Académique Documents
Professionnel Documents
Culture Documents
Our priority in servicing our new customers is to ensure that we have all the necessary documentation on
file. This process helps us in protecting the security of each client as well as preparing for future
transactions such as wire, check, and ACH withdrawals.
Below is the required paperwork. Please submit the following via email, fax or mail.
Proof of Address * (If address on application is not on ID) - any financial bank statement, utility bill, or
similar statement within 3 months. (Please make sure the submitted proof of address matches what you entered on
your application)
3 preferred user IDs (letters and numbers only, between 6-32 in length) *
We will make a selection based on availability. Once the User ID is assigned to your account, a password will be
generated automatically from our system, which you will be informed. You may then change your password to
something of your choice.
Individual
IRA or SEP
Account
PLAN ESTABLISHMENT:
Forms needed to establish an IRA Account (Traditional or Rollover):
1. IRA Adoption Agreement
2. Authorization to Transfer Plan Assets to Successor Custodian (complete only if appropriate).
3. IRA Deposit slip
Forms needed to establish a Simplified Employee Pension Plan (SEP):
1. PF10066 – SEP Employer Plan Documentation
2. IRA Account Application (To be completed by each SEP participant)
3. Authorization to Transfer Plan Assets to Successor Custodian (complete only if appropriate).
4. IRA Deposit Slip
Send completed forms along with initial contribution check(s) to your personal broker. All forms should
have original signatures and checks should be made payable to "Apex Clearing Corporation".
NOTE: An individual cash account will be opened with Apex Clearing Corporation (If you are opening a
spousal IRA two separate accounts should be opened). The title of this account will be:
NAME OF PARTICIPANT
APEX C/F TYPE OF ACCOUNT (Traditional IRA, Rollover IRA, SEP IRA)
PARTICIPANT ADDRESS
ELIGIBILITY:
Traditional IRA - You can establish and contribute to an IRA if you received taxable compensation (as defined in
IRS Pub. 590) during the year and will not reach the age of 70 1/2 by the end of the year. Contributions for 2015 -
2016 may not exceed the lesser of 100% of compensation or $5,500 ($6,500 for individuals 50 years of age or
better). If you maintain multiple IRA accounts, the maximum aggregate contribution to all of the accounts cannot
exceed these totals. An IRA for any year may be opened and funded at any time before the due date for filing your
tax return, not including any extensions.
Rollover IRA - If you received an eligible rollover distribution from your employer's qualified pension, profit
sharing or stock bonus plan, annuity plan, or tax sheltered annuity plan (403(b) plan), you can roll over all or
part of it into an IRA. Rollover contributions must be made by the 60th day after the day you receive a distribution
from your employer's plan in order to continue their tax-deferred status. Effective for distributions taken on or after
January 1, 2015, you are permitted to roll over only one distribution from an IRA (Traditional, Roth, or SIMPLE)
in a 12‐month period, regardless of the number of IRAs you own. A distribution may be rolled over to the same
IRA or to another IRA that is eligible to receive the rollover.
SEP IRA - Any employer, including a sole proprietor with no employees, can establish a SEP for the benefit of all
eligible employees. The owner of the business is also considered an employee who is eligible to receive a SEP
contribution. Up to the lesser of 25% of compensation or $53,000 can be contributed annually for an eligible
employee (or such other amount provided by law). An eligible employee who receives a SEP contribution can also
make an annual IRA contribution as described above. A SEP IRA may be opened and funded up until the
employer's tax filing deadline, including extensions.
BEFORE EXECUTING THESE FORMS YOU SHOULD CONSULT WITH YOUR ATTORNEY OR TAX
ADVISOR TO DETERMINE WHETHER THIS IRA WILL ACCOMPLISH YOUR GOALS.
ACCOUNT NUMBER
Please print. All Information must be completed in order for your account to be processed.
1. Account FULL NAME OF PARTICIPANT (First/ Middle/ Last)
Information
SOCIAL SECURITY/ INDIVIDUAL TAXPAYER IDENTIFICATION NUMBER DATE OF BIRTH
BUSINESS ADDRESS
OCCUPATION EMPLOYER
IF YOU ARE AFFILIATED WITH OR WORK FOR A SECURITIES FIRM, PLEASE SPECIFY COMPANY.
IF YOU ARE A DIRECTOR, 10% SHAREHOLDER OR POLICY-MAKING OFFICER OF A PUBLICLY TRADED COMPANY, PLEASE SPECIFY THE COMPANY.
HAVE YOU GRANTED TRADING AUTHORIZATION TO ANOTHER PARTY? IF YES, REQUEST TRADING AUTHORIZATION FORM AND PROVIDE NAME OF AGENT
Yes No
If you do not want your name, address and security position released to requesting companies in which you hold securities,
please check here.
INVESTMENT ANNUAL INCOME LIQUID NET WORTH ESTIMATED NET WORTH RISK
2. Investment INVESTMENT OBJECTIVE (excluding residence)
EXPERIENCE (from all sources) (cash & liquid investments only) TOLERANCE
Profile ____ Capital Preservation (05) ____ None (00) ___ Under $25,000 (01) ___ Under $50,000 (01) ___ Under $50,000 (01) ____ Low (01)
____ Income (04) ____ Limited (01) ___ $25,001 to $50,000 (02) ___ $50,001 to $100,000 (02) ___ $50,001 to $100,000 (02) ____ Medium (02)
____ Growth (03) ____ Good (02) ___ $50,001 to $100,000 (03) ___ $100,001 to $200,000 (22) ___ $100,001 to $200,000 (22) ____ High (03)
____ Speculation (06) ____ Extensive (03) ___ $100,001 to $200,000 (23) ___ $200,001 to $500,000 (23) ___ $200,001 to $500,000 (23)
___ $200,001 to $300,000 (24) ___ $500,001 to $1,000,000 (24) ___ $500,001 to $1,000,000 (24)
____ Other (08)
___ $300,001 to $500,000 (25) ___ $1,000,001 to $5,000,000 (25) ___ $1,000,001 to $5,000,000 (25)
TAX BRACKET ___ $500,001 to $1,200,000 (26) ___ Over $5,000,001 (26) ___ Over $5,000,001 (26)
% ___ Over $1,200,001 (27)
3. Suitability TIME HORIZON LIQUIDITY NEEDS The ability to quickly and easily convert all or a portion of the
The number of years planned to invest to achieve a particular financial goal. account assets into cash without experiencing significant loss.
