Fill - Free fillable INHERITED INDIVIDUAL RETIREMENT ACCOUNT APPLICATION (Kinecta) PDF form

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Traditional IRA Simplifier

INHERITED INDIVIDUAL RETIREMENT ACCOUNT APPLICATION

The term Inherited IRA Owner is used below to mean a beneficiary who is entitled to receive distributions from the original

owner’s account.

PART 1. INHERITED IRA OWNER

Name

Address Line 1

Address Line 2

City/State/ZIP

Tax ID (SSN/TIN)

Date of Birth Phone

Email Address

Account Number

Relationship to Original Owner

PART 2. INHERITED IRA CUSTODIAN

To be completed by the inherited IRA custodian

Name

Address Line 1

Address Line 2

City/State/ZIP

Phone Organization Number

This is an amendment to an existing inherited IRA.

PART 3. ORIGINAL OWNER’S INFORMATION

Name (First/MI/Last) Date of Birth

Social Security Number Date of Death

PART 4. PAYMENT ELECTION INFORMATION

Has there been a payment election made for the assets you inherited from the employer-sponsored retirement plan or Traditional IRA?

Yes (If yes, provide election information below)

The previous payment election made (Select one)

Five-Year Rule

Ten-Year Rule

Life Expectancy Payments*

* If life expectancy payments are being taken, what is the date of birth of the individual whose life expectancy is being used to calculate the

payment?

Note: If incorrect or incomplete information regarding a previous payment election is provided, the custodian will not be held responsible for any

penalties that may be incurred due to removing an insufficient amount.

PART 5. CONTRIBUTION INFORMATION

Contribution Amount Contribution Date

CONTRIBUTION TYPE (Select one)

(If the check is payable to you and you are not a spouse beneficiary, the assets are not eligible for an inherited IRA)

Transfer (Direct movement of inherited assets from a Traditional IRA into this inherited IRA)

Direct Rollover From an Eligible Employer-Sponsored Retirement Plan (A direct movement of inherited assets from an eligible employer-sponsored

retirement plan into this inherited IRA)

By selecting this transaction, I irrevocably designate this contribution as a rollover.

A spouse beneficiary also has the following option available.

Indirect Rollover From an Eligible Employer-Sponsored Retirement Plan (Inherited assets were paid to the spouse beneficiary and are now being

moved into this inherited IRA)

By selecting this transaction, I irrevocably designate this contribution as a rollover.

KINECTA FEDERAL CREDIT UNION

ATTN: MEMBER SERVICE SUPPORT C/U 140

1440 ROSECRANS AVE

MANHATTAN BEACH CA 90266

(800) 854-9846

11379

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This is page 2 of the inherited IRA Application for , Account Number

PART 6. INVESTMENT AND DEPOSIT INFORMATION

INVESTMENT INFORMATION (Complete this section as applicable.)

Investment Description Quantity or Amount Investment Number Term or Maturity Date Interest Rate

DEPOSIT METHOD

Cash or Check (If the contribution type is transfer from a Traditional IRA or direct rollover from an eligible employer-sponsored retirement plan, the

check must be from a financial organization made payable to the custodian for this inherited IRA.)

Internal Account

Account Number Type (e.g., checking, savings, IRA)

External Account (e.g., EFT, ACH, wire) (Additional documentation may be required and fees may apply.)

Name of Organization Sending the Assets Routing Number (Optional)

Account Number Type (e.g., checking, savings, IRA)

Deposit Taken by

PART 7. BENEFICIARY DESIGNATION

I designate that upon my death, the assets in this inherited account be paid to the beneficiaries named below. The interest of any beneficiary that

predeceases me terminates completely, and the percentage share of any remaining beneficiaries will be increased on a pro rata basis. If no beneficiaries

are named, my estate will be my beneficiary.

I elect not to designate beneficiaries at this time and understand that I may designate beneficiaries at a later date.

PRIMARY BENEFICIARIES (The total percentage designated must equal 100%. If more than one beneficiary is designated and no percentages are

indicated, the beneficiaries will be deemed to own equal share percentages in the inherited IRA.)

Name

Address

City/State/ZIP

Date of Birth Relationship

Tax ID (SSN/TIN) Percent Designated

Name

Address

City/State/ZIP

Date of Birth Relationship

Tax ID (SSN/TIN) Percent Designated

CONTINGENT BENEFICIARIES (The total percentage designated must equal 100%. If more than one beneficiary is designated and no percentages

are indicated, the beneficiaries will be deemed to own equal share percentages in the inherited IRA. The balance in the account will be payable to

these beneficiaries if all primary beneficiaries have predeceased the inherited IRA owner.)

