Fillable College Savings Plan Rollover Form (Washington)

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College Savings Plan Rollover Form (Washington)

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The College Savings Plan Rollover Form (Washington) form is 6 pages long and contains:

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  • 6 check-boxes
  • 70 other fields

Country of origin: US
File type: PDF

BROWSE WASHINGTON FORMS

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College Savings Plan Rollover Form
Important information about this form:
• Fill out this form to make a rollover from another 529 College Savings account,
a UTMA/UGMA Account*, Coverdell Education Savings Account or qualified
U.S. Savings Bond.
• Do not use this form to roll over a Guaranteed Education Tuition (GET)
program account to DreamAhead. To learn more about how to initiate a
GET to DreamAhead rollover, visit www.dreamahead.wa.gov/get-rollovers.
• Do not use this form to change the Beneficiary of a DreamAhead account,
instead use the Change Beneficiary Form.
• If you need to open an account, sign up online at DreamAhead.wa.gov or
submit an Enrollment Form along with this form.
• The Account Owner must remain the same. If you would like to change the
Account Owner, please do so on the other 529 College Savings account before
completing this form.
• For direct rollovers from other 529 College Savings accounts into your
DreamAhead account, you must have the information available for your
other 529 College Savings accounts. The funds will be sent directly to your
DreamAhead account by the Plan Manager for the other 529 college savings
account. The other 529 College Savings account might also require
a Medallion Signature Guarantee in Step 7.
• For indirect rollovers from a 529 College Savings account, you must deposit
the amount you withdrew from the other 529 College Savings account within
60 days of opening a new DreamAhead account or the monies may be subject
to tax penalties.
• You can only make one rollover for this Beneficiary’s account once every
12 months.
• There’s a $500,000 maximum account balance for DreamAhead accounts.
• A Medallion Signature Guarantee is required for an entity account or an
account for which the individual completing the form is acting in a legal
capacity as a representative of the Account Owner (Step 7).
• Make sure you use black ink to type or print clearly in capital letters. Please
use a paperclip, do not staple pages together.
Need help?
Give us a call Monday – Friday
from 6am – 5pm PT at
1-844-529-5845 or
1-844-888-2253 (TTY)
Mail the form to:
DreamAhead College
Investment Plan
P.O. Box 9661
Providence, RI 02940-9661
Overnight Mail:
DreamAhead College
Investment Plan
4400 Computer Drive
Westborough, MA 01581
* Uniform Gift to Minors Act (UGMA)/Uniform Transfer to Minors Act (UTMA)
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Is the Beneficiary the same for both the other 529 account and the DreamAhead account?
Yes
No, and I certify that the new Beneficiary listed above meets the permitted family member
designation in Section 529 (includes biological and step parents, aunts, uncles, siblings,
children, first cousins, nieces and nephews; parents, siblings, children, nieces and nephews
by marriage; legally adopted children; and half-brothers or half-sisters) of the Beneficiary.
Direct Rollover information
3
Only complete this step if you’re making a direct rollover.
This is the other 529 College Savings account you’re rolling assets from.
2 Rollover type
Select the type of rollover you want to make and follow the assigned steps.
Direct rollover – Roll over assets directly from another 529 College Savings account into a
DreamAhead account. (Complete Step 3, 5, and possibly 7 if a Signature Medallion Guarantee is
required by the other 529 College Savings Plan Manager)
Indirect rollover – Deposit assets that have been withdrawn from another 529 College Savings
account, UGMA/UTMA account, Coverdell Education Savings Account or qualified U.S. Savings
Bond into the new DreamAhead account. (Complete Step 4, and 5)
DreamAhead account number (Leave this blank if you’re enrolling in a new account)
DreamAhead account information
1
This is the 529 College Savings account you’re rolling assets into.
Please submit an Enrollment Form with this form if you are opening a new DreamAhead account.
Name of Account Owner (First and last)
Account Owner’s Social Security or Taxpayer Identification Number
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Other 529 College Savings Plan information
College Savings Plan name
continued from page 2