Information ___ Short (Less than 3 Years) (01) ___ Longest (8 years or more) (03) ___ Very Important (01) ___ Not Important (03)
___ Average (4 to 7 Years) (02) ___ Somewhat Important (02)
(Check One)
4. Type of Traditional IRA Rollover Account SEP - Simplified Employee Pension Account
Account NAME OF BUSINESS
(Check One)
5. Contribution
Regular IRA contribution for tax year 20 _____
Type
Rollover from an IRA, employer-sponsored retirement plan or 403(b)
SEP IRA, contribution for tax year 20 _____ (employer will make SEP contribution to participants IRA account)
Transfer of existing IRA or SEP IRA
ACCOUNT NUMBER
8. Trusted Contact Please see the 'Trusted Contact' section under the Final Disclosure for more information
NAME
MAILING ADDRESS
9. Beneficiary I hereby make the following designation of beneficiary pursuant to the provisions of the Apex Clearing Corporation
Designation Custodial Agreement:
In the event of my death, pay any interest I may have in my Custodial Account in equal proportions unless otherwise indicated to the
following Primary Beneficiary or Beneficiaries:
Primary NAME RELATIONSHIP DATE OF BIRTH SHARE PERCENTAGE
Beneficiary or %
Beneficiaries 1 ADDRESS SOCIAL SECURITY NUMBER
If none of the above-named Primary Beneficiaries survives me, pay any interest I may have in my Custodial Account in equal
proportions unless otherwise indicated to the following Alternate Beneficiary or Beneficiaries of the survivor(s) thereof:
Alternate NAME RELATIONSHIP DATE OF BIRTH SHARE PERCENTAGE
Beneficiary or %
Beneficiaries 1 ADDRESS SOCIAL SECURITY NUMBER
I understand that the Beneficiaries named herein may be changed or revoked by me at any time by filing a new designation in writing
with the custodian.
Spouse Consent (See Note):__________________________________________________
Note: Consent of the Account holder's (Participant) Spouse may be required (for example, in a Community Property or Marital
Property State) to effectively designate a beneficiary other than or in addition to the Participant's Spouse. Please consult a legal, tax, or
other professional advisor to confirm if this consent is necessary. I indemnify Apex Clearing Corporation from any adverse action
as a result of my beneficiary designation.
The custodian named on the application has given the Depositor the disclosure (b) If the Depositor dies before the required beginning date, the remaining interest
statement required by Regulations section 1.408-6. will be distributed in accordance with (i) below or, if elected or there is no
designated beneficiary, in accordance with (ii) below.
The Depositor has assigned the custodial account the sum indicated on the application.
(i) The remaining interest will be distributed in accordance with paragraphs
The Depositor and the custodian make the following agreement: (a)(i) and (a)(ii) above (but not over the period in paragraph (a)(iii), even if
longer), starting by the end of the calendar year following the year of the
ARTICLE I
Depositor’s death. If, however, the designated beneficiary is the
Except in the case of a rollover contribution described in section 402(c), 403(a)(4),
403(b)(8), 408(d)(3), or 457(e)(16), an employer contribution to a simplified employee Depositor’s surviving spouse, then this distribution is not required to begin
pension plan as described in section 408(k), or a recharacterized contribution described before the end of the calendar year in which the Depositor would have
in section 408A(d)(6), the custodian will accept only cash contributions up to $3,000 per reached age 70½. But, in such case, if the Depositor’s surviving spouse
year for tax years 2002 through 2004. That contribution limit is increased to $4,000 for
tax years 2005 through 2007 and $5,000 for 2008 and thereafter. For individuals who dies before distributions are required to begin, then the remaining interest
have reached the age of 50 before the close of the tax year, the contribution limit is will be distributed in accordance with (a)(ii) above (but not over the period
increased to $3,500 per year for tax years 2002 through 2004, $4,500 for 2005, $5,000 in paragraph (a)(iii), even if longer), over such spouse’s designated
for 2006 and 2007, and $6,000 for 2008 and thereafter. For tax years after 2008, the
above limits will be increased to reflect a cost-of-living adjustment, if any. beneficiary’s life expectancy, or in accordance with (ii) below if there is no
such designated beneficiary.
ARTICLE II
(ii) The remaining interest will be distributed by the end of the calendar year
The Depositor’s interest in the balance in the custodial account is nonforfeitable.
containing the fifth anniversary of the Depositor’s death.
ARTICLE III 4. If the Depositor dies before his or her entire interest has been distributed and if the
1. No part of the custodial account funds may be invested in life insurance contracts, designated beneficiary is not the Depositor’s surviving spouse, no additional
nor may the assets of the custodial account be commingled with other property contributions may be accepted in the account.
except in a common trust fund or common investment fund (within the meaning of
5. The minimum amount that must be distributed each year, beginning with the year
section 408(a)(5)).
containing the Depositor’s required beginning date, is known as the “required
2. No part of the custodial account funds may be invested in collectibles (within the minimum distribution” and is determined as follows.
meaning of section 408(m)) except as otherwise permitted by section 408(m)(3),
(a) The required minimum distribution under paragraph 2(b) for any year,
which provides an exception for certain gold, silver, and platinum coins, coins
beginning with the year the Depositor reaches age 70½, is the Depositor’s
issued under the laws of any state, and certain bullion.
account value at the close of business on December 31 of the preceding year
divided by the distribution period in the uniform lifetime table in Regulations
ARTICLE IV
section 1.401(a)(9)-9. However, if the Depositor’s designated beneficiary is his
1. Notwithstanding any provision of this agreement to the contrary, the distribution of
or her surviving spouse, the required minimum distribution for a year shall not
the Depositor’s interest in the custodial account shall be made in accordance with
be more than the Depositor’s account value at the close of business on
the following requirements and shall otherwise comply with section 408(a)(6) and
December 31 of the preceding year divided by the number in the joint and last
the regulations thereunder, the provisions of which are herein incorporated by
survivor table in Regulations section 1.401(a)(9)-9. The required minimum
reference.