Name

Address

City/State/ZIP

Date of Birth Relationship

Tax ID (SSN/TIN) Percent Designated

Name

Address

City/State/ZIP

Date of Birth Relationship

Tax ID (SSN/TIN) Percent Designated

Check here if additional beneficiaries are listed on an attached addendum. Total number of addendums attached to this Inherited IRA

PART 8. SIGNATURES

Important: Please read before signing.

I understand the eligibility requirements for the type of inherited IRA contribution I am making, and I state that I do qualify to make the contribution.

I have received a copy of the Inherited IRA Application, the 5305-A Custodial Account Agreement, the Financial Disclosure, and the Disclosure

Statement. I understand that the terms and conditions that apply to this inherited IRA are contained in this Application and the Custodial Account

Agreement. I agree to be bound by those terms and conditions. Within seven days from the date I open this inherited IRA I may revoke it without

penalty by mailing or delivering a written notice to the custodian.

I assume complete responsibility for

• determining that I am eligible to establish an inherited IRA,

• ensuring that all rollover or transfer contributions I make are within the limits set forth by the tax laws, and

• the tax consequences of any rollover or transfer contributions and distributions.

Signature of Inherited IRA Owner Date (mm/dd/yyyy)

Signature of Witness Date (mm/dd/yyyy)

Signature of Custodian Date (mm/dd/yyyy)

ELECTRONIC TRANSFER NOT AVAILABLE

XXXX N/A XXXXX

XXXXXXXXXXXXXXX N/A XXXXXXXXXXX

XXXXXXX N/A XXXXXXXX

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INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT AGREEMENT

Form 5305-A under section 408(a) of the Internal Revenue Code. FORM (Rev. April 2017)

The depositor named on the application is establishing a Traditional

individual retirement account under section 408(a) to provide for his or

her retirement and for the support of his or her beneficiaries after death.

The custodian named on the application has given the depositor the

disclosure statement required by Regulations section 1.408-6.

The depositor has assigned the custodial account the sum indicated on

the application.

The depositor and the custodian make the following agreement:

ARTICLE I

Except in the case of a rollover contribution described in section 402(c),

403(a)(4), 403(b)(8), 408(d)(3), or 457(e)(16), an employer contribution

to a simplified employee pension plan as described in section 408(k) or a

recharacterized contribution described in section 408A(d)(6), the

custodian will accept only cash contributions up to $5,500 per year for

tax years 2013 through 2017. For individuals who have reached the age

of 50 by the end of the year, the contribution limit is increased to $6,500

per year for tax years 2013 through 2017. For years after 2017, these

limits will be increased to reflect a cost-of-living adjustment, if any.

ARTICLE II

The depositor’s interest in the balance in the custodial account is

nonforfeitable.

ARTICLE III

1. No part of the custodial account funds may be invested in life

insurance contracts, nor may the assets of the custodial account be

commingled with other property except in a common trust fund or

common investment fund (within the meaning of section 408(a)(5)).

2. No part of the custodial account funds may be invested in collectibles

(within the meaning of section 408(m)) except as otherwise permitted

by section 408(m)(3), which provides an exception for certain gold,

silver, and platinum coins, coins issued under the laws of any state,

and certain bullion.

ARTICLE IV

1. Notwithstanding any provision of this agreement to the contrary, the

distribution of the depositor’s interest in the custodial account shall be

made in accordance with the following requirements and shall

otherwise comply with section 408(a)(6) and the regulations thereunder,

the provisions of which are herein incorporated by reference.

2. The depositor’s entire interest in the custodial account must be, or

begin to be, distributed not later than the depositor’s required

beginning date, April 1 following the calendar year in which the

depositor reaches age 70½. By that date, the depositor may elect, in a

manner acceptable to the custodian, to have the balance in the

custodial account distributed in: (a) A single sum or (b) Payments over

a period not longer than the life of the depositor or the joint lives of

the depositor and his or her designated beneficiary.

3. If the depositor dies before his or her entire interest is distributed to

him or her, the remaining interest will be distributed as follows:

(a) If the depositor dies on or after the required beginning date and:

(i) the designated beneficiary is the depositor’s surviving spouse,

the remaining interest will be distributed over the surviving

spouse’s life expectancy as determined each year until such

spouse’s death, or over the period in paragraph (a)(iii) below

if longer. Any interest remaining after the spouse’s death will

be distributed over such spouse’s remaining life expectancy as

determined in the year of the spouse’s death and reduced by

one for each subsequent year, or, if distributions are being

made over the period in paragraph (a)(iii) below, over such

period.

