FIDELITY FORMS

To assist you as a Representatives of WIS, in keeping your focus where it belongs, on your business, below is a list of Fidelity’s most commonly used account types as well as a link to the required forms for each of these account types.

For accounts that are not listed, please verify with our Operations department to determine which forms are required.

We will continually be adding other forms. Please contact Operations for any form not currently listed.

We do our best to ensure that the documents found in this section are the most current. Should you decide to keep any of these documents on your desktop, we recommend you review the forms on a consistent basis to confirm those you have are the most recent.

Form

Description

Use this form to open a 529 Plan brokerage account with WIS to be held at National Financial Services LLC (“NFS”)

This agreement describes the features and policies associated with the account. 

Use this form to open a 529 Plan brokerage account with WIS to be held at National Financial Services LLC (“NFS”)

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system.

Required for Taxpayers Identification Number and Certification

BlackRock(OH, Fidelity and CollegeAmerica 

This form is intended to analyze the expense difference between the “C” share being offered and its Class “A” counterpart. This form should be used for other shares classes as well, such as E, M or T shares.

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Supporting documentation required for Corporate Accounts

Required for Taxpayers Identification Number and Certification

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Margin Account Privileges Supplemental Application for Fidelity signed and dated by the account owner and a principal from WIS.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Required for legal entities created by a filing of a public document with a Secretary of State or similar office, a general partnership, and any similar business entity formed in the United States or a foreign country.   Note:  Legal entity does not include sole proprietorships or unincorporated associations,

Required for all legal entities.  Used to gather information of who owns, controls and profits from the legal entities. Must include Seal or Articles of Incorporation.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Required for Taxpayers Identification Number and Certification

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Copy sufficient to open account

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Copy sufficient to open account.  Notary required on document.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Use this form to establish a Transfer on Death (“TOD”) Individual account registration and to designate a beneficiary(ies) for your Transfer on Death (“TOD”) account.

Required for Taxpayers Identification Number and Certification

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Margin Account Privileges Supplemental Application for Fidelity signed and dated by the account owner and a principal from WIS.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Premiere Select IRA Application signed and dated by the account owner and a principal from WIS

Fidelity guidelines to determine contributions

The Depositor whose name appears on the accompanying Application is establishing a traditional individual retirement account (under Section 408(a) of the Internal Revenue Code) to provide for his or her retirement and for the support of his or her beneficiaries after death.

This is the agreement for your IRA account. Account agreement includes Retirement Plan Agreement, IRA Custodial Agreement, IRA Disclosure & the Important Information Affecting, the Premier Select IRA.  Provide to client to keep for their records.

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

This form allows WIS to give verbal instructions to Fidelity to distribute funds out of an account to the owner of the account including overriding standing instructions. WIS WILL still require written instructions from the client on file before requesting any distribution. WIS approves Level 1 only.

* Not eligible for DocuSign

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Use this form to elect to establish payment for the annual maintenance fee for the Premiere Select (Name the IRA type: Traditional, Roth, Rollover, SEP or SIMPLE IRA, IRA Beneficiary Distribution Account (BDA) or Roth IRA BDA).  Use one form per IRA account

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Sent to clients who have alternative investment in their retirement account.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

***

If number one and an IRA account is already open, please skip 1 & 2

1.  Establish an IRA account using this Premiere Select IRA Application

2.  Include a WIS Client Agreement

3.  Include a copy of the original IRA owner’s death certificate

4.  Complete and submit this IRA Transfer Request for Spousal Beneficiary

* Not eligible for DocuSign

5.  If the Beneficiary wants to distribute funds to himself he would complete this IRA distribution form

* Not eligible for DocuSign

6. Fidelity guidelines to determine contributions

7. The Depositor whose name appears on the accompanying Application is establishing a traditional individual retirement account (under Section 408(a) of the Internal Revenue Code) to provide for his or her retirement and for the support of his or her beneficiaries after death.

8. This is the agreement for your IRA account.  Account agreement includes Retirement Plan Agreement, IRA Custodial Agreement, IRA Disclosure & the Important Information Affecting, the Premier Select IRA.  Provide to client to keep for their records.

9. Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting  Beneficial Owners on the account held with Fidelity.

10. WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally  itemized, (as commissions are) on your printed confirmation or statements.

11.  Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

1.  Establish an IRA account using this IRA Application – Select Traditional DBA Based on this selection Fidelity  moves the assets themselves to the newly established account.

2.  Include a WIS Client Agreement

3.  Include a copy of the original IRA owner’s death certificate

4.  If the Beneficiary wants to distribute funds at any time, they would complete this IRA Distribution form

* Not eligible for DocuSign

5. Fidelity guidelines to determine contributions

6. The Depositor whose name appears on the accompanying Application is establishing a traditional individual retirement account (under Section 408(a) of the Internal Revenue Code) to provide for his or her retirement and for the support of his or her beneficiaries after death.

7. This is the agreement for your IRA account. Account agreement includes Retirement Plan Agreement, IRA Custodial Agreement, IRA Disclosure & the Important Information Affecting, the Premier Select IRA.  Provide to client to keep for their records.

8. Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting  Beneficial Owners on the account held with Fidelity.

9. WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally  itemized, (as commissions are) on your printed confirmation or statements.

10. Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

1.  Establish an IRA account using this IRA Application – Select Traditional DBA Based on this selection Fidelity  moves the assets themselves to the newly established account.

2.  Include a WIS Client Agreement

3.  Include a copy of the original IRA owner’s death certificate

4.  If the Beneficiary wants to distribute funds at any time, they would complete this IRA Distribution form

* Not eligible for DocuSign

5. Fidelity guidelines to determine contributions

6. The Depositor whose name appears on the accompanying Application is establishing a traditional individual retirement account (under Section 408(a) of the Internal Revenue Code) to provide for his or her retirement and for the support of his or her beneficiaries after death.

7. This is the agreement for your IRA account. Account agreement includes Retirement Plan Agreement, IRA Custodial Agreement, IRA Disclosure & the Important Information Affecting, the Premier Select IRA.  Provide to client to keep for their records.

8. Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting  Beneficial Owners on the account held with Fidelity.

9. WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally  itemized, (as commissions are) on your printed confirmation or statements.

10. Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Premiere Select IRA Application signed and dated by the account owner and a principal from WIS

Fidelity guidelines to determine contributions

The Depositor whose name appears on the accompanying Application is establishing a traditional individual retirement account (under Section 408(a) of the Internal Revenue Code) to provide for his or her retirement and for the support of his or her beneficiaries after death.

This is the agreement for your IRA account. Account agreement includes Retirement Plan Agreement, IRA Custodial Agreement, IRA Disclosure & the Important Information Affecting, the Premier Select IRA.  Provide to client to keep for their records.

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Use this form to elect to establish payment for the annual maintenance fee for the Premiere Select (Name the IRA type: Traditional, Roth, Rollover, SEP or SIMPLE IRA, IRA Beneficiary Distribution Account (BDA) or Roth IRA BDA).  Use one form per IRA account

This form allows WIS to give verbal instructions to Fidelity to distribute funds out of an account to the owner of the account including overriding standing instructions. WIS WILL still require written instructions from the client on file before requesting any distribution. WIS approves Level 1 only.

* Not eligible for DocuSign

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Sent to clients who have alternative investment in their retirement account.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

This is the agreement for your ROTH & ROTH BDA accounts. Account agreement includes Retirement Plan Agreement, ROTH IRA Custodial Agreement, ROTH IRA Disclosure & the Important Information Affecting the Premier Select IRA and ROTH.

Premiere Select IRA Application signed and dated by the account owner and a principal from WIS

Fidelity guidelines to determine contributions

The Depositor whose name appears on the accompanying Application is establishing a traditional individual retirement account

Use this form to request a conversion of all or any part of your Premiere Select Traditional, Rollover, SEP, or SIMPLE IRA (“IRA”) to a Premiere Select Roth IRA with WIS

This form allows WIS to give verbal instructions to Fidelity to distribute funds out of an account to the owner of the account including overriding standing instructions. WIS WILL still require written instructions from the client on file before requesting any distribution. WIS approves Level 1 only.

