Customer Identification Form - KeyDirect.com

KeyBank Retirement AccountCustomer Identification FormBank Number: 3211 Social Security Number:ACCOUNT HOLDERINFORMATIONNameLegal AddressCity, State, Zip CodeCountryHome PhoneDate of BirthBusiness PhoneIDENTITYCERTIFICATIONSIMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING NEW ACCOUNTS AT KEYTo help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain,verify, and record information that identifies each customer who opens an account. Therefore, all new and existing customers are subject to theidentity verification requirements.When a customer opens an account with any entity within the KeyCorp family of companies, we will ask for their name, address and identificationnumber, and, in the case of an individual, his or her date of birth. For trusts and estates, we may also obtain this information for individualsassociated with the trust or estate. In all cases, Key is committed to protecting the privacy and identity of each of its customers.Failure to supply this required information will prohibit us from completing this request.(Please refer to List A, Customer Identifying Documents for Individuals for acceptable types of ID.)What type of ID is this?ID numberIndicate the following:Which state/country issued it? Expiration Date Issue DateOCCUPATION ANDINDUSTRYWhat is your occupation?(Select and input information from list B)ALL SECTIONS MUST BE COMPLETEDWhat is your worker classification?(Circle one)Hourly Self-Employed Manager/Executive StudentRetired Unemployed Salary/Non-ManagerEmployer Name:Which of the following bestdescribes your employer industry?(Circle one)Public Administration Retail Trade Construction ServicesFinance, Insurance &Real EstateMining Manufacturing Wholesale TradeTransportation, Communications, Electric,Gas & Sanitary ServicesAgriculture, Forestry, Fishing,LandscapingWhich of the following most accurately describes thespecific Industry of your employer?(Select and Input information from list C):EF-88-2001 (03/14)

SOURCE OFINCOMEWhat is your Source of Income?(Circle all that apply)Salary/ Wages Royalties PensionInvestments Lottery Winnings Real EstateNo Income Public Assistance TrustOtherIncome FromFamily Owned BusinessChose Not To RespondIf other, please describe:NRA / VISA / OFACWhat is your country (countries) of citizenship?What is your country of permanent residence?Do you have a temporary residence and/orown real property outside of the United States?YESNOIf yes, in which countries?What is your current Visa status?(If applicable, circle one)Asylum Tourist Authorized Work Permit TrainingDiplomatic Visitor Student No VisaFrom what country did you obtain your Visa?POLITICALLYEXPOSEDPERSONAre you, an immediate family member or close associateof a person who occupies or has occupied a high positionin a foreign government?YESNODo you occupy, or have you occupied in the past,a high position for a foreign government?YESNODo any beneficial parties to the account currently occupy, or haveoccupied in the past, a high position for a foreign government?YESNOPOUCH ACTIVITYDo you anticipate any delivery method that involves the use of carrieror courier to transport currency, monetary instruments and otherdocuments physically from outside the United States? (If yes,proceed to questions below.)YESNOIf yes, for what country (countries) will the delivery methodthat involves the use of carrier or courier to transportcurrency, monetary instruments and other documentsphysically from outside the United States originate?If yes, estimated ANNUAL dollar amount of delivery method thatinvolves monetary instruments and other documents physically theuse of carrier or courier to transport currency, from outside theUnited States? (Choose one) $1 - $3,000 $3,001 - $5,000 $5,001 - $10,000 $10,001 -$25,000 >$25,000If yes, what is the likely purpose of the pouch activity? Business Family Residing AbroadPersonal TravelRegular Payment AbroadSIGNATURESCustomer signatureDateEF-88-2001 (03/14)