(ii) the designated beneficiary is not the depositor’s surviving

spouse, the remaining interest will be distributed over the

beneficiary’s remaining life expectancy as determined in the

year following the death of the depositor and reduced by one

for each subsequent year, or over the period in paragraph

(a)(iii) below if longer.

(iii) there is no designated beneficiary, the remaining interest will

be distributed over the remaining life expectancy of the

depositor as determined in the year of the depositor’s death

and reduced by one for each subsequent year.

(b) If the depositor dies before the required beginning date, the

remaining interest will be distributed in accordance with

paragraph (i) below or, if elected or there is no designated

beneficiary, in accordance with paragraph (ii) below.

(i) The remaining interest will be distributed in accordance with

paragraphs (a)(i) and (a)(ii) above (but not over the period in

paragraph (a)(iii), even if longer), starting by the end of the

calendar year following the year of the depositor’s death. If,

however, the designated beneficiary is the depositor’s surviving

spouse, then this distribution is not required to begin before

the end of the calendar year in which the depositor would

have reached age 70½. But, in such case, if the depositor’s

surviving spouse dies before distributions are required to

begin, then the remaining interest will be distributed in

accordance with paragraph (a)(ii) above (but not over the

period in paragraph (a)(iii), even if longer), over such spouse’s

designated beneficiary’s life expectancy, or in accordance with

paragraph (ii) below if there is no such designated beneficiary.

(ii) The remaining interest will be distributed by the end of the

calendar year containing the fifth anniversary of the depositor’s

death.

4. If the depositor dies before his or her entire interest has been

distributed and if the designated beneficiary is not the depositor’s

surviving spouse, no additional contributions may be accepted in the

account.

5. The minimum amount that must be distributed each year, beginning

with the year containing the depositor’s required beginning date, is

known as the “required minimum distribution” and is determined as

follows.

(a) The required minimum distribution under paragraph 2(b) for any

year, beginning with the year the depositor reaches age 70½, is

the depositor’s account value at the close of business on

December 31 of the preceding year divided by the distribution

period in the uniform lifetime table in Regulations section 1.401(a)

(9)-9. However, if the depositor’s designated beneficiary is his or

her surviving spouse, the required minimum distribution for a

year shall not be more than the depositor’s account value at the

close of business on December 31 of the preceding year divided

by the number in the joint and last survivor table in Regulations

section 1.401(a)(9)-9. The required minimum distribution for a

year under this paragraph (a) is determined using the depositor’s

(or, if applicable, the depositor and spouse’s) attained age (or

ages) in the year.

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(b) The required minimum distribution under paragraphs 3(a) and

3(b)(i) for a year, beginning with the year following the year of the

depositor’s death (or the year the depositor would have reached

age 70½, if applicable under paragraph 3(b)(i)) is the account

value at the close of business on December 31 of the preceding

year divided by the life expectancy (in the single life table in

Regulations section 1.401(a)(9)-9) of the individual specified in

such paragraphs 3(a) and 3(b)(i).

reaches age 70½ can be made as late as April 1 of the following

year. The required minimum distribution for any other year must

be made by the end of such year.

6. The owner of two or more Traditional IRAs may satisfy the minimum

distribution requirements described above by taking from one

Traditional IRA the amount required to satisfy the requirement for

another in accordance with the regulations under section 408(a)(6).

ARTICLE V

1. The depositor agrees to provide the custodian with all information

necessary to prepare any reports required by section 408(i) and

Regulations sections 1.408-5 and 1.408-6.

2. The custodian agrees to submit to the Internal Revenue Service (IRS)

and depositor the reports prescribed by the IRS.

ARTICLE VI

Notwithstanding any other articles which may be added or incorporated,

the provisions of Articles I through III and this sentence will be controlling.

Any additional articles inconsistent with section 408(a) and the related

regulations will be invalid.

ARTICLE VII

This agreement will be amended as necessary to comply with the

provisions of the Code and the related regulations. Other amendments

may be made with the consent of the persons whose signatures appear

on the application.

ARTICLE VIII

8.01 Definitions – In this part of this agreement (Article VIII), the words

“you” and “your” mean the inherited IRA owner. The words “we,”

“us,” and “our” mean the custodian. The words “inherited IRA

owner” mean the individual establishing this inherited IRA with

either a direct rollover contribution from an eligible inherited

employer-sponsored retirement plan or a transfer from an

inherited IRA. The word “Code” means the Internal Revenue Code,

and “regulations” means the Treasury regulations.

