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Page 1 of 7
Questions? Go to Fidelity.com/pws or call 800-343-3548.
Automatic Withdrawals — Inherited IRA
Use this form to establish, change, or delete an ongoing automatic withdrawal plan for an Inherited IRA or Inherited Roth IRA account.
This form provides an administrative service that allows you, as the beneficiary, to schedule reoccurring payments based on a schedule
determined by you.
By selecting any of the options listed in this form, Fidelity does not represent that you will meet your RMD requirements. The options
are designed to offer flexibility for taking withdrawals. The Inherited RMD option is more tailored to help certain beneficiaries meet
RMD requirements, but Fidelity cannot guarantee the appropriateness of electing one of these options for your personal circumstances.
Do NOT use this form for Fidelity Retirement Plans; Traditional, Roth, Rollover, SEP, or SIMPLE IRAs; nonretirement accounts; or annuities.
Go to Fidelity.com/forms to find the appropriate form. Not available to nonresident aliens due to tax-withholding requirements. Type on
screen or fill in using CAPITAL letters and black ink. If you need more room for information or signatures, make a copy of the relevant page.
Helpful to Know
• Important to note: It is your responsibility to ensure that
your withdrawals comply with IRS rules and deadlines.
This form may not present all options for calculating your
RMD under IRS methods. The options for distribution will
be based on several factors, including the date of death
(before or after 1/1/2020), the age of the decedent, and
your relationship to the deceased. You should consult a
tax advisor prior to completing this form.
• Inherited assets must be separated into your own
account by 12/31 of the year after the date of death in
order for Fidelity to calculate your required minimum
distribution (RMD) using your date of birth, or the oldest
beneficiary’s date of birth, as applicable.
• RMDs for inherited accounts are generally required
under IRS regulations to begin by 12/31 of the year
after the year of death. Exceptions to this beginning
date apply only to spouses of the original owner, who
may delay beginning to take RMDs until the year in
which the original owner would have reached RMD
age. Additionally, and for deaths after 1/1/2020, cer-
tain non-spouse, trust, charity, estate, and other entity
beneficiaries will be required to distribute the entire IRA
balance no later than the end of a specific period of
time, either 10 years (for a non-spouse individual) or 5
years (for a trust, estate, charity, or other entity).
• If the original Non-Roth IRA owner passed away after
his or her required beginning date for taking RMDs,
OR you are a Successor beneficiary on either an IRA
or a Roth IRA, you may be responsible for taking any
remaining year-of-death RMDs to comply with the
original owner’s RMD requirement. This requirement is
separate from the Inherited IRA RMD requirements.
• Any RMD calculations will include the specified Fidelity
Inherited IRA or Inherited Roth IRA only. If you have
any other Inherited IRAs or Inherited Roth IRAs at
either Fidelity or other institutions, you will be required
to calculate your RMD for them separately.
• For mutual funds, note that:
– Withdrawals could trigger redemption or transaction
fees (see the applicable fund prospectus).
– If a fund is closed to new investors, you will not be
able to purchase new shares of the fund in the future
if you draw your fund balance down to zero.
• If you want to withdraw the value of individual securi-
ties, ETFs, and certain non-eligible mutual funds (such
as closed-end funds), you must sell them in advance
and withdraw them as cash.
• Excess distributions cannot be returned to the
Inherited IRA account. Please be sure to complete
this form carefully to prevent an excess distribution.
1. Original Owner Information
Name
Social Security or Taxpayer ID Number Original Owner’s Date of Death Original Owner’s Date of Birth
Provide the original
owner’s information.
Not required
for Successor
beneficiaries or
a fixed amount plan.
1.820237.122 019001101
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Page 2 of 7
2. Your Information
Account Owner Name
Fidelity Inherited IRA /Inherited Roth IRA Account Number
Social Security or Taxpayer ID Number Date of Birth MM DD YYYY
Spouse of original IRA owner
Non-spouse individual inheritor of the original owner (i.e., sibling, grandchild, or friend)
Minor child of the original IRA owner
A trust other than a Look-Through Trust, estate, charity, or entity
Look-Through Trust For deaths occurring before 1/1/2020, if eligible to use a life expectancy calculation, pro-
vide the date of birth of the oldest beneficiary in Section 4a. Fidelity will calculate based on the information
given. If not eligible, the default will be the Five-Year Rule.
