SECTION B: PHOTO IDENTIFICATION

Complete this section with the information contained on your current government-issued photo ID (Driver’s License, Passport, etc). In addition, you MUST ATTACH A LEGIBLE COPY OF THE PHOTO ID to the application form. This requirement is part of the government’s fight against terrorism and money laundering activities required under the US Patriot Act and other Federal regulations. These laws and regulations require that financial institutions obtain, verify, and record certain identifying information from an individual seeking to open a new account. We are required to obtain and verify name, address, social security number and other information that will allow us to identify you. After your application has been received, a representative from IRA Services Trust Company may contact you to confirm the information provided.

SECTION C: Account Type Designation & Preposed Account Transfer/Opening Balance

Select the option for the type of account you wish to open. Complete a separate application form if you wish to open different account types.

If you are opening a Traditional or Roth IRA and it is a beneficial account where you are the beneficiary, you must complete the INHERITED IRA ACCOUNT form and attach it to your application. 

If you are opening a SEP IRA, please attach a copy of the plan document (or IRS Form 5305-SEP).

If you are opening a SIMPLE IRA, please attach a copy of the plan document (or IRS Form 5304-SIMPLE).

DESIGNATE ACCOUNT TYPE:

Select only one account type below. Complete a separate application form if you wish to open different account types.

D. BENEFICIARY DESIGNATION, INTERNET ACCESS & REPRESENTATIVE AUTHORIZATION

BENEFICIARY DESIGNATION - Complete and attach the BENEFICIARY DESIGNATION form. Use as many pages as necessary. Each page must be complete, signed by you and dated. You must show the percentage share each beneficiary is to receive and the percentages must add to 100% for each type of beneficiary, primary or secondary. In community or marital property states, if anyone other than the spouse is named as primary beneficiary, the spouse must sign all beneficiary designation forms.

INTERNET ACCESS - You may gain access to your account online, through our website at www.IRAServices.com, by completing the INTERNET ACCESS REQUEST form. Submit it with this application form, or submit it at a later time by fax to 650-745-2902 or by email to [email protected]. Please ensure that the e-mail address you provided above in Section A is a valid email address; a temporary password and instructions on how to view your account online will be sent to that email address when we establish your online access.

REPRESENTATIVE AUTHORIZATION - If you wish to designate a representative for your account, complete and attach a REPRESENTATIVE AUTHORIZATION form. The person you designate as an authorized representative will be able to gain access to your account information, however, they will not be able to execute any transactions on your behalf unless they provide us with a Power of Attorney.

E. FUNDING YOUR ACCOUNT AND/OR TRANSFERRING OR ROLLING OVER ASSETS IN-KIND

There is a minimum balance requirement of $300. See our FEE SCHEDULE & FINANCIAL DISCLOSUREfor details.

It is recommended that you fund your account with at least $600 more than your intended investment amount so there are sufficient funds to cover the amount of your investment, the investment purchase fees and the $300 minimum balance requirement. Your investment request will not go out if you have insufficient funds in your account to cover fees and the $300 minimum balance requirement. If you intend to transfer or rollover assets in-kind, please read the instruction sheet for more information; you are still expected to maintain the $300 minimum balance requirement, so please fund your account accordingly.     

I will fund my account by:
(check all that apply; refer to the instruction sheet for an explanation of your funding options)

Transferring cash and/or assets in-kind from another IRA – Complete and submit a TRANSFER AUTHORIZATION form with your most recent statement  from the financial institution from which you are transferring.

Rolling over cash and/or assets in-kind from another or qualified retirement plan         

Cash rollovers:

I will submit a DEPOSIT INFORMATION form when the cash rollover is deposited to my IRA Services Trust Company account. I understand that I will have to initiate a cash rollover by contacting my other IRA custodian or my Plan Administrator, and I acknowledge that this will be a rollover contribution of a distribution from another IRA, or of a lump sum distribution or plan termination distribution paid to me within one taxable year from a qualified employee benefit plan or annuity, either of which is contributed to this IRA within 60 days of receipt of such funds. 

In-kind rollovers:

If rolling over assets in-kind, I understand that I must submit a DEPOSIT INFORMATION form indicating my intent to rollover my asset(s) within the 60-day rollover period. If the asset has been distributed to me, I will attach a copy of the Assignment/Change of Ownership document or distribution notice from my prior custodian.

Making a contribution - I have attached a contribution check, and have completed and attached a DEPOSIT INFORMATION form.

Converting an existing Traditional, SEP and/or SIMPLE account(you may select this option only if you have designated “Roth” as the  account type in Section C above) – I have completed and attached a ROTH CONVERSION & RECHARACTERIZATION REQUEST form.