8.02 Notices and Change of Address – Any required notice regarding

this inherited IRA will be considered effective when we send it to

the intended recipient at the last address that we have in our

records. Any notice to be given to us will be considered effective

when we actually receive it. You, or the intended recipient, must

notify us of any change of address.

8.03 Representations and Responsibilities – You represent and warrant

to us that any information you have given or will give us with

respect to this agreement is complete and accurate. Further, you

agree that any directions you give us or action you take will be

proper under this agreement, and that we are entitled to rely upon

any such information or directions. If we fail to receive directions

from you regarding any transaction, if we receive ambiguous

directions regarding any transaction, or if we, in good faith, believe

that any transaction requested is in dispute, we reserve the right to

take no action until further clarification acceptable to us is received

from you or the appropriate government or judicial authority. We

will not be responsible for losses of any kind that may result from

your directions to us or your actions or failures to act, and you

agree to reimburse us for any loss we may incur as a result of such

directions, actions, or failures to act. We will not be responsible for

any penalties, taxes, judgments, or expenses you incur in connection

with your inherited IRA. We have no duty to determine whether

your contributions or distributions comply with the Code,

regulations, rulings, or this agreement.

We may permit you to appoint, through written notice acceptable

to us, an authorized agent to act on your behalf with respect to

this agreement (e.g., attorney-in-fact, executor, administrator,

investment manager), but we have no duty to determine the

validity of such appointment or any instrument appointing such

authorized agent. We will not be responsible for losses of any kind

that may result from directions, actions, or failures to act by your

authorized agent, and you agree to reimburse us for any loss we

may incur as a result of such directions, actions, or failures to act

by your authorized agent.

You will have 60 days after you receive any documents, statements,

or other information from us to notify us in writing of any errors or

inaccuracies reflected in these documents, statements, or other

information. If you do not notify us within 60 days, the documents,

statements, or other information will be deemed correct and

accurate, and we will have no further liability or obligation for such

documents, statements, other information, or the transactions

described therein.

By performing services under this agreement we are acting as your

agent. You acknowledge and agree that nothing in this agreement

will be construed as conferring fiduciary status upon us. We will not

be required to perform any additional services unless specifically

agreed to under the terms and conditions of this agreement, or as

required under the Code and the regulations promulgated

thereunder with respect to inherited IRAs. You agree to indemnify

and hold us harmless for any and all claims, actions, proceedings,

damages, judgments, liabilities, costs, and expenses, including

attorney’s fees arising from or in connection with this agreement.

To the extent written instructions or notices are required under

this agreement, we may accept or provide such information in any

other form permitted by the Code or applicable regulations

including, but not limited to, electronic communication.

8.04 Disclosure of Account Information – We may use agents and/or

subcontractors to assist in administering your inherited IRA. We

may release nonpublic personal information regarding your

inherited IRA to such providers as necessary to provide the

products and services made available under this agreement, and

to evaluate our business operations and analyze potential product,

service, or process improvements.

8.05 Service Fees – We have the right to charge an annual service fee

or other designated fees (e.g., a transfer, rollover, or termination

fee) for maintaining your inherited IRA. In addition, we have the

right to be reimbursed for all reasonable expenses, including legal

expenses, we incur in connection with the administration of your

inherited IRA. We may charge you separately for any fees or

expenses, or we may deduct the amount of the fees or expenses

from the assets in your inherited IRA at our discretion. We reserve

the right to charge any additional fee after giving you 30 days’

notice. Fees such as subtransfer agent fees or commissions may be

paid to us by third parties for assistance in performing certain

transactions with respect to this inherited IRA.

Any brokerage commissions attributable to the assets in your

inherited IRA will be charged to your inherited IRA. You cannot

reimburse your inherited IRA for those commissions.

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8.06 Restrictions on Contributions to the Inherited IRA – Your inherited

IRA may receive multiple rollover contributions from inherited

qualified retirement plans, 403(a) annuity plans, 403(b) tax-

sheltered annuity plans, or 457(b) governmental deferred

compensation plans, or multiple transfers from inherited

Traditional IRAs. In order to combine these inherited retirement

assets in the same inherited IRA, you must have inherited the

assets from the same owner and they must have been subject to

the same beneficiary payment elections and calculation methods

as under the receiving inherited IRA. You may not make regular

contributions to this inherited IRA.