Successor beneficiary or second-generation beneficiary
3. Request Type and Reason
Type of Request
ESTABLISH a new automatic withdrawal plan
CHANGE an existing automatic withdrawal plan
Type of Plan to Be Changed Examples: Inherited RMD, Fixed Dollar Amount, Five-Year Rule, Fixed Period
DELETE an existing automatic withdrawal plan
Skip to Section 10.
Type of Plan to Be Deleted Examples: Inherited RMD, Fixed Dollar Amount, Five-Year Rule, Fixed Period
To set up automatic
withdrawal plans
for more than one
Inherited IRA,
complete a
separate form for
each account.
Indicate the type of
beneficiary you are.
Check one.
1.820237.122 019001102
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Page 3 of 71.820237.122 019001103
4. Select Your Automatic Withdrawal Plan Type
Specify your automatic withdrawal plan type below. Due to passage of the SECURE Act legislation, distribution rules for IRA inheritors have
changed for beneficiaries of IRA owners that pass away in 2020 or after. You may wish to consult a tax advisor prior to completing this form.
• If the original account owner passed away in 2019 or before, complete 4a ONLY and skip 4b.
• If the original account owner passed away in 2020 or after, complete 4b ONLY and skip 4a.
4a. If the original account owner passed away in 2019 or before, choose your plan type in this section.
After completing 4a, skip to Section 5.
Fixed Dollar Amount As a reminder, by using this withdrawal plan type, you assume all responsibility for meeting IRS
RMD rules for the account.
Skip to Section 6.
Amount
$
.
Inherited RMD
Spouse or non-spouse individual inheritor of original IRA owner (Ex., minor, sibling, grandchild, friend, other
family member).
Estate, charity, entity, or all trusts other than a Look-Through Trust. Note: This option is available only if the
original owner was taking his or her RMDs on or before the time of death.
Original Owner’s Date of Birth MM DD YYYY
Look-Through Trust
Note: You are required to ensure that the Look-Through Trust requirements are met.
Oldest Beneficiary’s Date of Birth MM DD YYYY
Five-Year Rule (Available to a non-spouse, trust, charity, entity, or estate beneficiary where the original owner had NOT
started his or her RMDs.)
Using the fifth year after the year of death, Fidelity will calculate the amount to distribute for the year, as
adjusted for Section 5, and distribute it over the frequency you have chosen in Section 6. Withdraw all money
by December 31 of the fifth year after the year of the original owner’s death. This option is always available for
Inherited Roth IRAs.
Fixed Period If you choose this option rather than the Inherited RMD option, you may not meet the RMD requirements for
your account. You are responsible for ensuring that RMD requirements are met. Using the time frame provided below, Fidelity
will distribute the balance, as adjusted from Section 5, over the frequency you have chosen in Section 6.
Deplete your account in this many years:
Number of Years
.
If choosing this
option, specify the
dollar amount of
each distribution. The
12/31 market value
below is not required for
the Fixed Dollar
Amount option.
If choosing this option,
Fidelity will determine
the fifth year based on
the date of death you
entered in Section 1.
This option is
available if you are a
Successor beneficiary
OR if you have
determined your own
distribution period.
Select Your Automatic Withdrawal Plan Type continues on next page.
Page 4 of 7 019001104
4b. If the original account owner passed away in 2020 or after, choose your plan type in this section.
Do not complete 4a above.
Fixed Dollar Amount As a reminder, by using this withdrawal plan type, you assume all responsibility for meeting IRS
RMD rules for the account.
Skip to Section 6.
Amount
$
.
Inherited RMD (Note: You must meet one of the criteria in this section to establish an Inherited RMD
plan type.)
Spouse inheritor of original IRA owner.
A disabled or chronically ill beneficiary, or someone who is less than 10 years younger than the original
IRA owner.
Estate, charity, entity, or all trusts other than a Look-Through Trust. Note: This option is available only if the
original owner was taking his or her RMDs on or before the time of death.
Original Owner’s Date of Birth MM DD YYYY
Ten-Year Rule (Available only to a beneficiary that is a natural person.)
Using the tenth year after the year of death, Fidelity will calculate the amount to distribute for the year, as
adjusted for Section 5, and distribute it over the frequency you have chosen in Section 6. Withdraw all money
by December 31 of the tenth year after the year of the original owner’s death.
