IRA ACCOUNT APPLICATION
(ONLINE)		 Marsco Investment Corporation
101 Eisenhower Parkway
Roseland, NJ 07068
Member FINRA/SIPC
www.marsco.com 1-800-962-7726
Fax: 973-228-9762		 

									
									
   

   

				 
				 Secure Application
  	

  	

  		1.
  		Account Type
  	

  	

  		 
  		    Traditional IRA  
  		Rollover IRA  SEP IRA  Roth IRA  For other Account Types please apply by mail
  		    Please tell us how you heard about Marsco   
  		
  	

  		

			  		2.
			  		
			  			

			  				

			  						OWNER
			  						BENEFICIARY
			  				

			  				

			  						
			  							

			  								

			  									First Name
			  									MIDDLE
			  									LAST
			  								

			  								

															
															
															
													

			  							

			  								
			  						
											 

												 

													   I hereby designate the person(S) named below as my primary beneficiary(ies) to receive
payment of the balance of my Marsco IRA account upon my death:		
												 

											 

													
										

			  					

											
												

													

														Street Address
													

													

															
													

												

													
											
											

												

													 
													PRIMARY BENEFICIARY #1
													PRIMARY BENEFICIARY #2
												

												

													  NAME
													
													
												

											

													
			  					

			  					

											
												

													

														City
														State
														Zip
													

													

															
															
															
													

												

													
											
											

													

														  Relationship
														
														
												

											

													
			  					

			  					

											
												

													

														Home Phone
														WORK #
														CELL #
													

													

															
															
															
													

												

													
											
											

											

													  DESIGNATED %
													
													
												

											

													
			  					

			  					

											
												

													

														SOCIAL SECURITY NUMBER OR TAX ID NUMBER
														Date of Birth
													

													

															
															
													

												

													
											
											

											

													  Address
													
													
												

											

													
			  					

			  					

											
												

													

														Citizenship   U.S   Resident Alien
													

												

													
											
											

												

													  CITY, STATE
													
													
												

											

													
			  					

			  					

											
												

													

														Occupation   
													

												

													
											
											

														

																  SOC SEC #
																
																
												

											

													
			  					

			  					

											
												

													

															Employer Name
														

														

																
													

												

													
											
											 

											  

													   BIRTHDATE
													 
													 
												 

											 

											 

																							  

																									   TO INCLUDE ADDITIONAL PRIMARY BENEFICIARIES AND/OR CONTINGENT BENEFICIARIES,
PLEASE COMPLETE AND MAIL/FAX THE IRA DESIGNATION OF BENEFICIARY FORM AVAILABLE
IN THE FORM CENTER. SPOUSAL CONSENT IS REQUIRED IN MARITAL PROPERTY
STATES - CA,ID,NM,TX,WA,AZ,LA,NV,WI		
																								 

											 

													
			  					

			  			

			  				
  	

  	

			 3.
			 Funding Your Account VIA Electronic Funds Transfer OR Account Transfer From Another Firm
  	

  	

				 
				ELECTRONIC FUNDS TRANSFER (ACH): ABA NUMBER    Bank Account Number  
  	

  	

  		 
  		Bank Name    City    State    Zip  
  	

  	

			  
			 Initial Deposit Request $    CONTRIBUTION TYPE 
			  CURRENT YR 
			  PRIOR YR 
			  ROLLOVER  
			 Account Type  Checking 
  		Savings
  	

  	

			  		 
			  		
			  				

			  					

			  							

			  							AND/OR
			  							

			  					

			  				

			  					
  	

  	

			  
			 ACCOUNT TRANSFER FROM ANOTHER BROKERAGE/FINANCIAL INSTITUTION:  Name of Financial Institution  
  	

  	

				 
				Your Account #    Estimated Net Value  
  	

  	

				 
				  YOUR ENTIRE ACCOUNT WILL BE TRANSFERRED IN KIND, THE ACCOUNT TITLE MUST BE IDENTICAL TO SECTION 2 ABOVE.
  	

  	

				4.
				EMAIL ADDRESS                                    You may simply log into your account to view, print, or save your documents.
  	

  	

			  
				EMAIL ADDRESS     * Required for initial receipt of User ID and Temporary Password
  	

  	

				5.
				PLEASE ANSWER THE FOLLOWING FINANCIAL INFORMATION AND ACKNOWLEDGEMENTS
  	

  		

				  
			  
			   

			   	

								
									

										

												APPROXIMATE ANNUAL
INCOME		
												*ESTIMATED NET
WORTH		
												*INVESTABLE ASSETS
										

										

											  Under $25,000
											  Under $25,000
											  Under $25,000
										

											

												  $25,001 - $50,000
												  $25,001 - $100,000
												  $25,001 - $100,000
										

											

												  $50,001 - $100,000
												  $100,001 - $500,000
												  $100,001 - $500,000
										

										

											  $100,000+
											  $500,000+
											  $500,000+
										

									

										 
										*(Exclusive of home)
										*(including cash & securities)
										

									

										
								
									

										

												INVESTMENT OBJECTIVES:  GROWTH  INCOME  TRADING/SPECULATION  
										

										

												(I understand that my trading strategies are at my own discretion.)
										

