REQUEST FOR CLIENT INFORMATION FORM

If you will complete and submit the information requested below, we will send you our client information form by return mail.

It is very helpful to complete as much of our information form as you can prior to our meeting with you. This will allow you to look up important information in advance that may not otherwise be readily available.

PLEASE COMPLETE CONTACT FORM

Last Name First Name

Address

City St. Zip

Contact Phone Number

Email Address

Questions or Comments


    Securities offered through Tandem Securities, Inc. Member FINRA, SIPC. MSRB. | 3706 SW Topeka Blvd. Suite 400, Topeka, KS 66609 (785) 266-8333
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