WIS FORMS

As a Registered Representative of WIS, you need to focus your time on revenue generating activities such as client and asset acquisition. WIS understands this unique business challenge. In this section of Forms, we have provided the documentation necessary to help you grow and maintain your business.

We do our best to ensure that the documents and manuals found in this section are the most current. Should you decide to keep any of these documents on your desktop, we recommend you review the forms on a consistent basis to confirm those you have are the most recent.

Form

Description

Operations

ACH and Fed Fund Wire Request

For use when requesting an ACH or Fed Fund Wire from a customer account. NOTE: If Fed Fund is is for an international wire the Fed Fund Wire – International WIre Disclosure must accompany the request.

* Not eligible for DocuSign

Address Change Request

Use to change legal and/or mailing address, add or change email address or to update phone number. Revised 08/2021

Affidavit of Domicile

A notarized affidavit executed by the legal representative of an estate reciting the residence of the decedent at the time of death.

* Not eligible for DocuSign

DocuSign Guidelines

The increasing e-Signature technology usage such as DocuSign requires us to ensure that our process in dealing with electronic document is aligned with current rules and regulations

Dodd Frank Disclosure

The Reg E Dodd Frank Disclosure is needed for all international wires, in either USD or foreign currency.

* Not eligible for DocuSign

Fidelity Charges and Fees

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements. Revised 4/22

Interested Party Form

Use to add/change or delete an interested party on account. Revised 08/2021

Journal Request

For use when client requests to move assets from one NFS account to another.

* Not eligible for DocuSign

WIS Fidelity Physical Certificates Letter of Authorization and Release

form must be completed if the registration on the certificate being deposited into a Fidelity account does not match the account registration of the brokerage account.

Letter of Explanation for U.S. & Foreign Mailing Address – Single Signer

Use when a foreign client’s legal address is a different mailing address or a US address. Each beneficial owner must provide a separate document.

Online Access Request and Household Account Linking Agreement – Fidelity, Pershing & Black Diamond

Complete and submit the form to enable the client with online access. Through online access clients can go paperless for statements and confirms.

Online Trading Disclosure

Customer acknowledges that this disclosure statement applies to transactions entered by the customer for execution through a designated trading system via the internet.

Pershing Charges and Fees

International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Same Name Certification

Use this form to authenticate any name differences on an accounts. Do not use this form for registration changes or name changes.

* Not eligible for DocuSign

Signature Specimen

This card is used for signature verification only and gives no financial or fiduciary authority on any account listed

* Not eligible for DocuSign

Stock Bond Power

A document separate from the stock certificate that is utilized when surrendering shares to the brokerage account

* Not eligible for DocuSign

W-8BEN-E

Certificate of Status of Beneficial Owner for United States Tax Withholding and Reporting (Entities). Internal Revenue (IRS) form only to be utilized by entities

W-8BEN and W8 Written Statement for Certification of Foreign Tax ID Letter of Explanation

Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding and Reporting (Individuals)

W8 Written Statement for Certification of Foreign Tax ID and DOB and Letter of Explanation

To be used with Existing W8 for recertification. Inclusion of TIN and DOB or act as Letter of Explanation as to why a Foreign TIN is missing

Wedbush Charges & Fees

Notice Regarding Transaction Pricing Policy and Charges for Special Services

WIS Client Agreement

Accompanies any and all new business established through WIS

WIS PO Box Authorization Form

Authorizes WIS to send all correspondence, including, but not limited to statements, confirmations, notices, checks and securities to a PO Box.

Western Disclosures – Supplement to Fidelity Brokerage Account Agreement

Acts as a supplement to the Fidelity Brokerage Account Agreement. Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system.

Worthless Security Form – Fidelity (NFS)

Worthless Securities Release

Worthless Security Form – Pershing Request for Disposition of Non-Transferable Security

Use when the security is worthless and there is no transfer agent.

Worthless Security Form – Pershing Disposal of Security with Insignificant Value

Use when the security is worthless but does have a transfer agent.

Worthless Security Form – Wedbush

Worthless Securities Release

* Not eligible for DocuSign

Compliance

1031 Disclosure

Required disclosure to be used when purchasing a TIC / 1031

*Not eligible for DocuSign

529 Analyzer

This form is intended to analyze the expense difference between the “C” share being offered and its Class “A” counterpart. This form should be used for other shares classes as well, such as E, M or T shares.

*Not eligible for DocuSign

Change of Broker-Dealer

Use to change the broker-dealer of record at the Insurance or Mutual Fund Company

*Not eligible for DocuSign

Checks Received and Delivered Blotter

Use to record incoming and outgoing checks

*Not eligible for DocuSign

Client Disclosure Form Alternative Products

Required disclosure to be used when purchasing Alternative Products

*Not eligible for DocuSign

Client Disclosure Form Qualified Opportunity Zone Funds (QOZ)

Required disclosure to be used with Qualified Opportunity Zone Funds (QOZ)

*Not eligible for DocuSign

Client Disclosure Form Mutual Funds

Required disclosure to be used when purchasing Mutual Funds

*Not eligible for DocuSign

Client Disclosure Form Structured Products

Required disclosure to be used when purchasing a Structured Product.

*Not eligible for DocuSign

Employer Sponsored Plan to IRA – Client Disclosure

To be used when rolling an employee sponsored plan to an IRA

Incoming Stock Verification

Used to verify course of certificates, as needed.

IPO Agreement Form

Use this form to confirm that the account is eligible to purchase new issues either because no restricted person holds a beneficial interest in the account, or because the account has implemented procedures to reduce the beneficial interests of all restricted persons or this account is exempt from the restrictions of FINRA Rule 5130.

Linked CD Disclosure

Required disclosure to be used when purchasing a broker CD.

Managed Account Conversion Client Disclosure

To be used when converting a client account from commission based to managed.

Mutual Fund C Share Disclosure

Mutual Fund “C” Share Disclosure Form to support the purchase of class C shares in an account with a time horizon of three or more years when the purchase, series of purchases, exchanges or aggregate holdings in class C shares exceeds $25,000, regardless of whether the transaction is solicited or unsolicited.

Option – November 2012 Supplement

November 2012 Supplement must accompany the Option Disclosure to the customer.

*Not eligible for DocuSign

Option Disclosure: Characteristics & Risk of Standardized Options

Prior to buying or selling an option, investors must read a copy of the Characteristics & Risks of Standardized Options, also known as the options disclosure document (ODD). It explains the characteristics and risks of exchange traded options. Note: This document is 186 pages.

*Not eligible for DocuSign

Outside Business Activity (OBA) Disclosure

All outside business activity (activity that is not paid through Western International Securities) must be disclosed prior to engaging in in such actiivity. Use this form to begin the review process of any OBA. (REV 7/15/2021)

*Not eligible for DocuSign

Securities Received & Delivered Blotter

Use to record incoming and outgoing certificates

*Not eligible for DocuSign

Unsolicited Trade Letter

Letter sent to client to confirm unsolicited transaction

Variable Disclosure

Required disclosure to be used when purchasing or exchanging into Variable Annuity

*Not eligible for DocuSign

WIS Brokerage Services Disclosure Summary

Information about the business practices, compensation and conflicts of interest related to the brokerage business of WIS

WIS Client Agreement

Accompanies any and all new business established through WIS

WIS FIA Transaction Cover Sheet

Required for any advisor wishing to do a fixed index annuities transaction.

Trading

Block Trade-Buy

Used for multiple (block) buy orders

Block Trade-Sell

Used for multiple (block) sell orders

Electronic Trading Disclosure

Used when client request online trading through ClientToolkit. Account must be approved prior to submission of the Electronic Trading Disclosure

Fidelity International Trade Execution and Settlement Fees

Order Ticket – Buy

Use anytime a Buy order is called, emailed or messaged into a Trading Desk (Western or third party) and the trade will not generate an electronic order ticket at the time of entry (e.g. Morcom& NetX360).

Order Ticket – Fixed Income

Use anytime a Fixed Income order is called, emailed or messaged into a Trading Desk (Western or third party) and the trade will not generate an electronic order ticket at the time of entry (e.g. Morcom& NetX360).

Order Ticket – Mutual Fund

Use anytime a Mutual Fund order is called, emailed or messaged into a Trading Desk (Western or third party) and the trade will not generate an electronic order ticket at the time of entry (e.g. Morcom& NetX360).

Order Ticket – UIT Rollover

Use anytime a UIT Rollover is called, emailed or messaged into a Trading Desk (Western or third party) and the trade will not generate an electronic order ticket at the time of entry (e.g. Morcom& NetX360).

