CLIENT APPLICATION FORM

. The Applicant is an Individual (All sections except 1 and 7, along with Client Information Sheet for individual, co-account holder, agent or attorney.)

. The Applicant is an Organization (All sections in gray along with a Client Information sheet for each person described in part 3, on page 1 are relevant.

Name of Applicant (name of organization for corporate, partnership or trust accounts):

(1) ACCOUNT INFORMATION FOR ACCOUNTS OF COMPANIES AND OTHER ORGANIZATIONS

Contact Person:

Principal Place of Operations/Business: Domicile of Organization

Registered Office:

Address:

Mailing Address APT/SUITE NO.

CITY STATE /PROVINCE COUNTRY POSTAL CODE

Tel: ( ) Fax: ( ) Email:

Beneficial Owner(s) of Organization:

Residence of Beneficial Owner(s):

Is the organization a reporting issuer to any regulatory body? ? No ? Yes, Name of regulatory body:

Is the entity owned by/affiliated to the executive, legislative, administrative, military or judicial branches of a state or a political party, owned by a senior figure in any of these? ? No ? Yes, Details:

Nature / Activities of Organization:

(2) PROFILE:

Main Source of Funds (activity & country):

Licenses Required (if any) for Activities Noted Above:

Purpose of Account:

Objectives: ? Maximum Income ? Income with Growth ? Balanced ? Growth with Income ? Growth

Investment Preferences: ? These are Preferences (attach details) ? These are Aversions (attach details)

Please give the account numbers of any other accounts held in the name of account holder at Magnate Premier or our Parent Company:

Has anyone been authorized with Trading Authority or Discretionary Authority in handling the account? ? No ? Yes (attach authority)

Does the Private Banker have a direct or indirect interest in the account other than in commissions? ? No ? Yes, Details:

Are you, your spouse, children, siblings, parents, spouse's parents are a senior figure in:

? the executive, legislative, administrative, military, or judicial branches of a state;

? a state –owned entity; ? a political party;

? none of the above?

Are you a senior officer or director of the company whose shares are traded on an exchange or over the counter? ? No ? Yes

(2) PROFILE (Cont :

Do you, along or as part of a group, have a control position in any such company? No Yes, Position:

Company Details:

Do any other parties other than the person(s) name on the account:

Have any financial interest in the account? ? No ? Yes If yes, name(s) and/or details:

Guarantee this account? ? No ? Yes If yes, name(s) and/or details:

Are you or your spouse an Employee, Director, Partner, or Officer of a securities dealer, or of a stock exchange itself or the S.E.C or any other self-regulatory organization? ? No ? Yes, If yes provide details:

ACCOUNT HOLDER

CO-ACCOUNT HOLDER

Net Liquid Assets

Net Fixed Assets

Total Net Worth

Net Liquid Assets

Net Fixed Assets

Total Net Work

(3) JOINT ACCOUNT AGREEMENT

It is the expressed intention of the undersigned that ownership of this account be vested as (check one):

Joint tenants with rights of survivorship and not as tenants in common. (Applicable only to those persons residing and domiciled in jurisdictions permitting beneficiary designations other than by Will). In the event of death of either or any of the undersigned, the entire interest in the joint account shall be vested in the survivor or survivors on the same terms and conditions as therefore held, without in any manner releasing the undersigned or their estates from the liability for in the terms and conditions governing Joint Accounts.

Tenants in Common. In the event of the death of either party or any of the undersigned, the interests in the tenancy as of the business on the date of death of the decedent (or on the following business day if the date of death is not a business day) shall be equal unless otherwise specified immediately below.

If the interests are NOT to be equal, please designate the percentage interest of each tenant:

NAME OF PARTICIPANT OR HIS OR HER ESTATE % NAME OF PARTICIPANT OR HIS OR HER ESTATE %

Any taxes, costs, expenses or other charges becoming lien against or payable out of the account as the result of the death of the decedent, or through exercise by his or her estate or representative of any rights in the account shall, so far as possible, be deducted from the interest of such decedent. This provision shall not release the decedent's estate from the liability provided for in the terms and conditions governing Joint Accounts.

Each of the undersigned herby acknowledges that he/she has read and understood the terms and conditions of the Joint Account Agreement as is told in section 16. of the terms and conditions of the Account Agreement.

(4) INVESTMENT OBJECTIVES AND RISK TOLERANCE

I agree to allocate the following (approximate) percentage of my assets held in my accounts with your firm to relatively low risk, income producing securities which may include, but not limited to, governmental Treasury bills, notes, strips, agency securities, Savings Bond, Money Market Funs, and other high-quality, income-producing securities.

% - Lower-risk income producing securities

I agree to allocate the following (approximate) percentage of my assets held in my accounts with your firm to income producing securities which bear higher risk than those described above, which may include, but will not be limited to, moderate quality bonds and preferred shares, income trust units, and high yielding, blue chip common stock; or debentures

% - Moderate to higher risk, income producing securities

I agree to allocate the following (approximate) percentage of my assets held in my accounts with your firm to moderate risk securities, which may include, but not limited to, non-speculative growth-oriented common stock or mutual funds.

