Administrative Forms

IRA Disclosure Statement - Financial Projection Information Form # 31 Revised 12/02

Financial Projection Information Form
1% Assuming no reduction

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IRA Disclosure Statement - Financial Projection Information Form # 31A Revised 12/02

Financial Projection Information Form
1% Assuming Reduction

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IRA Disclosure Statement - Financial Projection Information Form # 31B Revised 12/02

Financial Projection Information Form
2%

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Change of Name.Address or Beneficiary to IRA Account Form # 36 Revised 9/99

Change of Name, Address or Beneficiary to IRA Account Form

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Iowa State Withholding Form # 39 Revised 8/07

Iowa State Withholding Form

Purpose of Form: A separate IRA or QP distribution form has been completed setting forth the amount of your IRA or other type of pension distribution. This distribution may either be a non-periodic distribution or may be part of a series of distributions, and it may be subject to Iowa income tax withholding. The primary purpose of this form is to set forth the state of Iowa withholding rules with respect to a distribution from an IRA or other pension plan.

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IRA Contribution Form # 54 Revised 10/06

IRA / SIMPLE / SEP IRA Contribution Form

The contributions which you make to your traditional IRAs and Roth IRAs must be combined for purposes of the contribution limit. Contributions are first considered made to the traditional IRA and then to the Roth IRA, regardless of when the actual contributions are made. Thus, if you contribute more than the limit to such accounts, the excess will arise in the Roth IRA.

This form can be imprinted. Call 800-346-3961 for details.

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IRA Contribution Form (7 x 3½) Form # 54-A Revised 11/05

IRA Contribution Form (7 x 3½) Size

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IRA Contribution Form (Comprehensive) Form # 54-B Revised 3/07

IRA Contribution Form (Comprehensive)

The contributions which you make to your traditional IRAs and Roth IRAs must be combined for purposes of the contribution limit.Contributions are first considered made to the traditional IRA and then to the Roth IRA,regardless of when the actual contributions are made. Thus, if you contribute more than the limit to such accounts, the excess will arise in the Roth IRA.

This form can be imprinted. Call 800-346-3961 for details.

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Periodic IRA Contribution Instruction Form # 54-C Revised 8/07

Periodic IRA Contribution Instruction Form

Purpose of Form: The accountholder uses this form to establish or change a periodic contribution schedule. This form is designed to be used by those accountholders who are eligible to make regular or spousal IRA contributions to either a traditional or Roth IRA.

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Trust or Self-Directed Contribution Form # 54-SD Revised 2/07

Trust or Self-Directed Contribution Form

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Notice of Internal Recharacterization of IRA Contributions Form # 54-TR1 Revised 4/06

Notice if Internal Recharacterization of IRA Contributions Form

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54TR1

Notice of External Recharacterization of IRA Contributions Form # 54-TR2 Revised 4/06

Notice of External Recharacterization of IRA Contributions Form

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54TR2

Establishing a Substantially Equal Periodic Distribution Schedule Form # 55 Revised 8/07

Establishing a Substantially Equal Periodic Distribution Schedule Form

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Package contains 25 forms. Call for quantity pricing or for imprint orders.

We also have SEPP with is a unique software that produces RMD, Amortization and Annuity Factor Projections for your accountholders. It provides side-by-side comparisons and fills out the appropriate forms for you.

Special Election Changing a Substantial Equal Periodic Payment Form # 55C Revised 8/07

Special Election Changing a Substantial Equal Periodic Payment Form

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Instructions & Authorizations to Transfer Traditional IRA Funds to Another Traditional IRA Form # 56 Revised 5/08

Instructions & Authorizations to Transfer Traditional IRA Funds to Another Traditional IRA Form

