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All information submitted through this form will be transmitted encrypted to UBS via the internet. However, you understand and agree that due to the nature of the Internet, UBS cannot always foresee or anticipate technical or other risks or difficulties that might arise during such transmission. These risks or difficulties may result in loss of data, unauthorized interception, delay in transmission or other service interruptions, which you agree and accept that UBS will not be responsible for.

For your protection, please do not include any confidential information, such as account numbers, Social Security numbers, credit card numbers, passwords, or other non-public information when submitting this form. UBS also does not accept or act on 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. through this form. Please contact the appropriate office or your client advisor for such transactions.

By providing your telephone number and/or e-mail address, you expressly allow UBS to contact you by telephone and/or unsecured e-mail.

Please note: The use of e-mail can involve substantial risks - for example, information can be intercepted, corrupted, lost, destroyed, arrive late or be incomplete. E-mails can also contain corrupted files, viruses, links or other destructive or deceptive items that could harm or interfere with your computer or device. E-mails could also be sent by people who try to trick, mislead or deceive others into sharing information, particularly personal or financial information, under false pretenses. By allowing UBS to contact you by e-mail, you understand that communications sent via e-mail are not secure or error-free, and accept the risks that come with communicating with UBS via email. You also accept and agree that UBS has no liability or responsibility for any loss or damage resulting from the use of e-mails or any losses that you might suffer as a result of communicating with UBS via e-mail.

Please see our E-Mail Disclosure for more information about our e-mail practices and policy.

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