% - Moderate risk, growth oriented securities

I agree to allocate the following (approximate) percentage of my assets held in my accounts with your firm to speculative, higher risk securities, which may include, but will not be limited to, penny stock, higher risk funds, or warrants. This may also include any trading activity which encourages aggressive short-term trading in any security.

% - Higher-risk, speculative securities and trading strategies

100%

Percentages must total 100

(5) CLIENT STATEMENT INFORMATION

Delivery Schedule for Statements: ? Monthly ? Quarterly ? Annually ? Never

Forwarding Method: ? Fax ? Mail ? E-mail ? Will Collect ? On-Line Access Only Base Reporting Currency: ? USD ? Euro ? _______

(6) ELECTRONIC ACCESS (for on-line access to the account)

When you sign up for access to our on-line services, you agree to certain terms and conditions that set forth the terms of your relationship with Magnate Premier. If you have not had the opportunity to review the terms and conditions governing access to your account and services via our website, please take time to read our Electronic Access Agreement which can be found online at: www.magnatepremier.com/docs/magnate_electronic_access_agreement.pdf

? Please send the username and provisional password for the account to:

(6) ELECTRONIC ACCOUNT ACCESS (Cont)

Fax No ( ) or Email Address

Or Mailing Address APT/ SUITE NO.

CITY STATE /PROVINCE COUNTRY POSTAL CODE

You can also request on-line trading capabilities. There is no additional cost for this extended service. Should you select this option, you can continue to direct trade orders by traditional means at any time (i.e. telephone, fax, etc.).

? I authorize Magnate Premier to accept any trade instructions submitted through my account on-line:

As an added benefit, we have designed the website with the knowledge that certain of our clients (both corporate and individuals) would benefit from being able to provide their advisors (e.g. investment advisor, accountant, etc.) or parent corporation with “View Only” access to the account. “View Only” subscribers cannot give any instructions in respect of the account but can view and reconcile account balances and transaction histories.

? I authorize Magnate Premier to provide the following person/organization with “View Only” access to my account:

Name:

Relationship to Account Holder

Please send the additional “View Only” username and provisional password for the account to the above-named party at:

Fax No ( ) or Email Address

Or Mailing Address APT/ SUITE NO.

CITY STATE /PROVINCE COUNTRY POSTAL CODE

In the event that you lose your password, you will be required to participate in a security check that will involve submitting the answer to a “Challenge Question”. Please select a question from the list below and provide the answer for the chosen question in the appropriate space.

? Mother's maiden name? _________________________ ? City in which you were born? ___________________________________

? Favorite color? ? First School Attended?

(7) SECURITIES REGISTRATION FORM:

? Investment Contract – the names of all such participants are listed in the investment agreement submitted with the Account Agreement.

? Unit Shares – the names of all such shareholders are listed in the share register submitted with the Account Agreement.

? Bearer Shares – the share certificates of all such shares will be submitted into the custody of Magnate Premier Limited.

(8) SIGNATURE SECTION

I/We, the undersigned, certify that the information provided in this application and any attachments is true and complete. I/We acknowledge that I/we have read the Account Agreement and accept the terms and conditions set therein and, it electronic access is requested, I/we acknowledge that I/we also read the Electronic Access Agreement and accept the terms and conditions set therein.

. Pursuant to the regulations of the Securities and Exchange Commission of New Zealand , the Financial Reporting Act and the Anti-Money Laundering laws we are obliged to verify the signatures of any person(s) involved with this account. This includes any individual authorized to give instructions in respect of an account.

. Please ensure that a certified copy of your passport photographs/signature page is attached to the application.

ACCOUNT HOLDER'S NAME

ACCOUNT HOLDER'S NAME

DATE

ACCOUNT HOLDER'S SIGNATURE

DATE

ACCOUNT HOLDER'S SIGNATURE

VERIFIED AGAINST ID

VERIFIED AGAINST ID

WITNESS NAME WITNESS SIGNATURE

WITNESS NAME WITNESS SIGNATURE

BANK REFERENCE

Bank Name

Address & Contact Person

Account Number

Client Information

Sections marked with “*” are not applicable to agents or attorneys.

If additional details cannot be accommodated on the form they should be submitted on a separate page under the appropriate headings.

Name in Full:

Language:

? Mr. ? Miss ? Mrs ? Dr

Marital Status:

Approximate Annual Income*:

Occupation:

Employer

Years Employed

Citizenship

Date and Country of Birth

Number of Dependents

Residency for Tax Purposes

Residential Address: APT/SUITE NO.

City State / Province Country Postal Code

Tel: ( ) Fax: ( )

Email Address:

Business Address: APT/SUITE NO.

City State / Province Country Postal Code

I would describe my investment knowledge as: ? Excellent ? Good ? Fair ? Minimal

EXPECTED TRANSACTIONS

NUMBER

TYPICAL VALUE RANGE

MAIN COUNTERPARTIES

OR SECURITIES MKTS

SECURITIES AND SECTORS TRADE

Deposits

Withdrawals

Private Placement

DISBURSEMENTS (FOR PERSONAL ACCUNTS ONLY)*:

Type

Amount

Frequency

Account #

Transit

Personal

Income Taxes

Other

Other