Solera Plan Services Solo 401(k) Application -

Let’s get started!

We look forward to helping you unlock your retirement plan and start investing as you choose with a Solera Plan Services Solo 401(k). Please provide the information below and we’ll get started promptly.

Please review the Solera Plan Services Solo 401(k) Terms of Service before you begin.

"*" indicates required fields

Contact Information

Tell us about you.

Plan Participant & Primary Trustee*

Please 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 address.

Enter a different billing address

Billing Address

Please provide the billing address for your payment card if different than the primary address.

Street Address Address Line 2 City State ZIP Code

Business Information

Tell us about your business that will sponsor the Solo 401(k) as an employee benefit plan.

Employer Name*

Your business name as registered with the state. Your name if you are a sole proprietor.

Business Entity Type*

What is the business type?

Sole Proprietorship

LLC (Incl. LLC taxed as S-Corp.)

Partnership / LLP

S-Corporation

C-Corporation

Other

Date of Incorporation*

Enter date of business formation for a corporation.

Tax Year End Date*

Enter the last date of the tax year if other than December 31 (MM/DD),

Last 4 Digits of Employer EIN*

Enter the last 4 digits of the EIN of the sponsoring employer if a business or your SSN if a sole proprietor.

Other Plans Sponsored by This Business*

Has this business that will be setting up the Solo 401(k) sponsored one or more of the following employee benefit retirement plans (past or current).

No Prior Employer Plans

401(k) or other qualified employer plan

SEP IRA

SIMPLE IRA

Additional Businesses*

Do you and/or your spouse have ownership in other businesses that may be considered a Control Group or Affiliated Service Group? If yes, we will contact you for additional details.

Yes

Trustees & Participants

Tell us who will have control over the plan and who will hold retirement savings within the plan. Any person who will have signing authority will be sent their own Solera Bank application and need to provide identity verification.

Co-Trustee & Additional Particpant*

A co-trustee has discretionary power to administer the plan just like the primary trustee. A co-trustee may or may not also be a plan participant. A plan participant is a spouse or business partner who is employed by and compensated by the business, and will hold retirement savings within the plan.

No Co-Trustee

Appoint a Co-Trustee (non-participant)

Appoint a Co-Trustee who is also a plan participant

Co-Trustee Name*

Enter the full name of the Co-Trustee

Co-Trustee Address*

Same as Primary Address

Street Address Address Line 2 City State ZIP Code

Co-Trustee Email*

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

Co-Trustee Phone*

Co-Trustee as Bank Signer*

Will your co-trustee need to have signing authority on plan bank accounts?

Yes. The Co-Trustee needs bank signing authority.

Bank Accounts to Setup

A separate bank account will be setup for each participant and tax type. Pease tell us the types of accounts you will need for your plan. An account needs to exist for any type of funds you plan to rollover or contribute to the plan. Contact our team if you need assistance. You can skip this section and complete your application if you are unsure.

Primary Participant Accounts Needed

Traditional Tax-Deferred

Roth

Additional Participant Accounts Needed

Traditional Tax-Deferred

Roth

I Need Assistance

If you are unsure about account types, please check this box. A Solera Plan Services consultant will reach out to help. We need this information before we can setup your Solera Bank accounts, which is several days into the process.

Please contact me to help with bank accounts

Qualification and Acknowledgements

Please review the Solera Plan Services Solo 401(k) Terms of Service before completing this section.

Representation of Plan Eligibility*

I represent that I am self-employed and have no full time employees as described in the Solo 401(k) Terms of Service

3rd Party Designee*

I authorize Solera Plan Services, LLC to act as a 3rd party designee on my behalf to apply for and receive an EIN for this 401(k) plan from the IRS, and to answer questions about completion of form SS-4.

Monthly Fee Subscription*

I acknowledge and accept that a $5 per month services fee will be billed via credit card subscription beginning in the month following plan setup. 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.

I have read and agree to the Solera Plan Services Solo 401(k) Terms of Service

Digital Signature*

Enter full legal name

Payment

Solera Plan Services Solo 401(k) Plan

Price:

Coupon

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Phone

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