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The form is used to certify that two names refer to one individual, often required for financial or legal purposes.
Both names must be signed by the individual to validate the certification.
A date must be provided to indicate when the certification was completed.
The form includes a section for a signature guarantee, which may be necessary for certain transactions.
The form requires specific account details such as Sub Firm No., BR Code, FA Code, and Account Number.
The document indicates that accounts are carried by First Clearing, LLC, which is a member of FINRA/SIPC.
