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Ally Bank

PO Box 

+RUVKDP, PA 19

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Subject Line: Operations

Fax Number: 866-699-2969

Ally Bank Member FDIC

QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM

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IRA ACCOUNT APPLICATION

Product Type Selection

IRA ONLINE SAVINGS ACCOUNT IRA HIGH YIELD 9-MONTH CD

IRA HIGH YIELD 3-MONTH CD IRA HIGH YIELD 3-YEAR CD

IRA RAISE YOUR RATE 2-YEAR CD IRA HIGH YIELD 12-MONTH CD

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Applicant Information

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each person who opens an account. What this means for you: when you open an account, we will ask for your name, a street address, date of birth, and

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to identify you.

You authorize us to contact you by using any telephone number you provide to us, including a mobile or cell phone number that you are authorized to

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you for any contact, but your mobile phone service provider may.

If you have a freeze on your credit as a feature of credit security monitoring, we may contact you to lift the freeze temporarily to verify your identity.

We only open accounts for legal U.S. residents. By signing and submitting this application, you are acknowledging that you are a U.S. citizen or resident

alien of the U.S.

Check all that apply:

I am a legal U.S. Resident

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Date of Birth information below.)

FIRST NAME M.I. LAST NAME / SUFFIX SOCIAL SECURITY NUMBER

DATE OF BIRTH

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QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM

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Provide a prior residential address if the applicant has been at the above address for less than 5 years. In addition, provide a copy of one of the

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SECURITY QUESTION SECURITY ANSWER 027+(5¶60$,'(11$0(

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How are you planning to fund your account?

ACCOUNT NUMBER

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Detailed, IRA funding instructions will be provided to you in your New Account Welcome Kit.

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Regular contribution

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Account Agreement

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the Ally Bank Deposit Agreement that will be sent to you after your account is opened. You authorize us to obtain a consumer report from a consumer

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■

Introduction

The Depositor whose name appears on the Application to Participate is establishing a

Roth Individual Retirement Account (Roth IRA) under section 408A to provide for his or her

UHWLUHPHQWDQGIRUWKHVXSSRUWRIKLVRUKHUEHQH¿FLDULHVDIWHUGHDWK7KH&XVWRGLDQQDPHGRQ

the Application to Participate has given the Depositor the disclosure statement required by

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RQWKH$SSOLFDWLRQWR3DUWLFLSDWH

7KH'HSRVLWRUDQGWKH&XVWRGLDQPDNHWKHIROORZLQJDJUHHPHQW

ARTICLE I

([FHSWLQWKHFDVHRIDTXDOL¿HGUROORYHUFRQWULEXWLRQGHVFULEHGLQVHFWLRQ$HRUD

UHFKDUDFWHUL]HGFRQWULEXWLRQGHVFULEHGLQVHFWLRQ$GWKH&XVWRGLDQZLOODFFHSWRQO\

FDVKFRQWULEXWLRQV XSWRSHU\HDUIRUWKURXJK)RULQGLYLGXDOVZKRKDYH

UHDFKHGWKHDJHRIE\WKHHQGRIWKH\HDUWKHFRQWULEXWLRQOLPLWLVLQFUHDVHGWRSHU

\HDUIRUWKURXJK)RU\HDUVDIWHUWKHVHOLPLWVZLOOEHLQFUHDVHGWRUHÀHFWD

FRVWRIOLYLQJDGMXVWPHQWLIDQ\

ARTICLE II

1. The annual contribution limit described in Article I is gradually reduced to $0 for higher

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OLYLQJDGMXVWPHQWLIDQ\$GMXVWHGJURVVLQFRPHLVGH¿QHGLQVHFWLRQ$F

2. ,Q WKH FDVH RI D MRLQW UHWXUQ WKH$*,OLPLWVLQ WKH SUHFHGLQJ SDUDJUDSK DSSO\WR WKH

FRPELQHG$*,RIWKH'HSRVLWRUDQGKLVRUKHUVSRXVH

ARTICLE III

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ARTICLE IV

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PD\WKHDVVHWVRIWKH&XVWRGLDO$FFRXQWEHFRPPLQJOHGZLWKRWKHUSURSHUW\H[FHSWLQDFRPPRQ

WUXVWIXQGRUFRPPRQLQYHVWPHQWIXQGZLWKLQWKHPHDQLQJRIVHFWLRQD

2.1RSDUWRIWKH&XVWRGLDO$FFRXQWIXQGVPD\EHLQYHVWHGLQFROOHFWLEOHVZLWKLQWKHPHDQLQJ

RI VHFWLRQ P H[FHSW DV RWKHUZLVH SHUPLWWHG E\ VHFWLRQ P ZKLFK SURYLGHV DQ

H[FHSWLRQIRUFHUWDLQJROGVLOYHUDQGSODWLQXPFRLQVFRLQVLVVXHGXQGHUWKHODZVRIDQ\VWDWH

DQGFHUWDLQEXOOLRQ

ARTICLE V

1. If the Depositor dies before his or her entire interest is distributed to him or her and

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(a) 7KHUHPDLQLQJ LQWHUHVW ZLOO EH GLVWULEXWHG VWDUWLQJ E\ WKH HQG RI WKH FDOHQGDU \HDU

IROORZLQJWKH\HDURIWKHGHSRVLWRUVGHDWKRYHUWKHGHVLJQDWHGEHQH¿FLDU\VUHPDLQLQJ

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(b) The remaining interest will be distributed by the end of the calendar year containing the

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2. The minimum amount that must be distributed each year under paragraph 1(a) above is

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OLIHH[SHFWDQF\LQWKHVLQJOHOLIHWDEOHLQ5HJXODWLRQVVHFWLRQDRIWKHGHVLJQDWHG

EHQH¿FLDU\ XVLQJ WKH DWWDLQHG DJH RI WKH EHQH¿FLDU\ LQ WKH \HDU IROORZLQJ WKH \HDU RI WKH

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3. ,IWKH'HSRVLWRUVVXUYLYLQJVSRXVHLVWKHGHVLJQDWHGEHQH¿FLDU\VXFKVSRXVHZLOOWKHQ

EHWUHDWHGDVWKH'HSRVLWRU

ARTICLE VI

1. 7KH'HSRVLWRUDJUHHVWRSURYLGHWKH&XVWRGLDQZLWKDOOLQIRUPDWLRQQHFHVVDU\WRSUHSDUH

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General Instructions

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RWKHUZLVHQRWHG

Purpose of Form

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PHHWVWKHUHTXLUHPHQWVRIVHFWLRQ$+RZHYHURQO\

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Roth individual retirement account (Roth IRA) is established

after the form is fully executed by both the individual

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Depositor. The Depositor is the person who establishes the

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Article I.7KH'HSRVLWRUPD\EHVXEMHFW WR D  WD[ RQ

excess contributions if (1) contributions to other individual

retirement arrangements of the Depositor have been made

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income exceeds the applicable limits in Article II for the

WD[\HDURU(3) the Depositor's and spouse's compensation

is less than the amount contributed by or on behalf of them

IRUWKHWD[\HDU

Article V. This article describes how distributions will be made

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pursuant to this article should be reviewed periodically to ensure

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WR$UWLFOH,;

Article IX. Article IX and any that follow it may incorporate

additional provisions that are agreed to by the Depositor and

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RI WKH &XVWRGLDQ &XVWRGLDQ¶V IHHV VWDWH ODZ UHTXLUHPHQWV

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2. 7KH&XVWRGLDQDJUHHVWRVXEPLWWRWKH,56DQG'HSRVLWRUWKHUHSRUWVSUHVFULEHGE\WKH,56

ARTICLE VII

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ARTICLE VIII

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ARTICLE IX

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Roth Individual Retirement Custodial Account

(Under Section 408A of the Internal Revenue Code)

(Rev. April 2017)

Department of the Treasury

Internal Revenue Service

Form

Do not ¿OH

with the Internal

Revenue Service

5305-RA

Roth IRA Custodial Disclosure Statement

Introduction

This disclosure statement describes the statutory and regulatory provisions applicable

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Revocation of Account

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whose taxable compensation is reduced because of pay exclusions for combat service

Congratulations

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Application to Participate

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The Application is used to record all of the participant information necessary

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Roth IRA Custodial Agreement

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Disclosure Statement

The Disclosure Statement is a nontechnical description of the rules governing

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Tax Credits for Roth IRA Contributions. ,I\RXDUHDJHRURYHUDQG\RXDUHQRW

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credit is reduced by taxable distributions you or your spouse received from IRAs or

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plus net income attributable to a Roth IRA or to a Traditional IRA by the applicable

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Converting to a Roth IRA

You may be allowed to roll over (convert) your IRA (other than a Roth IRA) or

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included in your income for the year in which the distribution is received from a

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already rolled over one distribution from a Traditional IRA to another Traditional IRA

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Rollover Contributions

Introduction. Yo u may be able to roll over a distribution from a Roth IRA or from

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Roth IRA-to-Roth IRA Rollovers. You may withdraw all or any portion of the assets

from one Roth IRA (including this one) and roll over all or any part of these assets to

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Designated Roth Account-to-Roth IRA Rollovers*HQHUDOO\\RXDUHHOLJLEOHWRUROO

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of a designated Roth account distribution that is rolled over to a Roth IRA is treated

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a designated Roth account distribution that is rolled over to a Roth IRA is treated as

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apply to rollovers of funds between a designated Roth account and a Roth IRA See

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Transfers

Roth IRA-to-Roth IRA Transfers. You may transfer all or any portion of the assets

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Distributions

Aggregation and Ordering Rules. :KHQ\RXWDNHDGLVWULEXWLRQIURPD5RWK,5$

that Roth IRA is aggregated with all your other Roth IRAs (but not Traditional IRAs)

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Required Minimum Distributions. The required minimum distribution (RMD) rules

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Death Distribution Options. $Q\EHQH¿FLDU\ZLWKGUDZLQJIXQGVIURP\RXU5RWK

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single life expectancy is based on his attained age in the year for which the distribution

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expectancy is based on his attained age in the year following the year of your death

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UHFHLYHWKHHQWLUHEDODQFHLQWKHDFFRXQWE\'HFHPEHU of the tenth year following

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Additional Options Available to the Surviving Spouse. In addition to the options

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penalty tax unless removed (along with net income attributable) by the applicable date

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commingled with other property except in a common trust fund or common investment

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Financial Disclosure

Projection of Future Balance. The balance in a Roth IRA increases as a direct result

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in all events at the end of each year. The rate of interest payable on the investments

is subject to change for the duration of the Roth IRA and cannot be guaranteed at a

constant rate.

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Variable Rate Account. If your Roth IRA funds are invested in a variable rate account

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Projection of Future Balance (Use Method 1 or Method 2)

Method 2

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DJHVDQG7KHVHEDODQFHVDUHQRWJXDUDQWHHG7KHDFWXDOEDODQFHVZLOOGHSHQGRQPDQ\

IDFWRUVLQFOXGLQJWKHLQWHUHVWUDWHVDQGWHUPVRIIXWXUHLQYHVWPHQWV7KHIROORZLQJEDODQFHVZKLFK

DUHRQO\SURMHFWLRQVDUHEDVHGRQWKHFXVWRGLDOfees discXVVHGRQWKHSUHYLRXVSDJHLIDQ\and the

IROORZLQJDVVXPSWLRQV

5HJXODU5RWK,5$$VVXPLQJDQDQQXDOGHSRVLWPDGHRQWKH¿UVWGD\RIHDFK\HDU

5ROORYHU5RWK,5$$VVXPLQJDRQHWLPHGHSRVLWPDGHRQWKH¿UVWGD\RIWKH¿UVW\HDU

Investment annual percentage yield

Penalty for early withdrawal of investment

End of year





Account Value

End of year

you attain age

Account Value







Zs͘ϭϮͬϮϬϭϵ

ΞϮϬϭϵWDEŽĐŽƉǇƌŝŐŚƚĐůĂŝŵŝƐďĞŝŶŐŵĂĚĞƚŽƚŚĞh͘^͘ŐŽǀĞƌŶŵĞŶƚǁŽƌŬ͕/ŶƚĞƌŶĂůZĞǀĞŶƵĞ^ĞƌǀŝĐĞ&ŽƌŵϱϯϬϱͲZ͘