8.07 Investment of Amounts in the Inherited IRA – You have exclusive

responsibility for and control over the investment of the assets of

your inherited IRA. All transactions will be subject to any and all

restrictions or limitations, direct or indirect, that are imposed by

our charter, articles of incorporation, or bylaws; any and all

applicable federal and state laws and regulations; the rules,

regulations, customs, and usages of any exchange, market, or

clearing house where the transaction is executed; our policies and

practices; and this agreement. After your death, your successor

beneficiaries will have the right to direct the investment of your

inherited IRA assets, subject to the same conditions that applied to

you during your lifetime under this agreement (including, without

limitation, Section 8.03 of this article). We will have no discretion

to direct any investment in your inherited IRA. We assume no

responsibility for rendering investment advice with respect to your

inherited IRA, nor will we offer any opinion or judgment to you on

matters concerning the value or suitability of any investment or

proposed investment for your inherited IRA. In the absence of

instructions from you, or if your instructions are not in a form

acceptable to us, we will have the right to hold any uninvested

amounts in cash, and we will have no responsibility to invest

uninvested cash unless and until directed by you. We will not

exercise the voting rights and other shareholder rights with respect

to investments in your inherited IRA unless you provide timely

written directions acceptable to us.

You will select the investment for your inherited IRA assets from

those investments that we are authorized by our charter, articles

of incorporation, or bylaws to offer and do in fact offer for

inherited IRAs (e.g., term share accounts, passbook accounts,

certificates of deposit, money market accounts).

8.08 Successor Beneficiaries – We may allow you, if permitted by state

law, to name successor beneficiaries for your inherited IRA. This

designation can only be made on a form provided by or acceptable

to us, and it will only be effective when it is filed with us during

your lifetime. Each inherited IRA beneficiary designation form that

you file with us will cancel all previous designations. The consent

of a successor beneficiary will not be required for you to revoke a

successor beneficiary designation. If you do not designate a

successor beneficiary, your estate will be the successor beneficiary.

In no event will the successor beneficiary be able to extend the

distribution period beyond that required for you.

If we so choose, for any reason (e.g., due to limitations of our

charter or bylaws), we may require that a successor beneficiary

take total distribution of all IRA assets by December 31 of the year

following the year of death.

8.09 Required Minimum Distributions – You are required to take

minimum distributions from your inherited IRA. The options

available to you as a beneficiary of a deceased plan participant or

deceased IRA owner are described in Article IV, section three.

8.10

Termination of Agreement, Resignation, or Removal of Custodian –

Either party may terminate this agreement at any time by giving

written notice to the other. We can resign as custodian at any time

effective 30 days after we send written notice of our resignation to

you. Upon receipt of that notice, you must make arrangements to

transfer your inherited IRA to another financial organization. If you

do not complete a transfer of your inherited IRA within 30 days

from the date we send the notice to you, we have the right to

transfer your inherited IRA assets to a successor inherited IRA

trustee or custodian that we choose in our sole discretion, or we

may pay your inherited IRA to you in a single sum. We will not be

liable for any actions or failures to act on the part of any successor

trustee or custodian, nor for any tax consequences you may incur

that result from the transfer or distribution of your assets pursuant

to this section.

If this agreement is terminated, we may charge to your inherited

IRA a reasonable amount of money that we believe is necessary to

cover any associated costs, including but not limited to one or

more of the following.

• Any fees, expenses, or taxes chargeable against your inherited IRA

• Any penalties or surrender charges associated with the early

withdrawal of any savings instrument or other investment in

your inherited IRA

If we are a nonbank custodian required to comply with Regulations

section 1.408-2(e) and we fail to do so or we are not keeping the

records, making the returns, or sending the statements as are

required by forms or regulations, the IRS may require us to

substitute another trustee or custodian.

We may establish a policy requiring distribution of the entire

balance of your inherited IRA to you in cash or property if the

balance of your inherited IRA drops below the minimum balance

required under the applicable investment or policy established.

8.11 Successor Custodian – If our organization changes its name,

reorganizes, merges with another organization (or comes under

the control of any federal or state agency), or if our entire

organization (or any portion that includes your inherited IRA) is

bought by another organization, that organization (or agency) will

automatically become the trustee or custodian of your inherited

IRA, but only if it is the type of organization authorized to serve as

an inherited IRA trustee or custodian.

8.12 Amendments – We have the right to amend this agreement at any

time. Any amendment we make to comply with the Code and

related regulations does not require your consent. You will be

deemed to have consented to any other amendment unless,

within 30 days from the date we send the amendment, you notify

us in writing that you do not consent.

