Tracking Code:

Need Assistance?

If you require assistance, please contact our Client Service Team Monday thru Friday, 8:00 a.m. - 4:30 p.m. CT at the number displayed below and have your tracking code ready - .

Our staff are available to assist you at any time of day. If you require assistance, please call the number displayed below.

In order to assist you, our call center representative may ask you to save where you are up to in the form. You can save your form by clicking the button below.

Please resolve the following issues before proceeding

Click on an issue to go directly to the related section of the form.

errors found:

warnings found:

Account Open Checklist

To open an account you will need: •Identifying information - Tax ID number (e.g. social security number), date of birth, etc. •Contact information - Legal residential address, e-mail address, phone number
Additional items you may need during the account open process: •To process a transfer into your new account, a recent statement from your current custodian •If you pay account fees by credit card or ACH, your credit card or bank information •Beneficiaries’ names, birth dates, and tax IDs •To submit an alternative asset investment direction, information regarding the asset

IRA Agreement

Account Open Request

Fields marked with * are required

Simple IRA Adoption Agreement

Simple IRA Plan

Please select the type of Simple IRA you have. *

Simple IRA: 5304

Simple IRA: 5305

Difference between SIMPLE Form 5304 and 5305

Form 5304-SIMPLE allows each eligible employee to select his or her own financial institution to receive contributions whereas with the Form 5305-SIMPLE, the employer designates a financial institution to be used.

IRS Form required

We require the IRS Form -SIMPLE, signed by your employer, to be submitted to Millennium before the account can be opened. Please use the version provided to you after you submit your application.

Employer Information

Is this your current Employer's SIMPLE plan? *

Yes

Name of Employer *

Use ITIN instead of SSN

type

Social Security Number (SSN) *

Individual Tax ID Number (ITIN) *

displayedOption

Preferred Contact Details

Phone *

Type *

Employer Address

Country *

Address Line 1 *

Address Line 2

City *

State *

Zip *

State *

Zip *

Province *

Postal Code *

State/Province *

Postal Code *

I acknowledge that I have entered the correct address and wish to continue.

Verifying Address... Please wait.

AddressResult

Which Address? *

Entered

Suggested

SEP IRA Contribution Agreement

In order to complete the account opening process, we require a completed SEP IRA Contribution Agreement form signed by your employer.

Beneficiary Designation

Account Open Request

Fields marked with * are required

Transfer on Death

Transfer on Death (TOD) Registration

Transfer on death is a form of account registration which for a custodial account allows the sole owner, the last surviving joint tenant, and each tenant in common to transfer upon their death the ownership of the account, or in the case of a tenant in common that tenant’s ownership interest in the account, to one or more designated beneficiaries without going through probate or being subject to the deceased person’s will. A beneficiary may be removed or changed by the current sole owner or tenant without the consent of the beneficiary upon a written direction delivered to the Custodian. This cannot be completed online, please click here to access our Transfer on Death Registration Form.

Info message

Account Ownership

Upon the death of one joint tenant, account ownership vests equally in the surviving joint tenant(s).

Account Beneficiary Designation

You may wish to designate beneficiaries to your IRA in the event of your death. Each beneficiary can be assigned a percentage share of your account. This can also be done after your account is open, but if you fail to provide a beneficiary designation, upon your death assets in your account will be distributed pursuant to the provisions of the Article in your Millennium Custodial Account Agreement entitled Designation of Beneficiaries.

If your account transferred due to the resignation of a prior custodian, adding beneficiary information here will replace any and all prior beneficiary designations applicable to this account.

Existing Beneficiaries

Primary Beneficiary

Beneficiary Relationship *

Percentage to Beneficiary *

Contact Type

Title

First Name

Middle Name

Last Name

Suffix

Name of Entity/Trust

Country

Address Line 1

Address Line 2

City

State

Zip

State

Zip

Province

Postal Code

State/Province

Postal Code

I acknowledge that I have entered the correct address and wish to continue.

Verifying Address... Please wait.

AddressResult

Which Address? *

Entered

Suggested

Use ITIN instead of SSN

type

Social Security Number (SSN) *

Individual Tax ID Number (ITIN) *

displayedOption

Date of Birth *

Masked DOB

Total Primary Beneficiary %

Existing Beneficiaries

Contingent Beneficiary

Beneficiary Relationship *

Percentage to Beneficiary *

Contact Type

Title

First Name

Middle Name

Last Name

Suffix

Name of Entity/Trust

Country

Address Line 1

Address Line 2

City

State

Zip

State

Zip

Province

Postal Code

State/Province

Postal Code

I acknowledge that I have entered the correct address and wish to continue.

Verifying Address... Please wait.

