This form must be typed. Do not send hand written form

AccountClosureFurtherInformationRequest

This form must be typed. Do not send hand written form.

SHOKHRUKH

ORZIKULOV

5

9

9

1

9

0

2

1
FirstnameLastname

[e-mail]
Date of birth
Email

AA0416860

[phone]

Telephone number Passport/IDnumber

Address
The Republic of Uzbekistan, Tashkent city, 36/14/39

City /CountryTashkent/Uzbekistan Postcode 100106

Postal Address

Why have you opened an investment account with Unique Finance at the first place?

_____FOR IVESTMENT_____________________________________________________________

__________________________________________________________________________________________________________________________________________________________________________________________________

Why you have decided to close your account?


_____I NEED CASH________________________________________________________________
_________________________________________________________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________________________________________________________
Who introduced you to the system? FRIEND__________________________________________

What is your total annual income(beforetax)? _______________________________________________________________________________________________________________________

What is your day job? Engineer-programmer______________________________________

What was the source of the funds you have used to open Unique Finance Account? SAVE MONEY___________________

AccountClosure–Requestformoreinformation–GlobalPortfolioManagement–C9918-12


Forofficialuseonly