PERSHING FORMS

To assist you as a Representatives of WIS, in keeping your focus where it belongs, on your business, below is a list of Pershing’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.  Additional documents may be necessary if an account requires Margin, Option, Check-writing or Debit Cards.

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

Accompanies any and all new business established through WIS

Request for Taxpayer Identification Number and Certification

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

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

Required for Coverdell Education IRA Accounts

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Accompanies any and all new business established through WIS

Accompanies any and all new business established through WIS

Request for Taxpayer Identification Number and Certification

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Provided by the Court

A notarized affidavit executed by the legal representative of an estate reciting the residence of the decedent at the time of death

* Not eligible for DocuSign

Accompanies any and all new business established through WIS

Use this form to authorize the designation of an individual account as “Transfer on Death.”

Required for Taxpayers Identification Number and Certification

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Use this form to establish a CreditAdvance account for margin trading (if approved).

Accompanies any and all new business established through WIS

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Required for Traditional Self-Directed Individual Retirement Accounts

***

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

1. Establish a Traditional IRA account using this IRA Application

2. Include a WIS Client Agreement

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

4. Complete and Submit the Asset Movement Form

* Not eligible for DocuSign

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

* Not eligible for DocuSign

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

1. Establish an Inherited Traditional IRA or an Inherited ROTH IRA account using this Application ** This document is 46 pages long. The ROTH is pages 23 – 39. The Inherited IRA Adoption is page 41 – 46. You must select IRA or ROTH.

2.Include a WIS Client Agreement

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

4. Complete and Submit the Asset Movement Form

* Not eligible for DocuSign

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

* Not eligible for DocuSign

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

1. Establish an Inherited Traditional IRA or an Inherited ROTH IRA account using this Application ** This document is 46 pages long. The ROTH is pages 23 – 29. The Inherited IRA Adoption is page 41 – 46. You must select IRA or ROTH.

2.Include a WIS Client Agreement

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

4.Complete and Submit the Asset Movement Form

* Not eligible for DocuSign

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

* Not eligible for DocuSign

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Accompanies any and all new business established through WIS

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

IRS Simplified Employee Pension Individual Retirement Accounts Contribution Agreement

Required for SEP Self-Directed Individual Retirement Accounts

Accompanies any and all new business established through WIS

Use this form to request a conversion of assets from Traditional IRAs, SEP IRAs, and SIMPLE IRAs to Roth IRAs, or for a recharacterization of assets between a Roth IRA and a Traditional IRA, SEP IRA, or SIMPLE IRA.

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Required for ROTH Self-Directed Individual Retirement Accounts

Accompanies any and all new business established through WIS

Use this form to authorize the designation of a joint account as “Transfer on Death.”

Request for Taxpayer Identification Number and Certification

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Use this form to establish a CreditAdvance account for margin trading (if approved).

Required to open a Joint Account where the owners have Rights of Survivorship

Required to open a Joint Account where the owners in common each have an individual interest

Accompanies any and all new business established through WIS

Copy of Plan Document required for Third Party Administrative Plan

Request for Taxpayer Identification Number and Certification

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Acknowledgment that custodian/trustee or third-party administrator is responsible for tax reporting

Accompanies any and all new business established through WIS

Required for all trust accounts. Describes Trustee powers related to the brokerage account

Supporting documentation required for Trust Accounts

Request for Taxpayer Identification Number and Certification

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

401 (k) Account Opening Kit

Custodial Account Agreement

Used when opening a new account when a Separate W-9 is not used.

Use this form to transfer (either partially or in full) assets held at another organization into your control through Pershing, as well as to request the rollover of assets from a qualified retirement plan (QRP) into an individual retirement account or another QRP.

Use this form to open a Corestone account and authorize the issuance of a Visa® debit card(s) and the Bank of New York Mellon to issue checks as indicated on the application.

