New Account Application

Step 1 of 5

Advisor representative

Rep ID #

Type of Account*

Will you be entering information for 2 clients?*

2 clients are required for JTWROS, Trust, UGMA, UTMA, 529.

Yes

Erisa account?

Yes

Axos checking account?

Default is NO checking account.

Yes

Important information for Client Care Team

Any applicable information goes in this field.

Beneficiaries

Number of Beneficiaries

How many beneficiaries would you like to enter now? Click next if no beneficiaries.

Name of Beneficiary 1

First Middle Last

Address of Beneficiary 1

Street Address Address Line 2 City State ZIP Code

Social Security Number Beneficiary 1

Date of Birth Beneficiary 1

Relationship Beneficiary 1

What is the relationship with the account owner?

Beneficiary 1 Type

Primary

Contingent

Percentage for Beneficiary 1

Please enter a number from 1 to 100.

Beneficiary 2

Name of Beneficiary 2

First Middle Last

Address of Beneficiary 2

Street Address Address Line 2 City State ZIP Code

Social Security Number Beneficiary 2

Date of Birth Beneficiary 2

Relationship Beneficiary 2

What is the relationship with the account owner?

Beneficiary 2 Type

Primary

Contingent

Percentage for Beneficiary 2

Please enter a number from 1 to 100.

Beneficiary 3

Name of Beneficiary 3

First Middle Last

Address of Beneficiary 3

Street Address Address Line 2 City State ZIP Code

Social Security Number Beneficiary 3

Date of Birth Beneficiary 3

Relationship Beneficiary 3

What is the relationship with the account owner?

Beneficiary 3 Type

Primary

Contingent

Percentage for Beneficiary 3

Please enter a number from 1 to 100.

Beneficiary 4

Name of Beneficiary 4

First Middle Last

Address of Beneficiary 4

Street Address Address Line 2 City State ZIP Code

Social Security Number Beneficiary 4

Date of Birth Beneficiary 4

Relationship Beneficiary 4

What is the relationship with the account owner?

Beneficiary 4 Type

Primary

Contingent

Percentage for Beneficiary 4

Please enter a number from 1 to 100.

Client information

Information for Client 2

Beneficiaries

Beneficiary 2

Beneficiary 3

Beneficiary 4

Suitability