DS4 IRA Trust

Discount Solo 401K

Checkbook IRA Trust Application
We look forward to helping you unlock your retirement plan and start investing as you choose with a DS4 Checkbook IRA Trust. Please provide the information below and we’ll get started promptly.
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Contact Information

IRA Account Holder
Primary Trustee Full Name*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Primary/Tax Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County or Parish*
YesNo
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Social Security Number*
This is needed to apply for the Trust and IRA EIN's

Trust Information
Trust Name*
All names will end in "Investment Trust". Example: Acme Investment Trust. 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.
Co-Trustee

Only appoint a co-trustee 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. A successor trustee will take over administration of the trust in the event of your incapacitation or death.
Appoint a Co-TrusteeNo Co-Trustee
Co-Trustee Name*
Full Legal Name of Co-Trustee
Co-Trustee Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Co-Trustee as Bank Signer

Will your Co-Trustee be actively involved in the present-day administration of your Trust 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-Trustee needs bank signing authorityNo, the Co-Trustee does not need signing authority

Acknowledgements
Date*

MonthDayYear
Date
Signature*

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My Products*

DS4 IRA Trust

$549.00 Quantity

Enter coupon

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Form SS-4 (Rev. December 2017)

Application for Employer Identification Number (For use by employers, corporations, partnerships, trusts, estates, churches, government agencies, Indian tribal entities, certain individuals, and others
EIN
Department of the Treasury Internal Revenue Service

a Go to www.irs.gov/FormSS4 for instructions and the latest information. a See separate instructions for each line.a Keep a copy for your records.
1 Legal name of entity (or individual) for whom the EIN is being requested
2 Trade name of business (if different from name on line 1)
3 Executor, administrator, trustee, “care of” name
4a Mailing address room, apt., suite no. and street, or P.O. box5a Street address if different Do not enter a P.O. box
4b City, state, and ZIP code (if foreign, see instructions)
Address

4a Mailing address room, apt., suite no. and street, or P.O. box5a Street address if different Do not enter a P.O. box

Street Address Line 2

5b City, state, and ZIP code (if foreign, see instructions)State / Province

Postal / Zip Code
6 County and state where principal business is located
Type or print clearly.
7a Name of responsible party
7b SSN, ITIN, or EIN
Is this application for a limited liability company (LLC)

8bIf 8a is “Yes,” enter the number of
LLC members
8c 9a
If 8a is “Yes,” was the LLC organized in the United States? Type of entity (check only one box Sole proprietor (SSN) Partnership

Corporation (enter form number to be filed) a

Personal service corporation Church or church-controlled organization

Caution. If 8a is “Yes,” see the instructions for the correct box to check. Estate (SSN of decedent) Plan administrator (TIN) Trust (TIN of grantor) Military/National Guard Farmers’ cooperative
Other (specify) aOther (specify) a
State/local government Federal government Indian tribal governments/enterprises

Group Exemption Number (GEN) if any a

If a corporation, name the state or foreign country (if applicable) where incorporated Reason for applying (check only one box)

Started new business (specify type) a

Banking purpose (specify purpose) a Changed type of organization (specify new type) a
Other (specify) aOther (specify) a
Created a trust (specify type) a Created a pension plan (specify type) a

Date business started or acquired (month, day, year See instructions.
Closing month of accounting year
14
If you expect your employment tax liability to be $1,000 or

Highest number of employees expected in the next 12 months (enter -0- if none If no employees expected, skip line 14.
Agricultural
Household
Other
less in a full calendar year and want to file Form 944 annually instead of Forms 941 quarterly, check here. (Your employment tax liability generally will be $1,000 or less if you expect to pay $4,000 or less in total wages

If you do not check this box, you must file Form 941 for

First date wages or annuities were paid (month, day, year nonresident alien (month, day, year) Check one box that best describes the principal activity of your business.

Note: If applicant is a withholding agent, enter date income will first be paid to

Health care & social assistance
Other (specify) a
Accommodation & food service
Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided.
Has the applicant entity shown on line 1 ever applied for and received an EIN?

