X-Square Balanced IRA

IRA Type *TraditionalRothThe IRA account type you would like to open

IRA Payment Source *ContributionRolloverBothChoose Contribution if you're opening a new IRA account. Choose Rollover if you're rolling over a current IRA account from another institution. Or choose Both if you'd like to do both, Contribution and a Rollover.

Contribution Amount *$500-$5000

Existing financial institution/employer plan *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

Policy/Account # *

Instrument # (for Popular Roll overs)

Transfer Type *

Certificate of DepositOther

Certificate of Deposit Maturity Date

Certificate of Deposit Value at Maturity *

I authorize you to liquidate and transfer to X-Square IRA *Full TransferPartial Transfer $Partial Transfer %

Transfer Amount *

Approximate Transfer Amount

Please distribute proceeds *ImmediatelyBy

Date *

Please Transfer/Rollover From: *Traditional IRARoth IRA401(k)Keogh

Do you have copies of your existing IRA account statement? *YesNo

Upload copy of most recent account statement

No file chosen

Would you like to rollover more accounts? *YesNo

Please Transfer/Rollover From: *Traditional IRARoth IRA401(k)Keogh

Policy/Account # *

Instrument # (for Popular Roll overs)

Transfer Type *

Certificate of DepositOther

Certificate of Deposit Value at Maturity *

Certificate of Deposit Maturity Date

Existing financial institution/employer plan for 2nd roll over *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

I authorize you to liquidate and transfer to X-Square IRA *Full TransferPartial Transfer $Partial Transfer %

Transfer Amount *

Approximate Transfer Amount

Please distribute proceeds *ImmediatelyBy

Date *

Do you have copies of your existing IRA account statement for 2nd roll over? *YesNo

Upload copy of most recent account statement for 2nd roll over

No file chosen

Occupation *

Employer *

Employer Street Address *

Employer Apartment, suite, etc

Employer City *

Employer State/Province

Employer ZIP / Postal Code *

Employer Country

Employer Phone *0 / 10

Identification Type *PassportDriver's LicenseGov't Issued ID

State or Country of Issuance *

Expiration Date *

Upload Identification *

No file chosen

Signature *