Five-Year Rule (Available to a trust, charity, entity, or estate beneficiary where the original owner had NOT
started his or her RMDs).
Using the fifth year after the year of death, Fidelity will calculate the amount to distribute for the year, as
adjusted for Section 5, and distribute it over the frequency you have chosen in Section 6. Withdraw all money
by December 31 of the fifth year after the year of the original owner’s death. This option is always available for
Inherited Roth IRAs.
Fixed Period If you choose this option rather than the Inherited RMD option, you may not meet the RMD requirements for
your account. You are responsible for ensuring that RMD requirements are met. Using the time frame provided below, Fidelity
will distribute the balance, as adjusted from Section 5, over the frequency you have chosen in Section 6.
Deplete your account in this many years:
Number of Years
.
5. Calculation Adjustments Complete ONLY if one or both of these circumstances apply.
Provide the 12/31 market value of any Inherited IRA assets that were in the process of being transferred to the
above Inherited IRA last year, but were not included in last year’s 12/31 market value as reported by Fidelity:
Amount
$
.
Reduce this year’s automatic distribution amount by the amount of the following distribution(s) already made this year:
Amount
$
.
If choosing this
option, specify the
dollar amount of
each distribution. The
12/31 market value
below is not required for
the Fixed Dollar
Amount option.
If choosing this option,
Fidelity will determine
the tenth year based on
the date of death you
entered in Section 1.
If choosing this option,
Fidelity will determine
the fifth year based on
the date of death you
entered in Section 1.
This option is
available if you are a
Successor beneficiary
OR if you have
determined your own
distribution period.
If applicable, this
section must be
completed when using
the Inherited RMD,
Five-Year Rule, Ten-Year
Rule, and Fixed
Period option.
1.820237.122
Form continues on next page.
4. Select Your Automatic Withdrawal Plan Type, continued
019001105 1.820237.122 Page 5 of 7
6. Distribution Schedule
Distribution payments may be made earlier or later depending on market availability. Examples include payments that are scheduled for a
day when the stock market is closed or for a day that doesn’t exist in every month (29th–31st), or payments scheduled close to the begin-
ning or end of the year.
Withdrawal Schedule
If this is an RMD plan and you begin withdrawals midyear, your entire RMD for the current year will be paid out evenly over the remaining
number of scheduled payments for the year. For custom frequency options, log on to Fidelity.com/updateaccountfeatures or call Fidelity. If
no frequency is indicated, you will receive annual distributions on the 5th of every December.
Annually
Quarterly
Monthly
Start Date MM DD YYYY
7. Funding Your Distribution
You can choose to fund your distribution in one of two ways, as described below. If your distribution is from a Fidelity managed account,
skip to Section 8.
Proportional Distributions
Distributions will be withdrawn from the Eligible Positions in the account identified in Section 2. Eligible Positions include your core position
(for brokerage IRAs), all Fidelity mutual funds, and those non-Fidelity mutual funds available through Fidelity
®
FundsNetwork
®
where the
mutual fund company has agreed to make the fund available for automatic distributions.
Distribute proportionally from all Eligible Positions in the account.
Default if no choice indicated.
Fixed Amount/Percentage Distributions
Liquidate and distribute ONLY from these positions in the amount or percentage listed:
For Fixed Dollar Amount plans only.
Core Position or Fund Name/Number Amount
OR
Percentage
$
.0%
.
Core Position or Fund Name/Number Amount
OR
Percentage
$
.0%
.
Core Position or Fund Name/Number Amount
OR
Percentage
$
.0%
.
Core Position or Fund Name/Number Amount
OR
Percentage
$
.0%
.
Core Position or Fund Name/Number Amount
OR
Percentage
$
.0%
.
Total
must add up to 100%.
.0%
Secondary Withdrawal Instructions for Fixed Amount/Percentage Distributions:
Will be used if there are insufficient funds in the above core position or fund name(s)/number(s); and will be distributed from any
Eligible Positions with the lowest value to the highest value.
Any core position, and then any non-core money market position(s)
Any core position, then any non-core money market position(s), and then any other mutual fund position(s)
Default if no choice indicated.
Check ONLY one and
provide start date.
All funds listed must
be held in the account
listed in Section 2.
Use the “Amount”
column ONLY if you
chose “Fixed Dollar
Amount” option in
Section 4. The com-
bined total amount
must equal the amount
you indicated in
Section 4.
