Solo 401 (k) General

1
Name* This field is required.
First Name
Middle Name
Last Name
2
Street Address* This field is required.
3
City* This field is required.
4
State* This field is required.
5
Zip Code* This field is required.
6
DATE OF BIRTH* This field is required.
Date
Month
Day
Year
7
Social Security Number* This field is required.
8
PHONE NUMBER* This field is required.
9
EMAIL ADDRESS* This field is required.
example@example.com
10
Name of Business* This field is required.
11
Street Address* This field is required.
12
City* This field is required.
13
State* This field is required.
14
Zip code* This field is required.
15
EIN of Business* This field is required.
16
Nature of Business* This field is required.
17
Type of Entity
Sole Proprietorship
Partnership
C -Corp
S-Corp
LLC
18
Does the Fiscal Year end in December 31st?* This field is required.
YESNO
19
When does your Fiscal Year End?* This field is required.
20
Are you the sole owner of the above-names business?* This field is required.
YESNO
21
What Percentage do you own?* This field is required.
22
Please list the name(s) of any owner(s) and their percentages* This field is required.
23
How many w-2 employees are employed by the above named business, other than your spouse?* This field is required.
Zero
One or more
24
In addition to the above named business, do you own or control any other business?* This field is required.
Yes
No
25
How many W-2 employees are employed by the other business, other than you and your spouse?* This field is required.
Zero
One or More
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
27
Here is a guide to help you with your rollover.This guide will also be attached in your email as a link.
28
Firm Name* This field is required.
American Funds
Edward Jones
E-Trade
Fidelity
LPL Financial
Pershing
Charles Schwab
TD Ameritrade
Vanguard
Other
29
Enter Other Firm Name
30
Transfer Amount (approximately)
31
Please Upload Supporting Documents(Optional)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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32
Old Employers Firm Name* This field is required.
33
Rollover Amount (approximately)* This field is required.
34
Tax Year for Contribution* This field is required.
35
Would you like to add a beneficiary?
Yes
No
36
Beneficiary's Full Name* This field is required.
37
Beneficiary's DOB
Date
Month
Day
Year
38
Beneficiary's Social Security Number
39
Share Percentage * This field is required.
40
Relationship to Account Owner* This field is required.
41
How did you hear about IRA Club?
42
My Products* This field is required.
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My Bag
2
My Bag
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
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Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
Total costUSD
IRA Club Solo 401(k) Membership Annual Fee
$365.00+Edit
Back
Application Fee
$60.00+Edit
Back
$500 Dollar Minimum Contribution
$500.00+Edit
Back
Enter Coupon
Total cost $0.00
My Products
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43
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.
44
Signature Date* This field is required.
Date
Month
Day
Year
45
Terms and Conditions* This field is required.
46
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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