Marketing Form

Are you a UBS client?

Yes No

Do you currently have an advisor?

Yes No

First name

Last name

Country of residence

State

Phone

E-mail

Investable assets

up to $1M $1M -$10M >$10M

Tell us more about your needs

Preferred Contact Time (EST)

Name of the event

Location

Branch F.A. Name

Branch Address

Document Name Downloaded

Site Owner F.A. Email

INQUIRY_TO

UBS Form Types

F.A. Web Site Url

Legal note Legal note

The data entered into this form is transmitted encrypted to UBS Switzerland AG via the internet and distributed to local UBS offices appropriately. Nevertheless, in order to maintain discretion, please do not include any confidential data such as account numbers. Via this form UBS does not accept any instructions for business transactions such as the opening of accounts, payment orders, trading orders, revocations of orders or authorizations, blocking of credit cards, changes of address, etc. Please contact the appropriate office or your client advisor for such transactions.

By providing your telephone number and/or e-mail address above you expressly approve UBS contacting you via telephone and/or via unsecured e-mail.

Please note: The use of e-mail can involve substantial risks such as lack of confidentiality, potential manipulation of contents or sender's address, wrong recipient, viruses etc. UBS assumes no responsibility for any loss or damage resulting from the use of e-mails. UBS recommends in particular that you do not send any sensitive information, that you do not include details of the previous message in any reply, and that you enter e-mail addresses manually every time you write an e-mail.

As a firm providing wealth management services to clients, UBS Financial Services Inc. offers investment advisory services in its capacity as an SEC-registered investment adviser and brokerage services in its capacity as an SEC-registered broker-dealer. Investment advisory services and brokerage services are separate and distinct, differ in material ways and are governed by different laws and separate arrangements. It is important that clients understand the ways in which we conduct business, that they carefully read the agreements and disclosures that we provide to them about the products or services we offer. A small number of our financial advisors are not permitted to offer advisory services to you, and can only work with you directly as UBS broker-dealer representatives. Your financial advisor will let you know if this is the case and, if you desire advisory services, will be happy to refer you to another financial advisor who can help you. Our agreements and disclosures will inform you about whether we and our financial advisors are acting in our capacity as an investment adviser or broker-dealer. For more information, please review the PDF document at ubs.com/relationshipsummary.

Confirmation

This communication should not include individual personal information or identifying data such as a UBS account number. Please do not place any orders or trade instructions through this form. All orders should be made by calling your Financial Advisor directly.

Please visit our website at https://financialservicesinc.ubs.com/wealth/E-maildisclaimer.html for important disclosures and information about our e-mail policies. For your protection, please do not transmit orders or instructions by e-mail or include account numbers, Social Security numbers, credit card numbers, passwords, or other personal information.

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