Employment Application

Ruggiero Investments– Applications

Step 1 of 9

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Applicant Information

Legal Name

First Name Middle Name Last Name

Address

Street Address Address Line 2 City State ZIP Code

Home #

Cell #

Social Security:

Date of Birth

MM slash DD slash YYYY

Are you a U.S. Citizen:

Yes

If not, are you Authorized to work in the U.S

Yes

Country of Citizenship:

Education

Type	Name	Start Date	Completed	Diploma	Actions

There are no Entries.

Maximum number of entries reached.

Position Applying for:

Today’s Date:

MM slash DD slash YYYY

Employment Experience

Previous Employer

Job Title	Company Name:	Dates of Employment (from)	To	Actions

There are no Entries.

Maximum number of entries reached.

Background Check

Have you served as a Member of the Armed Forces:

Yes

Branch

Rank

Honorable Discharge

Yes

Date From

MM slash DD slash YYYY

Date To

MM slash DD slash YYYY

Have you ever been convicted of a Felony?

Yes

If yes, please explain

Professional Licenses & Designations

FINRA License’s Series

Designations:

CFP

CFA

CHFC

CIMC

CPA

LLB/JD

CLU

Other

Business Production Characteristics

What are your Annual Gross Fees and Commissions for:

Trailing 12 Months:

Last Year:

Two Years Prior:

Total Assets Under Management:

Total # of Accounts:

Total # of Households:

Fee Based:

Non Fee Based:

Cash Balances:

# Accounts using Margin

# Accounts using Options: