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WellsTrade® Self-Directed Retirement Plan Agreement (ERISA)
Account Number
(Client to complete-Required)
Sub Firm #
205
Doc Code
Account Number
WTTCIP
(Office Use Only)
Identification of Plan.
Date of the Trust
The exact title of the plan and trust (collectively, the “Trust”) to which this agreement applies is: (example: XYZ, Inc. Profit-Sharing Plan)
/
Address
City
State
/
ZIP Code
Address (LEGAL RESIDENCE if mailing address is a P.O. Box or different from Home address. NOTE: P.O. Box is not a legal address.
Business Phone:
(
Nature of Plan.



)
-
Taxpayer ID No.:
The plan is classified as the following type:



Profit-Sharing
401k Retirement Plan
Defined Benefit Plan


Individual 401k Retirement Plan
457b Non Governmental Retirement Plan
457b Governmental Retirement Plan
Certification & Authorization.
457f Retirement Plan
Non Qualified Deferred
Compensation Plan


Money Purchase Pension Plan
Employee Stock Ownership
Program
There are no other trustees of the trust other than the undersigned.
We (the “Trustees”) certify that we have the power under ERISA, the Plan document, the Trust agreement and applicable law to enter into the transactions,
initiate and give instructions on behalf of the plan and, if there are multiple trustees, that each individual listed below may take such actions without the
consent of the others.
Wells Fargo Advisors is hereby authorized to accept orders without inquiry on the above mentioned account from the individual(s) listed below.
 Trustee Directed
 Participant Directed
Name (please print)
Name
Name
Name
Acceptance of Terms.
Wells Fargo Advisors, LLC and Wells Fargo Advisors Financial Network, LLC (hereinafter in this agreement collectively referred to as “WFA”),
are separate, non-bank affiliates of Wells Fargo & Company. Stocks, bonds, mutual funds and other securities bought and sold through WFA are
not deposits of any bank and are not insured or otherwise protected by the Federal Deposit Insurance Corporation (“FDIC”), or any other
government agency; are not an obligation of any bank or any affiliate of WFA; are not endorsed or guaranteed by Wells Fargo & Company, WFA,
or any bank or any affiliate of WFA; and involve investment risk including possible loss of principal. CDs purchased through WFA are FDIC
insured up to $250,000 in the event of the failure of the issuing bank and are covered by SIPC in the event of the failure of WFA. Neither form of
insurance protects against declines in the market value of the CDs to the extent a secondary trading market exists. By signing this agreement, I
acknowledge that I have read and understood the foregoing.
We understand that borrowing money to purchase or carry securities in a margin account is prohibited by WFA in ERISA accounts and any transactions
effected by us will be settled on a cash basis.
We, the Trustees, jointly and severally, and as Trustees agree to indemnify you and hold you harmless from any claim, loss expense (including, but not
limited to attorneys’ fees) or liability for effecting transactions of the type(s) specified above, pursuant to the instructions given by any of the individuals listed
above.
RATIFICATION. The information set forth on all documents sent to the undersigned by WFA will be deemed conclusive unless objected by the undersigned
within 10 days of its being provided.
By signing below, the Trustees certify that they have personally completed this agreement.
The Plan, Trustees, and Participants acknowledge that this agreement contains a pre-dispute clause located on page 2 under the header
“ARBITRATION,” and by reference, on page 1, paragraph 5 of the WFA General Account Agreement and Disclosure document. The undersigned
hereby acknowledges receipt of this agreement and the WFA General Account Agreement and Disclosure document. Unless you object in
writing, you agree that pursuant to rule 14b-1(c) of the securities and exchange commission, broker is obliged to provide your name(s) and
address(es) to each requesting issuer in which you hold securities in nominee name. This rule prohibits such issuer from using your name(s)
and address(es) for any purpose other than corporate communications.
Authorized Signature(s): All Trustees must sign.
Signature(s)*
Date
X
Signature(s)
Date
X
Signature(s)
Date
X
Signature(s)
Date
X
Authorized Signature: Participant must sign.
Signature
Date
X
*Should only one person execute this agreement, it shall be a representation that the signer is the sole trustee. Where applicable, plural references in this
certification shall be deemed singular.