Order Ticket – UIT Single Trade

Use anytime a UIT Trade order is called, emailed or messaged into a Trading Desk (Western or third party) and the trade will not generate an electronic order ticket at the time of entry (e.g. Morcom& NetX360).

Order Ticket- Sell

Use anytime a Sell order is called, emailed or messaged into a Trading Desk (Western or third party) and the trade will not generate an electronic order ticket at the time of entry (e.g. Morcom& NetX360).

Trade Error Correction Form

Must use for trade correction or adjustment such as a buy/sell to correct, intraday trade bust requests, same-day and post-trade date account designation changes (i.e., moving a trade from one account to another), post-trade date commission adjustments. Submit the Trade Error Correction Form to the trading department at Trading@WISDirect.com for the correction to be processed.

Miscellaneous

Certification Regarding Beneficial Owner and Controlling Person form

Required for all legal entities. Used to gather information of who owns, controls and profits from the legal entities.

Fidelity Mutual Fund Share Class Conversions Request Form

Use this form to request a mutual fund shares class conversion

WIS Approved Products

Approved Product List 11-2020

WIS Approved Products FIA

WIS Fixed Indexed Annuity Approved Products

WIS Mutual Fund Families

WIS Mutual Fund Families (7.29.2022)

WIS Alternative Investment Offerings

WIS Approved Products VA

Variable Annuity Approved Products

WIS Approved Products RILA

WIS Client Request for Signature Guarantee

To induce Western International Securities to guarantee client signature(s)

* Not eligible for DocuSign

WIS Organizational Chart

WIS Organizational Chart 10-2020

Advisory

ADV Part II A

ADV Part II A (Firm Brochure) must be provided to each client upon the opening of a managed account within the Western RIA. Use with managed accounts.

ADV Part II B

ADV Part II B (Rep Brochure). This disclosure brochure is specific to the rep and must be provided to each client upon the opening of a managed account within the Western RIA

Black Diamond Benchmark Enrollment Form

To enroll into a benchmark to track alongside your client account.

Contour Brochure

Contour Wrap Fee Program Brochure. Revision Date 1/31/22

Executing Broker Agreement

This Agreement describes the terms and conditions pursuant to which Western acts as the executing broker for transactions placed by your Investment Advisor.

Financial Consulting Agreement (ERISA)

ERISA Consulting Services Agreement

Financial Consulting Agreement (NON-ERISA)

Non-ERISA Consulting Services Agreement

Financial Consulting Billing Statement

Consulting Billing Statement

Managed Account Conversion Disclosure

Client disclosure when an account is converted from commission-based to fee-based.

Mutual Fund Class conversion Guide (Fidelity Custody and Clearing)

This is the step-by-step process for an advisor to submit a Mutual Fund conversion request form through the Wealthscape platform.

* Not eligible for DocuSign

Mutual Fund Class conversion Guide (Pershing)

This is the step-by-step process for an advisor to submit a Mutual Fund conversion request form through the Wealthscape platform.

* Not eligible for DocuSign

WIS Investment Management Agreement

Investment Management Agreement –Transaction Base Pricing with Schedules

Commissions

Commission Pay Dates

Western International Securities Commission Pay Dates

Direct Deposit Authorization

Use to initiate or change representative commission direct deposits.

* Not eligible for DocuSign

Assistant Forms

New Assistant Hiring Process

Hiring a new assistant is a big step for most advisors, as it represents a partnership in many ways. Assistants often get to know your clients very well, and reflect your business approach as well as your ethics. It is important to us as a WIS family that everyone fits in, and that they have been hired using a standardized process, ensuring fairness and equal opportunity.

NLSA-LSA WIS Appraisal Form

The attached questionnaire represents part of the registration process at Western International Securities, Inc. (“WIS”). Please answer all questions and return to WIS for review.

Non-Compete Disclosure

Prior to becoming associated with an Atria Wealth Solutions, Inc. affiliated Broker Dealer (the “Broker Dealer”), we request that a prospective representative provide the following information and assurances.

Outside Business Activity (OBA) Form

All outside business activity (activity that is not paid through Western International Securities) must be disclosed prior to engaging in in such actiivity. Use this form to begin the review process of any OBA.

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WIS FORMS

Operations

Compliance

Trading

Miscellaneous

Advisory

Commissions

Assistant Forms

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