INVESTOR PERSONAL INFORMATION FORM

PLEASE COMPLETE & SUBMIT THE FOLLOWING FORM

The information gathered through this form is strictly confidential and is intended for internal purposes. Rest assured, it will not be shared or distributed in any manner. Its sole purpose is to facilitate the administration and management of your investments within the CitySide network.

Please do not enter the number the portfolio manager will call you to get it over the phone after the form was sent.

Energency Contact Info:

Have you designated an emergency contact for your investment affairs in case of unavailability or emergency situations, whether temporary or permanent?

If invest through a legal Entity:

Investors utilizing investment entities other than their personal name are kindly requested to fill out the following section.

Legal Counsel Information:

What legal firm and or legal counsel is handling your legal affairs?

CPA & Tax Advisor

Which firm or CPA firm are you utilizing as your tax advisor and for filing your tax returns?

Custodian of Company Info

If you are investing with a self-directed IRA or Roth IRA and utilizing a custodian company, kindly furnish the requested information below.
Or account manager

Please confirm and submit the form