distribution for a year under this paragraph (a) is determined using the
2. The Depositor’s entire interest in the custodial account must be, or begin to be, Depositor’s (or, if applicable, the Depositor and spouse’s) attained age (or
distributed not later than the Depositor’s required beginning date, April 1 following ages) in the year.
the calendar year in which the Depositor reaches age 70½. By that date, the
(b) The required minimum distribution under paragraphs 3(a) and 3(b)(i) for a
Depositor may elect, in a manner acceptable to the custodian, to have the balance in
year, beginning with the year following the year of the Depositor’s death (or
the custodial account distributed in: (a) A single sum or (b) Payments over a period the year the Depositor would have reached age 70½, if applicable under
not longer than the life of the Depositor or the joint lives of the Depositor and his or paragraph 3(b)(i)) is the account value at the close of business on December 31
her designated beneficiary. of the preceding year divided by the life expectancy (in the single life table in
3. If the Depositor dies before his or her entire interest is distributed to him or her, the Regulations section 1.401(a)(9)-9) of the individual specified in such
remaining interest will be distributed as follows: paragraphs 3(a) and 3(b)(i).
(a) If the Depositor dies on or after the required beginning date and: (c) The required minimum distribution for the year the Depositor reaches age 70½
can be made as late as April 1 of the following year. The required minimum
(i) the designated beneficiary is the Depositor’s surviving spouse, the distribution for any other year must be made by the end of such year.
remaining interest will be distributed over the surviving spouse’s life
6. The owner of two or more Traditional IRAs may satisfy the minimum distribution
expectancy as determined each year until such spouse’s death, or over the
requirements described above by taking from one Traditional IRA the amount
period in paragraph (a)(iii) below if longer. Any interest remaining after
required to satisfy the requirement for another in accordance with the regulations
the spouse’s death will be distributed over such spouse’s remaining life
under section 408(a)(6).
expectancy as determined in the year of the spouse’s death and reduced by
one for each subsequent year, or, if distributions are being made over the ARTICLE V
period in paragraph (a)(iii) below, over such period. 1. The Depositor agrees to provide the custodian with all information necessary to
(ii) the designated beneficiary is not the Depositor’s surviving spouse, the prepare any reports required by section 408(i) and Regulations sections 1.408-5 and
remaining interest will be distributed over the beneficiary’s remaining life 1.408-6.
expectancy as determined in the year following the death of the Depositor 2. The custodian agrees to submit to the Internal Revenue Service (IRS) and Depositor
and reduced by one for each subsequent year, or over the period in paragraph the reports prescribed by the IRS.
(a)(iii) below if longer.
You may designate one or more persons or entities as beneficiary of your 8.10 Resignation or Removal of Custodian – We may resign as Custodian at
IRA. This designation can only be made on a form provided by or acceptable any time upon 30 days written notice to the Participant. Upon
to us, and it will only be effective when it is filed with us during your resignation, we may, but shall not be required to, appoint a successor
lifetime. Unless otherwise specified each beneficiary designation you file with custodian under this Agreement; provided that any successor custodian
us will cancel all previous designations. The consent of your beneficiary(ies) shall satisfy the requirements of Code section 408(a)(2). Upon any such
will not be required for you to revoke a beneficiary designation. If you have successor’s acceptance of appointment, we shall transfer the assets of
designated both primary and contingent beneficiaries and no primary the custodial account, together with copies of relevant books and
beneficiary(ies) survives you, the contingent beneficiary(ies) will acquire the records, to such successor custodian; provided, however, that we are
designated share of your IRA. If you do not designate a beneficiary or if all authorized to reserve such sum of money or property as we may deem
advisable for payment of any liabilities constituting a charge on or
against the assets of the custodial account, or on or against us. We shall
not be liable for the acts or omissions of any successor custodian. If no
If we are required to comply with Regulations section 1.408–2(e), and If any part of this agreement is held to be illegal or invalid, the remaining
we fail to do so, or we are not keeping the records, making the returns or parts will not be affected. Neither your nor our failure to enforce at any time
sending the statements as are required by forms or Regulations, the IRS or for any period of time any of the provisions of this agreement will be
may, after notifying you, require you to substitute another trustee or construed as a waiver of such provisions, or your right or our right thereafter
custodian. to enforce each and every such provision.
We may establish a policy requiring distribution of the entire balance of 8.18 Arbitration – This agreement contains a Predispute Arbitration Clause.
your IRA to you in cash or property if the balance of your IRA drops By Signing an Arbitration Agreement the Parties agree as follows:
below the minimum balance required under the applicable investment or
A. All parties to this agreement are giving up the right to sue each
policy established. other in court, including the right to a trial by jury except as
provided by the rules of the Arbitration form in which a claim
Termination of Custodial Account - You may terminate this is filed;
Agreement at any time upon notice to us in a manner and form B. Arbitration awards are generally final and binding; a party’s
acceptable to us. Upon such termination, we shall transfer the assets of ability to have a court reverse or modify an arbitration award
the custodial account, reduced by the amount of any unpaid fees or is very limited.
C. The liability of the parties to obtain documents, witness
expenses, to the custodian or trustee of another individual retirement statements and other discovery i s generally more limited in
account (within the meaning of Code section 408) or other retirement Arbitration than in court proceedings;
plan designated by you. We shall not be liable for losses arising from the D. The Arbitrators do not have to explain the reason(s) for their
acts, omissions, delays or other inaction of any such transferee award unless in an eligible case, a joint request for an
explained decision has been submitted by all parties to the
custodian or trustee. If we receive notice of your intention to terminate
panel at least 20 days prior to the first scheduled hearing
the custodial account and you have not designated a transferee custodian date.
or trustee for the assets in the custodial account, the custodial account E. The panel of Arbitrators will typically include a minority of
reduced by any unpaid fees or expenses, will be distributed to you. Arbitrators who were or are affiliated with the securities
industry.