NOT applicable to
Fidelity managed
accounts.
Form continues on next page.
0
019001106
1.820237.122
Page 6 of 7
8. Distribution Method
You must obtain a Medallion signature guarantee in Section 10 if establishing EFT instructions for a bank account that is not in your name, if
directing to a Fidelity account of which you are not the owner, if the requested per-payment amount is over $100,000, or if the address on the
account has been changed within the past 10 days.
Directly deposited into a Fidelity nonretirement brokerage account. Deposits will be made to the core position.
Requires a Medallion signature guarantee if going to an account of which you are not the owner.
Fidelity Nonretirement Account Number
Directly deposited into a Fidelity nonretirement mutual fund account. The first three characters of the account number
are 2 followed by two letters (example: 2AB-123456).
Fidelity Nonretirement Account Number Fidelity Fund Name or Symbol If applicable.
Electronic funds transfer (EFT) to a bank or credit union account. To add EFT to an account, go to Fidelity.com/eft or
provide your bank information below.
If EFT cannot be established for any reason, a check will be sent to your address of record.
A. EFT to your bank account. You must be an owner on the Fidelity account and the bank account. Provide
your account information below. You must attach a voided check, deposit slip, or bank statement with
the account number and all owner names preprinted on it.
Checking Savings
B. 3rd Party EFT to someone else. (Available for brokerage accounts only.) The names on the bank account
and the Fidelity account are different. This option ONLY allows you to move money TO the outside account
and may not be used to make transfers for commercial purposes. Provide the account information below.
A Medallion signature guarantee is required in Section 10.
Owner(s) Name(s) Exactly as on Bank Account
Bank Routing/ABA Number Bank Name
Checking or Savings Account Number
Check mailed to the address of record
Default if no choice indicated or if we are unable to process your choice.
9. Tax Withholding
Distributions from your non-Roth IRA are subject to federal and, where applicable, state income tax withholding unless you elect not to
have withholding apply below (if you are a U.S. citizen or other U.S. person, including a resident alien individual). If you do not elect out
of withholding, federal income tax will be withheld at the rate of 10% from your total IRA distribution amount, unless you indicate a higher
percentage below (federal and state tax withholding combined cannot total more than 99%). If you made nondeductible contributions to
your IRA, this may result in excess withholding from your distributions. If you elect not to have withholding apply to your distributions or
if you do not have enough federal income tax withheld from your distribution, you may be responsible for payment of estimated tax. You
may incur penalties under the estimated tax rules if your withholding and estimated tax payments are not sufficient. Withholding instruc-
tions provided will remain effective for all automatic withdrawals until you either revoke them or give us new instructions. See “State Tax
Withholding — IRA Withdrawals” at the end of this form.
Federal
Do NOT withhold federal taxes
Withhold federal taxes at the rate of:
Percentage
Minimum 10%; maximum 99%. Whole
numbers; no dollar amounts. Note that
if there is federal tax withholding, certain
states require that there also be state tax
withholding.
%
State
Do NOT withhold state taxes unless required by law
Withhold state taxes at the applicable rate
Withhold state taxes at the rate of:
Percentage
Maximum 99%. Whole numbers;
no dollar amounts.
%
Check one and
provide any required
information.
If you ONLY
have one set of EFT
instructions already
established for the
account referenced
in Section 2, check
the box and skip to
Section 9. Otherwise,
complete the entire
section.
Provide bank
information ONLY if
establishing new EFT
instructions OR if you
have multiple EFT
instructions available
for the account refer-
enced in Section 2.
Check one in each
column. IRA owner’s
legal/residential
address determines
which state’s tax
rules apply.
Form continues on next page.
1.820237.122 Page 7 of 7 019001107
On this form, “Fidelity” means Fidelity Brokerage Services LLC and its affiliates. Brokerage services are
provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC. 435837.22.0 (04/20)
Did you sign the form? Send the ENTIRE form and any
attachments to Fidelity Investments. You will receive a Revised
Account Profile confirming your distribution instructions.
Questions? Go to Fidelity.com/pws or
call 800-343-3548.
