Name
(asitappearsonyouraccount)
AccountNumber AccountType
(Trad.,ROTH,SEP)
EmailAddress DaytimePhoneNumber
ContractPrice ExpectedClosingDate
PercentageofOwnership
%
PropertyAddress City State ZipCode
County ParcelNumber BrokerName
PropertyType
SingleFamily MultiFamily Commercial VacantLand
EarnestMoneyAmount PaymentMethod
WireTransfer
($15.00FeeApplies)
$
RegularCheck Cashier'sCheck
($30.00OvernightFeeApplies)
BankName BankABA/RoutingNumber
BankAddress City,State,ZipCode
RecipientName RecipientAccountNumber
ForFurtherCreditTo/PaymentDetails
Name Address
City,State,ZipCode
TelephoneNumber
(OvernightMailOnly)
AccountInformation
InvestmentInformation
REALESTATEPURCHASE
LETTEROFAUTHORIZATION
EarnestMoney
WIREINSTRUCTIONSMAIL
v.11.16
REALESTATEPURCHASE
LETTEROFAUTHORIZATION
ClosingAgentName/Company ContactName
PhoneNumber FaxNumber EmailAddress
FaxNumber Attention
EmailAddress Attention
MailTo
Address City State ZipCode
CheckOne:
OvernightMail
($30.00FeeApplies)
RegularMail
PaymentMethod
BankName BankABA/RoutingNumber
BankAddress City,State,ZipCode
RecipientName RecipientAccountNumber
ForFurtherCreditTo/PaymentDetails
RegularCheck IssueCashier'sCheck
($30.00OvernightFeeApplies)
UPSOvernightMail
($30.00FeeApplies)
Name
TelephoneNumber
(OvernightMailOnly)
Address City,State,ZipCode
WireTransfer
($15.00FeeApplies)
MAIL FAXEMAIL
InvestmentFundingInstructions
ClosingDocumentsDeliveryInstructions
RegularMail
MailingAddress
(IfdifferentfromPayeeAddress)
ClosingAgent
v.11.16
REALESTATEPURCHASE
LETTER
OF
AUTHORIZATION
NameasitAppearsonCard BillingAddress
City,State,ZipCode CardNumber ExpirationDate
SecurityCode
Signature Date
PaymentofFees(IfApplicable)
UDirectIRAAccount EnclosedCheck CreditCard
(CompleteCreditCardSection)
Allfeesassociatedwiththistransactionaredueandpayableatthetimeofprocessing thisrequest.Ifnopaymentelectionis
made,feeswillbedeductedfromyourUDirectIRAAccount.Thistransactionwillnotbeprocessedifsufficientfundsarenot
available.
CreditCardInformation(ForPaymentofFees)
CardType
(ChooseOne)MasterCardVisa
IherebyauthorizeUnitedBanktochargethecreditcardlistedaboveforthefeesassociatedwiththis
LetterofAuthorization,and/orforanyfeesassociatedwithmyaccount.Ifmycreditcardisdeclined,
UnitedBankmayrefusetohonorthisLetterofAuthorization.Ifmycreditcardisdeclined,
UnitedBank
maychargemyUDirectaccountforthefees.ImayremainobligatedtopayfeesevenafterIterminate
UnitedBankasmycustodianasperouragreements.IguaranteeandwarrantthatIamthelegal
cardholderforthiscreditcardandthatIamlegallyauthorized
toenterintothisbillingagreementwith
UnitedBank.Iagreethatelectronicexecutionofthisauthorizationiseffectiveasmyoriginalsignature.
v.11.16
REALESTATEPURCHASE
LETTEROFAUTHORIZATION
AccountOwnerSignature
Signature Date
Iagreethatelectronicexecutionofthisauthorizationiseffectiveasmyoriginalsignature.Electronicexecutionmeansaffixinganimageofmy
signatureinthesignaturebox;placing/s/infrontoforbehindmyprintednameinthesignaturebox;oranyothermethodthatreflectsmyname
orsignature
whichcanbeverified
Youmayexecutethisauthorizationusinganelectronicsignature.Insertanimageofyoursignatureinthesignaturebox;orplacea/s/infrontof
orbehindyourprintednameinthesignaturebox;or,useanyothermethodthatreflectsyournameorsignatureand
whichcanbeverified.
IunderstandthatUnitedBankisa“fiduciary”formyaccountassuchtermisdefinedintheInternalRevenueCode,ERISA,oranyapplicable
federal,stateorlocallaws.Iagreetorelease,indemnify,defend,andholdUnitedBankharmlessfromanyclaimsarisingoutof
thisinvestment,
butnotlimitedtoclaimsthataninvestmentisnotprudent,proper,diversifiedor
otherwiseincompliancewithERISA,theInternalRevenueCodeoranyotherapplicablefederal,stateorlocallaws.Ialso
understandandagreethatUnitedBankasCustodianwillnotberesponsibletotakeany
actionshouldtherebeanydefaultwithregardtothis
investment.
Iamdirectingyoutocompletethistransactionasspecifiedabove.Iconfirmthatthedecisiontoconductthistransactionisinaccordancewiththe
rulesofthisaccountandthatIagreetoholdharmlessandwithoutliabilityUnited
BankasCustodianofmyaccount.
I,theundersignedIRAaccountholderoftheSelfDirectedIndividualRetirementAccountidentifiedabove,indirectingUnitedBankasCustodianof
myIRA,doherebycertifyandaffirmthatthistransactiondoesnotviolatethestandardsofprohibitedtransactionscontainedintheUnitedStates
Code,theInternalRevenueCode,orcaselawand/oragencyissuedopinionsinterpretingthelawasapplicabletomyaccount.Iaffirmthatin
interpretingthesesourcesoflaw,IhavesoughttheadviceofoutsidecounselorIbelievemyknowledgeofthesesourcesoflawisadequateto
direct
theCustodiantocompletethetransaction.IagreetoprovidesufficientdocumentationtotheCustodian,ifrequested,toassistthe
Custodianwithdeterminingthedetailsofthetransaction.IfurtheragreethattheCustodianmayrefusetocompletethistransactionifthe
Custodianbelievesthatthetransactionviolatesprovisionsof
theUnitedStateCodeandRegulationsthereunder,oranyapplicablelocal,federalor
statelaw.UnitedBank,atitssolediscretion,mayrefusetocompletethistransactionevenifthereisnoapparentlegalviolation.
IunderstandthatmyaccountisselfdirectedandthatUnitedBankasCustodiandoesnot
reviewthemeritsand/or
acceptabilityorsuitabilityofanyinvestment.IunderstandthatUnitedBankdoesnotdeterminewhetherthisinvestmentisacceptableunderthe
EmployeeRetirementIncomeSecurityAct(ERISA),theInternalRevenueCodeand/oranyother
applicablefederal,stateorlocallaws,includingsecuritieslaws.Iunderstandthatitis
myresponsibilitytoreviewany
investmentstoensurecompliancewiththeserequirements.
v.11.16