New Client Account Application
General Information
Full Name
*
First Name
Middle Name
Last Name
Preferred Name
Date of Birth
*
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Month
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Day
Year
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SSN or TIN
*
Reenter SSN or TIN
*
DL Issued State
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
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Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
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Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Drivers License #
*
DL Issued Date
*
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Month
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Day
Year
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DL Expiration Date
*
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Month
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Day
Year
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Phone Information
Mobile Phone Number
*
Home Phone Number
Phone Preference
*
Mobile
Home
Email Information
Personal Email
*
example@example.com
Business Email
example@example.com
Email Preference
*
Personal
Business
Address Information
Mailing Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Preferred Contact Method
*
Phone
Email
Snail Mail
Legal Address Same as Mailing?
*
Yes
No
Legal Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Additional Information
Citizenship
*
U.S. Citizen
Resident Alien
Non-Resident Alien
U.S. Citizen Living Abroad
Gender
*
Male
Female
Country of Citizenship
*
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Marital Status
*
Married
Single
Divorced
Widowed
Spouse Name
First Name
Last Name
Number of Dependents
*
Place of Birth
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Employment Info
Employment Status
*
Employed
Self Employed
Retired
Home Based
Student
Unemployed
Employer Name
Occupation
Industry
Year Employed
Employer Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Work Phone Number
Financial Profile
Estimated Annual Income
*
Federal Tax Bracket
*
0% - 15%
16% - 28%
29% - 33%
34% - 39%
What is your Estimated Net Worth?
*
Estimate only: Include all assets (equity in real estate, retirement accounts, other investments, bank accounts, etc)
What is your Estimated Liquid Net Worth?
*
Estimate only: Include all assets that could be liquidated easily (everything above excluding real estate, businesses, etc)
What are your Annual Living Expenses?
*
$0 - $25,000
$25,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
> $500,000
Do you have any upcoming significant Special Expenses?
*
$0 - $25,000
$25,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
> $500,000
Other
Time Frame for Special Expenses
N/A
Within 2 years
3 - 5 years
6 -10 years
Over 10 years
Investment Experience
Do you have prior investment experience?
*
Yes
No
Please Fill in the Details of Your Investment Experience
*
Years of Experience
Approx Current Value
Annuities
Bonds
Stocks
Mutual Funds
401k or Similar Plans
Alternative Investments
Managed Accounts
Other
What is the estimated value of this account?
*
What Type of Accounts are being opened?
*
Non-Retirement (Investment, Brokerage, After-Tax, etc)
Retirement (IRA, ROTH IRA, SEP IRA, 401k, etc)
College Savings Plan (529)
Other
Who will Own the Account?
*
Account Owned Only in Your Name
Jointly Between Two Individuals
Transfer On Death
Other
Which Advisor are you working with?
Terry L Norris
AJ Norris
Calvin Davis
AJ Norris & Calvin Davis
Secondary Account Owner Information
If the account is to be owned jointly between two individuals or transferred on death to another individual, please provide the secondary account holder's email address so we can send them a link to this form for completion.
Secondary Account Owner Email Address
Account Beneficiaries
For Transfer on Death, Retirement Accounts or College 529 Plans
Beneficiary Name (1)
Date of Birth
Gender
Male
Female
Relationship
Spouse
Non-Spouse
Non-Person
Primary or Secondary?
Primary
Secondary
Percentage
SS#
Beneficiary 1 Social Security Number
Beneficiary Name (2)
Date of Birth
Gender
Male
Female
Relationship
Spouse
Non-Spouse
Non-Person
Primary or Secondary?
Primary
Secondary
Percentage
SS#
Beneficiary 2 Social Security Number
Beneficiary Name (3)
Date of Birth
Gender
Male
Female
Relationship
Spouse
Non-Spouse
Non-Person
Primary or Secondary?
Primary
Secondary
Percentage
SS#
Beneficiary 3 Social Security Number
Beneficiary Name (4)
Date of Birth
Gender
Male
Female
Relationship
Spouse
Non-Spouse
Non-Person
Primary or Secondary?
Primary
Secondary
Percentage
Beneficiary Name (5)
Date of Birth
Gender
Male
Female
Relationship
Spouse
Non-Spouse
Non-Person
Primary or Secondary?
Primary
Secondary
Percentage
Beneficiary Name (6)
Date of Birth
Gender
Male
Female
Relationship
Spouse
Non-Spouse
Non-Person
Primary or Secondary?
Primary
Secondary
Percentage
Document Upload Section
Not Required but review and upload if applicable.
If possible, please upload a copy of your Driver's License for our records:
Browse Files
Supported file types: pdf, jpg, jpeg, png
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Do you want to link a bank account to your investment account for easy deposits and withdrawals?
*
Yes
No
Yes, but I'll send a copy of a voided check to info@norrisfinancialgroup.com
Voided Check - Investment Account Deposits & Withdrawals
Browse Files
If you would like to link your investment account at Norris Financial Group to a bank account for funding and withdrawal purposes, please upload a voided check for the bank account that you would like to link.
Cancel
of
Are we transferring an existing account from another investment provider?
*
Yes
No
Yes, but I'll send a copy of my most recent statement to info@norrisfinancialgroup.com
Current Investment Account Statement
Browse Files
If we are funding the investment account from an existing investment account then please upload your most recent statement here.
Cancel
of
Will this account be owned by a trust?
*
Yes
No
Yes, but I'll send a copy of the trust document to info@norrisfinancialgroup.com
Trust Documents
Browse Files
If the account is to be opened in the name of a trust, please upload the trust document here.
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