Regular mail
Fidelity Investments
Attn: Retirement Distributions
PO Box 770001
Cincinnati, OH 45277-0035
Overnight mail
Fidelity Investments
Attn: Retirement Distributions
100 Crosby Parkway KC1B
Covington, KY 41015
10. Signature and Date
By signing below, you:
• Authorize and request the custodian for
the Fidelity IRA, Fidelity Management Trust
Company and its agents, affiliates, employees,
or successor custodians (Fidelity), to make
the withdrawals based on the withdrawal
plan type indicated in either Section 4(a) (for
deaths occurring prior to 1/1/2020), or 4(b)
(for deaths occurring on or after 1/1/2020),
from the Inherited IRA or Inherited Roth IRA
account indicated in Section 2.
• Acknowledge that Inherited IRA or Inherited
Roth IRA distributions (to the extent assets
have not been in the Roth IRA for the
Five-Year aging period) will generally be
taxed as ordinary income.
• Accept full responsibility for withdrawing the
RMD from your Inherited IRA or Inherited
Roth IRA, in accordance with applicable
IRS regulations.
• Indemnify and hold Fidelity harmless from
any liability (including taxes, penalties and
interest, and tax preparer or filing fees) in
the event that the automatic withdrawal
plan selected fails to distribute the
minimum amount required in accordance
with the applicable IRS regulations.
Custodial account holders for the minor of
the original IRA owner (death after 1/1/2020):
• Custodian agrees that he or she is ultimately
responsible for withdrawing the minimum
required distributions on behalf of the minor
until the account is transferred to the minor
upon reaching the age when the account must
be transferred. The time frame in which the
account must be depleted for a minor reaching
the age of majority is within 10 years unless the
beneficiary is disabled or chronically ill.
Trustee or Executor (death after 1/2/2020):
• Trustee or Executor understands that he
or she is responsible for determining the
applicable distribution option(s) available to
the Trust or Estate.
• Trustee or Executor understands that a Life
Expectancy plan will be based on a Fixed
Period and will not be recalculated annually.
Customers requesting Fixed Amount,
Fixed Period, Five-Year Rule, or Ten-Year
Rule plans:
• Understand that you may not meet RMD
rules and that you accept full responsibility
for withdrawing the RMD in accordance
with applicable IRS regulations appropriate
to your situation.
Customers requesting EFT:
• Authorize and request Fidelity to make EFT
distributions from the Fidelity IRA(s) listed
in this form by initiating debit entries to the
account indicated in this form.
• Authorize us, upon receiving instructions
from you or as otherwise authorized by
you, to make payments from you and to
you or to your designee, by credit or debit
entries to the designated account at the
financial institution named in this form or
the financial institution specified in your
existing instructions (the “Bank”). You
authorize the Bank to process such entries
and to credit or debit the designated
account at that Bank for such entries. You
ratify such instructions and agree that
neither we nor any mutual fund will be
liable for any loss, liability, cost, or
expense for acting upon all such
instructions believed to be genuine if we
employ reasonable procedures to prevent
unauthorized transactions. You agree that
this authorization may only be revoked by
written notice to us in such time and manner
as to afford us and the Bank a reasonable
opportunity to act upon it.
• Warrant and represent that (i) the third
party’s account identified in Section 8
is owned by a natural person, (ii) that
person has authorized his/her account
to be credited in accordance with your
instructions, and (iii) the account has
been established for personal, family, or
household use, and not for commercial
purposes.
• Understand that Fidelity may purge unused
EFT instructions from your account(s) on a
periodic basis without notice to you.
• Understand that Fidelity may terminate the
EFT instructions from your account(s) at any
time in its sole discretion.
For Connecticut Residents:
• Acknowledge that, as a resident of CT, your
distributions from retirement accounts are
subject to the highest marginal tax rate. If
you are exempt from state tax, you have the
option to elect out of state tax withholding.
Otherwise, penalties may apply. The penalty
for reporting false information is a fine of
not more than $5,000, imprisonment for not
more than five years, or both.
• Confirm that your state tax withholding
election is true, complete, and correct.
A Medallion signature guarantee is required:
• to establish EFT instructions for a bank account that is not in your name.
• to request a per-payment amount greater than $100,000.
• if the withdrawals are going to a Fidelity account with no common owner.
If the form is completed at a Fidelity Investor Center, the Medallion signature guarantee is not required. You can get a Medallion signature
guarantee from most banks, credit unions, and other financial institutions. A notary seal/stamp is NOT a Medallion signature guarantee.
