Sole Proprietorship Certification Form

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SOLE PROPRIETORSHIP CERTIFICATION
NEW ACCOUNT
I,
hereby confirm and certify that I am engaged in business
(Proprietor Name)
under the assumed name and style of the company, and at the location, listed below. I also certify that I am the sole
owner of said company, and no other person, partnership, or corporation has any right, title, or ownership interest
therein. All securities and other property in the name of said company are owned solely by me.
Name of Company
Tax ID
Location of Company
City/State/ZIP Code
If there is any change in ownership, title, or interest in this business, Scottrade will be immediately advised in writing. I
may not voluntarily assign any obligations hereunder without prior written consent from Scottrade. If I assign my
obligations as permitted hereunder, my obligations under the Scottrade ® Brokerage Account Agreement, and any other
applicable agreements, shall be binding upon my successors and assigns.
I understand that all transactions conducted by me, as Sole Proprietor, are at my own risk, and that Scottrade does not
monitor the account for suitability or risk of any trade. Accordingly, I hereby ratify and confirm any and all transactions
with Scottrade hertofore or hereafter made by me for the above Sole Proprietorship account.
I hereby agree to indemnify Scottrade, its affiliates, successors, assigns, officers, directors, agents, and employees, and
hold them free and harmless from, and to promptly pay Scottrade upon demand for, any and all losses, liabilities, claims,
damages, and costs (including reasonable attorney fees) or financial obligations that may arise as a result of Scottrade’s
reliance on the information provided in this document, and from acting upon instructions believed by Scottrade to have
originated with me (Sole Proprietor). I hereby agree that I will personally be responsible for any debts that arise in my
Sole Proprietorship Account. This indemnity is in addition to, and no way limits or restricts any rights or responsibilities
that have been made under any other agreement or agreements between me and Scottrade.
By signing below, I acknowledge that I have read and agree to the terms and conditions of the Scottrade ®
Brokerage Account Agreement.
X
Signature of Sole Proprietor
Date
Brokerage products and services offered through Scottrade, Inc. Member
FINRA
/ SIPC.
*SF1015*
SF1015/2-16

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