8.11 Successor Custodian – If our organization changes its name, F. The rules of some Arbitration forums may impose time limits
reorganizes, merges with another organization (or comes under the for bringing a claim in Arbitration. In some cases, a claim that
control of any federal or state agency), or if our entire organization (or is ineligible for Arbitration may be brought in court.
any portion that includes your IRA) is bought by another organization, G. The rules of the Arbitration forum in which the claim is filed,
and any amendments thereto, shall be incorporated into this
that organization (or agency) will automatically become the trustee or
agreement.
custodian of your IRA, but only if it is the type of organization
authorized to serve as an IRA trustee or custodian. The following Arbitration Agreement should be read in conjunction
with the disclosures above. Any and all controversies , disputes or
8.12 Amendments and Termination of the Plan – We have the right to amend claims between the Customer and You, or the Introducing Broker,
or terminate this agreement at any time consistent with the provisions of or the Agents, Representatives, Employees, Directors, Officers, or
applicable law without obtaining your consent, or the consent of your Control Persons of You or The Introducing Broker, Arising out
spouse or your beneficiary(ies). You will be deemed to have consented to of, in connection with, from or with respect to (a) Any
any other amendment unless, within 30 days from the date we send the provisions of or the validity of this agreement or any related
amendment, you notify us in writing that you do not consent. agreements, (b) The relationship of the parties hereto, or (c)
8.13 Withdrawals or Transfers – All requests for withdrawal or transfer will be Any controversy arising out of your business, the
in writing on a form provided by or acceptable to us. The method of Introducing Broker’s business or t h e Customer’s accounts,
distribution must be specified in writing or in any other method acceptable to Shall be conducted pursuant to the code of Arbitration
us. The tax identification number of the recipient must be provided to us procedure of the Financial Industry Regulatory Authority
before we are obligated to make a distribution. Withdrawals will be subject to (“FINRA”). Arbitration must be commenced by service of a
all applicable tax and other laws and regulations, including but not limited to written demand for Arbitration or a written Notice of Intention
possible early distribution penalty taxes, surrender charges, and withholding to Arbitrate. The decision and award of the Arbitrator(s) shall
requirements. be conclusive and binding upon all parties and any judgment
upon any award rendered may be entered in a court having
8.14 Transfers From Other Plans – We can receive amounts transferred to this jurisdiction thereof, and neither party shall oppose such
IRA from the trustee or custodian of another IRA. In addition, we can accept entry.
direct rollovers of eligible rollover distributions from employer-sponsored
retirement plans as permitted by the Code. We reserve the right not to accept No person shall bring a putative or certified class action to
any transfer or direct rollover. arbitration, nor seek to enforce any pre-dispute arbitration
agreement against any person who has initiated in court a putative
8.15 Liquidation of Assets – We have the right to liquidate assets in your IRA if class action; or who is a member of a putative class who has not
necessary to make distributions or to pay fees, expenses, taxes, penalties, or opted out of the class with respect to any claims encompassed by the
surrender charges properly chargeable against your IRA. If you fail to direct us putative class action until: (i) the class certification is denied; or (ii)
as to which assets to liquidate, we will decide, in our complete and sole the class is de-certified; or (iii) the customer is excluded from the
discretion, and you agree to not hold us liable for any adverse consequences class by the court. Such forbearance to enforce an agreement to
that result from our decision. arbitrate shall not constitute a waiver of any rights under this
8.16 Restrictions on the Fund – Neither you nor any beneficiary may sell, agreement except to the extent stated herein.
transfer, or pledge any interest in your IRA in any manner whatsoever, except 8.19 Payment For Order Flow/Order Routing - “Payment for order flow” is
as provided by law or this agreement. a common and widespread industry practice whereby a brokerage firm
The assets in your IRA will not be responsible for the debts, contracts, or receives monetary or non-monetary remuneration in return for the routing
torts of any person entitled to distributions under this agreement. of customer orders toa designated exchange, market maker, dealer, or
market center for execution. Apex Clearing receives payment for order
8.17 What Law Applies – This agreement is subject to all applicable federal and
GENERAL INSTRUCTIONS
Section references are to the Internal Revenue Code unless otherwise noted.
PURPOSE OF FORM
Form 5305-A is a model custodial account agreement that meets the requirements
of section 408(a) and has been pre-approved by the IRS. A Traditional individual
retirement account (Traditional IRA) is established after the form is fully
executed by both the individual (Depositor) and the custodian and must be
completed no later than the due date (excluding extensions) of the individual’s
income tax return for the tax year. This account must be created in the United
States for the exclusive benefit of the Depositor and his or her beneficiaries.
Do not file Form 5305-A with the IRS. Instead, keep it with your records.
For more information on IRAs, including the required disclosures the Custodian
must give the Depositor, see Pub. 590, Individual Retirement Arrangements (IRAs).
DEFINITIONS
Custodian – The custodian must be a bank or savings and loan association, as
defined in section 408(n), or any person who has the approval of the IRS to act as
custodian.
Depositor – The Depositor is the person who establishes the custodial account.
IDENTIFYING NUMBER
The Depositor’s Social Security number will serve as the identifying number of his or
REQUIREMENTS OF AN IRA We reserve the right to do any one of the following by April 1 of the year
following the year in which you turn age 70½.
A. CASH CONTRIBUTIONS – Your contribution must be in cash, unless it is a
rollover contribution. (a) Make no distribution until you give us a proper withdrawal request
B. MAXIMUM CONTRIBUTION – The total amount you may contribute to an (b) Distribute your entire IRA to you in a single sum payment
IRA for any taxable year cannot exceed the lesser of 100 percent of your
compensation or $5,500 for 2014 and 2015, with possible cost-of-living (c) Determine your required minimum distribution each year based on your life
adjustments each year thereafter. If you also maintain a Roth IRA (i.e., an IRA expectancy calculated using the Uniform Lifetime Table, and pay those
subject to the limits of Internal Revenue Code Section (IRC Sec.) 408A), the distributions to you until you direct otherwise
maximum contribution to your Traditional IRAs is reduced by any contributions
you make to your Roth IRAs. Your total annual contribution to all Traditional If you fail to remove a required minimum distribution, an additional penalty
IRAs and Roth IRAs cannot exceed the lesser of the dollar amounts described tax of 50 percent is imposed on the amount of the required minimum
above or 100 percent of your compensation. Deposits received by us without an
distribution that should have been taken but was not. You must file IRS Form
IRA Contribution Form will be deposited and reported to the IRS in accordance
with the following policy: 5329 along with your income tax return to report and remit any additional taxes
to the IRS.