We need the following information for Account Owner in case there are any questions about the account:
Who should we contact?
Telephone number
Contact name (First and last)
Other 529 College Savings account number
Name of Account Owner (First and last)
Account Owner’s Social Security or Taxpayer Identification Number
529 Plan State Sponsor (2-character state abbreviation)
If you need to change the Account Owner, please make the change
with the other 529 College Savings plan before completing this form.
Email address associated with other 529 College Savings account
Street address 1 Street address 2
City ZIP Code
Other Plan Manager’s address
State
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College Savings Plan Rollover Form
Instructions for the other 529 College Savings Plan
These instructions will be used by the other 529 College Savings Plan Manager. To add more investment
portfolios, please include a separate page with this form.
This should be the sum of the portfolios listed
in Step 3A above.
Amount
Full rollover amount
(There’s a $500,000 maximum
account balance)*
,
,
.
.
$
$
Investment portfolio name
Source of funds:
What’s the total?
A
B
Full balance
Partial amount
Amount
,
.
$
Investment portfolio name
Full balance
Partial amount
Amount
,
.
$
Investment portfolio name
Full balance
Partial amount
* Rollovers that would cause the DreamAhead account to exceed the $500,000 maximum account balance will be
rejected in their entirety.
Name of Beneficiary (First and last)
Beneficiary’s Social Security or Taxpayer Identification Number
Telephone number
continued from page 3
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College Savings Plan Rollover Form
Indirect Rollover information
4
Only complete this step if you’re making an indirect rollover.
Another 529 College Savings Account
The assets from the other 529 College Savings account must be deposited within 60 days of
withdrawal. Please provide the information below and submit a copy of the most recent quarterly
statement from the other 529 College Savings account along with your check and this form.
Proceeds from the withdrawal of a Coverdell Education Savings Account (Coverdell ESA)
Provide the information below and submit an account statement with these amounts along with
your check and this form.
Proceeds from the withdrawal of a qualified U.S. Savings Bond
Provide the breakdown of cost basis and earnings below and submit a Form 1099 with these
amounts along with your check and this form.
Proceeds from the withdrawal of a UGMA/UTMA account
Provide the information below and submit an account statement with these amounts along with
your check and this form.
Tell us what’s on the check:
Make the check payable to the
DreamAhead College Investment Plan.
Full amount of the rollover
(There’s a $500,000 maximum account balance)*
,
.
$
Rollover details:
Principal of the rollover
, .
$
Earnings of the rollover
, .
$
What is the source of the funds for this indirect rollover?
A
B
C
* Rollovers that would cause the DreamAhead account to exceed the $500,000 maximum account balance will
be rejected in their entirety.
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Rollover contribution information
Provide instructions to the DreamAhead College Investment Plan for how to invest the rollover amount provided
in either Step 3 or Step 4.
For a full list of all the portfolio options, please go online to www.DreamAhead.wa.gov or see the Program
Details Booklet for important information about the investment options before making a decision.
Please clearly print the portfolio name, code and amount you’d like to contribute below. Reference the
Investment Portfolio Options Appendix at the end of this form for a list of all portfolio names and codes.
5
Portfolio name
Portfolio name
Portfolio name
Portfolio name
Portfolio name
Percent
Percent
Percent
Percent
Percent
Code
Code
Code
Code
Code
%
%
%
%
%
Total = 100%
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College Savings Plan Rollover Form
By signing this, you’re agreeing to these statements:
• I confirm that I received, understand, consent, and agree to all the terms and conditions of the DreamAhead
Program Details Booklet as they relate to this rollover request.
• If I’m making a direct rollover, I authorize the other 529 College Savings Plan Manager, or its designee,
to roll over assets into the DreamAhead account according to these instructions.
• I certify that this is the only rollover for this Beneficiary’s 529 College Savings account in the last 12 months.
• I certify that if rolling over assets to my DreamAhead for a new Beneficiary, they qualify as a “Member of
the Family.”
• If this is an indirect rollover from another 529 College Savings account, the request was made within 60
days of withdrawal.
• I understand that I cannot make additional contributions when the fair market value of my DreamAhead
account exceeds $500,000.
• I understand that if this is an indirect rollover, the Account Owner of the account from which assets are
being withdrawn, is responsible for providing the DreamAhead account with a statement that certifies the
breakdown of the assets being rolled over. I further understand that until such statement is provided, the
DreamAhead College Investment Plan will treat the entire rollover as earnings.
• I understand that a rollover that doesn’t meet the above conditions may result in the earning portion of the
deposit being considered a non-qualified withdrawal subject to federal income tax and an additional 10%
federal tax, and may be subject to state or local income tax.
• I certify that the above is, to the best of my knowledge, accurate data regarding the rollover of all 529 College
Savings Plan account assets in the referenced account. I further certify that I have signing authority over both
the DreamAhead account and the account from which assets are being rolled over.
Signature of Account Owner/Custodian/Authorized Representative
of Entity
Date (mm/dd/yyyy)
Sign the form
6
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College Savings Plan Rollover Form
A Medallion Signature Guarantee
Keep in mind that:
• You’re providing the following information as underwritten certification that your signature is genuine.
• You can get a Medallion Signature Guarantee from an authorized officer of a bank, broker, or other qualified
financial institution. A notary public doesn’t qualify, and you cannot guarantee your own signature. You may
be required to provide proof of your authority to act on behalf of the DreamAhead account.
• Only sign if you are in the presence of an authorized officer providing the Medallion Signature Guarantee.
Signature of Account Owner/Custodian/Authorized
Representative of Entity
Signature Guarantor
Title
Name of Institution
Have the Authorized Officer stamp here
Date (mm/dd/yyyy)
I certify that the information provided herein is true and complete in all respects, and that I have read and
understand, consent, and agree to all the terms and conditions of the Program Details Booklet.
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9
Appendix – DreamAhead Investment Portfolio Options
For descriptions and details about all of these portfolio options, please go online to www.DreamAhead.wa.gov or see
the Program Details Booklet for important information including descriptions, details, and risks about the
investment options before making a decision.
Static Portfolios
Year of Enrollment
Conservative
Code
Code
Portfolio Name
Portfolio Name
WACCP
WACIN
WACCG
WACBA
WACMG
WACGR
WACAG
WAC38
WAC36
WAC34
WAC32
WAC30
WAC28
WAC26
WAC24
WAC22
WACEC
Cash Preservation Portfolio
Income Portfolio
Income & Growth Portfolio
Balanced Portfolio
Conservative Growth Portfolio
Moderate Growth Portfolio
Growth Portfolio
Year of Enrollment 2038 - Conservative
Year of Enrollment 2036 - Conservative
Year of Enrollment 2034 - Conservative
Year of Enrollment 2032 - Conservative
Year of Enrollment 2030 - Conservative
Year of Enrollment 2028 - Conservative
Year of Enrollment 2026 - Conservative
Year of Enrollment 2024 - Conservative
Year of Enrollment 2022 - Conservative
College Enrolled Conservative
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10
Moderate
Growth
Code
Code
Portfolio Name
Portfolio Name
WAM38
WAM36
WAM34
WAM32
WAM30
WAM28
WAM26
WAM24
WAM22
WACEM
WAA38
WAA36
WAA34
WAA32
WAA30
WAA28
WAA26
WAA24
WAA22
WACEA
Year of Enrollment 2038 - Moderate
Year of Enrollment 2036 - Moderate
Year of Enrollment 2034 - Moderate
Year of Enrollment 2032 - Moderate
Year of Enrollment 2030 - Moderate
Year of Enrollment 2028 - Moderate
Year of Enrollment 2026 - Moderate
Year of Enrollment 2024 - Moderate
Year of Enrollment 2022 - Moderate
College Enrolled Moderate
Year of Enrollment 2038 - Growth
Year of Enrollment 2036 - Growth
Year of Enrollment 2034 - Growth
Year of Enrollment 2032 - Growth
Year of Enrollment 2030 - Growth
Year of Enrollment 2028 - Growth
Year of Enrollment 2026 - Growth
Year of Enrollment 2024 - Growth
Year of Enrollment 2022 - Growth
College Enrolled Growth
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College Savings Plan Rollover Form (Washington)

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Completed 23 March 2021

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