LINQTO APPLICATION

1
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
Solo 401(k)
2
Name of Business* This field is required.
3
Address of Business* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
EIN of Business* This field is required.
5
Nature of Business* This field is required.
6
When Does the fiscal year end?* This field is required.
December 31st
Other
7
Please Specify * This field is required.
8
Type of Entity* This field is required.
Sole Proprietorship
Partnership
C -Corp
S-Corp
LLC
9
Are you the sole owner of the above-named business?* This field is required.
Yes
No
10
What Percentage of the business do you own?* This field is required.
11
Please List the name(s) of any other owner(s) and their percentage(s)* This field is required.
12
How many W-2 employees are employed by the above-named business, other than you and your spouse?* This field is required.
Zero
One or more
13
In addition to the above-named business, do you own or control any other business?* This field is required.
Yes
No
14
How Many W-2 employees are employed by other business, other than you and your spouse?* This field is required.
Yes
No
15
Name* This field is required.
First Name
Last Name
16
Street Address* This field is required.
17
City* This field is required.
18
State* This field is required.
19
Zip Code* This field is required.
20
DATE OF BIRTH* This field is required.
Date
Month
Day
Year
21
Social Security Number* This field is required.
22
PHONE NUMBER* This field is required.
23
EMAIL ADDRESS* This field is required.
example@example.com
24
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
Pension/Annuity
25
Here is a guide to help you with your rollover.This guide will also be attached in your email as a link.
26
Firm Name* This field is required.
American Funds
Edward Jones
E-Trade
Fidelity
LPL Financial
Pershing
Charles Schwab
TD Ameritrade
Vanguard
Other
27
Enter Other Firm Name
28
Transfer Amount (approximately)
29
Please Upload Supporting Documents(Optional)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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30
Old Employers Firm Name* This field is required.
31
Rollover Amount (approximately)* This field is required.
32
Tax Year for Contribution* This field is required.
33
Would you like to add a beneficiary?
Yes
No
34
Beneficiary's Full Name* This field is required.
35
Beneficiary's DOB
Date
Month
Day
Year
36
Beneficiary's Social Security Number
37
Share Percentage * This field is required.
38
Relationship to Account Owner* This field is required.
39
How did you hear about IRA Club?
40
Credit Card Information (Fee Arrangement)* This field is required.
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ORDER SUMMARY
Total costUSD
IRA Club MembershipAnnual Fee
$175.00Edit
Back
ApplicationOne time set up fee
$35.00Edit
Back
$500 Dollar Minimum Contribution
$500.00Edit
Back
Enter Coupon
Total cost $0.00
First Name
Last Name
41
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.
42
Signature Date* This field is required.
Date
Month
Day
Year
43
Terms and Conditions* This field is required.
44
SignatureThis 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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