* Not eligible for DocuSign

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Use this form to elect to establish payment for the annual maintenance fee for the Premiere Select (Name the IRA type: Traditional, Roth, Rollover, SEP or SIMPLE IRA, IRA Beneficiary Distribution Account (BDA) or Roth IRA BDA).  Use one form per IRA account

Sent to clients who have alternative investment in their retirement account.

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Premiere Select IRA Application signed and dated by the account owner and a principal from WIS

Fidelity guidelines to determine contributions

The Depositor whose name appears on the accompanying Application is establishing a traditional individual retirement account (under Section 408(a) of the Internal Revenue Code) to provide for his or her retirement and for the support of his or her beneficiaries after death.

This is the agreement for your IRA account. Account agreement includes Retirement Plan Agreement, IRA Custodial Agreement, IRA Disclosure & the Important Information Affecting, the Premier Select IRA.  Provide to client to keep for their records.

IRS Simplified Employee Pension Individual Retirement Accounts Contribution Agreement

Sent to clients who have alternative investment in their retirement account

Use this form to elect to establish payment for the annual maintenance fee for the Premiere Select (Name the IRA type: Traditional, Roth, Rollover, SEP or SIMPLE IRA, IRA Beneficiary Distribution Account (BDA) or Roth IRA BDA).  Use one form per IRA account

This form allows WIS to give verbal instructions to Fidelity to distribute funds out of an account to the owner of the account including overriding standing instructions. WIS WILL still require written instructions from the client on file before requesting any distribution. WIS approves Level 1 only.

* Not eligible for DocuSign

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Index as to the required pages of the SIMPLE documents

Includes the following forms:  Company Profile, Adoption Agreement, Employee Summary Plan Description, SIMPLE IRA Application, Plan Agreement, Custodial Agreement, Customer Agreement, Salary Reduction Agreement

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Use this form to elect to establish payment for the annual maintenance fee for the Premiere Select (Name the IRA type: Traditional, Roth, Rollover, SEP or SIMPLE IRA, IRA Beneficiary Distribution Account (BDA) or Roth IRA BDA).  Use one form per IRA account

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Use this form to authorize the transfer of assets currently at another firm to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Use this form to establish a Transfer on Death (“TOD”) Joint Tenant With Rights of Survivorship account registration and to designate a beneficiary(ies) for your Transfer on Death (“TOD”) account.

Required for Taxpayers Identification Number and Certification

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Margin Account Privileges Supplemental Application for Fidelity signed and dated by the account owner and a principal from WIS.

Required to open a Joint account.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Required for Taxpayers Identification Number and Certification

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Margin Account Privileges Supplemental Application for Fidelity signed and dated by the account owner and a principal from WIS.

Required for all legal entities.  Used to gather information of who owns, controls and profits from the legal entities.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Required for all legal entities. Used to gather information of who owns, controls and profits from the legal entities.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Supporting documentation required for Partnership Accounts.  Include pages naming partners and officers.  Must be a signed and dated document.

Required for Taxpayers Identification Number and Certification

Required for all legal entities.   Used to gather information of who owns, controls and profits from the legal entities.

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Margin Account Privileges Supplemental Application for Fidelity signed and dated by the account owner and a principal from WIS.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

This is the agreement for your IRA account. Account agreement includes Retirement Plan Agreement, IRA Custodial Agreement, IRA Disclosure & the Important Information Affecting, the Premier Select IRA.  Provide to client to keep for their records.

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Defined Contribution Basic Plan Document 04

How to set up your individual 401(k) profit sharing plan

Use this application to establish a Premiere Select Retirement Plan – Individual 401(k) Profit Sharing Plan account.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system.

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Required for Taxpayers Identification Number and Certification

Plan Documents for all Non-Prototype IRA are required

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Required for Taxpayers Identification Number and Certification

Plan Documents for all Non-Prototype Retirement Plan (NP) are required

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

To Open and Administer Securities Accounts(s)

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

*** One WIS Agreement is needed for each participant including the employer

Instructions on documentation needed to establish & administer plan as well as instructions on which documents need to be returned.

Complete this Adoption Agreement in its entirety.  If a paired plan must also complete the Money Purchase Pension Plan Adoption Agreement.