AddressResult

Which Address? *

Entered

Suggested

Use ITIN instead of SSN

type

Social Security Number (SSN) *

Individual Tax ID Number (ITIN) *

displayedOption

Date of Birth *

Masked DOB

Total Contingent Beneficiary %

Spousal Consent

Contact Type

Title

First Name

Middle Name

Last Name

Suffix

Name of Entity/Trust

Spousal Consent Required

Since you are married, designated a primary beneficiary other than your spouse and live in a community property state we require you to get spousal consent. The beneficiaries being designated will not be added to your account record until we have received the Beneficiary Designation form signed by your spouse. This form will be provided to you at the end of this application.

Investment Advisor

Account Open Request

Fields marked with * are required

Designation of Investment Advisor

I hereby designate and appoint the firm or individual identified below as my advisor ("Advisor") for my account at Millennium. My Advisor may (1) view my IRA online; (2) receive account statements; (3) discuss my account with Millennium; (4) to the extent there are sufficient funds in my account, direct the purchase in my account of (i) traditional assets; and (ii) additional investments into alternative assets that are then currently held in my account; (5) direct the full or partial sale, liquidation or collection of any assets held in my account; and (6) direct the transfer of funds from my account at Millennium to my Brokerage Account with a designated third party.

Firm Name

Representative Name

Representative Names *

Representative Name

Preferred Contact Details

Phone *

Type *

Email *

Confirm Email *

Additional Firm Contact

Preferred Contact Details

Additional Email

Confirm Additional Email

Address

Country *

Address Line 1 *

Address Line 2

City *

State *

Zip *

State *

Zip *

Province *

Postal Code *

State/Province *

Postal Code *

I acknowledge that I have entered the correct address and wish to continue.

Verifying Address... Please wait.

AddressResult

Which Address? *

Entered

Suggested

Account Data Sharing

Your account data can be shared between Millennium and your Advisor or Brokerage Firm to help facilitate the management of your account by your designated Investment Advisor. By checking Yes below, you agree to have your Millennium account data shared and will be able to facilitate easy transfer of funds between your Millennium account and a designated brokerage account.

Do you allow your data to be downloaded and shared with a third party reporting system? *

Yes, download my data directly to a third party reporting system as indicated by my Advisor.

No, do not share or download my data to a third party reporting system.

Brokerage Firm Name

Master Brokerage Account Number

Sub client's account number

Authorization

I hereby instruct Millennium without any further directions from me to (i) provide the daily positions including valuations, and transaction activity ("Client Data"), for my account with Millennium to my Brokerage Firm (Collectively, "Brokerage Account"); or (ii) accept instructions from my Investment Advisor to download my data directly to any other third-party portfolio management system provider utilized by my Investment Advisor.

In providing these standing instructions, I acknowledge, confirm and agree that (i) the Brokerage Account is distinct and separate from the account at Millennium; (ii) these instructions do not provide the Brokerage Firm any authority as to, responsibility for, or interest in the account with Millennium; (iii) these instructions do not provide Millennium any authority as to, responsibility for, or interest in my Brokerage Account; and (iv) Millennium shall honor the authorization(s) given herein and otherwise by me to the Investment Advisor until such time as Millennium receives written notice from me that such authorization(s) have been revoked.

Payment and Fees

Account Open Request

Fields marked with * are required

Fee Schedule

Payment Election

We require all account owners to enter a payment method for Millennium to charge account fees.

Client Fee Payment:

Please select your preferred payment method *

Bank Details

After entering the ABA routing number, we will lookup the Bank Name associated with that number. If the Bank Name that populates is different than your Bank Name, please go back and re-enter the correct ABA number.

Transit/ABA No. (9 digits) *

Bank Account Number *

Additional Documentation Required

We were unable to find your bank information. You will be required to provide a copy of voided check at the end of the application.

Name(s) on the account *

Bank Phone No.

Bank Name *

Bank Account Type *

Checking

Savings

By executing this Adoption Agreement, I authorize Millennium Trust Company to debit my checking account for the establishment and annual account fees.

Millennium Trust’s online processes are PCI DSS compliant. For more information on the online security requirements of capturing cardholder data visit PCI security standards.

Name of Cardholder

As it appears on card

Contact Type

Title

First Name

Middle Name

Last Name

Suffix

Name of Entity/Trust

Getting Started

Open an Account

Referral

Referral Code

Referral Information

Download Forms

Personal Information

Phone

Address

Alternate Address

:

Phone

Address

IRA Agreement

Simple IRA Adoption Agreement

Simple IRA Plan

Employer Information

Employer Address

SEP IRA Contribution Agreement

Beneficiary Designation

Transfer on Death

Info message

Account Beneficiary Designation

Primary Beneficiary

Contingent Beneficiary

Spousal Consent

Investment Advisor

Designation of Investment Advisor

Additional Firm Contact

Address

Account Data Sharing

Third Party Access

Designated Third Party Information

Third Party:

Address

Address

Authorization(s)

Payment and Fees

Fee Schedule

Payment Election

Name of Cardholder