1. Any deposit we receive below the IRS Annual Contribution Limit for your
account will be deposited and reported to the IRS as Current Year 3. Your designated beneficiary is determined based on the beneficiary(ies)
Contributions (CYC). We will not aggregate deposits, and multiple deposits designated as of the date of your death, who remain your beneficiary(ies) as of
below the IRS limit will all be reported to the IRS as CYC and could result in September 30 of the year following the year of your death.
an over-contribution in your account. If you die on or after your required beginning date, distributions must be made to
2. Deposits we receive above the IRS Annual Contribution Limit for your your beneficiary(ies) over the longer of the single life expectancy of your
account will be deposited and reported to the IRS as Rollover Contributions. designated beneficiary(ies), or your remaining life expectancy. If a beneficiary
other than an individual or qualified trust as defined in the Treasury Regulations
C. Contribution Eligibility – You are eligible to make a regular contribution to your
is named, you will be treated as having no designated beneficiary of your IRA for
IRA if you have compensation and have not attained age 70½ by the end of the
purposes of determining the distribution period. If there is no designated
taxable year for which the contribution is made.
beneficiary of your IRA, distributions will commence using your single life
D. Catch-Up Contributions – If you are age 50 or older by the close of the taxable expectancy, reduced by one in each subsequent year.
year, you may make an additional contribution to your IRA. The maximum
If you die before your required beginning date, the entire amount remaining in
additional contribution is $1,000 per year.
your account will, at the election of your designated beneficiary(ies), either
E. Nonforfeitability – Your interest in your IRA is nonforfeitable.
(a) be distributed by December 31 of the year containing the fifth anniversary of
F. Eligible Custodians – The custodian of your IRA must be a bank, savings and loan your death, or
association, credit union, or a person or entity approved by the Secretary of the
Treasury. (b) be distributed over the remaining life expectancy of your designated
beneficiary(ies).
G. Commingling Assets – The assets of your IRA cannot be commingled with
other property except in a common trust fund or common investment fund. If your spouse is your sole designated beneficiary, he or she must elect either
option (a) or (b) by the earlier of December 31 of the year containing the fifth
H. Life Insurance – No portion of your IRA may be invested in life insurance anniversary of your death, or December 31 of the year life expectancy
contracts.
payments would be required to begin. Your designated beneficiary(ies), other
I. Collectibles – You may not invest the assets of your IRA in collectibles (within than a spouse who is the sole designated beneficiary, must elect either option
the meaning of IRC Sec. 408(m)). A collectible is defined as any work of art, rug (a) or (b) by December 31 of the year following the year of your death. If no
or antique, metal or gem, stamp or coin, alcoholic beverage, or other tangible election is made, distribution will be calculated in accordance with option
personal property specified by the Internal Revenue Service (IRS). However, (b). In the case of distributions under option (b), distributions must
specially minted United States gold and silver coins, and certain state-issued commence by December 31 of the year following the year of your death.
coins are permissible investments. Platinum coins and certain gold, silver, Generally, if your spouse is the designated beneficiary, distributions need not
platinum, or palladium bullion (as described in IRC Sec. 408(m)(3)) are also commence until December 31 of the year you would have attained age 70½,
permitted as IRA investments. if later. If a beneficiary other than an individual or qualified trust as defined
J. Required Minimum Distributions – You are required to take minimum in the Treasury Regulations is named, you will be treated as having no
distributions from your IRA at certain times in accordance with Treasury designated beneficiary(ies) of your IRA for purposes of determining the
Regulation 1.408-8. Below is a summary of the IRA distribution rules. distribution period. If there is no designated beneficiary of your IRA, the
Service Fees: We have the right to charge an annual service fee and other designated
fees (e.g., a transfer, rollover or termination fee) in conjunction with your
IRA. In addition, we have the right to be reimbursed for all reasonable
expenses, including legal expenses, we incur in connection with the
administration of your IRA. We may charge you separately for any fees or
expenses, or we may deduct the amount of the fees or expenses from the
assets in your IRA at our discretion. The full annual service fee attributable
to the year in which you terminate your IRA, along with the termination fee,
shall be due and payable upon termination of your IRA regardless of the date
during the year in which you terminate your IRA. We reserve the right to
charge any additional fee upon 30 days’ notice to you that the fee will be
effective. Fees such as sub transfer agent fees or commissions may be paid
to us by third parties for assistance in performing certain transactions with
respect to this IRA.
Any brokerage commissions attributable to the assets in your IRA will be
charged to your IRA. You cannot reimburse your IRA for those
commissions.
The value of your IRA will be solely dependent upon the performance of any
investment instrument chosen by you to fund your IRA. Therefore, no projection of
the growth of your IRA can be reasonably shown or guaranteed. There are certain
fees and charges associated with the investments you may select for your IRA. In the
event this agreement is terminated or you transfer out of your existing IRA, a fee
will apply. Additionally, brokerage commissions may apply according to your
selection of investments. Questions relative to brokerage commission(s) should be
discussed with your broker or investment advisor prior to executing any orders or
you may refer to the prospectus which will describe the terms of the investment you
choose.
You will select the type of investment for your IRA assets, provided, however, that
your selection of investments shall be limited to any investment vehicle obtainable
by us, that we are authorized by our charter, articles of incorporation, or bylaws to
offer and do in fact, in our sole discretion offer for investment in IRAs.. For
example, investments may include but shall not be limited to common stocks,
government and corporate bonds, mutual funds, the purchase of put options on
existing positions and writing of covered listed call options and such other options
strategies that we may, from time to time, in our sole discretion make available for
IRAs and which strategies are approved for your account by your broker.
Investments not generating confirmations must be accompanied by additional
written instructions and such other documentation as we may, in our sole discretion,
require. We shall act as a stockbroker or dealer whenever such services are
required. We may, in our sole discretion, make available to you, additional
investment offerings, which shall be limited to publicly traded securities, mutual
funds, money market instruments and other investments that are obtainable by us
and that we, in our sole discretion, determine that we are capable of holding in the
ordinary course of our business.