A. Customer Identifying Documents for Individuals (must have a photo and be unexpired to bea primary form of ID) U. S. Passport Foreign Passport (including Mexican and Canadian) U. S. Military ID Card U. S. State Driver’s License Canadian Driver’s License Mexican Driver’s License Native American Tribal Identification Card Mexican Matricula Consular Identification Card U. S. State ID Card (issued to residents of a U.S. State) Permanent Resident Card (Green Card) (Form I-551)B. List of OccupationsArchitectsAthletes and related workersClergyClerical occupations, except equip operatorComputer, matheml, & operations researchComputing & office equipment operatorsConstruction laborersConstruction occupations, n.e.c.Construction tradesDentistsDisabledEditors, rptrs, pr spec & announcersElec. assem., install., repair. occupationsEngineering & related technology & technicianEngineers and surveyorsExcavate, grading, paving and related occupationsExtractive occupationsFabricators, assemblers & hand wkg occupationsFarm operators and managersFishers, hunters, and trappersFishery and related occupationsFood and bev. prep and svc. occupationForestry and logging occupationsHealth technologists & techniciansHomemakerInsurance, secure, real est. & serv salesLawyers and judgesMachine operators and tendersMachine setup operatorsMachine trades occupations, n.e.c.Management related occupationsMaterial moving occup, except transportationMilitary occupationsMiscellaneous manual occupationsMiscellaneous occupationsMiscellaneous personal svc occupationMotor freight occupationsNatural scientistsOc. In fabric, assem., repair of metal necOc. In fabrication/repair of wood prodOc. In machine stone, clay, glass rel prodOccupations in extraction of mineralsOccupations in metal fabricating, n.e.c.Occupations in writingOfficials & administrators, public adminEF-88-2001 (03/14)Officials and administrators, otherOther agricultural & related occupationsOther health diagnosing & treating practicePackaging and materials handling occupationPainting, decorating and related occupationPharm, diet, therap, & phys assistantsPhysiciansPlant and system operatorsPrecision production occupationsPrivate household occupationsProcess. of petro, coal, nat/mfg gasProcessing Occupations, N.E.C.Prod inspectors, testers, samplersProtective service occupationsRegistered nursesReligious workers/clergyRetiredSales occupation, consumable commoditiesSales occupation, servicesSales occupations, commoditiesSales related occupationsScience technologists & techniciansService occup, except private held & proSocial and recreation workersSocial scientists & urban plannersStenography, typing, filing, rel. occup.Structural work occupations, n.e.c.StudentSupervisors; clerical occupationsSupervisors; construction & extractive occupSupervisors; marketing & sales occupationsSupervisors; mechanics & repairersSupervisors; production occupationsSupervisors; service occupationsSupervisors; transport & material movingTeachers, colleges & universitiesTeachers, except college & universityTechnic; except health, enginrg & sciencesTextile occupationsTransportation occupationsUnemployedUnemployed w/incomeVehicle washers & equipment cleanersVeterinariansVocational & educational counselorsWriters, artist, performers & related

C. List of IndustriesAccounting, Auditing, and Bookkeeping ServicesAgricultural production – cropsAgricultural production – livestockAgricultural – Other Agricultural servicesAmusement and recreational servicesAmusement ParksApparel and accessory storesArt DealersAutomatic Merchandising Machine OperatorAutomobile ParkingAutomotive dealersAutomotive repair and servicesBabysitting BureausBarber shops, Barber collegesBars, Drinking Places (Alcoholic Beverages)Beauty shops, salons, manicure/pedicure,cosmetology schoolsBoat DealersBusiness Services – Other MiscellaneousCarwashesCasinos, Racinos, Card Rooms, Bookies, Lottery,and Bingo ParlorsCatalog and Mail – Order HousesCivic, Social, and Fraternal AssociationsClothing alteration/repair and Laundry/GarmentService and Diaper ServiceCoin-operated Amusement Devices including slotmachines, arcade games, and jukeboxesCommunicationsComputer programming, Data Processing, & OtherRelated ServicesConstruction – General building contractorsConstruction – Heavy construction contractorsConstruction – Special trade contractorsDiet and Weight Reducing ServicesDrive-In Motion Picture TheatersDry-cleaning plantsEating and drinking places – OtherEducational servicesElectric, gas, and sanitary servicesEngineering and management servicesFinance – Branches and Agencies of Foreign BanksFinance – Clearinghouses, Electronic FundsTransfer, Payment ProcessorsFinance – Commodity Contracts Brokers & DealersFinance – Depository institutionsFinance – Federal & Federally – Sponsored CreditAgenciesFinance – Foreign Trade and International BankingInstitutions, International Trade FinancingFinance – Holding and other investment OfficesFinance – Investment AdviceFinance – Investors, NECEF-88-2001 (03/14)Finance – Loan BrokersFinance – Miscellaneous Business CreditInstitutionFinance – Mortgage Bankers & LoanCorrespondentsFinance – Non-Deposit Trust FacilitiesFinance – Nondepository credit institutionsFinance – Personal Credit InstitutionsFinance – Real Estate Investment TrustsFinance – Security Brokers, Dealers & FlotationCompaniesFinance – Security, commodity brokers andserviceFinance – Services Allied With the Exchange ofSecurities or Commodities, NECFinance – Short Term Business Credit InstitutionsFinance – Trusts – Educational, Religious, andCharitableFinance – Trusts, Except Educational, Religious,and CharitableFishing, hunting, and trappingForestryFormal Wear and Costume RentalFruit and vegetable marketsFurniture, home furnishings and equipment storesGasoline Service Stations (with or withoutconvenience stores)Grocery stores, supermarkets (with or w/o generalmerchandise, Convenience stores (with or w/ogas)Health ServicesHotels, Motels, Motor Inns, LodgingHotels, rooming houses, camps, and other lodgingplacesInsurance agents, brokers and serviceInsurance carriersLaundry – Coin-operated Laundries andDrycleaningLaundry – Garment Pressing, and Agents forLaundries and DrycleanersLawn and garden ServicesLegal servicesLiquor StoresManufacturing – Food and kindred productsManufacturing – Apparel and other textile productsManufacturing – Chemicals and allied productsManufacturing – Electrical and electronicequipmentManufacturing – Fabricated metal productsManufacturing – Furniture and fixturesManufacturing – Industrial machinery andequipmentManufacturing – Instruments and related productsManufacturing – Leather and leather products

