EverBank IRA Transfer Request Instructions

EverBank IRA Transfer Request

Product Information

This product is an IRA transfer request form for Traditional IRA and SIMPLE IRA accounts. It is used to request the transfer of assets from one IRA account to another.

Part 1: Recipient Information
The recipient is the individual requesting the transfer. The following information is required:

• Name (First/MI/Last)
• Date of Birth
• Phone
• Email Address
• Account Number

Part 2: Accepting IRA Trustee or Custodian
This section is to be completed by the IRA trustee or custodian who will receive the assets.

Part 3: Relationship of Recipient to Current IRA Owner
This section determines the relationship between the recipient and the current IRA owner. The following relationship types can be selected:

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

Part 4: Current IRA Owner
This section requires information about the current IRA owner, including their name, social security number, and account number.

Part 5: Current IRA Trustee or Custodian
This section requires information about the current IRA trustee or custodian, including their name, address, and contact details.

Part 6: Required Minimum Distribution (RMD) or Life Expectancy Payment Instructions
This section is to be completed if the recipient is the current IRA owner and meets certain age requirements. It includes options for distributing the required payment.

Part 7: Transfer Instructions
This section provides options for the transfer, including one-time transfer or transferring the entire IRA balance.

Product Usage Instructions

To use this form for an IRA transfer request, follow these steps:

1. Fill out the recipient information in Part 1, including name, date of birth, phone, email address, and account number.
2. If you are the IRA trustee or custodian receiving the assets, complete Part 2.
3. Select the appropriate relationship type in Part 3 based on your relationship to the current IRA owner.
4. Provide the necessary information about the current IRA owner in Part 4.
5. Fill out the details of the current IRA trustee or custodian in Part 5.
6. If applicable, complete Part 6 regarding required minimum distribution or life expectancy payment instructions.
7. Choose the desired transfer option in Part 7, either a one-time transfer or transferring the entire IRA balance.

Once all sections are completed, upload the form and any additional documentation through your account at everbank.com. Select the Actions tab, then in the TIAA Documents section, choose Upload documents. Select the files you want to upload, choose a folder to upload them to, and follow the provided directions.

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 Folder to upload files to and follow directions

TRANSFER REQUEST
The term IRA will be used below to mean Traditional IRA and SIMPLE IRA, unless otherwise specified.

PART 1. RECIPIENT

Individual requesting the transfer

• Name (First/MI/Last) _____
• Date of Birth ____
• Phone __
• Email Address ___
• Account Number__
• Suffix__

ACCEPTING ACCOUNT TYPE
(Select one)

• Traditional IRA
• SIMPLEIRA
• Inherited Traditional IRA
• Inherited SIMPLE IRA

PART 2. ACCEPTING IRA TRUSTEE OR CUSTODIAN
To be completed by the IRA trustee or custodian receiving the assets

• Name : EverBank, N.A. EverBank, N.A., World Markets division
• Address Line 1: PO Box 44060
• Address Line 2 ___
• City/State/ZIP: Jackson ville,FL 32231
• Phone___
• Organization Number ___
• Contact Name ___

PART 3. RELATIONSHIP OF RECIPIENT TO CURRENT IRA OWNER

RELATIONSHIP TYPE
(Select one)

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

PART 4. CURRENT IRA OWNER

• Name (First/MI/Last) __
• Social Security Number ____
• Account Number__
• Suffix __

CURRENT ACCOUNT TYPE
(Select one)

• Traditional IRA Inherited
• Traditional IRA
• SIMPLE IRA Inherited
• SIMPLE IRA

PART 5. CURRENT IRA TRUSTEE OR CUSTODIAN

• Name __
• Address Line 1___
• Address Line 2___
• City/State/ZIP ___
• Phone _____

PART 6. REQUIRED MINIMUM DISTRIBUTION (RMD) OR LIFE EXPECTANCY PAYMENT INSTRUCTIONS
To be completed if the recipient is the current IRA owner and is age 701/2 or older this year or is a beneficiary receiving life expectancy payments

IF YOU HAVE NOT YET TAKEN YOUR REQUIRED PAYMENT FOR THIS YEAR, COMPLETE THE FOLLOWING. (Select one)

• Distribute my RMD or life expectancy payment to me before transferring my IRA assets.
• Retain my RMD or life expectancy payment amount. I understand that I am responsible for satisfying my RMD or life expectancy payment.
• Include the amount that represents my RMD or life expectancy payment in the transfer. I understand that I am responsible for satisfying my RMD or life expectancy payment.

Name of Recipient __, Account Number

PART 7. TRANSFER INSTRUCTIONS

TRANSFER OPTIONS
(Select one)

• One-Time Transfer
  • Transfer Amount ____
  • Transfer Date ____
  • Entire IRA Balance
  • This Transfer Will Close the Current IRA
• Recurring Transfer
  • Transfer Amount ____
  • Transfer Start Date ____
  • Frequency(Select one)
  • Monthly
  • Quarterly Semi-Annually
  • Annually
  • Other __

MAKE PAYABLE TO(If the accepting account type is an inherited IRA, the Name of Recipient must identify both the recipient and the original IRA owner.)

EverBank, N.A. as  Trustee or Custodian of

Name of Accepting IRA Trustee or Custodian

• IRA
• Name of Recipient

ASSETHANDLING (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 IRA assets and certify that all information provided by me is true and accurate. I understand that I am responsible for determining that this IRA transfer qualifies under the rules that apply to such transfers and agree to comply with those rules. I understand that special rules apply to SIMPLE IRA to Traditional IRA transfers. 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____Date (mm/dd/yyyy)
  Signature of Recipient

• X____Date (mm/dd/yyyy)
  Notary Public/Signature Guarantee (If required by the trustee or custodian)

• X____Date (mm/dd/yyyy)
  Authorized Signature of Accepting Trustee or Custodian

302 / 2325 (Rev. 10/2017)

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©2017 Ascensus, Inc.

References

• Banking, Investing & Commercial Financing | EverBank

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