J. D. Seibert & Company, Inc.
Discount Stockbrokers
20 WEST 9th STREET   /   CINCINNATI, OHIO   45202
(513) 241-8888  /  (800) 247-3396

Forms

ACH Agreement

This form is used for clients to establish Electronic Transfer Instructions for Pre-Arranged (Debits) and Automatic Deposits (Credits)

Corporate Account

This form is used for a Corporation to open an account or accounts in its name.

Householding Form

This form is used for clients that have more than one account and would prefer to receive multiple statements in a single envelope.

IRA Beneficiary Designation Form

This form is for designating Beneficiary or Beneficiaries for the Individual Retirement Account, in the event of death.

IRA or SEP Application Form

This form is required when opening any Regular, Transfer, Rollover, or SEP (Simplified Employee Pension Plan) Individual Retirement Account.

IRA Distribution Form

This form is required for all IRA distributions whether it be mandatory, premature, disability, divorce, or death.

Joint Account with Rights of Survivor Form

This form is required when opening any account that is registered in two or more names.

LLC Agreement Form

This form is required for establishing a Limited Liability Company account.

Margin Agreement Form

This form is required when an account is borrowing against the equity within the account.

Money Market Funds Check Writing

This form is to authorize your signature for check writing against your money funds.

New Account Application Form

This form is required to open any new account or to reopen an inactive account. There may be additional forms required depending on the type of account being opened.

Option Agreement Form

This form is required to get approval to exercise put and call options.

Partnership or Investment Club Account

This form is required to authorize you to open a securities account for a Partnership or Investment Club.

Qualified Retirement Plan - Simplified Money Purchase Pension Plan

This plan establishment kit is required when opening up a standardized profit sharing plan and or a standardized money purchase plan.

Roth IRA Form

This form is required when opening a Roth IRA Account.

Roth IRA Distribution Request Form

This form is required when requesting to distribute funds from a Roth IRA Account.

5305-SEP Form: Simplified Employee Pension - IRA Contribution Agreement

This form is required for an employer to make an agreement to provide benefits to all eligible employees under a simplified employee pension.

Simple IRA Account Form

This form is required when opening a Simple (Savings Incentive Match Plan for Employees) IRA Account.

5304-Simple Form: Employee Savings Incentive Match Plan

The purpose of this form is to serve as a model SIMPLE plan document that an employer may use to establish a SIMPLE IRA plan, under which each eligible employee is permitted to select the financial institution for his or her SIMPLE IRA.

Trading Authorization

This form is to authorize an agent, to act on your behalf, in the Purchase and Sale of Securities, Options, and Commodities.

Transfer of Account Form

This form is required when transferring an account from one institution to another and must be accompanied by the latest customer statement.

Trustee Certification Form

When opening a trust account, this form is required to verify the current trustees on the account.

Valet Account Application Form

This form replaces the new account form when opening a valet account. See http://www.valetaccount.com/ for details.

Member SIPC and FINRA

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