Complete this Adoption Agreement in its entirety.    If a paired plan must also complete the Profit Sharing Plan Adoption Agreement.

Form to acknowledge employer has read and understands the fees and compensation that National Financial Services LLC may receive in connection with the servicing of the account. The signed form is submitted with the Adoption Agreement.

Each participant of the plan (including the Employer) must complete the Premiere Select Retirement Plan Account Application C.

If plan has participants other than the employer/participant, the employer must provide a copy of the Summary Plan Description to each participant and beneficiary within 90 days after they become eligible to participate in the Plan.   This document stays with the employer

Document that describes the rules, terms, conditions, and provisions of the Plan.  Employer should keep a copy.

Copies of favorable determination letters received from the IRS, which provide an opinion that the Premiere Select Retirement Plan meets the requirements of a qualified plan under the Internal Revenue Code

A Prototype Plan.  For use with the Premiere Select Retirement Plan, Basic Plan Document No. 08

Use this form to add or change the beneficiaries (“beneficiary”) for your Premiere Select Retirement Plan account. Do NOT use for Premiere Select IRAs and nonretirement accounts.

Information on distribution options including the election of an annuity form of payment under the plan.

This is the agreement for your IRA account. Account agreement includes Retirement Plan Agreement, IRA Custodial Agreement, IRA Disclosure & the Important Information Affecting, the Premier Select IRA.  Provide to client to keep for their records.

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Used to request a distribution from your Premiere Select Retirement Plan Account (“PSRP Participant Account”) or Premiere Select Retirement Plan Beneficiary Distribution Account (“PSRP-BDA,” together with PSRP Participant Account, “PSRP Account”). If you wish to request a distribution from more than one PSRP Account, you must complete a separate form for each PSRP Account.

* Not eligible for DocuSign

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Use this form to establish (or, add or change at a later date) Trustee information on a Trust account

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Supporting documentation required for Trust Accounts

Required for Taxpayers Identification Number and Certification

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

Margin Account Privileges Supplemental Application for Fidelity signed and dated by the account owner and a principal from WIS.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Accompanies any and all new business established through WIS

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Required for Taxpayers Identification Number and Certification

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

Acts as a supplement to the Fidelity Brokerage Account Agreement.  Use in lieu of the Western Client Agreement – only if using documents from the Wealthscape New Accounts opening system. 

Use this form to establish, change, or revoke instructions for paying the annual maintenance fee for your Premiere Select Traditional, Roth, Rollover, SEP or SIMPLE IRA, IRA Beneficiary Distribution Account (BDA) or Roth IRA BDA, referred to as “IRA” or “account,” held through Fidelity. Use one form per IRA account.

*Not eligible for DocuSign

For use with Fidelity PSP & MPP Retirement Plans for One Time Distribution

*Not eligible for DocuSign

This form can be used to request a one -time distribution or a periodic distribution for firms that have 3rd party options for an account. A separate form must be completed for each account. The information below provides best practices when submitting the form. This does not cover every required field. It is important to review all information on the form carefully.

*Not eligible for DocuSign

The information in this job aid provides best practices when submitting the form. This does not cover every required field. It is important to review all information on the form carefully.

*Not eligible for DocuSign

Use this form to request a one-time, tax-reportable Charitable Distribution (“CD”) from your Premiere Select Traditional, Roth, Rollover, inactive SEP, inactive SIMPLE, IRA Beneficiary Distribution Account (BDA) or Roth IRA BDA held through Fidelity.

*Not eligible for DocuSign

Encompasses One Time & Periodic Instructions.  One form per request.

*Not eligible for DocuSign

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

*Not eligible for DocuSign

Use this form to recharacterize: • Annual contributions you made to a Traditional IRA as annual Roth IRA contributions; • Annual contributions you made to a Roth IRA as annual Traditional IRA contributions; • Conversion contributions you made to a Roth IRA back to the original Traditional IRA, SEP-IRA, or SIMPLE IRA (“deconverting”); or • Qualified rollover contributions you made to a Roth IRA or Roth IRA Beneficiary Distribution Account (Roth IRA BDA) from a workplace savings plan to a Traditional IRA or Traditional IRA Beneficiary Distribution Account (IRA BDA). Do NOT use this form for a conversion or reconversion.

