Provide your personal information. PAGE 1

First Name

Middle Name (Optional)

Last Name

Suffix

Email Address

Social Security Number (US Only)

Date of Birth (mm/dd/yyyy)

Mother's Maiden Name

Create login ID and Password for your Account. PAGE 2

Login ID (At least 6 characters)

Athena Equity Representative (Contact Person)

Password

At least 8 characters.
At least 1 number.
At least 1 Capital Letter.

Confirm Password

Security Question

Answer

Provide your legal address and phone number. PAGE 3

Street Address (No P.O. Boxes)

Street Address 2 (Apt., Ste., Bldg - Optional)

City

State

Zip Code

Country

Citizenship

Phone Number

Mobile Number

Provide your employment and financial details. PAGE 4

Securities industries regulations require that we collect this information. It also helps recommend the right account features for your needs.

Employment Status

Occupation

Employer Name

Employer Street Address No P.O. Boxes

Employer Street Address 2 Apt., Ste., Bldg (Optional)

City

State

Zip Code

Country

Annual Income Nearest thousands

Liquid Net Worth Nearest thousands

Additional Details. PAGE 5

Are you a director, a 10% shareholder or an officer of a publicly traded company?

Yes
No

Are you associated with a brokerage firm, a member of a stock exchange or the NASD?

Yes
No

Have you ever filed for arbitration or sought other legal remedies against a brokerage firm?

Yes
No

New Account Application

Individual Brokerage Account

Provide your personal information. PAGE 1

Create login ID and Password for your Account. PAGE 2

Provide your legal address and phone number. PAGE 3

Provide your employment and financial details. PAGE 4

Additional Details. PAGE 5

Are you a director, a 10% shareholder or an officer of a publicly traded company?

Are you associated with a brokerage firm, a member of a stock exchange or the NASD?

Have you ever filed for arbitration or sought other legal remedies against a brokerage firm?

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New Account Application

Individual Brokerage Account

Provide your personal information. PAGE 1

Create login ID and Password for your Account. PAGE 2

Provide your legal address and phone number. PAGE 3

Provide your employment and financial details. PAGE 4

Additional Details. PAGE 5

Are you a director, a 10% shareholder or an officer of a publicly traded company?

Are you associated with a brokerage firm, a member of a stock exchange or the NASD?

Have you ever filed for arbitration or sought other legal remedies against a brokerage firm?