SDIRA Account Application - SouthStar Bank, S.S.B.

Which account would you like to open?

Self-Directed IRA- Checkbook Control Account

Checkbook IRA- Control Account Only

Solo 401K- Control Account Only

Contact Information
Your First Name*
Your Middle Name
Your Last Name*
Your Phone Number*
Email*

Consent
I agree to receive occasional text messages regarding my account from SouthStar Bank

Are you a US citizen?*

Yes

No

Address
Street Address*
Appartment/Suite
City*
State*
ZIP Code*
Have you been at this address for longer than 18 months?*

Yes

No
Is your home address the same as your mailing address?*

Yes

No
Street Address*
Appartment/Suite
City*
State*
ZIP Code*

Personal Information
Gender*

Male

Female
Birthday*
MM slash DD slash YYYY

Marital Status*

Single

Married

Divorced

Widowed

Employment Information
Employment Status*

Employed

Self Employed

Unemployed

Retired
Current Job Title*

Most Recent Job Tiltle*
Name Of Employer*
Name Of Most Recent Employer*
Your Industry*

Investment Options
What do you plan to invest in?
What do you plan to invest in?*
What do you plan to invest in?*

Trust Information
Name of your Trust*
EIN*

Trust creation date*
MM slash DD slash YYYY

State Trust was created in*

LLC or Trust Information
Name of your LLC or Trust
EIN

LLC or Trust creation date
MM slash DD slash YYYY

State LLC was registered or State Trust was created in
LLC or Trust Address

Same as residential

Same as mailing

Other
LLC or Trust Address
Address Line 1 Apartment/Suit City State ZIP Code

LLC or Trust Information
Name of your LLC or Trust*
EIN*

LLC or Trust creation date*
MM slash DD slash YYYY

State LLC was registered or State Trust was created in*
LLC or Trust Address*

Same as residential

Same as mailing

Other
LLC or Trust Address*
Address Line 1 Apartment/Suit City State ZIP Code

Current Custodian Information
Custodian Name
First Last
Custodian Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Custodian Phone Number
Custodian Email

Current Custodian Information
Custodian Name*
First Last
Custodian Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Custodian Phone Number*
Custodian Email*

Trust Information
Upload Operating Agreement, SS-4, state filed business docs
Accepted file types: pdf, Max. file size: 50 MB.

Identity Verification
SouthStar Bank takes your financial security seriously

1. An image of your ID or passport
2. Recent Image
Upload image of your ID or passport government issued photo ID*
Accepted file types: pdf, jpg, png, Max. file size: 50 MB.
Upload a recent Image*
Accepted file types: jpg, png, Max. file size: 50 MB.
These steps will ensure that the only person who can open an account in your name is you.

Review your form before submission
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Welcome!

Contact Information

Address

Personal Information

Employment Information

Investment Options

Trust Information

LLC or Trust Information

LLC or Trust Information

Current Custodian Information

Current Custodian Information

Trust Information

Identity Verification