Purpose of Form: This IRA Transfer Form is to be used to transfer funds from one traditional IRA to another traditional IRA. Because every traditional IRA is authorized to receive SEP contributions, there are no special rules applying to the transfer of SEP-IRA funds as there are for SIMPLE IRAs. SEP-IRA funds within a traditional IRA may be transferred to another SEP-IRA or to another traditional IRA which does not contain any SEP-IRA funds. This Formis not to be used to transfer funds from a SIMPLE-IRA to another SIMPLE-IRA, a SIMPLE-IRA to a traditional IRA, a Roth IRA to a Roth IRA or a Coverdell ESA to a Coverdell ESA. If your institution is the successor custodian/trustee which will receive the transfer, then you and your accountholder will need to complete this transfer form and furnish it to the current custodian/trustee. If your institution is the current custodian/trustee which will transfer the traditional IRA funds, then you will need to have the IRA accountholder and the successor custodian/trustee complete this transfer form and return it to you.

This form can be imprinted. Call 800-346-3961 for details.

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Instructions & Authorization to Transfer Inherited IRA Funds Form # 56-I Revised 8/04

Instructions and Authorizations to Transfer Inherited IRA Funds Form

Purpose of Form: Inherited IRA accounts are subject to the required minimum distribution requirements found in section 408(a) and (b) of the Internal Revenue Code (IRC) and related regulations. When an IRA accountholder dies, his or her designated beneficiary(ies) inherits the IRA or a portion of the IRA. The IRC and related regulations do not expressly authorize the transfer of an inherited IRA account from one IRA custodian/trustee to another IRAcustodian/trustee. The purpose of this form is to authorize such a transfer if the current IRA custodian/trustee of the existing IRA is provided sufficient certification from the successor IRA custodian/trustee that it understands that the transferred IRA is an inherited IRA, and that applicable required minimum distribution (RMD) rules will be complied with.

This form is not to be used by a spouse beneficiary who elects to treat the deceased accountholder’s IRA as his or her own.

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Instructions & Authorization to Transfer Traditional IRA Funds to Another Traditional IRA Form # 56-SD Revised 5/08

Instructions & Authorization to Transfer Traditional IRA Funds to Another Traditional IRA Form

Purpose of Form: This form is for U.S. citizens, resident aliens, or their estates who are recipients of pensions, annuities, including commercial annuities, and certain other deferred compensation. Use this form to tell payers the correct amount of Federal income tax to withhold from your payment(s). You also may use this form to choose (a) not to have any income tax withheld from the payment(except for eligible rollover distributions or payments to U.S. citizens delivered outside the United States or itspossessions) or (b) to have an additional amount of tax withheld.

This form can be imprinted. Call 800-346-3961 for details.

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Instructions to Convert, Via Transfer, Traditional IRA Funds to a Roth IRA Form # 56-TR Revised 3/07

Instructions to Convert, via Transfer, Traditional IRA Funds to a Roth IRA Form

Special Election Under Revenue Ruling 2002-62 Form # 55-C Revised 10/04

Special Election Under Revenue Ruling 2002-62 Form
Changing a Substantially Equal Periodic Payment Schedule

Purpose of Form: This form allows an accountholder to change his/her previous substantially equal periodic payment method, without incurring the 10% penalty tax, allowed under Revenue Ruling 2002-62, which was issued October 21, 2002.

This form can be imprinted. Call 800-346-3961 for details.

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Special Explanation to Accountholder for an IRA Recharacterization Form # 56-TREX Revised 2/07

Special Explanation to Accountholder for an IRA Recharacterization for the 2007 Tax Year Form

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Special Explanation to Accountholder for an IRA Recharacterization Form # 56-TREX Revised 8/07

Special Explanation to Accountholder for an IRA Recharacterization for the 2008 Tax year Form

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IRA Distribution Form # 57 Revised 3/07

IRA Distribution Form
Form to document all traditional IRA distributions. It is also the Substitute W-4P for the accountholder's Federal withholding election and the financial institution's withholding notice.

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IRA Distribution Form # 57A Revised 3/08

Certification for Tax-Free Charitable Distribution Form # 57C

Certification for Tax-Free Charitable Distribution

Form to document all traditional IRA distributions. It is also the Substitute W-4P for the accountholder's Federal withholding election and the financial institution's withholding notice.

