Signature Page Ghisialne Maxwell
Signature Page Ghisialne Maxwell
Account Number and Description
z Signature Requirement
By signing below and depositing cash or securities in my account, I acknowledge that I have read, understand and agree with the enclosed UBS Client
Relationship Agreement, as well as the terms, conditions and disclosures in the Agreements and Disclosures booklet that I previously received,
IRA Benefldary Designation
By signing below, I designate the beneficiary or beneficiaries that appear
on the enclosed Account information pages.
Employer Retirement Plan Rollovers
For fOlloVPIS born an employees retirement darn I have reviewed the
options available and evaluated the Investment and non-investment
considerations described in the IRA Rollover Disclosure avallabe In the
Agreements and Disclosures booklet; I understand the fees and costs
associated with IRA and I have made the decision to roll over my
assets to a UBS IRA independently. I also understand that if UBS
provides services to my employees retirement plan, none of the
information provided to me by MIS or its employees about rolhng over to
an IRA was provided as part of any existing fiduciary relationship to the
plan under ERISA and that neither UBS nor its employees acted as an
ERISA fiduciary in supplying such information. Electronic Delivery Consent
As you requested, we have sent your agreements and disclosure booklet
and other account-related documents electronically to
which we consider to be the e-mall address of
record or all owners of the account. The Information is also available at
www.ubs.com/accountdisdosures or by request to your financial Advisor.
Scott Stedman I Lyle Cavielat 1.212-821.7000.
The Client Relationship Agreement contains a pre-dispute arbitration clause located in the final section under the title "Arbitration'
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For Accounts:
Y1 23697 Traditional IRA - Sole Owner
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