Individual (个人账户) Sole Proprietorship (独资经营)

Keogh (基奥计划)

Joint Tenants In Common (生存者权利联名账户)

Joint Tenants With Right of Survivorship (联名共同拥有)
Name: (姓名)
Sex:(性别)
Date of Birth(出生日期)

Street Address:
(街道地址)

City:(城市)
State:(省或州)
Zip:(邮编)
Country:(国家)
Marital Status:
(婚姻状态)
Telephone:(电话)
Email:(电子邮件地址)
 
Employment Information (工作信息)
Employers Name:
(雇主名称)
Years There:
(工作年限)
Nature of Business:
(业务性质)
Position Held:
(担当职务)
Employers Telephone:
(雇主电话)
Employers Address:
(雇主地址)

If joint account, what percentage of ownership?
(若为联名账户,您拥有的比例是多少)