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Certification of Disability for Traditional & Roth IRAs Form #57-D Revised 9/05

Disablity Withdrawal Form

Purpose of Form: This form provides certification that a distribution from a traditional or Roth IRA is exempt from the 10% premature withdrawal penalty because the IRAaccountholder, though under age 59½, is considered to be disabled under the requirements of Code section 72(m)(7). The IRA accountholder is to sign this form and obtain a doctor’s signature certifying the disability.The IRA accountholder is then to present this form to the Custodian/Trustee of the IRA prior to the disbursement of any funds.

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IRA Self-Directed or Trust Distribution Form 57-SD Revised 4/08

IRA Self-Directed or Trust Distribution Form
Form to document all IRA Self-Directed or Trust distributions. It is also the Substitute W-4P for the accounthodler's federal withholding election.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

IRA Distribution Form (includes state withholding) Form # 57-ST Revised 3/07

IRA Distribution Form (Includes State Withholding)
Form to document all IRA distributions. It is also the Substitute W-4P for the accountholder's Federal withholding election and state withholding certificate.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

Direction of Investment - IRA Form # 58SD1

Direction of Investment - IRA

Form which serves as the accountholder's Federal withholding election as well as your financial institution's required withholding notice to the accountholder or beneficiary.

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Package contains 50 forms. Call for quantity pricing or for imprint orders.

Trust or Self-Directed IRA Change of Investmt & Direction Form # 58SD2 Revised 3/06

Trust or Self-Directed IRA Change of Investmt & Direction

Form which serves as the accountholder's Federal withholding election as well as your financial institution's required withholding notice to the accountholder or beneficiary.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

Withholding Certificate for IRA Payments and Annual Reminder Notice Form # 59 Revised 3/06

Withholding Certificate for IRA Payments and Annual Reminder Notice
Form which serves as the accountholder's Federal withholding election as well as your financial institution's required withholding notice to the accountholder or beneficiary.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

Withholding Certificate for IRA Payments Upon Demand (Substitute IRS Form W-4P) Form # 59-A Revised 3/06

Withholding Certificate for IRA Payments Upon Demand (Substitute IRS Form W-4P)
Form which serves as the accountholder's Federal withholding election as well as your financial institution's required withholding notice to the accountholder or beneficiary.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

Reminder Notice - Withholding Election for Automatic IRA Distributions Form # 59-B Revised 4/08

Reminder Notice - Withholding Election for Automatic IRA Distributions

Form which serves as the accountholder's Federal withholding election as well as your financial institution's required withholding notice to the accountholder. It is used for those accountholders or beneficiaries receiving automatic distributions.

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Reminder Notice - Withholding Election for Periodic IRA Distributions Form # 59-C Revised 4/08

Reminder Notice - Withholding Election for Automatic IRA Distributions

Form which serves as the accountholder's Federal withholding election as well as your financial institution's required withholding notice to the accountholder. It is used for those accountholders and beneficiaries receiving automatic distributions.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

Withholding Certificate for IRA Payments and Annual Reminder Form # 59-D Revised 4/08

Withholding Certificate for IRA Payments and Annual Reminder

Form which serves as the accountholder's Federal withholding election as well as your financial institution's required withholding notice to the accountholder or beneficiary.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

IRA Beneficiary Designation Form # 61 Revised 9/07

IRA Beneficiary Designation
Form to make or change IRA beneficiary designations.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

IRA Benefiicary Designation Form # 61-A Revised 6/02

IRA Beneficiary Designation
Form to make IRA beneficiary designations.

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IRA Benefiicary Designation Form # 61-B

IRA Beneficiary Designation

Form to make IRA beneficiary designations.

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IRA Benefiicary Designation and Distribution Instructions Form # 61-D

IRA Beneficiary Designation and Distribution Instructions

Form to make IRA beneficiary designations.

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Package contains 50 forms. Call for quantity pricing or for imprint orders.

