Account Setup Form
Let's Begin!
 
Let's start with your information

This is the account holder information
 
First Name *

 
Last Name *

 
Phone Number *

 
Street Address: *

please include the apt/unit number if applicable
 
City: *

 
State: *

 
Zip code: *

 
SSN: *

This information is encrypted and secured
 
Date of birth: *

 
Are you married? *

     
 
Let's collect info on your current investment account

 
What kind of account is it?


 
What is your current investment account number?

You may leave this answer blank if you don't know the account number
 
Are you transferring the entire balance of your account?

     
 
Partial transfer

 
Would you like to close the account after funds have been transferred? *

     
 
What is the exact amount you'd like to transfer *

 
What is the approximate amount of funds in your account? *

 
And now we'll collect your beneficiary information

This section is optional and can be completed at a later time if you prefer.
 
How many beneficiaries would you like to specify at this time? *

(optional)

 
Beneficiary information (one)

 
Legal name: *

Full legal name
 
Street Address: *

please include the apt/unit number if applicable
 
City: *

 
State: *

 
Zip Code: *

 
SSN

this information is encrypted and secured
 
Date of Birth: *

 
Share %

What percentage of your IRA would like to designate to this beneficiary
 
Relationship *

Ex: Wife, Son, Daughter
 
Type of beneficiary *


 
Beneficiary Information (two)

 
Let's get information for your first beneficiary

 
Legal name: *

Full legal name
 
Street Address: *

please include the apt/unit number if applicable
 
City: *

 
State: *

 
Zip Code: *

 
SSN

this information is encrypted and secured
 
Date of Birth: *

 
Share %

What percentage of your IRA would like to designate to this beneficiary
 
Relationship *

Ex: Wife, Son, Daughter
 
Let's get information for your second beneficiary

 
Legal name: *

Full legal name
 
Street Address:

please include the apt/unit number if applicable
 
City: *

 
State: *

 
Zip Code: *

 
SSN

this information is encrypted and secured
 
Date of Birth: *

 
Share %

What percentage of your IRA would like to designate to this beneficiary
 
Relationship *

Ex: Wife, Son, Daughter
Thank you for completing your account setup form. A Noble Gold representative will be in touch shortly to confirm your new account!