General Application IRA Club

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What type of account would you like to establish?* This field is required.
Traditional IRA
Roth IRA
SEP IRA
SIMPLE IRA
Youth Account (17 Yrs or Younger)
Self Directed HSA
2
Name* This field is required.
First Name
Middle Name
Last Name
3
Street Address* This field is required.
4
City* This field is required.
5
State* This field is required.
6
Zip Code* This field is required.
7
Date Of Birth* This field is required.
8
DATE OF BIRTH* This field is required.
Date
Month
Day
Year
9
Social Security Number* This field is required.No Spaces or Dashes
10
PHONE NUMBER* This field is required.
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EMAIL ADDRESS* This field is required.
example@example.com
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How will you Fund Your Account? (Check All That Apply)* This field is required.(Please note, each account requires a $500 minimum cash balance)
IRA to IRA Transfer
Old Employer Plan (401k, 403b, 457, TSP)
Contribution
Pension/Annuity
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Here is a guide to help you with your rollover.This guide will also be attached in your email as a link.
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Firm Name* This field is required.
American Funds
Edward Jones
E-Trade
Fidelity
LPL Financial
Pershing
Charles Schwab
TD Ameritrade
Vanguard
Other
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Enter Other Firm Name
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Transfer Amount (approximately)
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Optional: Please upload your current custodian’s (Fidelity, Vanguard, TD, Schwab, etc.) statement to expedite the transfer process.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Old Employer's Firm Name* This field is required.
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Rollover Amount (approximately)* This field is required.
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Tax Year for Contribution* This field is required.
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Would you like to add a beneficiary?
Yes
No
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Beneficiary's Full Name* This field is required.
23
Beneficiary's DOB
Date
Month
Day
Year
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Beneficiary's Social Security NumberNo Spaces or Dashes
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Name The Share Percentage For This Beneficiary (ex: 100%)* This field is required.
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Relationship to Account Owner* This field is required.
27
How did you hear about IRA Club?
28
Please Use Promo Code (Minor) to Waive your Set Up FeePlease Use Promo Code (Minor) to Waive your Set Up Fee
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Membership Fees (For $0.00 carts, please click NEXT)* This field is required.
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ORDER SUMMARY
Total costUSD
IRA Club MembershipAnnual Fee
$175.00+Edit
Back
ApplicationOne time set up fee
$35.00+Edit
Back
$500 Dollar Minimum Contribution
$500.00+Edit
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Enter Coupon
Total cost $0.00
Membership Fees (For $0.00 carts, please click NEXT)
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Please choose a payment method for your IRA Club fees* This field is required.
Credit Card (Preferred Method)
Deduct from IRA
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Initials* This field is required.By signing this application, I acknowledge, on behalf of myself and all users authorized by me, that: I agree to accept electronic statements and notices via email and online to my IRA Club portal. IRA Club will provide a unique Contact ID to set up a User ID, Password, and Security Questions. Online access registration will be sent to the email address above within five business days after the account is active. The password chosen will be kept confidential. If a User ID or Password is lost or stolen, I will attempt to reset it or call IRA Club to obtain assistance. I agree to hold IRA Club harmless from all losses, liability, demands, judgments, claims, and expenses from my use of my email address listed above, the IRA Club website, and the IRA Club Portal IRA Club provides. I provide the indemnification without regard as to whether your claim is against my authorized representative or me.
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Signature Date* This field is required.
Date
Month
Day
Year
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Terms and Conditions* This field is required.
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Signature* This field is required.This application consists of three parts provided for review. By signing this application, I hereby establish an IRA under the provided Custodial Agreement (Form 5305) and Account Disclosure Statement. I designate IRA Club as my IRA Administrator. I agree to the terms outlined in the application and have read and examined the IRA Custodial Account Agreement (5305), Account Disclosure, and IRA Club Fee Schedule. I have retained a copy of my account documents, including a copy of this completed application. Please note, each account requires a $500 minimum cash balance.
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