Method 1

7KLVWDEOHKDVEHHQSUHSDUHGDVVXPLQJWKDW\RXZLOOPDNHOHYHODQQXDOFRQWULEXWLRQV

RIRQWKH¿UVWGD\RIHDFK\HDUZLWKDQDQQXDOSHUFHQWDJH\LHOGRI)RU

H[DPSOHLI\RXDWWDLQDJHLQWKH\HDU\RXVWDUWPDNLQJFRQWULEXWLRQVWR\RXU5RWK

,5$\RXZLOOKDYHEHHQLQWKHSODQ\HDUVDWWKHHQGRIWKH\HDULQZKLFK\RXDWWDLQ

DJH\HDUVDWDJHDQG\HDUVDWDJH8VLQJWKHDVVXPSWLRQVVWDWHGDERYH

you can read across the table and see that your account value without penalty would be

DWDJHDWDJHDQGDWDJH

5HJXODU5RWK,5$3URMHFWLRQ

This table has been prepared assuming the initial and only contribution to your Roth

,5$LVDUROORYHURIRQWKH¿UVWGD\RIWKH\HDUZLWKDQDQQXDOSHUFHQWDJH\LHOG

RI)RUH[DPSOHLI\RXDWWDLQDJHLQWKH\HDULQZKLFK\RXUROORYHUWR

\RXU5RWK,5$\RXZLOOKDYHEHHQLQWKHSODQ\HDUVDWWKHHQGRIWKH\HDULQZKLFK

\RXDWWDLQDJH\HDUVDWDJHDQG\HDUVDWDJH8VLQJWKHDVVXPSWLRQV

VWDWHGDERYH\RXFDQUHDGDFURVVWKH WDEOHDQGVHHWKDW \RXUDFFRXQWYDOXHZLWKRXW

SHQDOW\ZRXOGEHDWDJHDWDJHDQGDWDJH

5ROORYHU5RWK,5$3URMHFWLRQ

Account Values

Number

of Years

Number

of Years

3HQDOW\

1-Month

3HQDOW\

3-Month

3HQDOW\

6-Month

3HQDOW\

1-Month

3HQDOW\

3-Month

3HQDOW\

6-Month

3HQDOW\

$1,001.00

$2,003.00

$3,006.00

$4,010.01

$5,015.02

$6,021.04

$7,028.06

$8,036.08

$9,045.12

$10,055.17

$11,066.22

$12,078.29

$13,091.37

$14,105.46

$15,120.56

$16,136.68

$17,153.82

$18,171.97

$19,191.14

$20,211.34

$21,232.55

$22,254.78

$23,278.03

$24,302.31

$25,327.62

$26,353.94

$27,381.30

$28,409.68

$29,439.09

$30,469.53

$31,501.00

$32,533.50

$33,567.03

$34,601.60

$35,637.20

$36,673.84

$37,711.51

$38,750.22

$39,789.97

$40,830.76

$41,872.59

$42,915.47

$43,959.38

$45,004.34

$46,050.34

$47,097.39

$48,145.49

$49,194.64

$50,244.83

$51,296.08

$52,348.37

$53,401.72

$1,000.92

$2,002.83

$3,005.75

$4,009.68

$5,014.60

$6,020.53

$7,027.47

$8,035.42

$9,044.37

$10,054.33

$11,065.30

$12,077.28

$13,090.28

$14,104.28

$15,119.30

$16,135.34

$17,152.39

$18,170.46

$19,189.55

$20,209.65

$21,230.78

$22,252.93

$23,276.10

$24,300.29

$25,325.51

$26,351.75

$27,379.02

$28,407.31

$29,436.64

$30,466.99

$31,498.37

$32,530.79

$33,564.24

$34,598.72

$35,634.23

$36,670.78

$37,708.37

$38,747.00

$39,786.66

$40,827.36

$41,869.11

$42,911.89

$43,955.72

$45,000.59

$46,046.51

$47,093.47

$48,141.48

$49,190.54

$50,240.65

$51,291.81

$52,344.02

$53,397.28

$1,000.75

$2,002.50

$3,005.25

$4,009.01

$5,013.77

$6,019.53

$7,026.30

$8,034.08

$9,042.86

$10,052.65

$11,063.46

$12,075.27

$13,088.10

$14,101.93

$15,116.79

$16,132.65

$17,149.53

$18,167.43

$19,186.35

$20,206.29

$21,227.24

$22,249.22

$23,272.22

$24,296.24

$25,321.29

$26,347.36

$27,374.46

$28,402.58

$29,431.74

$30,461.92

$31,493.13

$32,525.37

$33,558.65

$34,592.96

$35,628.30

$36,664.68

$37,702.09

$38,740.54

$39,780.03

$40,820.56

$41,862.14

$42,904.75

$43,948.40

$44,993.10

$46,038.84

$47,085.63

$48,133.47

$49,182.35

$50,232.28

$51,283.27

$52,335.30

$53,388.38

$1,000.50

$2,002.00

$3,004.50

$4,008.01

$5,012.52

$6,018.03

$7,024.55

$8,032.07

$9,040.60

$10,050.14

$11,060.69

$12,072.25

$13,084.83

$14,098.41

$15,113.01

$16,128.62

$17,145.25

$18,162.90

$19,181.56

$20,201.24

$21,221.94

$22,243.66

$23,266.41

$24,290.17

$25,314.96

$26,340.78

$27,367.62

$28,395.49

