EverBank 6302 Roth IRA Transfer Request Instructions

verBank 6302 Roth IRA Transfer Request

Submission instructions

Upload this form and any additional documentation so that we can move forward in the quickest and most secure way.

• Simply log in to your account at everbank.com and: Select the Actions tab
• In the TIAA Documents section, select Upload documents Select Files you would like to upload
• Select the Folder to upload files to and follow directions

TRANSFER REQUEST

PART 1. RECIPIENT

• Individuals requesting the transfer
• Name (First/MI/Last) ____
• Date of Birth____ Phone _____
• Email Address____
• Account Number__ Suffix__
• ACCEPTING ACCOUNT TYPE (Select one)
• Roth IRA Inherited Roth IRA

PART 2. ACCEPTING ROTH IRA TRUSTEE OR CUSTODIAN

• To be completed by the Roth IRA trustee or custodian receiving the assets
• Name __
• Address Line 1 ___
• Address Line 2 ___
• City/State/ZIP ___
• Phone___ Organization Number ____
• Contact Name ___

PART 3. RELATIONSHIP OF RECIPIENT TO CURRENT ROTH IRA OWNER
RELATIONSHIP TYPE (Select one)

• I am the current Roth IRA owner.
• I am the former spouse of the current Roth IRA owner.
• I am the spouse beneficiary of the original Roth IRA owner transferring assets to my own Roth IRA.
• I am the beneficiary of the original Roth IRA owner transferring assets to an inherited Roth IRA.

PART 4. CURRENT ROTH IRA OWNER

• Name (First/MI/Last) __
• Social Security Number ____
• Account Number__ Suffix__
• CURRENT ACCOUNT TYPE (Select one)
• Roth IRA Inherited Roth IRA

PART 5. CURRENT ROTH IRA TRUSTEE OR CUSTODIAN

• Name___
• Address Line 1___
• Address Line 2___
• City/State/ZIP____
• Phone ____

PART 6. LIFE EXPECTANCY PAYMENT INSTRUCTIONS

IF YOU ARE A BENEFICIARY RECEIVING LIFE EXPECTANCY PAYMENTS, COMPLETE THE FOLLOWING.
Distribute my life expectancy payment to me before transferring the Roth IRA assets. Retain my life expectancy payment amount. I understand that I am responsible for satisfying my life expectancy payment. Include the amount that represents my life expectancy payment in the transfer. I understand that I am responsible for satisfying my life expectancy payment.

PART 7. TRANSFER INSTRUCTIONS
TRANSFER OPTIONS (Select one)

• One-Time Transfer
• Transfer Amount ____ Transfer Date ____
• Entire Roth IRA Balance This Transfer Will Close the Current Roth IRA
• Recurring Transfer
• Transfer Amount ____ Transfer Start Date ____
• Frequency (Select one) Monthly Quarterly Semi-Annually Annually Other ___
• MAKE PAYABLE TO (If the accepting IRA type is an inherited Roth IRA, the Name of Recipient must identify both the recipient and the original Roth IRA owner.)
• _ ___ as Trustee or Custodian of
• Name of Accepting Roth IRA Trustee or Custodian
• ___ Roth IRA
• Name of Recipient
• ASSET HANDLING (Investments identified below will be liquidated immediately unless otherwise specified in the Special Instructions section.)
• Asset Description Amount to be Transferred Special Instructions

PART 8. SIGNATURES

I authorize the transfer of these Roth IRA assets and certify that all information provided by me is true and accurate. I understand that I am responsible for determining that this Roth IRA transfer qualifies under the rules that apply to such transfers and agree to comply with those rules. I assume responsibility for any consequences that may result from this transfer and I agree that the trustee or custodian is not responsible for any consequences that may arise from executing this transfer request.

The trustee or custodian signing below agrees to accept the assets being transferred:

• X___ _
• Signature of Recipient Date (mm/dd/yyyy)
• X___ _
• Notary Public/Signature Guarantee (If required by the trustee or custodian) Date (mm/dd/yyyy)
• X___ _
• Authorized Signature of Accepting Trustee or Custodian Date (mm/dd/yyyy)

References

• Banking, Investing & Commercial Financing | EverBank

Read User Manual Online (PDF format)

Read User Manual Online (PDF format)  >>

Download This Manual (PDF format)

Download this manual  >>