8.13 Withdrawals or Transfers – All requests for withdrawal or transfer

will be in writing on a form provided by or acceptable to us. The

method of distribution must be specified in writing or in any other

method acceptable to us. The tax identification number of the

recipient must be provided to us before we are obligated to make

a distribution. Withdrawals will be subject to all applicable tax and

other laws and regulations, including but not limited to possible

early distribution penalty taxes, surrender charges, and withholding

requirements.

8.14 Transfers From Other Plans – We can receive amounts transferred

to this inherited IRA from the trustee or custodian of another

inherited Traditional IRA. In addition, we can accept rollovers of

eligible rollover distributions from inherited employer-sponsored

retirement plans as permitted by the Code. We reserve the right

not to accept any transfer or rollover.

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8.15 Liquidation of Assets – We have the right to liquidate assets in

your inherited IRA if necessary to make distributions or to pay

fees, expenses, taxes, penalties, or surrender charges properly

chargeable against your inherited IRA. If you fail to direct us as to

which assets to liquidate, we will decide, in our complete and sole

discretion, and you agree to not hold us liable for any adverse

consequences that result from our decision.

8.16 Restrictions on the Fund – Neither you nor any successor

beneficiary may sell, transfer, or pledge any interest in your

inherited IRA in any manner whatsoever, except as provided by

law or this agreement.

The assets in your inherited IRA will not be responsible for the

debts, contracts, or torts of any person entitled to distributions

under this agreement.

8.17 What Law Applies – This agreement is subject to all applicable

federal and state laws and regulations. If it is necessary to apply

any state law to interpret and administer this agreement, the law

of our domicile will govern.

If any part of this agreement is held to be illegal or invalid, the

remaining parts will not be affected. Neither your nor our failure

to enforce at any time or for any period of time any of the

provisions of this agreement will be construed as a waiver of such

provisions, or your right or our right thereafter to enforce each

and every such provision.

GENERAL INSTRUCTIONS

Section references are to the Internal Revenue Code unless otherwise noted.

PURPOSE OF FORM

Form 5305-A is a model custodial account agreement that meets the

requirements of section 408(a). However, only Articles I through VII have

been reviewed by the IRS. A Traditional individual retirement account

(Traditional IRA) is established after the form is fully executed by both the

individual (depositor) and the custodian. To make a regular contribution

to a Traditional IRA for a year, the IRA must be established no later than

the due date of the individual’s income tax return for the tax year

(excluding extensions). This account must be created in the United States

for the exclusive benefit of the depositor and his or her beneficiaries.

Do not file Form 5305-A with the IRS. Instead, keep it with your records.

For more information on IRAs, including the required disclosures the

custodian must give the depositor, see Pub. 590-A, Contributions to

Individual Retirement Arrangements (IRAs),

and Pub. 590-B, Distributions

from Individual Retirement Arrangements (IRAs).

DEFINITIONS

Custodian – The custodian must be a bank or savings and loan association,

as defined in section 408(n), or any person who has the approval of the

IRS to act as custodian.

Depositor – The depositor is the person who establishes the custodial

account.

TRADITIONAL IRA FOR NONWORKING SPOUSE

Form 5305-A may be used to establish the IRA custodial account for a

nonworking spouse.

Contributions to an IRA custodial account for a nonworking spouse must

be made to a separate IRA custodial account established by the

nonworking spouse.

SPECIFIC INSTRUCTIONS

Article IV – Distributions made under this article may be made in a single

sum, periodic payment, or a combination of both. The distribution option

should be reviewed in the year the depositor reaches age 70½ to ensure

that the requirements of section 408(a)(6) have been met.

Article VIII – Article VIII and any that follow it may incorporate additional

provisions that are agreed to by the depositor and custodian to complete

the agreement. They may include, for example, definitions, investment

powers, voting rights, exculpatory provisions, amendment and

termination, removal of the custodian, custodian’s fees, state law

requirements, beginning date of distributions, accepting only cash,

treatment of excess contributions, prohibited transactions with the

depositor, etc. Attach additional pages if necessary.

Page 7 of 11

DISCLOSURE STATEMENT

RIGHT TO REVOKE YOUR INHERITED IRA

You have the right to revoke your inherited IRA within seven days of the

receipt of the disclosure statement. If revoked, you are entitled to a full

return of the contribution you made to your inherited IRA. The amount

returned to you would not include an adjustment for such items as sales

commissions, administrative expenses, or fluctuation in market value.

You may make this revocation only by mailing or delivering a written

notice to the custodian at the address listed on the application.