WellsTrade® - Submit your completed form to:
Wells Fargo Advisors, LLC, Attention: H0004-014 ● PO Box 66535 ● St. Louis, MO 63166-9954 or Fax to 800-433-0738
Should you require assistance with this form, please call 1-800-TRADERS (1-800-872-3377)
Investment and Insurance Products:
Not Insured by FDIC or any Federal Government Agency
May Lose Value
Not a Deposit of or Guaranteed by a Bank or Any Bank Affiliate
Wells Fargo Advisors, LLC is a registered broker-dealer and separate non-bank affiliate of Wells Fargo & Company
590907 (Rev 00 – 11/12)
Copy 1—WFA
Copy 2—Client
Copy 3—Financial Advisor
Page 1 of 2
TO: Wells Fargo Advisors and First Clearing, LLC
To Whom It May Concern:
In consideration of Wells Fargo Advisors, LLC, or Wells Fargo Advisors Financial Network, LLC (hereinafter in this Agreement collectively known as “WFA”),
separate, non-bank affiliates of Wells Fargo & Company accepting and agreeing to act as my broker and of First Clearing, LLC (“FCC”), also a separate, nonbank affiliate of Wells Fargo & Company, carrying the account(s) of the undersigned, I agree to the following with respect to any of my Retirement Plan
accounts with you. Throughout this Agreement, “I”, “me”, “my”, “we”, and “us” and “the undersigned” refer to authorized signers and all others who are legally
obligated on this account. “You” and “your” refer to WFA and FCC, their subsidiaries and affiliates, their officers, directors, agents and employees. WFA and
FCC are non-bank subsidiaries of Wells Fargo & Company. As used herein, the term “affiliate” of WFA means Wells Fargo & Company and its subsidiaries
and affiliates, including without limitation, FCC. Each of WFA and its affiliates is a separately incorporated legal entity, none of which is responsible for the
obligations of the others. Where the context requires, the singular shall be the plural and the plural shall be the singular. As set forth in the WFA Client
Agreement and Disclosure and Designation of Responsibilities incorporated therein, I understand the role and services provided by WFA and FCC
respectively and agree that this Agreement inures to the benefit of both firms and their affiliates as applicable.
REPRESENTATIONS. The Trust and the signed Trustees (if more than one, then jointly and severally) hereby represent, warrant and agree as follows:
(a) WFA is NOT a fiduciary or an investment manager (as defined in ERISA sections 3(21) and 3(38), respectively), with respect to the Plan or any part of its assets.
(b) The Trust, the Trustees and the person(s) designated to give investment instructions on behalf of the Plan will make their own investment decisions, and will not
look to WFA as the primary source of their investment advice.
(c) WFA will have no obligation whatsoever to monitor the on-going performance of or to report to the Trust with respect to any investment made by the Trust which
shall rely exclusively on the persons designated to perform such monitoring and reporting.
(d) The Trust, the Trustees, the person(s) designated to give investment instructions on behalf of the Trust and any other fiduciary with respect to the Trust will not
engage in, nor permit the Trust to engage in any “prohibited transaction” (as defined by applicable statue and regulations).
(e) The Trust, the Trustees, the person(s) designated to give investment instructions on behalf of the Trust and any other fiduciary with respect to the Trust will
maintain all required and necessary records, and agree that WFA will have reasonable access thereto.
(f) The Plan’s definition of the term “fiduciary” is not so worded as to include the normal functions of a brokerage firm, either directly by naming brokerage firms as
“fiduciaries,” or indirectly within the scope of the definition.
(g) To the extent that a participant is designated, the Trustee Certifies that the Plan and trust permit self-direction if investments by the participant.
The representations listed above do not apply if Trustees have entered into a separate agreement with WFA whereby WFA has agreed to act as a
fiduciary by either exercising discretionary authority over investment of Plan assets or by providing ongoing investment advice to the Plan for a
fee.