If “Yes,” write previous EIN here a

Complete this section only if you want to authorize the named individual to receive the entity’s EIN and answer questions about the completion of this form.
Third
Designee’s name
Designee’s telephone number (include area code)
Party
Designee
Address and ZIP code
Designee’s fax number (include area code)
Format: (000) 000-0000.
Designee’s fax number (include area code)
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete.

Applicant’s telephone number (include area code)
Name and title (type or print clearly) a
Name and title (type or print clearly) a
Format: (000) 000-0000.
Applicant’s fax number (include area code)
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Form SS-4 (Rev. December 2017)

Application for Employer Identification Number (For use by employers, corporations, partnerships, trusts, estates, churches, government agencies, Indian tribal entities, certain individuals, and others
EIN
Department of the Treasury Internal Revenue Service

a Go to www.irs.gov/FormSS4 for instructions and the latest information. a See separate instructions for each line.a Keep a copy for your records.
1 Legal name of entity (or individual) for whom the EIN is being requested
2 Trade name of business (if different from name on line 1)
3 Executor, administrator, trustee, “care of” name
4a Mailing address room, apt., suite no. and street, or P.O. box5a Street address if different Do not enter a P.O. box
4b City, state, and ZIP code (if foreign, see instructions)
Address

4a Mailing address room, apt., suite no. and street, or P.O. box5a Street address if different Do not enter a P.O. box

Street Address Line 2

5b City, state, and ZIP code (if foreign, see instructions)State / Province

Postal / Zip Code
6 County and state where principal business is located
Type or print clearly.
7a Name of responsible party
7b SSN, ITIN, or EIN
Is this application for a limited liability company (LLC) (or a foreign equivalent)? If 8a is “Yes,” was the LLC organized in the United States? Type of entity (check only one box Sole proprietor (SSN) Partnership

8bIf 8a is “Yes,” enter the number of LLC members
8c 9a
Trust (TIN of grantor)
Corporation (enter form number to be filed) a
Trust (TIN of grantor)
Personal service corporation Church or church-controlled organization

Military/National Guard Farmers’ cooperative

Other nonprofit organization (specify) a Other (specify) a

State/local government Federal government Indian tribal governments/enterprises

Group Exemption Number (GEN) if any a

If a corporation, name the state or foreign country (if applicable) where incorporated Reason for applying (check only one box)

Started new business (specify type) a

Banking purpose (specify purpose) a Changed type of organization (specify new type) a
Created a trust (specify type) a
Created a trust (specify type) a
Compliance with IRS withholding regulations

Created a pension plan (specify type) a

Date business started or acquired (month, day, year See instructions.
Closing month of accounting year
14
If you expect your employment tax liability to be $1,000 or

Highest number of employees expected in the next 12 months (enter -0- if none If no employees expected, skip line 14.
Agricultural
Household
Other
less in a full calendar year and want to file Form 944 annually instead of Forms 941 quarterly, check here. (Your employment tax liability generally will be $1,000 or less if you expect to pay $4,000 or less in total wages

If you do not check this box, you must file Form 941 for

First date wages or annuities were paid (month, day, year nonresident alien (month, day, year) Check one box that best describes the principal activity of your business.

Note: If applicant is a withholding agent, enter date income will first be paid to

Health care & social assistance
Other (specify) a
Accommodation & food service
Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided.
Has the applicant entity shown on line 1 ever applied for and received an EIN?
No
If “Yes,” write previous EIN here a

Complete this section only if you want to authorize the named individual to receive the entity’s EIN and answer questions about the completion of this form.
Third
Designee’s name
Designee’s telephone number (include area code)
Party
Designee
Address and ZIP code
Designee’s fax number (include area code)
Format: (000) 000-0000.
Designee’s fax number (include area code)
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete.

Applicant’s telephone number (include area code)
Name and title (type or print clearly) a
Name and title (type or print clearly) a
Format: (000) 000-0000.
Applicant’s fax number (include area code)
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Should be Empty:

Discount Solo 401K

Contact Information

Trust Information

IRA Type and Funding

Acknowledgements

EIN

8c 9a

Third

Party

Designee

EIN

8c 9a

Third

Party

Designee