$29,424.38

$30,454.31

$31,485.26

$32,517.25

$33,550.26

$34,584.31

$35,619.40

$36,655.52

$37,692.67

$38,730.87

$39,770.10

$40,810.37

$41,851.68

$42,894.03

$43,937.42

$44,981.86

$46,027.34

$47,073.87

$48,121.44

$49,170.07

$50,219.74

$51,270.45

$52,322.23

$53,375.05

$1,001.00

$1,002.00

$1,003.00

$1,004.01

$1,005.01

$1,006.02

$1,007.02

$1,008.03

$1,009.04

$1,010.05

$1,011.06

$1,012.07

$1,013.08

$1,014.09

$1,015.11

$1,016.12

$1,017.14

$1,018.15

$1,019.17

$1,020.19

$1,021.21

$1,022.23

$1,023.25

$1,024.28

$1,025.30

$1,026.33

$1,027.35

$1,028.38

$1,029.41

$1,030.44

$1,031.47

$1,032.50

$1,033.53

$1,034.57

$1,035.60

$1,036.64

$1,037.67

$1,038.71

$1,039.75

$1,040.79

$1,041.83

$1,042.87

$1,043.92

$1,044.96

$1,046.00

$1,047.05

$1,048.10

$1,049.15

$1,050.19

$1,051.24

$1,052.30

$1,053.35

$1,000.92

$1,001.92

$1,002.92

$1,003.92

$1,004.93

$1,005.93

$1,006.94

$1,007.94

$1,008.95

$1,009.96

$1,010.97

$1,011.98

$1,012.99

$1,014.01

$1,015.02

$1,016.04

$1,017.05

$1,018.07

$1,019.09

$1,020.11

$1,021.13

$1,022.15

$1,023.17

$1,024.19

$1,025.22

$1,026.24

$1,027.27

$1,028.30

$1,029.32

$1,030.35

$1,031.38

$1,032.42

$1,033.45

$1,034.48

$1,035.52

$1,036.55

$1,037.59

$1,038.63

$1,039.66

$1,040.70

$1,041.74

$1,042.79

$1,043.83

$1,044.87

$1,045.92

$1,046.96

$1,048.01

$1,049.06

$1,050.11

$1,051.16

$1,052.21

$1,053.26

$1,000.75

$1,001.75

$1,002.75

$1,003.76

$1,004.76

$1,005.76

$1,006.77

$1,007.78

$1,008.78

$1,009.79

$1,010.80

$1,011.81

$1,012.83

$1,013.84

$1,014.85

$1,015.87

$1,016.88

$1,017.90

$1,018.92

$1,019.94

$1,020.96

$1,021.98

$1,023.00

$1,024.02

$1,025.05

$1,026.07

$1,027.10

$1,028.12

$1,029.15

$1,030.18

$1,031.21

$1,032.24

$1,033.28

$1,034.31

$1,035.34

$1,036.38

$1,037.41

$1,038.45

$1,039.49

$1,040.53

$1,041.57

$1,042.61

$1,043.65

$1,044.70

$1,045.74

$1,046.79

$1,047.84

$1,048.88

$1,049.93

$1,050.98

$1,052.03

$1,053.09

$1,000.50

$1,001.50

$1,002.50

$1,003.50

$1,004.51

$1,005.51

$1,006.52

$1,007.52

$1,008.53

$1,009.54

$1,010.55

$1,011.56

$1,012.57

$1,013.58

$1,014.60

$1,015.61

$1,016.63

$1,017.65

$1,018.66

$1,019.68

$1,020.70

$1,021.72

$1,022.74

$1,023.77

$1,024.79

$1,025.81

$1,026.84

$1,027.87

$1,028.90

$1,029.92

$1,030.95

$1,031.99

$1,033.02

$1,034.05

$1,035.08

$1,036.12

$1,037.16

$1,038.19

$1,039.23

$1,040.27

$1,041.31

$1,042.35

$1,043.39

$1,044.44

$1,045.48

$1,046.53

$1,047.57

$1,048.62

$1,049.67

$1,050.72

$1,051.77

$1,052.82

Ally Bank Member FDIC

Version 1.3. Last revised on 07/8/2010

Addendum to the Roth IRA Custodial Account Disclosure Statement

Right to Revoke

You are entitled to revoke your Roth IRA Plan for any reason within seven (7) calendar days after your

Roth IRA Plan is opened. You must revoke by providing us with written notice, by mailing to: Ally Bank,

P.O. Box 951, Horsham, PA 19044. Your notice is considered mailed on the date of the postmark. It must

be placed in the U.S. Mail, first-class postage prepaid. If you successfully revoke, you are entitled to the

amount of the original contribution, without interest. If you have questions about your right to revoke,

please call us at 1-877-247-ALLY (2559).

Tax and Legal Advice

Ally Bank does not provide tax or legal advice or interpret how tax rules affect your individual situation.

You should contact a qualified tax professional before you make any decision regarding IRAs.

Nondeductible Contributions

Unlike contributions to Traditional IRAs, contributions to your Roth IRA Plan are not deductible from your

gross income.

Designation of Beneficiary

You may designate a beneficiary or beneficiaries of your Roth IRA on the form provided by Ally Bank. If

you do not designate a beneficiary or if no primary or contingent designated beneficiary survives you,

payments from your Roth IRA shall be made to your surviving spouse or, if you do not have a surviving

spouse, to your estate.

Recharacterization of Contributions

You may not revoke your election to recharacterize a contribution once that contribution has been

transferred into another IRA.

Converting SEP IRAs to Roth IRAs

You may convert amounts in a SEP IRA under the same terms as an amount in any Traditional IRA. After

an amount in a SEP IRA has been converted to a Roth IRA, future contributions under the SEP IRA plan

may not be made into the converted Roth IRA.

Successor Custodian or Trustee

Upon your request or the request of a successor custodian or trustee on your behalf, Ally Bank will

distribute to you for rollover or transfer directly to the successor trustee or custodian all or any portion of

the assets of your Roth IRA Plan. You are responsible for following the rule that permits only one rollover

every 12 months. When the distribution or rollover is completed, Ally Bank is released from all further

responsibility for your Roth IRA Plan. We cannot determine or help you determine whether all or a portion

of the assets of your Roth IRA Plan are eligible to be rolled over to a qualified employer retirement plan.

Creditor Claims

Depending upon the particular facts and circumstances of each situation, and subject to applicable state

law, your Roth IRA Plan may be subject to the claims of creditors. Ally Bank will not assert defenses on

your behalf as against such creditors. You should consult with your legal advisor for guidance regarding

the law that is applicable to your situation.

Roth IRA Distributions That Are Not Qualified

The rules around determining whether a Roth IRA distribution is qualified are complex.

We recommend that you seek the advice of a qualified tax advisor if you are taking a Roth IRA Plan

distribution, particularly if you have converted balances from a non-Roth IRA Plan to your Roth IRA Plan.

Reports

Under your Roth IRA Plan, we will provide reports to you and the proper taxing authorities as required by

law. You must furnish us with any information that may be required in connection with the preparation of

such reports. If you have objections to any such report, you have 60 days after the date of the report’s

postmark to submit, in writing, details on any matter contained in or omitted from such report. After the

60-day period you are deemed to have approved the report, and we are released from liability to anyone,

including you and your beneficiaries, with respect to the content of the report.

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