DISCLOSURE DOCUMENTS: Wealth Planners, LLC Disclosure Document (Form ADV Part II and Schedules F and H) Wealth Planners Client Agreement Type of Account: Select One... IRA Roth IRA SIMPLE IRA SEP IRA Individual Taxable Community Property Trust Corporate First Name: Middle Initial: Last Name: Social Security #: DOB: Address: City: State: Select One... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ------------------------------ American Samoa Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico Virgin Islands Zip: Phone: Daytime Phone: Email Address: if joint account Spouse First Name: Spouse Middle Initial: Spouse Last Name: Spouse Social Security #: Spouse DOB: Beneficiary 1 First Name: Last Name: Social Security #: DOB: Relationship: Percentage: Beneficiary 2 First Name: Last Name: Social Security #: DOB: Relationship: Percentage: Beneficiary 3 First Name: Last Name: Social Security #: DOB: Relationship: Percentage: Contingent Beneficiary 1 First Name: Last Name: Social Security #: DOB: Relationship: Percentage: Contingent Beneficiary 2 First Name: Last Name: Social Security #: DOB: Relationship: Percentage: Contingent Beneficiary 3 First Name: Last Name: Social Security #: DOB: Relationship: Percentage: Initial Deposit Method: Select One... ACH transfer from checking or savings account Transfer an account from another firm Mail a check Securities Certificates Beginning Balance:
