Service Request

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Submission Date

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Rep Code

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Rep Name

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User Role

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Rep Email

Advisor Notification(Required)

Please provide the advisor's email for whom you are submitting the request. You will both get notifications upon completion of the service ticket. A Monday account is not required.

Client Name On Account(Required)

Existing Account Number (No Special Characters)(Required)

Custodian(Required)

Request Type

NOTE: Service requests received prior to 12pm ET will be actioned the day of submission, with all other service requests being executed on a best efforts basis that same day or the following business day, pending information and requirements are provided and in good order.

Please Choose the Request Type(Required)

NOTE: All require a client signature except the following: G Number for any Bison G numbers (not including Liquid Strategies); Periodic Plans, if already established Standing Payment Instructions/Money Move; Auto Investment of Dividends; Advisory Fee Modification, if a lower fee than established on Advisory Agreement

Request Information

Name of individual to add to Monday.com(Required)

Individual will be added as a guest status, that allows for visibility of assigned items and the ability to comment in the "message bubble," unless the email provided is in the Bison Wealth email domain.

Email of individual to add to Monday.com(Required)

Which is this rebate for?(Required)

Household

Specific Account(s)

Please outline the reason for the rebate.(Required)

Please provide the Orion Household ID that is to be rebated.(Required)

Please list all accounts that are to be rebated.(Required)

Account Name

Account Number

NOTE: You may add additional rows with the + sign to the right of the columns

What team or branch should this individual be added? For example, Trading Team, New York Team, Sarasota Team, REAP, etc.

Has the custodian been notified of the death?(Required)

Yes, notification has been submitted

No, please submit the notification to the custodian

What is the date of death?(Required)

Please list any additional accounts names & account numbers for all the decedents account under management.(Required)

Account Name

Account Number

NOTE: You may add additional rows with the + sign to the right of the columns

Select which item is needed.(Required)

Asset added only

Non-live linked account added

Non-live linked account and asset added

Please provide the following for the non-live account requested: Household name; account number; Tax Id (if applicable); Account type; Custodian; Management Style; Fund Family(Required)

Please list the asset that needs to be added.(Required)

Please list any additional accounts names & account numbers that is update involves.(Required)

Account Name

Account Number

NOTE: You may add additional rows with the + sign to the right of the columns

Which method would you like to set up on the above listed accounts involved?(Required)

Indirect payment from another account

Remove indirect payment, make accounts direct pay

Please provide the account number that is to pay for the indirect payment accounts listed above.(Required)

Has the third party item already been submitted to the custodian?(Required)

Yes, the request has been submitted to the custodian

No, the request has not been submitted, I will attach via link.

Please provide the work item number for the third party attestation.(Required)

Which type of householding would you like?(Required)

Add Householding

Remove Householding

Which platform does this apply?(Required)

Custodian Only

Orion Only

Both custodian AND Orion

What account is the primary account to household under?(Required)

Name & account number(s) that are being householded into the primary account household.(Required)

Account Name

Account Number

NOTE: You may add additional rows with the + sign to the right of the columns

Name & account number(s) that are being broken out into individual households.(Required)

Account Name

Account Number

NOTE: You may add additional rows with the + sign to the right of the columns

What household name would you like to display on statements?(Required)

Which platform does this apply?(Required)

Custodian Only

Orion Only (will be cancelling in Orion)

Both custodian AND Orion

Please be aware that custodian household requests requires a client signature.

Should the closed accounts also be delinked/removed from the custodian?(Required)

Yes, delink/remove from custodian

No, only closure for now

Would you like to close an account or a household?(Required)

Account only

Household

What household name(s) should be closed with this request?(Required)

Please note, all accounts within the household will be closed.

Current Fee assigned:(Required)

New Fee to change to:(Required)

Please note, if this is an increase from the current fee a new client advisory agreement will be needed. Attach that item below, if applicable. *This is not applicable to any TAMPs

List any other ACCOUNTS that this fee structure would apply to:

NOTE: You may add more than one account using the + to the right of the field

Justification For Fee Modification/Additional Details(Required)

What Money Manager would you like added to this account? Please attached the Investment Selection Form, if applicable.(Required)

Liquid Strategies (Overlay Manager)

Brooklyn

Howard Capital

Bison Wealth - Specific

Zacks

Dana

Other

Please provide Other Money Manager to add to the client account.(Required)

Existing Payout Structure:(Required)

Please provide the payout structure that are to replace the existing payout on the requested accounts.(Required)

List any other accounts that this payout structure would apply to:

NOTE: You may add more than one account using the + to the right of the field

Which one does the Advisor update apply?(Required)

Account Only

Full Household

Current Advisor assigned:(Required)

New Advisor to be assigned:(Required)

Which dividend option would you like to change?(Required)

Please list each security you would like the dividend modified.(Required)

Click the plus button to add additional lines.

Please select the dividend option you would like applied, select only one.(Required)

Reinvest Eligible Equity and Mutual Funds

Reinvest Eligible Equity Dividends

Hold in Account in Cash Position

Reinvest Eligible Mutual Fund Dividends

Please note the dividend option you chose will be applied to the choice you made above for all securities listed, or entire account.

G Number/ Master Number Modification

Are you adding or removing a G Number/Master Number?(Required)

Add

Remove

Select the option you would like for the G Number/Master Number Addition.(Required)

As a secondary (ie. additional advisor assists with servicing, for visibility)

As primary (ie. part of advisor primary book of business)

Advisor G Number/Master Number to be added/removed:(Required)

NOTE: For Liquid Strategies addition please submit an SMA Money Manager request.

Overlay

What Overlay action would you like?

Start Overlay

Modify Overlay

Close Overlay

What Overlay action would you like?

Start Overlay

Modify Overlay

Close Overlay

What modification would you like?(Required)

Increase Notional

Decrease Notional

What is the increase in notional?(Required)

What is the decrease in notional?(Required)

Special Request/Additional Information

Please outline, in detail, the request that is not an item listed in the selection form or any additional details needed. Attach any required documentation.

NOTE: If this request is one of the items addressed in the initial selection, this request will be rejected and instructions provided for accurate submission. If the detailed discription is not clear for the special request Operations will contact the advisor for clarification via the Monday.com line item message bubble.

Supplemental Required Documents For Requests

If there are no document upload prompts below, there are no supplemental documents required.

Please upload the Third-Party Disbursement & Standing Instructions Advisor Attestation form, completed with the required information OR the client EXECUTED third party SPI/Distribution form that requires an Advisor (RIA) authorized signer signature.(Required)

Max. file size: 2 GB.

Upload the Overlay worksheet - signed by the client(Required)

Drop files here or

Max. file size: 2 GB, Max. files: 10.

Please upload supporting statement documents for Cost Basis update

Drop files here or

Max. file size: 2 GB.

Please upload the death certificate. This will be submitted to the custodian and an estate case created.

Max. file size: 2 GB.

Please upload the executed Investment Advisory Agreement(Required)

Max. file size: 2 GB.

Please upload the SMA portfolio form signed by the client.(Required)

Max. file size: 2 GB.

Please upload any documents relating to special request, if needed.

Max. file size: 2 GB.