New Client Details – Getting Started
Email List
308
318
Advisor
*
KP Partner Pipedrive ID
123
124
Primary Investor ID
Deal ID
Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
/
Month
/
Day
Year
Date
SSN
*
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
Marital Status
*
Single
Married
Divorced
Domestic Partner
Widowed
Spouse ID
Spouse Full Name
*
First Name
Last Name
Spouse Email
*
example@example.com
# of Dependents
Highest Level of Education
High School
College
Post Graduate
Are you a US Citizen?
*
Yes
No
If not a U.S. citizen, please specify your country of citizenship below and submit green card or passport
*
Please upload copy of green card or passport
*
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Employment Status
*
Employed
Self Employed
Not Employed
Retired
Occupation
*
Employer Name
*
Title/Position
*
# Years 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
Household Annual Income in USD
*
For Example: $1,000,000 would be 1000000
Formatted: Household Annual Income
Household Liquid Net Worth in USD
*
Formatted: Household Liquid Net Worth
Household Net Worth in USD
*
Formatted: Household Net Worth
Tax Bracket %
*
Please Select
0%-15%
15.1%-32%
32.1%-50%
50.1%+
Please provide a copy of a valid government issued ID
(Driver's License, Passport, etc.)
Upload valid government issued ID
*
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How will you be investing? Type of Account. Only select ONE option. (if Entity or Trust, will need to upload formation documents)
*
Individual
Joint Account
Entity
Trust
Retirement Account (i.e. Equitable) OR Self-Directed IRA
Will you be setting up a new Retirement Account (i.e. Equitable) OR Self-Directed IRA with us?
Yes
No (please provide current Self-Directed IRA details below)
Custodian / Company Name
*
Custodian Contact Phone #
Custodian Contact Email
IRA Account Name
*
IRA Account ID
*
Please provide current Retirement Account Statements (if applicable)
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Please Provide Beneficiary Information
(this is needed for all retirement accounts being set-up)
Primary Beneficiary - Full Name
*
First Name
Last Name
Primary Beneficiary - Date of Birth
*
/
Month
/
Day
Year
Date
Primary Beneficiary - SSN
*
Primary Beneficiary - Phone #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Primary Beneficiary - Relationship
*
Primary Beneficiary %
*
Will there be contingent beneficiaries?
Yes
No
Contingent Beneficiary #1 - Full Name
First Name
Last Name
Contingent Beneficiary #1 - Date of Birth
/
Month
/
Day
Year
Date
Contingent Beneficiary #1 - SSN
Contingent Beneficiary #1- Phone #
Please enter a valid phone number.
Format: (000) 000-0000.
Contingent Beneficiary #1 - Relationship
Contingent Beneficiary #1 %
Contingent Beneficiary #2 - Full Name
First Name
Last Name
Contingent Beneficiary #2 - Date of Birth
/
Month
/
Day
Year
Date
Contingent Beneficiary #2 - SSN
Contingent Beneficiary #2- Phone #
Please enter a valid phone number.
Format: (000) 000-0000.
Contingent Beneficiary #2 - Relationship
Contingent Beneficiary #2 %
If you have additional beneficiaries, please add them here:
Is your entity an LLC or Corporation?
*
LLC
Corporation
LLC Designation
*
Single Member LLC
S-Corp
C-Corp
Partnership
Corporation Designation
*
S-Corp
C-Corp
Partnership
Entity Name
*
Tax ID of Entity
*
Title/Position
*
Entity Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Entity Liquid Net Worth $
Entity Net Worth $
Upload Entity Documents (Cert of Formation, EIN, etc)
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Trust Name
*
Tax ID of Trust (TIN or SSN)
*
Trustee Name
*
Trust Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Upload Trust Documents
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Joint Account Holder - Full Name
*
First Name
Last Name
Joint Account Holder - Email
*
example@example.com
Joint Account Holder - Phone #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Joint Account Holder - Date of Birth
*
/
Month
/
Day
Year
Date
Joint Account Holder - SSN
*
Joint Account Holder - Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Joint Account Holder - Highest Level of Education
High School
College
Post Graduate
Joint Account Holder - Are you a US Citizen?
*
Yes
No
Joint Account Holder - If not a U.S. citizen, please specify your country of citizenship and submit green card or passport
*
Joint Account Holder - Please upload copy of green card or passport
*
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Joint Account Holder - Employment Status
*
Employed
Self Employed
Not Employed
Retired
Joint Account Holder - Occupation
*
Joint Account Holder - Employer Name
*
Joint Account Holder - Title/Position
*
Joint Account Holder - # Years Employed
*
Joint Account Holder - 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
Joint Account Holder - Annual Income $
Joint Account Holder - Net Worth $
Joint Account Holder - Liquid Net Worth $
Joint Account Holder - Upload valid government issued ID
*
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Bank Info - Please provide Bank Account Information
(this is for the account you will receive distributions; if investing through entity/trust - bank account must be associated with entity/trust)
Type of Account
*
Checking
Savings
Bank Name
*
Name on the Account
*
Routing/ABA #
*
Account #
*
Upload copy of VOID Check
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Additional Information
Please provide any other information/notes necessary
Additional Notes
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