PRINT OWNER NAME
MEDALLION SIGNATURE GUARANTEE
OWNER SIGNATURE
SIGN
X
DATE MM/DD/YYYY
DATE
X
State Tax Withholding — IRA Withdrawals
Helpful to Know
• Each state sets its own withholding rates and require-
ments on taxable distributions. We apply these rates
unless you direct us not to (where permitted) or you
request a higher rate.
• Your account’s legal / residential address determines
which state’s tax rules apply.
• You are responsible for paying your federal, state, and
local income taxes and any penalties, including penal-
ties for insufficient withholding.
• Withholding taxes for Roth IRA distributions is optional.
• The state tax withholding rate, if indicated, must be
provided as a whole number from 1% to 100% for any
one-time withdrawals, or from 1% to 99% for any auto-
matic withdrawals.
Withholding Options
State of residence State tax withholding options
AK, FL, HI, NH, NV, SD,
TN, TX, WA, WY
• No state tax withholding is available (even if your state has income tax).
AR, IA, KS, MA, ME,
OK, VT
• If you choose federal withholding, you will also get state withholding at your state’s minimum withholding
rate or an amount greater as specified by you.
• If you do NOT choose federal withholding, state withholding is voluntary.
• If you have state withholding, you can request a higher rate than your state’s minimum but not a lower rate,
except on Roth IRA distributions.
CA, DE, NC, OR
• If you choose federal withholding, you will also get state withholding at your state’s minimum withholding
rate unless you request otherwise.
• If you do NOT choose federal withholding, state withholding is voluntary.
• If you have state withholding, you can request a higher rate than your state’s minimum but not a lower rate,
except on Roth IRA distributions.
CT, MI
• CT and MI generally require state income tax of at least your state’s minimum requirements regardless of
whether or not federal income tax is withheld.
• Tax withholding is not required if you meet certain state requirements governing pension and retirement
benefits. Please reference the CT or MI W-4P Form for additional information about calculating the amount
to withhold from your distribution.
• If you are subject to state tax withholding, you must elect state tax withholding of at least your state’s
minimum by completing the Tax Withholding section.
• Contact your tax advisor or investment representative for additional information about your state’s requirements.
DC
Only applicable if taking
a full distribution of entire
account balance.
• If you are taking distribution of your entire account balance and not directly rolling that amount over to
another eligible retirement account, DC requires that a minimum amount be withheld from the taxable
portion of the distribution, whether or not federal income tax is withheld. In that case, you must elect to
have the minimum DC income tax amount withheld by completing the Tax Withholding section.
• If your entire distribution amount has already been taxed (for instance only after-tax or nondeductible contributions
were made and you have no pre-tax earnings), you may be eligible to elect any of the withholding options.
• If you wish to take a distribution of both taxable and nontaxable amounts, you must complete a separate
distribution request form for each and complete the Tax Withholding section of the forms, as appropriate.
MS
• If you choose federal withholding, you will also get state withholding at your state’s minimum withholding
rate unless you request otherwise.
• If you do NOT choose federal withholding, state withholding will occur unless you request otherwise.
• If you have state withholding, you can request a higher rate than your state’s minimum but not a lower rate,
except on Roth IRA distributions.
OH
• State tax withholding is voluntary. If you choose state withholding, you can choose a higher rate than your
state’s minimum but not a lower rate, except on Roth IRA distributions.
SC
• SC requires state withholding if you have not provided a Tax ID or if you have been notified of a name/
Tax ID mismatch and have not resolved the issue. Otherwise, state tax withholding is voluntary and you can
choose the rate you want.
All other states
(and DC if not taking a
full distribution)
• State tax withholding is voluntary and you can choose the rate you want.
Important: State tax withholding rules can change, and the rules cited above may not reflect the current ruling of your state. Consult with
your tax advisor or state taxing authority to obtain the most up-to-date information pertaining to your state.
This tax information is for informational purposes only, and should not be considered legal or tax advice. Always consult a tax or legal
professional before making financial decisions.
We do not provide tax or legal advice and we will not be liable for any decisions you make based on this or other general tax information
we provide.
Fidelity Brokerage Services LLC, Member NYSE, SIPC; National Financial Services LLC, Member NYSE, SIPC 652041.6.0 (02/19)
Page 1 of 1
1.964543.105
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Completed 15 July 2020

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