Member application

Open your account.

Complete the application below for an individual or joint account. Fields marked with an asterisk are required. Your information is transmitted securely and held in strict confidence.

Encrypted submission AML / KYC compliant

Primary applicant

Client 1

TitleFull given name(s) *Surname *Date of birth *

Sex

MaleFemale

Unit numberStreet numberStreet name *Suburb / City *Province / State *Postcode *Country *

Home phone numberMobile phone number *Email address *

Joint account, if applicable

Client 2

This is a joint application

Identification

Know Your Customer (KYC)

In order to comply with anti-money laundering regulations you must provide a government issued form of identification and proof of address. For joint accounts, both individuals must provide the necessary documents.

Photos, colour photocopies and colour scans are acceptable.

Photo ID must be valid and proof of address no more than 3 months old.

Required documents are to be sent via email to accounts@maryana.ca.

Accepted form of photo identification *Accepted proof of address document *

Copies of the selected documents will be requested by secure upload once your application is reviewed.

Confirmations

Declaration

By signing this member application the individual(s) confirm that they:

Are 18 years of age or over (otherwise applications must be made in the name of a parent/guardian and signed by parent/guardian).Acknowledge that Maryana Capital Inc. reserves the right to refuse an account application at its discretion.Are not a politically exposed person.

Typed signature

Signature

Client 1

Signature (type full name) *Name *Date *

By submitting this application you agree to our terms of business and privacy policy. A typed signature carries the same legal effect as a handwritten signature.