If you send your notice by first class mail, your revocation will be deemed

mailed as of the postmark date.

If you have any questions about the procedure for revoking your inherited

IRA, please call the custodian at the telephone number listed on the

application.

REQUIREMENTS OF AN INHERITED IRA

A. Form of Contribution – Your contribution must be either a rollover

contribution from an eligible inherited employer-sponsored retirement

plan or a transfer contribution from an inherited Traditional IRA. Your

rollover or transfer contribution may be in cash and/or property.

B. Contribution Restrictions – You may not make regular contributions

to your inherited IRA.

C. Nonforfeitability – Your interest in your inherited IRA is nonforfeitable.

D. Eligible Custodians – The custodian of your inherited IRA must be a

bank, savings and loan association, credit union, or a person or entity

approved by the Secretary of the Treasury.

E. Commingling Assets

–

The assets of your inherited IRA cannot be

commingled with other property except in a common trust fund or

common investment fund.

F. Life Insurance – No portion of your inherited IRA may be invested in

life insurance contracts.

G. Collectibles – You may not invest the assets of your inherited IRA in

collectibles (within the meaning of IRC Sec. 408(m)). A collectible is

defined as any work of art, rug or antique, metal or gem, stamp or

coin, alcoholic beverage, or other tangible personal property specified

by the Internal Revenue Service (IRS). However, specially minted

United States gold and silver coins, and certain state-issued coins are

permissible investments. Platinum coins and certain gold, silver,

platinum, or palladium bullion (as described in IRC Sec. 408(m)(3)) are

also permitted as inherited IRA investments.

H. Required Minimum Distributions – You are required to take minimum

distributions from your inherited IRA at certain times in accordance

with Treasury Regulation 1.408-8. The calculation of the required

minimum distribution is based, in part, on determining the original

owner’s designated beneficiary. A designated beneficiary is determined

based on the beneficiaries designated as of the date of the original

owner’s death, who remain beneficiaries as of September 30 of the

year following the year of the original owner’s death. Any payment

elections you either made or defaulted to under an inherited

retirement plan or IRA generally carry over to this inherited IRA. Below

is a summary of the inherited IRA distribution rules.

If you fail to remove a required minimum distribution, an additional

penalty tax of 50 percent is imposed on the amount of the required

minimum distribution that should have been taken but was not. You

must file IRS Form 5329 along with your income tax return to report

and remit any additional taxes to the IRS.

Death of Original Owner Before January 1, 2020

1. If the original IRA owner or employer-sponsored retirement plan

participant died

(a) on or after the original owner’s required beginning date,

distributions must be made to you over the longer of your

single life expectancy, or the original owner’s remaining life

expectancy. If the original owner’s designated beneficiary was

not an individual or qualified trust as defined in the Treasury

regulations, the original IRA or employer-sponsored retirement

plan will be treated as having no designated beneficiary for

purposes of determining the distribution period. If there is no

designated beneficiary of the original IRA or employer-

sponsored retirement plan, distributions will commence using

the original owner’s single life expectancy, reduced by one in

each subsequent year.

(b) before the original owner’s required beginning date, the entire

amount remaining in the account will, at your election, either

(i) be distributed by December 31 of the year containing the

fifth anniversary of the original owner’s death, or

(ii) be distributed over your remaining life expectancy.

If the original IRA owner’s or participant’s spouse is the sole

designated beneficiary, he or she must elect either option (i) or

(ii) by the earlier of December 31 of the year containing the

fifth anniversary of the original owner’s death, or December 31

of the year life expectancy payments would be required to

begin. A designated beneficiary of the original owner, other

than a spouse who is the sole designated beneficiary, must

elect either option (i) or (ii) by December 31 of the year

following the year of the original owner’s death. If no election

is made, the distribution will be calculated in accordance with

option (ii). In the case of distributions under option (ii),

distributions must commence by December 31 of the year

following the year of the original owner’s death. Generally, if

the original owner’s spouse is the designated beneficiary,

distributions need not commence until December 31 of the

year the original owner would have attained age 72 (70½ if the

original owner would have attained 70½ before 2020), if later.

If the original owner’s designated beneficiary is not an

individual or qualified trust as defined in the Treasury

regulations, the original IRA or employer-sponsored retirement

plan will be treated as having no designated beneficiaries for

purposes of determining the distribution period. If there is no

designated beneficiary of the original IRA or employer-

sponsored retirement plan, the entire inherited IRA must be

distributed by December 31 of the year containing the fifth

anniversary of the original owner’s death.