Manufacturing – Lumber and wood productsManufacturing – Miscellaneous manufacturingindustriesManufacturing – Paper and allied productsManufacturing – Petroleum and coal productsManufacturing – Primary metal industriesManufacturing – Printing and publishingManufacturing – Rubber and miscellaneous plasticsproductsManufacturing – Stone, clay, glass, and concreteproductsManufacturing – Textile mill productsManufacturing – Tobacco manufacturersManufacturing – Transportation equipmentMembership organizations – Other MiscellaneousMining – Coal mining and ServicesMining – Metal mining and ServicesMining and Quarrying of Nonmetallic minerals, exceptfuelsMining – Oil and gas extractionMotion Picture Theaters (except drive-in)Motorcycle DealersMuseums, art galleries, botanical & zoologicalgardensOrnamental Shrub and Tree ServicesOther food storesPawnshopsPersonal Services – Other MiscellaneousPipelines, except natural gasPolitical OrganizationsPostal Service U.S.Private households servicesProcess Services, Patent Agents, Notaries Public andParalegal Services and Bail BondingPublic Administration – Administration of economicprogramsPublic Administration – Environmental quality andhousingPublic Administration – Executive, legislative, andgeneral governmentPublic Administration – Finance, taxation, andmonetary policyPublic Admin/International Affairs/Consulate,Diplomatic services – gov’t, Embassy, ForeignmissionPublic Administration – Justice, public order, andsafetyPublic Administration – National security andinternational affairsRacing, Including Track Operations, Jockeys,Horse Trainers, and Race Car Owners andDriversRailroadsReal estateRecreational Vehicle DealersReligious OrganizationsRepair services – MiscellaneousRestaurants, Cafeterias, Snack Beverage Bars,Food Svc Contractors, Caterers, Dinner TheatersRetail trade – Building materials, hardware,garden supply, & mobile homeRetail trade – General merchandise storesRetail trade – Other Miscellaneous RetailService Industries – Other MiscellaneousShoe Repair Shops and Shoeshine ParlorsSocial servicesTaxicabsTobacco Stores and StandsTransportation – airTransportation – Local and interurban passengertransitTransportation – Motor freight transportation andwarehousingTransportation – Other MiscellaneousTransportation servicesTransportation – Sightseeing Buses and Cableand Cog RailwaysTransportation – Water TaxiTransportation – Water transportationTravel AgenciesValet Parking ServicesVeterinary ServicesWholesale trade – Beer and AleWholesale trade – Flowers, Nursery Stock, andFlorists SuppliesWholesale trade – Fresh Fruits and VegetablesWholesale trade – other durable goodsWholesale trade – other nondurable goodsWholesale trade – Wine and Distilled AlcoholicBeveragesWholesale – Jewelry, Watches, Precious Stones &MetalsEF-88-2001 (03/14)