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Solo 401 (k)
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34
Questions
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1
Name
*
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First Name
Middle Name
Last Name
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2
Street Address
*
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3
City
*
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4
State
*
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5
Zip Code
*
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6
DATE OF BIRTH
*
This field is required.
/
Date
Month
Day
Year
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7
Social Security Number
*
This field is required.
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8
PHONE NUMBER
*
This field is required.
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9
EMAIL ADDRESS
*
This field is required.
example@example.com
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10
Name of Business
*
This field is required.
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11
Street Address
*
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12
City
*
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13
State
*
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14
Zip code
*
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15
EIN of Business
*
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16
Nature of Business
*
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17
Type of Entity
Sole Proprietorship
Partnership
C -Corp
S-Corp
LLC
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18
Does the Fiscal Year end in December 31st?
*
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YES
NO
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19
When does your Fiscal Year End?
*
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20
Are you the sole owner of the above-names business?
*
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YES
NO
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21
What Percentage do you own?
*
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22
Please list the name(s) of any owner(s) and their percentages
*
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23
How many w-2 employees are employed by the above named business, other than your spouse?
*
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Zero
One or more
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24
In addition to the above named business, do you own or control any other business?
*
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Yes
No
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25
How many W-2 employees are employed by the other business, other than you and your spouse?
*
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Zero
One or More
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26
How will you Fund Your Account?
*
This field is required.
(Please note, each account requires a $500 minimum cash balance)
IRA to Solo 401(k) Transfer
Old Employer Plan (401k, 403b, 457, TSP)
Contribution
Pension/Annuity
IRA to Solo 401(k) Transfer
Old Employer Plan (401k, 403b, 457, TSP)
Contribution
Pension/Annuity
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27
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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28
Firm Name
*
This field is required.
American Funds
Edward Jones
E-Trade
Fidelity
LPL Financial
Pershing
Charles Schwab
TD Ameritrade
Vanguard
Other
American Funds
Edward Jones
E-Trade
Fidelity
LPL Financial
Pershing
Charles Schwab
TD Ameritrade
Vanguard
Other
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29
Enter Other Firm Name
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30
Transfer Amount (approximately)
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31
Please Upload Supporting Documents
(Optional)
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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of
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32
Old Employers Firm Name
*
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33
Rollover Amount (approximately)
*
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34
Tax Year for Contribution
*
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35
Would you like to add a beneficiary?
Yes
No
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36
Beneficiary's Full Name
*
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37
Beneficiary's DOB
-
Date
Month
Day
Year
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38
Beneficiary's Social Security Number
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39
Share Percentage
*
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40
Relationship to Account Owner
*
This field is required.
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41
How did you hear about IRA Club?
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42
Initials
*
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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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43
Signature Date
*
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-
Date
Month
Day
Year
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44
Terms and Conditions
*
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45
Signature
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.
Clear
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46
My Products
*
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My Bag
2
My Bag
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
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ORDER SUMMARY
Total cost
USD
IRA Club Solo 401(k) Membership
Annual Fee
$
365.00
+
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Application Fee
$
60.00
+
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$500 Dollar Minimum Contribution
$
500.00
+
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47
Payment Methods
Debit Or Credit Card
Select PayPal Method
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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