Checkbook IRA LLC Application (SNB) -

We look forward to helping you unlock your retirement plan and start investing as you choose with a Safeguard Checkbook IRA LLC. Please provide the information below and we’ll get started promptly.

Please review our Checkbook IRA LLC Terms of Service before you begin.

If you would prefer, you may download a Checkbook IRA LLC Application to complete offline. Use this option if you wish to pay by check.

"*" indicates required fields

Contact Information

Tell us about you.

IRA Account Holder*

Enter your full legal name

Prefix First M.I. Last Suffix

Phone*

Primary/Daytime Phone Number

Email*

Primary email address

Primary/Tax Address*

No PO boxes allowed. Will be used as official tax address of plan.

Street Address Address Line 2 City State Zip Code

County / Parish*

Please enter the county or parish associated with your primary address.

Mailing Address

I have a different mailing address

Mailing Address

Address Address Line 2 City State Zip Code

LLC Formation Details

LLC Name Choice*

Provide a unique name for the new LLC. Use exact punctuation and spelling. Names must include the LLC suffix. Examples: ABC Investment Holdings, LLC or Riverside Properties, LLC. Your name does not need to be included, nor does there need to be mention that an IRA is involved. Simple and anonymous is good.

Alternate LLC Name Choice*

Please enter a 2nd name choice that is distinct from your primary choice.

LLC State of Formation*

The LLC state should be where the activities of the LLC will create nexus, and may not be your state of residence. Your Safeguard Advisor should have recommended the appropriate state for your situation. We do not form LLC's in California, New York, or Massachusetts. Speak to your Safeguard Advisor if your investment interests will take place in any of these states for an alternate entity structure.

LLC Registered Agent*

A LLC must name a registered agent, which is the individual or business designated to receive delivery of official summons. This must be a resident of the state or a separate state-licensed business with a physical in-state address where notice may be delivered during normal business hours. You may act as your own agent only if the LLC is formed in your state of residency.

I will be the registered agent

Please appoint a commercial registered agent ($49 setup, $40 annual fee)

I wish to designate my own agent (individual or business)

Email Preference*

Some states collect an email address as part of the LLC filing process and use that email to send official notifications to the LLC. It may be required or optional. When optional, the email may or may not be in the public record. If no email is provided, all state communications will be via US mail.

Provide email in all cases

Provide email only when private

Do not provide email if possible

Co-Manager

Only appoint a co-manager if you have another person who will be ACTIVELY involved in helping you administer investments and who needs bank signing authority. This may be a spouse, adult child, attorney, etc. This role is NOT related to plan inheritance.

Co-Manager (Optional)*

Will another person such as your spouse be actively involved in managing plan investments?

No Co-Manager

Appoint a Co-Manager

Co-Manager Name

Enter the full legal name of the Co-Manager

Co-Manager Address

Same as Primary Address

Address Address Line 2 City State ZIP Code

Co-Manager as Bank Signer

Will your co-manager be actively involved in the present-day administration of your LLC and need to have signing authority on the bank account? NOTE: They will need to complete a separate Solera Bank application for identification purposes.

Yes. The Co-Manager needs bank signing authority.

Co-Manager Email

Provide a unique email address for the co-manager different from the one you provided for yourself.

Co-Manager Phone

IRA Type and Funding

Please tell us more about your plan configuration and funding sources.

New IRA Type*

The new IRA type needs to match the tax type of funds being rolled over from your current plan. If you have a mix of tax-deferred and Roth funds, they cannot be combined into a single plan. Please contact your advisor for assistance.

Traditional IRA (From Traditional IRA, Rollover IRA or other tax-deferred retirement plan)

Roth IRA (From existing Roth IRA or Roth portion of an employer plan)

Inherited IRA*

Is this an IRA you have inherited?

Yes

Traditional IRA Funding Source(s)*

Check all that apply

Traditional or Rollover IRA

SEP IRA

SIMPLE IRA (must be at least 2 years old)

Employer Plan Tax-Deferred (401k, 403b, 457, TSP, pension, etc.)

New Contribution to the IRA

Roth IRA Funding Source(s)*

Check all that apply

Roth IRA

Employer Plan Roth Account (401k, 403b, 457, TSP, etc.)

New Contribution to the IRA

Initial Funding Amount*

A rough estimate of the full amount you intend to contribute, transfer, or rollover into your plan initially.

Acknowledgements

Please review the Safeguard Checkbook IRA LLC Terms of Service before completing this section.

3rd Party Authorization*

I authorize Safeguard Advisors, LLC to file the necessary documents with the state where the LLC will be formed. I also authorize Safeguard Advisors, LLC to act as a 3rd party designee on my behalf to apply for and receive an EIN from the IRS, and to answer questions about completion of form SS-4.

I have read and agree to the Safeguard Checkbook IRA LLC Terms of Service

Annual Custodial Fee Subscription*

I acknowledge and accept that a $199 per year IRA custodial fee will be billed via credit card subscription beginning in the first anniversary month of plan setup and every year thereafter. The credit card used for this invoice will be used by default. An option will be provided to specify an alternate card after plan setup has been completed.

Digital Signature*

Enter full legal name

Payment

Your Safeguard Relationship Fee can be paid personally or from the IRA. We recommend against paying from a Roth IRA account and wasting tax-free money on plan fees. If you wish to pay from the IRA, please provide a $300 deposit at this time. We will send a secondary invoice authorizing payment of the balance from the IRA once the IRA is setup. The $300 deposit may be reimbursed to you from the IRA LLC once formed. If payment from the IRA does not take place within 45 calendar days, we will charge the card provided for the balance due.

Safeguard Checkbook IRA LLC

Price:

Registered Agent Service

Yes - $49

Coupon Code

Enter a coupon code if one was provided with your plan proposal.

Payment Option

Pay in Full

Pay $300 Deposit

Payment Option

Pay in Full

Pay $300 Deposit

Payment Option

Pay in Full

Pay $300 Deposit

Payment Option

Pay in Full

Pay $300 Deposit

Payment Option

Pay in Full

Pay $300 Deposit

Total Due Today

If your billing address is different than your primary address, please provide it here.

I have a different billing address

Billing Address

Address Address Line 2 City State / Province / Region ZIP / Postal Code

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Comments

This field is for validation purposes and should be left unchanged.

Contact Information

LLC Formation Details

Co-Manager

IRA Type and Funding

Acknowledgements

Payment

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