Solera Plan Services IRA LLC 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 IRA LLC. Please provide the information below and we’ll get started promptly.

Please review the Solera Plan Services IRA LLC Terms of Service before you begin.

"*" 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 Line 1 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.

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 someone such as a spouse or adult child help you administer 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 Line 1 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 Solera Plan Service IRA LLC Terms of Service before completing this section.

3rd Party Authorization*

I authorize Solera Plan Services, LLC to file the necessary documents with the state of Colorado. I also authorize Solera Plan Services, 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 Solera Plan Services IRA LLC Terms of Service

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.

Digital Signature*

Enter full legal name

Payment

Solera Plan Services IRA LLC

Price:

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

I have a different billing address

Billing Address

Address Line 1 Address Line 2 City State ZIP Code

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Phone

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