Trusted Contact
“Under FINRA Rule 4512 Apex Clearing Corporation is required to disclose to
you (the customer) that Apex Clearing Corporation or an associated person of
Apex Clearing Corporation is authorized to contact the trusted contact person and
disclose information about the customer’s account to address possible financial
exploitation, to confirm the specifics of the customer’s current contact
information, health status, or the identity of any legal guardian, executor, trustee or
holder of a power of attorney, or as otherwise permitted by FINRA Rule 2165.”
ESTABLISHMENT Your Employer has adopted a type of Employee benefit plan known as a simplified employee pension (SEP) plan.
OF SEP PLAN To become a Participant in the Plan, you must meet the Plan’s eligibility requirements specified below. Once you
become a Participant, you are entitled to receive a certain share of the amounts your Employer contributes to the Plan.
All contributions will be deposited into a Traditional IRA for you. Contributions made to the Plan for you are yours to
keep. These features of the Plan are explained further in the accompanying Employee Information Booklet.
The actual Plan is a complex legal document that has been written in a manner required by the Internal Revenue Service.
The SEP Summary for Employees, however, is designed to explain and summarize the important features of the Plan. If
you have any questions or need additional information about the Plan, consult _______________________________ .
(Name of Employer Representative)
You may examine the Plan itself at a reasonable time by making arrangements with the above-mentioned
representative of your Employer.
ELIGIBILITY Employer Contributions: Your Employer is not required to make contributions to the Plan. However, if a
contribution is made, your IRA will receive a share of that contribution if you are an “eligible” Employee and if you
have met the age and service requirements set forth below.
Eligible Employees: Under the SEP Plan, all Employees can participate except the classifications of Employees
checked below:
Those Employees covered by the terms of a collective bargaining agreement (a union agreement) where
retirement benefits were negotiated.
Those Employees who are nonresident aliens who received no United States earned income from the Employer.
Those Employees that are determined to be acquired Employees as a result of an acquisition or similar
transaction with the Employer as described in the Code (during the transition period only).
Those Employees who did not earn at least $$1'from the Employer during the year. (7his amount
is subject to cost-of-living adjustments.)
CONTRIBUTION The amount of the Employer Contribution, if any, will be determined according to the formula selected below:
FORMULA Discretionary: An amount determined each year by the Employer.
Fixed Percent of Profits Formula: ________ % of the Employer’s profits in excess of $______________.
The Employer will not make Employer contributions to the SEP Plan.
Any Employer Contribution will be allocated to your IRA in accordance with the formula selected below:
Pro Rata Formula: Each eligible Employee will receive a pro rata portion of the Employer Contribution equal
to the ratio of his or her Compensation to the total Compensation of all eligible Employees. Thus, the
contribution will be the same percentage of Compensation for all Employees.
Flat Dollar Formula: The Employer Contribution for all eligible Employees will be the same dollar amount.
Integrated Formula: Integration allows contribution percentages among eligible Employees to vary. Details
about integration are provided in your Employee Information Booklet. The integration level is:
The Taxable Wage Base (TWB); or _______% of the TWB.
YES NO
REQUIREMENTS 1. Do you own or control a business from which your personal services are an income
producing factor?
If the answer is NO, STOP. You are not eligible to establish this Plan.
3. Is the business a member of an affiliated service group within the meaning of IRC
Section 414(m)?
4. Does the business use the services of leased employees within the meaning of IRC
Section 414(n)?
If you answered any of the above questions 2 through 4 YES, you may have to include the leased employees
and/or Employees of the other business(es) in this Plan. Consult your tax advisor to determine what
additional action, if any, you must take.
I certify that: 1. I am an authorized representative of the Employer and the Employer is eligible to
establish the SEP Plan of the Prototype Sponsor.
2. In determining my eligibility to adopt this Plan, I relied solely upon the advice of my
own advisors.
3. I agree not to hold the Prototype Sponsor responsible for any liabilities I may suffer as a
result of being found ineligible to establish this Plan.
DATE EXECUTED
TYPE NAME OF EMPLOYER
SIGNATURE OF EMPLOYER
These instructions are designed to help you, the Employer, along with your attorney and/or tax advisor, establish your SEP Plan. The instructions
are meant to be used only as a general guide and are not intended as a substitute for qualified legal or tax advice.
ADOPTION AGREEMENT
We recommend that you obtain the advice of your legal or tax advisor before you sign the Adoption Agreement.
EMPLOYER INFORMATION
Fill in the requested information.
If this is a new SEP Plan, check Option A and fill in the Effective Date. The Effective Date is usually the first day of the Plan Year in which this
Adoption Agreement is signed. For example, if an Employer maintains a Plan on a calendar year basis and this Adoption Agreement is signed on
September 24, 2013, the Effective Date would be January 1, 2013.
If the reason you are adopting this Plan is to amend and replace an existing SEP Plan, check Option B. The existing SEP Plan which will be
replaced is called a “Prior Plan.” You will need to know the Effective Date of the Prior Plan. The best way to determine its Effective Date is to
refer to the Prior Plan Adoption Agreement. The Effective Date of this amendment and restatement is usually the first day of the Plan Year in
which the Adoption Agreement is signed.
Within limits, you as the Employer can specify the number of years your Employees must work for you and the age they must attain before they
are eligible to participate in this Plan. Note that the eligibility requirements which you set up for the Plan also apply to you.
Suppose, for example, you establish a service requirement of three of the immediately preceding five years and an age requirement of 21. In that
case, only those Employees (including yourself) who have worked for you for three of the immediately preceding five years and are at least 21
years old are eligible to participate in this Plan.
If Employees will be given credit for service with a predecessor Employer, fill in the name of the predecessor Employer.
1. Generally, you are permitted to exclude Employees covered by the terms of a collective bargaining agreement (e.g., a union agreement)
where retirement benefits were bargained for. If you wish to exclude those Employees, check the first box under Section Three, Part D.
2. You are permitted to exclude those Employees who are nonresident aliens with no U.S. income. If you wish to exclude those Employees,
check the second box under Section Three, Part D.
3. You are permitted to exclude those Employees that are classified as Acquired Employees due to an acquisition or similar transaction described in
the Code (during a transition period). If you wish to exclude those Employees, check the third box under Section Three, Part D.
