed
Investments: Share sale contract, agent account, etc.
Company Sale: Sale contract, business details
Dividends: Financials, tax forms
Loan: Agreement, security documents

Evidence of Source of Funds

Bank statements
Deed of gift

GUIDANCE ON “CERTIFICATION” REQUIREMENTS

Copies of the above listed documents must be independently certified by a lawyer, bank manager or public notary, and contain both the date on which they were certified and the following wording: “certified as a true copy of the original as seen by me”. Additionally, the certification should provide the full name, signature, occupation, official stamp, business address and telephone number of the individual certifying the document(s).

It may be necessary for us to request further documentation and information in order to complete the due diligence process.

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Document Type	File Name	Size	Actions

Application Form

Execution Only Account

Individual & Joint Applicants

Important Information

REPRESENTATIVES

SERVICE TYPE

FIRST APPLICANT - PERSONAL INFORMATION

CURRENT PERMANENT RESIDENTIAL ADDRESS

PREVIOUS RESIDENTIAL ADDRESS (if less than 3 years at current address)

CONTACT DETAILS

NATIONALITY & TAX STATUS

FIRST APPLICANT - PERSONAL INFORMATION

EMPLOYMENT STATUS

MARITAL STATUS

DEPENDENTS

ISA CONSIDERATIONS

If you have a remaining ISA allowance, what is your ISA strategy for this current financial year?

ESTATE PLANNING

SECOND APPLICANT - PERSONAL INFORMATION

CURRENT PERMANENT RESIDENTIAL ADDRESS

PREVIOUS RESIDENTIAL ADDRESS (if less than 3 years at current address)

CONTACT DETAILS

NATIONALITY & TAX STATUS

SECOND APPLICANT - PERSONAL INFORMATION

EMPLOYMENT STATUS

MARITAL STATUS

DEPENDENTS

ISA CONSIDERATIONS

ESTATE PLANNING

SOURCE OF WEALTH & FUNDS

Source Type

HEALTH

ACCOUNT TYPE & USAGE

What account type(s) do you require?

BANK ACCOUNT INFORMATION

THIRD PARTY INFORMATION

Please detail the role of the third party:

Please detail what correspondence you wish to be provided to the third party:

ONLINE PORTAL SECURITY QUESTIONS

Question (choose four) Answer

DECLARATIONS

EXPRESS CONSENT FOR RECEIVING INFORMATION ELECTRONICALLY

DATA PROTECTION

MARKETING COMMUNICATION

CLIENT SIGNATURE(S)

FIRST APPLICANT

SECOND APPLICANT

APPENDIX I - ACCOMPANYING DOCUMENTATION FOR NON-UK CLIENTS

GUIDANCE ON “CERTIFICATION” REQUIREMENTS

Uploaded Documents

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