IRA ELIGIBILITY QUESTIONNAIRE

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Tell us about your existing retirement account and goals. Our team will review the information and explain possible next steps.

YOUR INFORMATION

IRA review.

Completing this questionnaire does not open an account, initiate a rollover or guarantee eligibility. An approved custodian must complete the formal IRA process.

FIRST NAMELAST NAME

EMAIL ADDRESSPHONE NUMBER

COUNTRYAGE RANGE

EMPLOYMENT STATUSRETIREMENT ACCOUNT

ESTIMATED ROLLOVER RANGECURRENT CUSTODIAN OPTIONAL

EXPECTED TIMELINEPRIMARY GOAL

ADDITIONAL INFORMATIONI currently own physical precious metals.I would like an IRA specialist to contact me.

I consent to Patriots Gold Group using the information submitted to evaluate my inquiry and contact me. I understand this questionnaire is educational and does not provide tax, legal or investment advice.

Patriots Gold Group does not provide tax or legal advice. Consult qualified independent professionals regarding the tax consequences, suitability and eligibility of any retirement transaction.

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IRA review.

Begin with
clear information.