LLC Account Opening Form - Peak Trust Company

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an Account. Identity verification also helps to protect you and us from identity fraud.

What this means for you: When you open an Account, we will ask you and persons associated with your account, for your name, address, date of birth, Social Security Number, and other information that will allow us to identify you. A copy of a valid Passport or Driver’s License is required at the time of account opening.

Name of Account:

Name of Member #1:

Date of Birth:

Physical Address:

City:

State:

Zip:

Country:

Telephone:

Email:

Social Security:

Is Mailing Address different than Physical Address?YesNo

[group ismailingdifferent]

Mailing Address:

City:

State:

Zip:

Country:

[/group]

Is Member a U.S. Citizen?YesNo

[group ismemberuscitizen1 clear_on_hide]

Please attach a legible copy of the Member’s Passport or Driver’s License

[/group]
[group ismemberuscitizenno1 clear_on_hide]

Please attach a legible copy of the Member’s Passsport.

[/group]

Do you need to add a second member?YesNo

[group AddMember2]

Name of Member #2:

Date of Birth:

Physical Address:

City:

State:

Zip:

Country:

Telephone:

Email:

Social Security:

Is Mailing Address different than Physical Address?YesNo

[group ismailingdifferent2]

Mailing Address:

City:

State:

Zip:

Country:

[/group]

Is Member a U.S. Citizen?YesNo

[group ismemberuscitizen2]

Please attach a legible copy of the Member’s Passport or Driver’s License

[/group]
[group ismemberuscitizenno2]

Please attach a legible copy of the Member’s Passsport.

[/group]

Do you need to add a third member?YesNo

[/group]

[group AddMember3]

Name of Member #3:

Date of Birth:

Physical Address:

City:

State:

Zip:

Country:

Telephone:

Email:

Social Security:

Is Mailing Address different than Physical Address?YesNo

[group ismailingdifferent3]

Mailing Address:

City:

State:

Zip:

Country:

[/group]

Is Member a U.S. Citizen?YesNo

[group ismemberuscitizen3]

Please attach a legible copy of the Member’s Passport or Driver’s License

[/group]
[group ismemberuscitizenno3]

Please attach a legible copy of the Member’s Passsport.

[/group]

Name of Attorney:

Name of Firm:

Address:

City:

State:

Zip:

Country:

Telephone:

Fax:

Email:

TAX REPORTING INFORMATION:

Please provide an executed copy of the W-9 or SS-4 for the underlying Member

Does the LLC require a separate TIN from the underlying member?YesNo

[group llcreqgrp]

Tax ID Number for the LLC

[/group]

If a separate TIN is required, will Peak Trust Company be responsible for applying for a TIN?YesNo

Note: If a party other than Peak Trust Company
is applying for the TIN, and the TIN has not been obtained yet, then a copy of the application for the
TIN MUST be attached to this form. An Account cannot be opened without a copy of such application. The
TIN must be assigned and submitted to Peak Trust Company within 30 days of opening the account.

PLEASE PROVIDE FIRM/INDIVIDUAL WHOM THE MEMBER WISHES TO PREPARE THE LLC’S INCOME TAX RETURNS:

Do you need Peak Trust Company to select who will prepare the LLC’s Income Tax Returns?YesNo

[group LLCIncomeTaxReturngrp]

Name of person preparing the LLC’s Income Tax Returns:

Name of Firm:

Address:

City:

State:

Zip:

Country:

Telephone:

Fax:

Email:

[/group]

PLEASE PROVIDE THE FIRM/INDIVIDUAL CHOSEN AS THE REGISTERED AGENT FOR THE LLC:

Name:

Name of Firm:

Address:

City:

State:

Zip:

Country:

Telephone:

Fax:

Email:

PLEASE PROVIDE THE NAME AND ADDRESS OF THE INDIVIDUAL TO RECEIVE BILLING INVOICES:

Name:

Address:

City:

State:

Zip:

Country:

Telephone Number(s)

Email:

Electronic InvoicesPaper InvoicesElectronic AND Paper Invoices

PERSON(S) TO RECEIVE LLC STATEMENTS:

Name:

Address:

City:

State:

Zip:

Country:

Telephone Number(s)

Email:

Please choose the frequency of account statements:AnnuallySemi-AnnuallyQuarterlyMonthly

Statement Delivery Method:Electronic StatementsPaper Statements

Note: If you select electronic statements, you will be provided with access to our online portal.

Do you need to add another person to receive LLC statements? YesNo

[group AddPerson2]

Name:

Address:

City:

State:

Zip:

Country:

Telephone Number(s)

Email:

Please choose the frequency of account statements:AnnuallySemi-AnnuallyQuarterlyMonthly

Statement Delivery Method:Electronic StatementsPaper Statements

Note: If you select electronic statements, you will be provided with access to our online portal.

Do you need to add another person to receive LLC statements? YesNo

[/group] [group AddPerson3]

Name:

Address:

City:

State:

Zip:

Country:

Telephone Number(s)

Email:

Please choose the frequency of account statements:AnnuallySemi-AnnuallyQuarterlyMonthly

Statement Delivery Method:Electronic StatementsPaper Statements

Note: If you select electronic statements, you will be provided with access to our online portal.

Do you need to add another person to receive LLC statements? YesNo

[/group] [group AddPerson4]

Name:

Address:

City:

State:

Zip:

Country:

Telephone Number(s)

Email:

Please choose the frequency of account statements:AnnuallySemi-AnnuallyQuarterlyMonthly

Statement Delivery Method:Electronic StatementsPaper Statements

Note: If you select electronic statements, you will be provided with access to our online portal.

[/group]

Attach Any Additional Documents