Required Distribution Notice Version 1 - 2008 Form # 62-V1

Required Distribution Notice Version 1

Form to make IRA beneficiary designations.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

Required Distribution Notice Version 2 - 2008 Form # 62-V2

Required Distribution Notice Version 2

Form to make IRA beneficiary designations.

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Package contains 50 forms. Call for quantity pricing or for imprint orders.

Required Distribution Notice Version 3 - 2008 Form # 62-V3

Required Distribution Notice Version 3

Form to make IRA beneficiary designations.

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Package contains 50 forms. Call for quantity pricing or for imprint orders.

Required Distribution Notice Version 4 - 2008 Form # 62-V4

Required Distribution Notice Version 4

Form to make IRA beneficiary designations.

This form can be imprinted. Call 800-346-3961 for details.

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Required Distribution Notice Version 5 - 2008 Form # 62-V5

Required Distribution Notice Version 5
Form to make IRA beneficiary designations.

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Package contains 50 forms. Call for quantity pricing or for imprint orders.

Required Distribution Notice Version 6 - 2008 Form # 62-V6

Required Distribution Notice Version 6

Form to make IRA beneficiary designations.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

Required Distribution Notice Version 7 - 2008 Form # 62-V7

Required Distribution Notice Version 7
Form to make IRA beneficiary designations.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 50 forms. Call for quantity pricing or for imprint orders.

Required Distribution Notice Version 8 - 2008 Form # 62-V8

Required Distribution Notice Version 8

Form to make IRA beneficiary designations.

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Package contains 50 forms. Call for quantity pricing or for imprint orders.

Periodic Payment Instruction for Distributions (59½ to 70½) Form # 63 Revised 4/08

Periodic Payment Instruction for Distributions (59½ to 70½)

Purpose of Form: The IRA accountholder uses this form to establish a periodic payment schedule that can be revoked at any time upon furnishing the Custodian/Trustee with written notification. This form is designed to be used by those IRA accountholders who are age 59½ or older during the current year but who are not subject to the required minimum distribution rules.

This form can be imprinted. Call 800-346-3961 for details.

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Periodic Payment Instruction for Minimum Distribution (70½ and Older) Form # 64 Revised 4*08

Periodic Payment Instruction for Minimum Distribution ( 70½ and Older)

Purpose of Form: This form is designed to be used by an IRA accountholder who has attained, or will attain, age 70½ or older during the current year. The IRA accountholder will use this form to establish a periodic payment schedule complying with the requirements of IRC section 408(a)(6) and regulation 1.408-8. Such periodic payment schedule may either be the individual’s first periodic payment schedule or a subsequent schedule. The most current schedule supercedes any previously-furnished schedule.

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Rollover Certification Form for Rollovers or Direct Rollovers # 65 Revised 3/05

Rollover Certification Form For Rollovers or Direct Rollovers
Form to have the accountholder irrevocably certify the rollover, as required by the IRS, and to fully document the rollover procedure.

This form can be imprinted. Call 800-346-3961 for details.

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Conduit IRA - Waiver Form # 65-W Revised 3/06

Conduit IRA - Waiver Form

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Determine Eligibility to use 60 Day Rollover waiver Form # 65-WR Revised 3/06

Determine Eligibility to use 60 Day Rollover waiver

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Direct Rollover Request Form # 66 Revised 10/06

Direct Rollover Request Form
This form requests the direct rollover of Qualified Plan funds to an IRA.

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Direct Rollover Request - By Inheriting Beneficiary Form # 66I Revised 10/06

Direct Rollover Request - By Inheriting Beneficiary Form

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Withdrawal of Current-Year Contributions (2008) Form # 67 Revised 8/07

Withdrawal of Current-Year Contributions (2008)
This form explains the rules for withdrawing certain contributions and documents the accountholder's request for withdrawal.

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Worksheet to Calculate the Income Related to a Recharacterized Contribution Form # 67-W Revised 8/07

Worksheet to Calculate the Income Related to a Recharacterized Contribution

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Worksheet to Calculate the Income Related to the withdrawal of a Current Year Contribution(s) Form # 67-W Revised 2/06

Worksheet to Calculate the Income Related to the Withdrawal of a Current Year Contribution

Purpose of Form: This form is used to calculate the interest or other income earned with respect to a current-year contribution which is being withdrawn under Internal Revenue Code section 408(d)(4). The formula as set forth in IRS Notice 2000-39 is being used.