MANAGEMENT OF PLAN. The Plan is relying solely upon the management of the person(s) designated. Notwithstanding any other provision of this
Agreement, the Plan and the Authorized Signers (if more than one, jointly and severally) hereby agree to indemnify, defend, and hold WFA harmless from
and against any and all claims made against WFA arising from or in any way connected with your acceptance of investment directions and other instructions
(including for the transfer of property outside of the Plan) from the person(s) designated, including, but not limited to, any claim that WFA is a fiduciary, Claims
related to plan prohibited transactions (as defined under ERISA and the Internal Revenue code), excise taxes, penalties, damages, loss, expense and/or
attorneys’ fees incurred by WFA in defense thereof.
LEGAL AND TAX ADVICE. Because you and your employees are prohibited from giving the Trust legal advice, it is hereby agreed and understood that
neither you or your employees or agents has any responsibility with respect to the legal or tax aspects of the Trust. The Trust represents that it has relied and
will continue to rely upon its own legal and tax advisors for retirement plan design, compliance and administration.
SUBSEQUENT CHANGES. We agree to inform you, in writing, of any amendment to either the Plan or the Trust, any change in the composition of the
Trustees or any other event which could alter the representations and certifications made above.
RULES AND REGULATIONS. All transactions in my account shall be subject to the constitution, rules, regulations, customs and usages of the exchange or
market, and its clearing house, if any, where the transactions are executed. Transactions shall also be subject to the provisions of federal and state securities
laws, as amended, and to the rules and regulations of the Securities and Exchange Commission and the Board of Governors of the Federal Reserve System.
You shall not be liable for any loss caused directly or indirectly by your compliance with such rules or regulations or government restrictions, exchange or
market rulings, suspension of trading, war, or other conditions beyond your control.
ARBITRATION.
Arbitration Disclosures:
This Agreement contains a pre-dispute arbitration clause. By signing an arbitration agreement, the parties agree as follows:
• All of the parties to this Agreement are giving up the right to sue each other in court, including the right to a trial by jury, except as provided by the rules
of the arbitration forum in which the claim is filed.
• Arbitration awards are generally final and binding; a party’s ability to reverse or modify an arbitration award is very limited.
• The ability of the parties to obtain documents, witness statements and other discovery is generally more limited in arbitration than in court proceedings.
• The arbitrators do not have to explain the reason(s) for their award unless, in an eligible case, a joint request for an explained decision has been submitted
by all parties to the panel at least 20 days prior to the first scheduled hearing date.
• The panel of arbitrators typically will include a minority of arbitrators who were or are affiliated with the securities industry.
• The rules of some arbitration forums may impose time limits for bringing a claim in arbitration. In some cases, a claim that is ineligible for arbitration may
be brought in court.
• The rules of the arbitration forum in which the claim is filed, and any amendments thereto, shall be incorporated into this Agreement.
No person shall bring a putative or certified class action to arbitration, nor seek to enforce any pre-dispute arbitration agreement against any person who
has initiated in court a putative class action; or who is a member of a putative class who has not opted out of the class with respect to any claims
encompassed by the putative class action until:
(i) the class certification is denied; or
(ii) the class is decertified; or
(iii) the client is excluded from the class by the court.
Such forbearance to enforce an agreement to arbitrate shall not constitute a waiver of any rights under this Agreement except to the extent stated herein.
Arbitration Provision:
It is agreed that all controversies or disputes which may arise between you and WFALLC including controversies or disputes with WFALLC’s clearing agent
(collectively, “us”) concerning any transaction or the construction, performance or breach of this Agreement or any other agreement between us, whether
entered into prior to, on, or subsequent to the date of this Agreement, including any controversy concerning whether an issue is arbitrable, shall be
determined by arbitration conducted before, and only before, an arbitration panel set up by either the Financial Industry Regulatory Authority ("FINRA") or
the New York Stock Exchange, Inc. ("NYSE") in accordance with their respective arbitration procedures. Any of us may initiate arbitration by filing a written
claim with the FINRA or the NYSE. Any arbitration under this Agreement will be conducted pursuant to the Federal Arbitration Act and the Laws of the State
of New York. The state or federal statute of limitations, statute of repose, non claim statute or any other time bar that would be applicable to any claim filed
in a court of competent jurisdiction shall be applicable to any claim filed in arbitration.
590907 (Rev 00 – 11/12)
Copy 1—WFA
Copy 2—Client
Copy 3—Financial Advisor
Page 2 of 2