Self-directed Brokerage Online Enrollment Form

Self-Directed Brokerage Online Enrollment Form

Plan Name

NOTE: Plan Name, Company ID and Plan ID are available on your company's benefits website.

Plan ID

Company ID

First Name

Middle Name

Last Name

Birthdate

Social Security Number

Mother's Maiden Name

Daytime Phone

Evening Phone

E-mail Address

Mailing Address

US/Canada

Other

Address Line 1

Address Line 2

City

State

Zip

Country

Is this mailing address a P.O. box?

Yes

Street Address

US/Canada

Other

Address Line 1

Address Line 2

City

State

Zip

Country

Question One: Are you or a member of your household affiliated or employed by a member of a stock exchange or the Financial Industry Regulatory Authority (FINRA)?

Yes

Question Two: Are you or a member of your household licensed by the Financial Industry Regulatory Authority (FINRA) or a registered investment advisor and using the license or registration in a professional sales, trading or customer service capacity?

Yes

Question Three: Are you or a member of your household a director, 10% shareholder or policy-making officer of a publicly traded company?

Yes

In order to access your Alight Financial Solutions account online you must create a User ID. Please provide 2 choices (between 4 and 15 letters and/or numbers). If none of your choices are available, Alight Financial Solutions will create an User ID for you. For your protection DO NOT use any portion of your social security number. This information is mandatory to establish online access to your account.

User ID
Second Choice

For your convenience, this account will be identified on the Alight Financial Solutions web site by your account number and by a nickname you provide:

Account Nickname

I have read and agree to the Memorandum of Understanding.

I have read and agree to the Plan Participant Agreement.

By checking this box I acknowledge that I emailed or mailed the Participant Disclosure, Memorandum of Understanding and read the following statement to the participant:

Since you are unable to complete this application online, I will email the agreement to you now. Please confirm that upon receipt of the disclosure you will review the terms of use. You acknowledge that if you do not agree to the terms, it is your responsibility to contact us in order to close the account.

Investment Specialist

PLEASE READ THE IMPORTANT DISCLOSURES BELOW
Alight Financial Solutions LLC, member FINRA, SIPC, is a broker/dealer that primarily provides services to retirement plans. It is a subsidiary of Alight Solutions LLC, a global human resources outsourcing and consulting firm, founded in 1940 and headquartered in Lincolnshire, Illinois. Alight Financial Solutions consults on investment issues with Alight Solutions' defined contribution clients, which represent millions of participants and is approaching $300 billion in assets. Securities are offered by Alight Financial Solutions, Member FINRA, SIPC.

Statement of Financial Condition Privacy Statement Legal Disclosures

Your enrollment form has been sent to Alight Financial Solutions for processing.
You will receive a User ID and password via email once your account is established.

An E-mail error has occurred.
Please check with Alight Financial Solutions to confirm your account is being opened.

A server processing error has occurred.
Please notify your plan administrator of the error and for help in opening the brokerage account.