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Midland requires this information form to be completed prior to onboarding IRA investors. This document helps our office better understand the nature and expectations for the investment in order to determine administrative feasibility while also tailoring our personal service to provide an excellent customer experience. Midland does not perform due diligence on any investment offering. We do not need performance reporting or audited financials, and Midland does not review for investment viability or suitability.

Get your investment set up with Midland by completing the form below.

Issuer Information


Fund Administrator Information (If Applicable)

Investment Information

Investment Name

In order to obtain information about your investors’ IRA account, including status information, each investor will need to sign an “Interested Party Form”. This form will also permit you to view accounts online.

List names, email addresses, and phone numbers of representatives that will be working with Midland in regards to this investment:

Wire Instructions

Acknowledgement

In order for Midland Trust Company (“Midland”) to administer this asset, the investment issuer agrees to the following:

  1. Issuer agrees to register ownership of investment to:
    Midland Trust Company, As Custodian FBO (Client Name) (Client Account Number) P.O. Box 07520, Fort Myers, FL 33919
  2. Issuer understands that the Taxpayer EIN for all Midland investments held in Traditional, Roth, SEP, Simple,HSA, and ESA accounts is 47-5560347. The IRA investors’ SSN should never be used for reporting purposes for retirement account investments. Employer plans such as 401k plans have a unique Tax ID for the plan.
  3. Issuer agrees to issue all payments, income, dividends, distributions and/or payoffs directly to Midland IRA.Due to regulation, it is not acceptable to send funds directly to an IRA holder.
  4. Issuer understands that Midland has not performed any due diligence on this investment, and understands that Midland IRA does not endorse this investment.
  5. Issuer agrees to provide Midland with annual valuation information as defined by IRS Publication 590
  6. Issuer agrees to provide Midland with evidence of ownership of each investment including original stock certificates, or written confirmation.
  7. Issuer acknowledges that IRAs are restricted from making mandatory capital calls if the capital call results in a prohibited transaction. Any additional investment will be done so on the account holder’s discretion.
  8. Issuer agrees to inform Midland if they become aware of any prohibited transaction as defined in IRC 4975.This would include IRA transactions with prohibited parties, transactions that personally benefit the IRAholder, and/or investments in life insurance or collectibles, which are prohibited by IRC 4975.
  9. Issuer agrees to notify Midland of any changes in address contact, or company status.
  10. Issuer understands that Midland does not promote, sell, or distribute any investment, including the investment described in this document. Additionally, Midland will not provide investment, tax, or legal advice to any party,including the issuer and/or IRA holders. Issuer understands that Midland IRA is a self-directed IRA administrator not an investor.
  11. Issuer agrees to not make any representations to any party that may contradict the language in this document.

Read, Understood, and Agreed to by:

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