IRA LLC | MyDirect IRA

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LLC Member Information - Account Holder Info

Please provide the information below for the retirement account holder(s) ie who owns the retirement account you want to invest. If you intend to combine retirement account funds of multiple types (Traditional IRA and Roth IRA) or multiple account holders (husband and wife), please consult with our team at 760-303-5909.

Accountholder Legal Name

SSN

Email address

Phone number

Self Directed IRA Custodian

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Management of the LLC

The Self-Directed IRA LLC manager supervises investments, files annual reports and required tax forms and conducts any other necessary acts to protect investments. You must designate at least one manager. Only managers have authority to sign contracts for the company. If the account holder wants to be the only person in control of investing their funds, mark "Account holder will manage".

Account holder will manage

Account holder will co-manage with

Managed by 3rd party

3rd

Name

Address

Email address

Phone number

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LLC Name Selection

Choice 1

State

Choice 2

State

Purpose of Business

Title

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LLC Name Selection

If you want to form your LLC in your home state, we will use the address provided above for document delivery, and please mark the "Account Owners Address" box below. If you are forming and LLC outside the state you reside (NOTE: Account holders who are investing in Real Estate with direct property ownership outside of their home state need to be filing the LLC in the state they intend to acquire their property. LLC's can be registered in multiple states, but it is best to start in the state you plan to acquire your property. If you to not own a current address where you can receive mail in state you intend to invest, mark 'Registered Agent Service Needed", and we will pass along the cost of the service. If you do have an address in the state you intend to invest where you can collect mail, click the "Use the following address" button, and provide the address in the field below.

Fee Payment Options

I hereby authorize MyDirect IRA to charge the payment amount currently due of

I understand payment made for services delivered by MyDirect IRA are non-refundable

I authorize MyDirect IRA to charge my Credit Card provided for the full one-time set-up fee.

I authorize MyDirect IRA to charge my Credit Card provided for an initial non-refundable deposit of

and the remaining fee of

to be deducted from my IRA account funds.

I authorize MyDirect IRA to charge my Credit Card provided for an initial non-refundable deposit of

and authorize MyDirect IRA to charge my credit card again for

once the LLC is established.

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Credit Card Authorization and Refund Policy

By signing this form, you give MyDirect IRA permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction only, unless authorized by the fee option selected below.

This form authorizes MyDirect IRA to charge the account / card provided on the phone or via secure payment link for the Set-up Fee in accordance with the signed MyDirect IRA Limited Liability Company Application, either via manual submission by MyDirect IRA of my Credit Card information, or via a secure payment link.

This payment authorization is for the IRA LLC or Solo-K LLC formation and facilitation services as discussed on the phone, for the amount indicated below only, and is valid for one (1) time use only, unless further authorization is provided below. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form.

Refunds must be requested directly with MyDirect IRA over the phone, and can only be requested within 48 hours of the set-up charge being incurred. If services are paid for in full, a refund of 50% of the set-up fee is permitted within the above stated time so as to cover hard costs incurred in the set-up of the LLC. If client elected to pay only a deposit toward the total set-up fee (50% of entire fee) the deposit as listed below is non-refundable, as it covers hard costs incurred by MyDirect IRA.

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Terms and Conditions

MyDirect IRA is a retirement account facilitator, and document filing service, not a law firm. MyDirect IRA does not provide legal services. No attorney-client relationship exists between Client and MyDirect IRA, its management, salespersons or MyDirect IRA's in-house legal counsel. MyDirect IRA provides IRA retirement facilitation service and CANNOT provide Client with legal, investment, or financial advice. Prior to making any investment decisions, please consult with the appropriate legal, tax, and investment professionals for advice.

MyDirect IRA is not engaged in rendering legal, accounting or other professional services. If legal advice or other professional assistance is required, the services of a competent professional person should be sought. The scope of Professional Services does not include the costs of any custodian related services.

The undersigned agrees to release MyDirect IRA and its representatives, employees, agents, officers and successors, in their individual and/ or corporate capacities, from all liability, causes of action of any nature and kind, known or unknown, which may arise out of any injury, loss, liability or damage that may be sustained as a result of investments or investment activities made by the client.

Date

Customer Signature:

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