4. You are permitted to exclude those Employees who have received less than $550 FOR 2012 and 2013 (indexed for cost-of-living
adjustments) of compensation during the plan year. If you want to exclude those Employees, check the fourth box under Section Three, Part
D.
Part A. Compensation
Select either Option 1, 2, or 3 depending on how the Plan will define Compensation for purposes of Employer Contributions. Refer to the
Definitions Section of the Plan for a description as to the Code requirements for each of these choices.
OTHER ITEMS
• Provide an Employee Information Booklet and a completed SEP Summary for Employees to each Employee.
• Make sure that all eligible Employees have established IRAs.
EMPLOYER INFORMATION
Name of Adopting Employer
Address
City State Zip
Telephone Adopting Employer’s Income Tax Year End
(month) (day)
Adopting Employer’s Federal Tax Identification Number
For purposes of determining whether an Employee has met the service requirement, an Employee shall be given credit for
service with the following predecessor employer(s). (Complete if applicable)
NOTE: If no option is selected in Part B, Option 1 (Pro Rata Formula) shall be deemed to be selected.
SECTION 5. COMPENSATION AND PLAN YEAR ELECTIONS Complete Parts A and B, as appropriate.
Part A. Compensation
For purposes of Employer Contributions, Compensation will mean all of each Participant’s: (Select one)
Option 1: W-2 wages.
Option 2: Section 3401(a) wages.
Option 3: 415 safe-harbor compensation.
NOTE: If no option is selected, Option 1 shall be deemed to be selected.
If the initial Plan Year is a short Plan Year (i.e., less than 12 months), specify such Plan Year’s beginning and ending dates.
SECTION 6. There are no elections required for Section Six. Refer to the Basic Plan Document for information regarding this section.
DEFINITIONS
ADOPTING EMPLOYER Means any corporation, sole proprietor, or other adjustments shall be made in multiples of $5,000. (The Compensation limit
entity named in the Adoption Agreement and any successor who by merger, for 2002 is $200,000.) If a Plan determines Compensation for a period of time
purchase, or otherwise, assumes the obligations of the Plan. that contains fewer than 12 calendar months, then the annual Compensation
limit is an amount equal to the annual Compensation limit for the calendar
ADOPTION AGREEMENT Means the document executed by the year in which the Compensation period begins multiplied by a fraction, the
Employer through which it adopts the Plan and thereby agrees to be bound by numerator of which is the number of full months in the short Compensation
all terms and conditions of the Plan. period, and the denominator of which is 12.
BASIC PLAN DOCUMENT Means this prototype plan document. EARNED INCOME Means the net earnings from self-employment in the
CODE Means the Internal Revenue Code of 1986 as amended. trade or business with respect to which the Plan is established, for which
personal services of the Self-Employed Individual are a material
COMPENSATION As elected by the Adopting Employer in the Adoption income-producing factor. Net earnings will be determined without regard to
Agreement, Compensation shall mean one of the following, except as items not included in gross income and the deductions allocable to such items.
otherwise specified in the Plan: Net earnings are reduced by contributions by the Employer to a qualified plan
or to a Simplified Employee Pension plan to the extent deductible under Code
1. W-2 Wages. (Information required to be reported under Code sections section 404.
6041, 6051, and 6052 (wages, tips, and other compensation as reported
on Form W-2)). Compensation is defined as wages within the meaning EMPLOYEE Means any person who is employed by the Employer as a
of Code section 3401(a) and all other payments of compensation to an common law employee and, if the Employer is a sole proprietorship or
Employee by the Employer (in the course of the Employer’s trade or partnership, any Self-Employed Individual who performs services with
business) for which the Employer is required to furnish the Employee a respect to the trade or business of the Employer as described in Code section
written statement under Code sections 6041(d), 6051(a)(3), and 6052. 401(c)(1). Further, any employee of any other employer required to be
Compensation must be determined without regard to any rules under aggregated under Code sections 414(b), (c), (m), or (o) and, unless otherwise
Code section 3401(a) that limit the remuneration included in wages indicated in the Adoption Agreement, any leased Employee required to be
based on the nature or location of the employment or the services treated as an employee of the Employer under Code section 414(n) shall also
performed (such as the exception for agricultural labor in Code section be considered an Employee.
3401(a)(2)).
EMPLOYER Means the Adopting Employer and any successor who by
2. 3401(a) Wages. Compensation is defined as wages within the meaning merger, consolidation, purchase, or otherwise assumes the obligations of the
of Code section 3401(a) for the purposes of income tax withholding at Plan. A partnership is considered to be the Employer of each of the partners
the source but determined without regard to any rules that limit the and a sole proprietorship is considered to be the Employer of the sole
remuneration included in wages based on the nature or location of the proprietor.
employment or the services performed (such as the exception for
agricultural labor in Code section 3401(a)(2)). If the Adopting Employer is a member of a controlled group of corporations
(as defined in Code section 414(b)), a group of trades or businesses under
3. 415 Safe-Harbor Compensation. Compensation is defined as wages, common control (as defined in Code section 414(c)), an affiliated service
salaries, and fees for professional services and other amounts received group (as defined in Code section 414(m)), or is required to be aggregated
(without regard to whether or not an amount is paid in cash) for personal with any other entity as defined in Code section 414(o), then for purposes of
services actually rendered in the course of employment with the the Plan, the term Employer shall include the other members of such groups or
Employer maintaining the SEP Plan to the extent that the amounts are other entities required to be aggregated with the Adopting Employer.
includible in gross income (including, but not limited to, commissions
paid to salespersons, compensation for services on the basis of a IRA Means a Traditional individual retirement account or Traditional
percentage of profits, commissions on insurance premiums, tips, individual retirement annuity, which satisfies the requirements of Code
bonuses, fringe benefits, and reimbursements or other expense section 408(a) or (b).
allowances under a nonaccountable plan (as described in Regulations PARTICIPANT Means any Employee who has met the eligibility
section 1.61-2(c), and excluding the following: requirements of Section 3.01 of the Plan and Section Three of the Adoption
(a) Employer contributions to a plan of deferred compensation which Agreement, and who is or may become eligible to receive an Employer
are not includible in the Employee’s gross income for the taxable Contribution.
