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The form explains required investment/document titling (Horizon Trust FBO format) to avoid delays and potential tax consequences, and includes document handling options for mail, email, fax, or additional processing instructions. Account owner authorization emphasizes self-directed responsibilities and directs the custodian passively to enact the transaction.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/authorization-to-take-action-form-rev-10-2024/303010/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/authorization-to-take-action-form-rev-10-2024/303010.png","ImageObject",442,249,{"name":88,"@type":89},"wps_ap_test_251126_0180","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-03","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",6,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What account and asset information is required on this form?","Question",{"text":109,"@type":110},"The form requests account owner details (name, account number, last 4 SSN digits, date of birth, and email) and asset information (asset name/description and asset reference number, if applicable).","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"Which types of actions can the account owner request in Part 3?",{"text":114,"@type":110},"Actions include authorizing documents requiring signatures, amending or replacing investment terms, submitting a 401(k) loan modification request, requesting specific letters, and requesting tax reporting documents.",{"name":116,"@type":107,"acceptedAnswer":117},"How can signed or reference documents be delivered under the document handling section?",{"text":118,"@type":110},"Select mail (regular or overnight with address details), email (email contact details), fax (fax number and attention line), and any additional processing instructions or notes.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},303010,1790492593,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":9},8796095027276,"https://avatar.qwps.com/avatar/d3BzX2FwX3Rlc3RfMjUxMTI2XzAxODA=","Authorization to Take Action Form  \n (888) 205-6036  (505) 212-0494  [operations@horizontrust.com](operations@horizontrust.com)[ ](operations@horizontrust.com) Horizon Trust Correspondence, PO BOX 27068, Newark NJ 07101  \nPART 1. ACCOUNT OWNER INFORMATION  \nFirst Name: M. I.: Last Name: Account \\#:  \nLast 4 SSN Digits: Date of Birth: (MM/DD/YYYY) Email Address:  \nPART 2. ASSET INFORMATION  \nAsset Name / Description: Asset Reference \\#: (If applicable)  \nPART 3. ACTION TO TAKE  \nPlease select and complete one of the options below.  \n Option 1. Documents Requiring Signatures (Please seepage 3 for document handling information)  I have read and approved the documents I am requesting to be signed.  \nDocument 1: Document 2:  \nDocument 3: Document 4:  \nInvestment & Document Titling  \nBecause your account is considered to be the legal owner of your investments, all assets and documents must reflect this ownership. Failure to title assets correctly may cause delays and/or tax consequences. The correct titling should be as follows:  \n“Horizon Trust FBO: (Your Name) (Account Type)”  \nExample: Horizon Trust FBO: Jane Doe Roth IRA  \n1 of 3 (Rev 10 .2024) AUTHORIZATION TO TAKE ACTION FORM  \n Option 2. Amend/Replace Terms of an Investment (New/amended documentation required) Current Investment Information (borrower name, company, security, terms, etc.):  \nNew Investment Information (borrower name, company, security, terms, etc.):  \nOption 3. 401(k) Loan Modification Request  \n(Day of the month)  \nRevise Bank Information (Copy of voided check required)  \nABA (Routing) \\#: Bank Account \\#:  \nLoan Deferral: (Loan Deferrals are subject to review and approval. If approved, a new amortization schedule is suggested or the original payment schedule will resume and you will be responsible for the deferred payments)  \n1 Month  \n2 Months  \n3 Months  \n Option 4. Request a Letter  \n Proof of Funds  Proof of Distribution/Recurring Distribution  \nOption 5. Tax Reporting Document Request  \n DO NOT generate 5500 tax form for my Solo 401(k) plan (Only applicable to plans with total value over $250,000)  \n! Note: Horizon Trust uses a Third-Party Administrator to assist in filing 5500 tax forms, but it is always the responsibility of the account holder to make sure the form is filed when applicable.  \n IRA & Savings Account-Mail all 1099R & 5498 forms to my address on file (Traditional, Roth, SEP, SIMPLE, HSA, CESA)  \n2 of 3 (Rev 10 .2024) AUTHORIZATION TO TAKE ACTION FORM  \nDocument Handling  \nA copy of the signed investment documents will be made available to you in accordance with our Information Security Policy. Please refer to the Investment Documentation section of your account’s Custodial Agreement and Disclosure Statements for more information about how we store your records. Select any additional handling options that may apply:  \n MAIL: Please mail the above reference documents to the following individual: (Complete the following information)  \nAttention to: Send signed documents via:  \nRegular Mail  \n Overnight Mail ($50.00)  \nAddress: City: State: Zip:  \nEMAIL: Please email the above reference documents to the following individual: (Complete the following information)  \nAttention to: Email:  \nFAX: Please fax the above reference documents to the following individual: (Complete the following information)  \nAttention to: Fax \\#:  \nAdditional Processing Instructions/Notes  \nPART 4. ACCOUNT OWNER AUTHORIZATION  \nImportant: Please read before signing.  \nI understand this is a self-directed account meaning that I am solely responsible for the selection, due diligence, management, review, retention and liabilities of all investment(s) and for the accuracy of the instructions provided to the Custodian or Administrator to fulfill those investments. I understand the Custodian and Administrator are not fiduciaries and do not provide investment, tax or legal advice. I hereby direct the Custodian, in a passive capacity, to enact this transaction for my account, ","cbCaiscw8uSkjB5L","https://ap.wps.com/l/cbCaiscw8uSkjB5L","pdf",181404,"English","# PART 1. ACCOUNT OWNER INFORMATION\n# PART 2. ASSET INFORMATION\n# PART 3. ACTION TO TAKE\n## Option 1. Documents Requiring Signatures\n## Option 2. Amend/Replace Terms of an Investment\n## Option 3. 401(k) Loan Modification Request\n## Option 4. Request a Letter\n## Option 5. Tax Reporting Document Request\n# Document Handling\n# PART 4. ACCOUNT OWNER AUTHORIZATION","[{\"question\":\"What account and asset information is required on this form?\",\"answer\":\"The form requests account owner details (name, account number, last 4 SSN digits, date of birth, and email) and asset information (asset name/description and asset reference number, if applicable).\"},{\"question\":\"Which types of actions can the account owner request in Part 3?\",\"answer\":\"Actions include authorizing documents requiring signatures, amending or replacing investment terms, submitting a 401(k) loan modification request, requesting specific letters, and requesting tax reporting documents.\"},{\"question\":\"How can signed or reference documents be delivered under the document handling section?\",\"answer\":\"Select mail (regular or overnight with address details), email (email contact details), fax (fax number and attention line), and any additional processing instructions or notes.\"}]","Authorization to Take Action Form - Rev 10 - 2024 | PDF",1789799438]