Form to be used to calculate the appropriate earnings related to certain excess contributions.

This form can be imprinted. Call 800-346-3961 for details.

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Transfer of IRA Funds from Deceased Accountholder to Beneficiary Form # 68 Revised 8/07

Transfer of IRA Funds From Deceased Accountholder to Beneficiary

Purpose of Form: This form is designed to provide the IRA Custodian/Trustee and its IRA data processor, if any, with the information which is needed to comply with the Form 5498 reporting rules as set forth in Rev. Proc. 89-52. The Custodian/Trustee is required to generate a Form 5498 for the current year on behalf of an IRA accountholder who has died during the current year and it is also required to generate a Form 5498 for each beneficiary for the current year and each subsequent year as the funds now belong to the beneficiary. For data processing purposes,the IRA funds of the deceased IRA accountholder should be transferred internally to the inherited IRA account of each beneficiary.

This form can be imprinted. Call 800-346-3961 for details.

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Special Instruction - Rollover from an IRA to an Qualfiied Plan, 403(b) Plan or Section 457(b)Plan Form # 69 Revised 5/03

Special Instruction - Rollover from an IRA to an Qualfiied Plan, 403(b) Plan or Section 457(b)Plan
Form that provides the authority for the IRA Custodian/Trustee to remit conduit IRA funds to a qualified plan in the name of the accountholder.

Purpose of form: To create the authority for the IRA custodian/trustee to remit the funds on behalf of the IRA accountholder directly to the eligible retirement plan. This special instruction is needed because the Internal Revenue Code does not authorize a direct rollover from an IRA to an eligible retirement plan as it does for a direct rollover of funds from an eligible retirement plan to an IRA. For federal income tax purposes, the IRA custodian/trustee must treat this transaction as if there was a distribution to the IRA accountholder. Therefore, the IRA custodian/trustee will prepare a Form 1099-R, reporting the distribution to the IRS. The Distribution will be reported on Form 1099-R as a Distribution Code G “Direct Rollover to an eligible retirement plan.”

This form can be imprinted. Call 800-346-3961 for details.

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Beneficiary's Distribution Election and Certification Form and Payment Form # 204 Revised 4/08

Beneficiary's Distribution Election and Certification Form

Purpose of Form: An IRA beneficiary who inherits the IRA of a deceased IRA accountholder is required by law to commence withdrawing such IRA funds within certain time deadlines. You are to use this form to instruct us how and when we are to make distributions to you to comply with the rules.

This form can be imprinted. Call 800-346-3961 for details.

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Inherited IRA Accountholder Distribution Instructions and Certification Form # 205 Revised 4/08

Inherited IRA Accountholder Distribution Instructions and Certification

Purpose of Form: An IRA beneficiary who inherits the IRA of a deceased IRA accountholder is required by law to commence withdrawing such IRA funds within certain time deadlines. You are to use this form to instruct us how and when we are to make distributions to you to comply with the rules.

This form can be imprinted. Call 800-346-3961 for details.

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Worksheet to Calculate the Required Minimum Distribution (RMD) Form # 306 Revised 5/02

Worksheet to Calculate the Required Minimum Distribution (RMD)

Purpose of Form: To calculate the RMD amount for the first year and for subsequent years.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 25 forms. Call for quantity pricing or for imprint orders.

Customer Notice and Determination of Customer Identity Form # 307

Customer Notice and Determination of Customer Identity

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Certification Election to Use the Alternative Method for RMDs Form # 312 Revised 2/01

Certification Election to Use the Alternative Method for RMDs

Purpose of Form: This form is to elect to use the alternative method authorized by Notice 88-83 and to certify to us that you have complied with the required minimum distribution rules.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 25 forms. Call for quantity pricing or for imprint orders.