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This Program Application must be completed and submitted to the Board of Trustees of the College and Jumpstart Savings Programs ("the Board") to open and become the Account Owner for a West Virginia Jumpstart Savings Account ("Account") offered by the Program's Savings Account Manager, United Bank, in the West Virginia Jumpstart Savings Program ("the Program").
Owner Information
Account Owner Legal Name:
First:
 
Middle:
Last:
 
Account Owner Social Security Number or Taxpayer Identification Number:       
Account Owner Date of Birth (mm/dd/yyyy):
 
 
Gender:
US Permanent Resident?
Citizenship:
UGMA/UTMA Custodian Name:
First:
 
Middle:
Last:
 
UGMA/UTMA Custodian Social Security Number or Taxpayer Identification Number:         
UGMA/UTMA Custodian Date of Birth (mm/dd/yyyy):
 
 
Gender:
Select the state in which the UGMA/UTMA custodial account was opened:
Citizenship:
(Please provide country of citizenship if Account Owner is a resident alien).
Name of Trust:
 
Trust Tax ID Number:         
Date of Trust (mm/dd/yyyy):
 
 
Name of Trustee:
First:
 
Middle:
Last:
 
Trustee Social Security or Taxpayer Identification Number:         
Trustee Date of Birth (mm/dd/yyyy):
 
 
Gender:
Citizenship:
(Please provide country of citizenship if Account Owner is a resident alien).