Fidelity Investment-Only (Non-Prototype) Retirement Account Application Completed Form Examples and Samples

MEMO
TO: Retirement Plan File
FROM: Sandra K. Oyelaran, Esq.
DATE: February 14, 2026
RE: Hartwell Precision Manufacturing – Defined Benefit Plan Fidelity Account Setup

This memo summarizes the key details gathered during our February 10th intake meeting with the principals of Hartwell Precision Manufacturing, Inc., a precision machining company incorporated and operating in the state of Ohio. The company is setting up a new non-prototype retirement account at Fidelity to hold assets for their existing defined benefit pension plan.

The plan is formally called the Hartwell Precision Manufacturing, Inc. Defined Benefit Pension Plan and was established on March 1, 2019. The plan's EIN is 88-4521976. The plan address — which should be used as the permanent address on all correspondence — is 4812 Craftsman Boulevard, Dayton, Ohio 45414. The plan is organized under the state of Ohio.

The account structure is a trustee-directed pooled arrangement, meaning the trustees collectively direct all investment decisions and individual employees do not have the ability to direct transactions or effect exchanges in the account.

There are two named trustees. The first trustee is Gerald Raymond Hartwell, born June 3, 1968, Social Security Number 521-88-4433. He resides at 209 Elmwood Drive, Centerville, Ohio 45459. His mobile phone is (937) 554-7821 and his email is [email protected]. Gerald is a U.S. citizen and is employed as the President and CEO of Hartwell Precision Manufacturing, Inc., located at 4812 Craftsman Boulevard, Dayton, OH 45414. He is not associated with any broker-dealer or registered investment adviser, and has no board-level affiliations with any publicly traded company.

The second trustee is Patricia Ann Mendez, born October 22, 1974, Social Security Number 609-44-8817. She lives at 57 Birchwood Lane, Kettering, Ohio 45429. Her mobile phone is (937) 612-3390 and her email is [email protected]. Patricia is also a U.S. citizen and serves as Chief Financial Officer at the same company. She has no broker-dealer associations or public company affiliations.

For the financial profile section: the company's plan has an annual income from all sources in excess of $100,000. The estimated net worth excluding the business real estate is well over $500,000, and the estimated liquid net worth is in the $100,001–$500,000 range. The company's principals fall in the ≥28% federal tax bracket. Given these factors and the long investment horizon of the pension plan, we recommend a Growth investment objective for the account.

Funding will be done by check at account opening — an initial check of $25,000 made payable to Fidelity Investments will be enclosed with the application. No fund-specific purchases are designated at this time; cash will default to the core position. No checkwriting, margin, or duplicate statement features are being requested at this time.

Please prepare the application accordingly and route to Gerald for primary trustee signature.