year in which contributed, or Employer Contributions under a SEP PLAN Means the prototype SEP Plan adopted by the Employer that is
plan, or any distributions from a plan of deferred compensation; intended to satisfy the requirements of Code section 408(k). The Plan consists
(b) Amounts realized from the exercise of a nonqualified stock option, of the Basic Plan Document plus the corresponding Adoption Agreement as
or when restricted stock (or property) held by the employee either completed and signed by the Employer.
becomes freely transferable or is no longer subject to a substantial PLAN YEAR Means the 12-consecutive month period which coincides with
risk of forfeiture; the Employer’s taxable year or such other 12-consecutive month period as is
(c) Amounts realized from the sale, exchange, or other disposition of designated in the Adoption Agreement.
stock acquired under a qualified stock option; and PRIOR PLAN Means a plan which was amended or replaced by adoption of
(d) Other amounts which received special tax benefits, such as this Plan, as indicated in the Adoption Agreement.
premiums for group-term life insurance (but only to the extent the
premiums are not includible in the gross income of the employee). PROTOTYPE SPONSOR Means the entity specified in the Adoption
Agreement that makes this prototype Plan available to employers for
Compensation shall include only that Compensation which is actually paid or adoption.
made available to the Participant during the Plan Year.
REGULATIONS Means the Treasury Regulations.
A Participant’s Compensation shall include any elective deferral described in
Code section 402(g)(3) or any amount that is contributed by the Employer at SELF-EMPLOYED INDIVIDUAL Means an individual who has Earned
the election of the Employee and that is not includible in the gross income of Income for a Plan Year from the trade or business for which the Plan is
the Employee under Code sections 125, 132(f)(4), or 457. established; also, an individual who would have had Earned Income but for
the fact that the trade or business had no net profits for the Plan Year.
The annual Compensation of each Participant taken into account under the
Plan for any year shall not exceed the Compensation limit described in Code TAXABLE WAGE BASE Means, with respect to any taxable year, the
section 401(a)(17) as adjusted by the Secretary of the Treasury for increases in contribution and benefit base in effect under Section 230 of the Social
the cost-of-living in accordance with Code section 401(a)(17)(B). Such Security Act at the beginning of the Plan Year.
#419(9/2002) ©2007 Ascensus, Inc., Brainerd, MN
PF10066-QPNA 04/17/2017
SECTION ONE ESTABLISHMENT AND PURPOSE OF PLAN
1.01 PURPOSE The purpose of this Plan is to provide, in accordance 1.03 USE WITH IRA This prototype Plan must be used with an IRS
with its provisions, a Simplified Employee Pension plan providing model IRA (Form 5305 or Form 5305-A) or any other plan that
benefits upon retirement for the individuals who are eligible to satisfies Code section 408(a) or 408(b).
participate hereunder.
A. Collective Bargaining Unit Employees. A collective B. Notification of Eligibility. The Employer shall notify each
bargaining unit Employee is an Employee included in a unit of Employee who becomes a Participant of his or her status as a
Employees covered by a collective bargaining agreement Participant in the Plan and of his or her duty to establish an
between the Employer and Employee representatives, if IRA to which Employer Contributions may be made.
retirement benefits were the subject of good faith bargaining C. Establishment of an IRA. If a Participant fails to establish
and if two percent or less of the Employees who are covered an IRA within a reasonable period of time after receiving
pursuant to that agreement are professionals as defined in notice from the Employer pursuant to Section 3.03(B) of the
Regulations section 1.410(b)-9. For this purpose, the term Plan, the Employer may execute any necessary documents to
“Employee representatives” does not include any organization establish an IRA on behalf of the Participant.
more than half of whose members are Employees who are
owners, officers, or executives of the Employer. 3.04 DETERMINATIONS UNDER THIS SECTION The Employer
B. Non-Resident Aliens. A non-resident alien is an Employee shall determine the eligibility of each Employee to be a Participant.
who is a non-resident alien (within the meaning of Code This determination shall be conclusive and binding upon all persons
section 7701(b)(1)(B)) and who received no earned income except as otherwise provided herein or by law.
(within the meaning of Code section 911(d)(2)) from the
Employer which constitutes income from sources within the 3.05 LIMITATION RESPECTING EMPLOYMENT Neither the fact
United States (within the meaning of Code section 861(a)(3)). of the establishment of the Plan nor the fact that an Employee has
become a Participant shall give to that Employee any right to
C. Acquired Employees. An acquired Employee is an Employee continued employment; nor shall either fact limit the right of the
who would be employed by another employer that has been Employer to discharge or to deal otherwise with an Employee
involved in an acquisition or similar transaction described without regard to the effect such treatment may have upon the
under Code section 410(b)(6)(C) with the Employer, had the Employee’s rights under the Plan.
transaction not occurred.
Section Seven of the Adoption Agreement must contain the signature of an authorized representative of the Adopting Employer evidencing the Employer’s agreement
to be bound by the terms of the Basic Plan Document and Adoption Agreement.
10. Q. Can I select the financial organization where I set up the IRA which
is to receive the SEP Plan contributions made on my behalf?
A. Generally, you may select the financial organization where you set up
the IRA which is to receive SEP Plan contributions made on your
behalf.
15. Q. Do I need to file any additional forms with the IRS because I
participate in a SEP plan?
A. No.
18. Q. My Employer has indicated in the SEP Summary for Employees that
contributions will be allocated using the “integrated formula.” What
does this mean and how does it affect me?
A. If the Plan uses the integrated formula, the Employer contribution for
Employees who have Compensation in excess of the integration level
will be a higher percentage than the contribution made for Employees
whose Compensation is below the integration level. The integration
level is indicated on the SEP Summary for Employees.
Allocating contributions under the integrated formula involves a four-
step process, which is explained below.
STEP 1: An amount is allocated for each eligible Employee not in
excess of three percent of the Employee’s total
Compensation.
STEP 2: Eligible Employees with Compensation greater than the
integration level receive an allocation not in excess of three
percent of their Compensation above the integration level.
REMAINING
TO BE
ALLOCATED $20,000 $12,860 $11,876 $4,564