										

												

										

										

												Is any applicant employed by or affiliated with a securities firm, a securities ex-
change or the NASD?  YES  NO		
										

										

												

										

										

												Is the applicant an officer, director, affiliate or 10% shareholder of a publicly
traded company?  YES-CUSIP    NO		
										

									

										
			  	

			  

			  

						6.
						Account Agreement
  	   

  	  

							 
							I hereby request that a brokerage account is established with Marsco Investment Corporation. I understand that Marsco is a discount brokerage firm that accepts customer orders to trade securities without advice. I accept responsibility for and understand that my investment decisions and trading strategies are at my sole discretion and risk.
ELECTRONIC FUNDING (ACH): I hereby authorize Marsco to initiate credit/debit entries to the bank account indicated above and further authorize my Bank to debit the same to such account. This authority Is to remain in full force and effect until Marsco has received written notification from me (or either of us) of its termination in such time and in such manner as to afford Marsco and our Bank reasonable Opportunity to act on it.		
							

						

							 
							ACCOUNT TRANSFER: I hereby authorize the above named Financial Institution to transfer all assets in my account to Marsco. I understand that to the extent that any assets in my account are not readily transferable, such assets may not be transferred within the required time frame. I authorize the delivering firm to liquidate any nontransferable money market assets and transfer the resulting credit balance.
 SECTION 1  GENERAL ACCOUNT AGREEMENT I acknowledge that I have read, understood and agree to the terms and conditions set forth in the General Account Agreement available at www. Marsco.com and request that you accept one or more accounts in my name. I understand and agree that my account(s) will be governed by this Agreement and I am at least 18 years of age and of full legal age in the state in which I reside.		
						

						

							 
							SECTION 2 - TAXPAYER CERTIFICATION (Substitute W-9) - Under penalties of perjury I certify that:
 1. The taxpayer identification number (TIN) shown on this form is correct (or I am waiting for one to be issued to me), and
 2. I am not subject to backup withholding either because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends or (c ) was notified by the IRS that I am no longer subject to backup withholding, and
 3. I am a U.S. person (including a U.S. resident alien).
 CERTIFICATION INSTRUCTIONS Cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because of underreporting interest or dividends on your tax return. For real estate transactions, item 2 does not apply.		
						

						

							 
							You are not required to sign the Certification for mortgage interest paid, the acquisition or abandonment of secured property, contributions to anindividual retirement arrangement (IRA), and generally payments other than interest and dividends, but you must provide your correct TIN.
  	  

  	  

						 
						SECTION 3 - APPOINTMENT OF EQUITY TRUST COMPANY AS TRUSTEE -I appoint Equity Trust Company to serve as Trustee. By making this appointment I agree to and acknowledge the following:
  • I have read and understand the Trust Agreement, Disclosure Statement, and Schedule of Trustee Fees in the IRA Document Booklet and agree to abide by the terms of the plan document.
  • I have read and understand the information provided in the Instructions in the IRA Document Booklet regarding float.
  • I agree to pay all applicable fees described in the Schedule of Trustee Fees, which may be changed from time to time. Any fee changes will be communicated to me in writing by Equity Trust Company. If I do not pay such Trustee fees directly, I authorize Marsco, as "custodian" to debit such Trustee fees from my retirement plan account.
  • I understand Equity Trust Company is not an investment advisor and does not endorse any particular investment. I agree to use independent judgment in making my investment decisions.
  • I agree to resolve disputes with Equity Trust Company through binding arbitration. See Article 5.8G of the Trust Agreement.
  •  I certify that the above social security number(s) are true and correct.

  	  

  	  

						 
						THIS AGREEMENT CONTAINS A PRE-DISPUTE ARBITRATION CLAUSE IN PARAGRAPH 6 ON PAGE 2 OF THE GENERAL ACCOUNT AGREEMENT. I ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT AND ACCEPT ITS TERMS PER MY SIGNATURE BELOW.YOU WILL BE SIGNING YOUR APPLICATION WITH AN ELECTRONIC SIGNATURE, WHICH ACKNOWLEDGES CONSENT AND IS CONSIDERED LEGALLY BINDING, JUST AS IF YOU HAD MANUALLY SIGNED THE APPLICATION.
  	  

				

						 
						

		  

		  

						 
						Account Holder Electronic Signature    Date