IRA Club General Application

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What type of Self Directed account would you like to establish?* This field is required.
Traditional IRA
Roth IRA
SEP IRA
SIMPLE IRA
Youth Account (17 Yrs or Younger)
HSA
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Name* This field is required.
First Name
Middle Name
Last Name
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Date of birth* This field is required.
4
Street Address* This field is required.
5
City* This field is required.
6
State* This field is required.
7
Zip Code* This field is required.
8
Social Security Number* This field is required.
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Phone Number* This field is required.
10
EMAIL ADDRESS* This field is required.
example@example.com
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How will you Fund Your Account?* 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 (Powered by Plaid)
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
15
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.(Optional)
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.
18
Rollover Amount (approximately)* This field is required.
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Tax Year for Contribution* This field is required.
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Contribution Amount
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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.
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Beneficiary's Date of birth
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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.
26
Relationship to Account Owner* This field is required.
27
Would you like to grant Third Party access?* This field is required.The designated party will have limited access to your IRA Club account but does not have authorization to transfer funds or make investments on your behalf.
YESNO
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Name of Designated Party
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Firm Name
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Third Party Email
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Third Party Phone Number
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How Did You Hear About Us?* This field is required.
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Please Use Promo Code (Youth) to Waive your Set Up FeePlease Use Promo Code (Youth) to Waive your Set Up Fee
34
Membership Fees (For $0.00 carts, please click NEXT)* This field is required.
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2
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$20
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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
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.
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* This field is required.
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Third Party Access signatureI now and forever hold harmless and release IRA Club and its employees for any and all errors in the execution of this agreement. I further understand and agree that IRA Club and its employees cannot be responsible for all actions that a third party may take. I understand disputes may arise from this agreement. IRA Club will settle disputes in Cook County, Illinois, and that the laws and regulations of Cook County, Illinois shall apply. Separation: I understand the IRA Club is an independent company and is not related to the third party.
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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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Contribute to your IRA Club AccountSign here to start the process and acknowledge your deposit.
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