*Not eligible for DocuSign

Use this form to request a conversion of all or any part of your Premiere Select  traditional, Rollover, SEP, or SIMPLE IRA (“IRA”) to a Premiere Select Roth IRA with the same Broker/Dealer. The receiving Roth IRA must already be established or this form needs to accompany a new account application.

*Not eligible for DocuSign

Allows ADVISOR to specify the dollar amount distributed to the client at the time of distribution. WIS approves Level 1 only.

*Not eligible for DocuSign

Use this form to establish, change, or delete standing Bank Wire, Electronic Funds Transfer (“EFT”), Journal and/or Check Disbursement instructions on your Premiere Select Traditional, Roth, Rollover, SEP or SIMPLE IRA, IRA Beneficiary Distribution Account (“BDA”), Roth IRA BDA, Premiere Select Retirement Plan account, or Retirement Plan BDA, held through Fidelity Clearing & Custody Solutions (Fidelity). Do NOT use this form for nonretirement accounts.

*Not eligible for DocuSign

Allows ADVISOR to specify the dollar amount distributed to client at the time of distribution.

*Not eligible for DocuSign

Standing instructions first and third party

*Not eligible for DocuSign

Do not submit this form to Fidelity Clearing & Custody Solutions (Fidelity). Ensure that your Home Office has processed the request. Fidelity approvals are not required within Integrated Cashiering Platform (ICP) for nonretirement standing payment instructions.

*Not eligible for DocuSign

Use this form to request a one-time transaction via Check Disbursement, Electronic Funds Transfer (“EFT”) or Bank Wire.

*Not eligible for DocuSign

Use this form to establish, change, or delete an earnings withdrawal plan for your nonretirement account held through Fidelity Clearing & Custody Solutions (Fidelity). Use one form for each account.

*Not eligible for DocuSign

Use this form to establish, change or delete a periodic withdrawal plan on your nonretirement account held through Fidelity Clearing & Custody Solutions (Fidelity). Use one form for each account.

*Not eligible for DocuSign

Use this form to establish, change, or delete standing Bank Wire, Electronic Funds Transfer (“EFT”), Journal and/or Check Disbursement instructions on your brokerage account. Do NOT use this form for Premiere Select® Retirement Accounts.

*Not eligible for DocuSign

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

*Not eligible for DocuSign

Use this form to send foreign currency that is currently in your account with Fidelity Clearing & Custody Solutions (Fidelity) to a bank account that you designate below. If you do not hold the currency, you must perform the currency exchange prior to submitting this form.

*Not eligible for DocuSign

Use this form (for non-internationally enabled accounts) to convert U.S. dollars (USD) to a certain currency and bank wire out from your account held with Fidelity Clearing & Custody Solutions (Fidelity) to a foreign financial institution.

*Not eligible for DocuSign

Allows account holder to set up scheduled incoming EFTs their retail or retirement accounts.  Can also be used for systematic purchases of mutual funds.

*Not eligible for DocuSign

Use this form to recharacterize: • Annual contributions you made to a Traditional IRA as annual Roth IRA contributions; • Annual contributions you made to a Roth IRA as annual Traditional IRA contributions; • Conversion contributions you made to a Roth IRA back to the original Traditional IRA, SEP-IRA, or SIMPLE IRA (“deconverting”); or • Qualified rollover contributions you made to a Roth IRA or Roth IRA Beneficiary Distribution Account (Roth IRA BDA) from a workplace savings plan to a Traditional IRA or Traditional IRA Beneficiary Distribution Account (IRA BDA). Do NOT use this form for a conversion or reconversion.

*Not eligible for DocuSign

Beneficiary Designation – Form to designate beneficiary on the retirement account

Required when adding a guardian or conservator to an existing IRA account. ** In addition to the form, the pertinent court documents must also be included to process the request.

Use this form to establish checkwriting on your Premiere Select Traditional IRA, Rollover IRA, Roth IRA or SEP-IRA (collectively “IRA”).

* Not eligible for DocuSign

Use this form to add or change the beneficiaries (“beneficiary”) for your Premiere Select Retirement Plan account. Do NOT use for Premiere Select IRAs and nonretirement accounts.