* Not eligible for DocuSign

Form for any Cost Basis Adjustments for Inherited Covered and Noncovered Securities (Date of Death or Step ups)

Use this letter as authorization to provide to and permit Pershing LLC, acting on behalf of Western International Securities, to share with the Issuer, information regarding your client’s account position(s), activity and other account related information.

Use this form to specify a change in the beneficiary for a Traditional individual retirement account (IRA), Roth IRA, simplified employee pension, SIMPLE IRA, or Education Savings Account.

This form is used for entities that are Non-Profit Organizations.

TPA to confirm that they are responsible for all applicable tax reporting, withholding, and all other reporting surrounding the retirement account.

Use this form to establish an account for option trading (if approved).

Western International Securities (Western International) believes that it is appropriate to set out those fees which may affect your account(s) but are not generally itemized, as are commissions on your printed confirmation or statements. These fees, which are subject to change, can include such charges as a wire fund fee, inactive fee or interest on hard to borrow securities.

Coverdell Education Savings Account Adoption Agreement establishes an Education Savings Account for the benefit of the Designated Beneficiary, in accordance with Internal Revenue Code Section 530.

This is the step‐by‐step process for an advisor to submit a Mutual Fund conversion request form through the NetX360 platform.

Required prior to purchasing precious metals

Complete this form to authorize Pershing to issue funds from your account for the specific dollar amount required to purchase an investment offered through a private investment.

* Not eligible for DocuSign

This brochure describes the features and benefits of SelectLink, a complimentary service that consolidates household statements, includes a summary cover page, and mails the documents in one convenient package.

Required to confirm that the client is the sole-proprietor of the entity

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)

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

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

Investment Management Agreement –Transaction Base Pricing with Schedules

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

Document is to accompany W-8Ben when a US mailing address is used

Use when the security is worthless and there is NO transfer agent. 

Use when the security is worthless and but DOES have a transfer agent.

The form enables the transfer funds between a client’s brokerage account and his/her bank or credit union account via the Automated Clearing House (ACH) system.

*Not eligible for DocuSign

Use this form to request that assets be moved between retail accounts and certain retirement accounts (individual retirement accounts, simplified employee pensions (SEPs), and salary reduction SEPs).  Also to be used for retirement account due to death or divorce.

*Not eligible for DocuSign

IRA Contribution Form

*Not eligible for DocuSign

Use this form to request a distribution from a Traditional individual retirement account (IRA), Roth IRA, simplified employee pension, SIMPLE IRA, and Education Savings Account.

*Not eligible for DocuSign

Qualified Retirement Account Contribution Form

*Not eligible for DocuSign

The Employee Retirement Income Security Act of 1974 (ERISA) requires that the client receive the information contained in this form prior to the annuity start date or distribution date. The Distribution Request Form must be completed by the client, or by the client and their employer, if applicable.

*Not eligible for DocuSign

Accompanies any and all new business established through WIS.

There are three basic steps to the overall plan establishment process. The instructions within will help walk you through the steps necessary to establish an  Individual(k) plan.

Use this form, the Individual(k) Adoption Agreement, to execute the Individual(k) plan document.

Complete this form for your records only. Submit a copy to Pershing. Do not submit a copy to Ascensus.

Complete this form only if the client chooses selecting Ascensus as Third Party Recordkeeper.

This form is used to supply pertinent information that will be needed during the installation process if your client chooses to have Ascensus act as the recordkeeper of the plan.

This form is used to establish Individual(k) brokerage accounts for all eligible participants. You do not need to complete this form if your client is the only participant in the plan.

Complete this form to make a contribution to the plan. Checks should be made payable to Pershing LLC FBO (Employer/Plan Name).

Fee Schedule. NOTE: Pershing fees are paid separately from those charged by a Third Party Administrator (TPA).

This form is used to supply Ascensus with plan sponsor and your (the financial advisor) contact information when using the Ascensus Document Compliance Services. The name of the plan on Form G should match the name of the plan from Form A. The Contact Information Form should be completed to ensure Ascensus can properly communicate IRS required deadlines to you and your client.

Describes and defines the plan information

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