BBC • Phone (201) 271-2590 • FAX (201) 271-2071
BPX/S87849 • Control 5 • Proof 3 • 9/25/03 • RUSH
Account Application – Entity
Toll Free Phone: 1-888-718-7878
Mon-Fri 8 a.m. to 8 p.m. ET.
Web Site: www.Independent529Plan.org
1. Please read the Disclosure Booklet and Enrollment Agreement (found in the Disclosure Booklet) for the Independent 529 Plan
carefully before completing this Application.
2. A separate Account Application must be completed for each Beneficiary. You can make and use a copy of this form for each Bene-
ficiary you wish to open an account for.
3. Print in capital letters and use blue or black ink.
Account Owner Information
Type of Entity (check one) (Read the attached insert regarding substantiation requirements before completing this Application.)
❑ College or University
❑ Trust or Estate (Foreign trusts not eligible)
❑ Internal Revenue Code Section (“IRC §”) 501(c)(3) Organization other than College or University
❑ Business Entity: Corporation; Partnership; Sole Proprietorship; Company; Association
❑ State or Local Government (or agency or instrumentality thereof)
Type of Account (check one):
❑ Entity Account for Named Beneficiary: (available to any entity)
❑ Qualified Scholarship Account for a Named Beneficiary
Name of Entity
Taxpayer Identification Number
Principal Place of Business or Local Office
Authorized Individual to Act on Behalf of the Entity (for Trust: Trustee’s Name; for Partnership:
Submit official documentation authorizing a specific individual to open the Account and conduct future transactions,
including the individual’s title or position. You can list up to two Authorized Individuals below and you can attach an addi-
tional page, if necessary. See attached inserts regarding documentary evidence and substantiation requirements.
Business Telephone Number
Social Security Number
Date of Birth (month/day/year)
IMPORTANT INFORMATION ABOUT PROCEDURE