Use when converting a Premier Select IRA to a ROTH

Use this form to provide additional information that can be used for the purpose of completing your Form 990-T filing.

Use this form to authorize the transfer of assets, currently at another firm, to your brokerage account held at Fidelity Clearing & Custody Solutions.

This checklist outlines the steps and documentation required to purchase an alternative investment after the asset in question has been operationally accepted for custody.

Go to NFS-What you Need to Know – What You Need to Do for more information on how “To purchase an Alternative Investment to HOLD in an IRA account or a Retail account at NFS, the client needs”; or “To purchase an Alternative Investment using funds in Retail Account and hold at the AI direct – not at NFS.”

Required to Purchase, Sell or Redeem an Alternative Investment in a Fidelity Retail and Retirement Brokerage account.   Do not use for capital call requirements.

This form is required to in order for Fidelity to hold any Alternative Investment in a client’s retail or retirement account.

This is the agreement for your brokerage account. It describes the features and policies associated with the account. Provide to client to keep for their records.

To add an additional signer to one’s check-writing.  Only to be used for Individual and Joint accounts. This does not remove a signer.

* Not eligible for DocuSign

Certifies the validity and effectiveness of a Durable Power of Attorney (“POA”) on the clients account.  Only needs to be signed by the POA agent.  NOTE:  Document states notary but signature guarantee is acceptable.

WIS believes that it is appropriate to publish those fees which may affect your account(s) but are not generally itemized, (as commissions are) on your printed confirmation or statements.

Use this form for your Premier Access Account to: • Upgrade or downgrade a new or existing account to Brokerage Portfolio or Brokerage Access. • Upgrade an existing account from Brokerage Access to Brokerage Portfolio or downgrade from Brokerage Portfolio to Brokerage Access. • Add or remove checkwriting and/or debit card features within your existing Brokerage Portfolio or Brokerage Access account.

* Not eligible for DocuSign

Required for requests to update cost basis with customer provided information. Requests should be submitted only when too large to easily enter in Wealthscape. Spreadsheet Includes: Sample, Column Definitions, & Instructions.

Use this form for your Select Access Account to: • Upgrade or downgrade Select Access Account  • Add or remove checkwriting and/or debit card features Select Access account.

* Not eligible for DocuSign

This is the step-by-step process for an advisor to submit a Mutual Fund conversion request form through the Wealthscape platform.

Account holders who share the same exact mailing address, but do not meet the criteria for automatic householding, may use this form to create a new Household Relationship, add to an existing Household Relationship, or to modify an existing Household Relationship.

This form must be completed if the registration on the certificate being deposited into a Fidelity account does not match the account registration of the brokerage account.

Margin Account Privileges Supplemental Application for Fidelity signed and dated by the account owner and a principal from WIS.

Use this form to request that a multiple margin relationship (“Relationship”) be established for an existing Brokerage Account with margin privileges that is held with Fidelity Clearing & Custody Solutions (Fidelity), to add a Brokerage Account to an existing Relationship, or to request approval to de-link a Brokerage Account from an existing Relationship.

Use this form to request that your Broker/Dealer identify all account owner(s) (“you”) as Objecting Beneficial Owners on the account held with Fidelity.

*Not eligible for DocuSign

Use this form to add options privileges to an existing brokerage account.

Use this form in conjunction with the Transfer of Assets form to list additional assets to be transferred to your Fidelity account.

Add, Update or Change the Trusted Contact listed on the account

Certificate of Status of Beneficial Owner for United States Tax Withholding and Reporting (Entities). Internal Revenue (IRS) form only to be utilized by entities

Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding and Reporting (Individuals)

To be used with Existing W8 for recertification.   Inclusion of TIN and DOB or act as Letter of Explanation as to why a Foreign TIN is missing

Investment Management Agreement –Transaction Base Pricing with Schedules

Use this form to grant trading to a Third-Party Agent (“Agent for your brokerage account (“account”)) held through WIS.

Use to request online access and to authorize WIS to link brokerage account(s).

Authorizes WIS to send all correspondence, including, but not limited to statements, confirmations, notices, checks and securities to a PO Box.

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