New Client Account Application

New Client Account Application
General Information
Full Name *

First Name Middle Name Last Name
Preferred Name
Phone Information
Mobile Phone Number *
Home Phone Number
Phone Preference *

Mobile Home
Email Information
Personal Email *
example@example.com
Business Email
example@example.com
Email Preference *

Personal Business
Address Information
Mailing Address *

Street Address

Street Address Line 2

City State

Zip Code
Preferred Contact Method *

Phone Email Snail Mail
Legal Address Same as Mailing? *

Yes No
Legal Address

Street Address

Street Address Line 2

City State

Zip Code
Additional Information
Citizenship *

U.S. Citizen Resident Alien Non-Resident Alien U.S. Citizen Living Abroad
Gender *

Male Female
Country of Citizenship *
Marital Status *

Married Single Divorced Widowed
Spouse Name

First Name Last Name
Number of Dependents *
SSN or TIN *
Date of Birth *

Month Day Year
Place of Birth

Street Address

Street Address Line 2

City State
Drivers License # *
DL Issued State *

Street Address

Street Address Line 2

State
DL Issued Date *

Month Day Year
DL Expiration Date *

Month Day Year
Employment Info
Employment Status *
Employer Name
Occupation
Industry
Year Employed
Employer Address

Street Address

Street Address Line 2

City State

Zip Code
Work Phone Number
Financial Profile
Estimated Annual Income *
Federal Tax Bracket *

0% - 15% 16% - 28% 29% - 33% 34% - 39%
What is your Estimated Net Worth? *
Estimate only: Include all assets (equity in real estate, retirement accounts, other investments, bank accounts, etc)
What is your Estimated Liquid Net Worth? *
Estimate only: Include all assets that could be liquidated easily (everything above excluding real estate, businesses, etc)
What are your Annual Living Expenses? *

$0 - $25,000 $25,001 - $50,000 $50,001 - $75,000 $75,001 - $100,000 $100,001 - $250,000 $250,001 - $500,000 > $500,000
Do you have any upcoming significant Special Expenses? *

$0 - $25,000 $25,001 - $50,000 $50,001 - $75,000 $75,001 - $100,000 $100,001 - $250,000 $250,001 - $500,000 > $500,000
Time Frame for Special Expenses
Investment Experience
Do you have prior investment experience? *

What is the estimated value of this account? *
What Type of Accounts are being opened? *

Non-Retirement (Investment, Brokerage, After-Tax, etc) Retirement (IRA, ROTH IRA, SEP IRA, 401k, etc) College Savings Plan (529)
Who will Own the Account? *

Account Owned Only in Your Name Jointly Between Two Individuals Transfer On Death
Which Advisor are you working with?
Secondary Account Owner Information

If the account is to be owned jointly between two individuals or transferred on death to another individual, please provide the secondary account holder's email address so we can send them a link to this form for completion.
Secondary Account Owner Email Address
Account Beneficiaries

For Transfer on Death, Retirement Accounts or College 529 Plans
Beneficiary Name (1)
Date of Birth
Gender

Male Female
Relationship

Spouse Non-Spouse Non-Person
Primary or Secondary?

Primary Secondary
Percentage
SS#
Beneficiary 1 Social Security Number
Beneficiary Name (2)
Date of Birth
Gender

Male Female
Relationship

Spouse Non-Spouse Non-Person
Primary or Secondary?

Primary Secondary
Percentage
SS#
Beneficiary 2 Social Security Number
Beneficiary Name (3)
Date of Birth
Gender

Male Female
Relationship

Spouse Non-Spouse Non-Person
Primary or Secondary?

Primary Secondary
Percentage
SS#
Beneficiary 3 Social Security Number
Beneficiary Name (4)
Date of Birth
Gender

Male Female
Relationship

Spouse Non-Spouse Non-Person
Primary or Secondary?

Primary Secondary
Percentage
Beneficiary Name (5)
Date of Birth
Gender

Male Female
Relationship

Spouse Non-Spouse Non-Person
Primary or Secondary?

Primary Secondary
Percentage
Beneficiary Name (6)
Date of Birth
Gender

Male Female
Relationship

Spouse Non-Spouse Non-Person
Primary or Secondary?

Primary Secondary
Percentage
Document Upload Section

Not Required but review and upload if applicable.
If possible, please upload a copy of your Driver's License for our records:

Browse Files
Supported file types: pdf, jpg, jpeg, png Cancel of
Do you want to link a bank account to your investment account for easy deposits and withdrawals? *

Yes No Yes, but I'll send a copy of a voided check to info@norrisfinancialgroup.com
Voided Check - Investment Account Deposits & Withdrawals

Browse Files
If you would like to link your investment account at Norris Financial Group to a bank account for funding and withdrawal purposes, please upload a voided check for the bank account that you would like to link. Cancel of
Are we transferring an existing account from another investment provider? *

Yes No Yes, but I'll send a copy of my most recent statement to info@norrisfinancialgroup.com
Current Investment Account Statement

Browse Files
If we are funding the investment account from an existing investment account then please upload your most recent statement here. Cancel of
Will this account be owned by a trust? *

Yes No Yes, but I'll send a copy of the trust document to info@norrisfinancialgroup.com
Trust Documents

Browse Files
If the account is to be opened in the name of a trust, please upload the trust document here. Cancel of
Submission Date

Month Day Year
Date Hour Minutes AM/PM Option
Should be Empty:

	Years of Experience	Approx Current Value
Annuities
Bonds
Stocks
Mutual Funds
401k or Similar Plans
Alternative Investments
Managed Accounts
Other

New Client Account Application

General Information

Phone Information

Email Information

Address Information

Additional Information

Employment Info

Financial Profile

Investment Experience

Secondary Account Owner Information

Account Beneficiaries

Document Upload Section