If you have inherited a qualified retirement plan, 403(a)

annuity, 403(b) tax-sheltered annuity, or 457(b) governmental

deferred compensation plan and have either elected or

defaulted to payments under the five-year rule, you may

change to a life expectancy payment election if, by December

31 of the year following the year of the original owner’s death,

you remove a life expectancy-based payment before rolling

over the remaining assets to your inherited IRA.

Page 8 of 11

2. If you have elected to take life expectancy payments and fail to

request your required minimum distribution by December 31, we

reserve the right to do any one of the following.

(a) Make no distribution until you give us a proper withdrawal

request

(b) Distribute your entire inherited IRA to you in a single sum

payment

based on your life expectancy calculated using the Single Life

Expectancy Table, and pay those distributions to you until you

direct otherwise

Death of Original Owner On or After January 1, 2020

The entire amount remaining in your account will generally be

distributed by December 31 of the year containing the tenth

anniversary of the original owner’s death unless you are an eligible

designated beneficiary or the account has no designated beneficiary

for purposes of determining a distribution period. This requirement

applies to beneficiaries regardless of whether the original owner died

before, on, or after the required beginning date.

If you are an eligible designated beneficiary, the entire amount

remaining in your account may be distributed (in accordance with the

Treasury Regulations) over your remaining life expectancy (or over a

period not extending beyond your life expectancy).

An eligible designated beneficiary is any designated beneficiary who is

• the original owner’s surviving spouse,

• the original owner’s child who has not reached the age of majority,

• disabled (A physician must determine that your impairment can be

expected to result in death or to be of long, continued, and indefinite

duration.),

• an individual who is not more than 10 years younger than the

original owner, or

• chronically ill (A chronically ill individual is someone who (1) is

unable to perform (without substantial assistance from another

individual) at least two activities of daily living for an indefinite

period due to a loss of functional capacity, (2) has a level of

disability similar to the level of disability described above requiring

assistance with daily living based on loss of functional capacity, or

(3) requires substantial supervision to protect the individual from

threats to health and safety due to severe cognitive impairment.)

Note that certain trust beneficiaries (e.g., certain trusts for disabled

and chronically ill individuals) may take distribution of the entire

amount remaining in the account over the remaining life expectancy

of the trust beneficiary.

Generally, life expectancy distributions to an eligible designated

beneficiary must commence by December 31 of the year following

the year of the original owner’s death. However, if the original

owner’s spouse is the eligible designated beneficiary, distributions

need not commence until December 31 of the year the original owner

would have attained age 72, if later. If the eligible designated

beneficiary is the original owner’s minor child, life expectancy

payments must begin by December 31 of the year following the year

of the original owner’s death and continue until the child reaches the

age of majority. Once the age of majority is reached, the beneficiary

will have 10 years to deplete the account.

If a beneficiary other than a person (e.g., an estate, a charity, or a

certain type of trust) is named, the original owner will be treated as

having no designated beneficiary of the IRA for purposes of

determining the distribution period. If the original owner died before

the required beginning date and there is no designated beneficiary of

the IRA, the entire IRA must be distributed by December 31 of the

year containing the fifth anniversary of the original owner’s death. If

the original owner died on or after the required beginning date and

there is no designated beneficiary of the IRA, distributions will

commence using the original owner’s single life expectancy, reduced

by one in each subsequent year.

INCOME TAX CONSEQUENCES OF ESTABLISHING AN

INHERITED IRA

A. Tax-Deferred Earnings – The investment earnings of your inherited

IRA are not subject to federal income tax until distributions are made

(or, in certain instances, when distributions are deemed to be made).

B. Taxation of Distributions – The taxation of inherited IRA distributions

depends on whether or not the original IRA owner had ever made

nondeductible IRA contributions or after-tax contributions to the

employer-sponsored retirement plan. If the original owner had only

made deductible IRA contributions or pretax contributions to an

employer-sponsored retirement plan, all inherited IRA distribution

amounts will be included in income.

If the original owner had ever made nondeductible contributions to

any IRA or after-tax contributions to an employer-sponsored

retirement plan, the following formula must be used to determine the

amount of any inherited IRA distribution excluded from income.

NOTE: Aggregate nondeductible contributions include all nondeductible

contributions made by the original owner through the end of the year

of the distribution that have not previously been withdrawn and

excluded from income. Also note that the aggregate IRA balance

includes the total balance of all of the original owner’s IRAs as of the

end of the year of distribution and any distributions occurring during

the year.

C. Income Tax Withholding – Any withdrawal from your inherited IRA is

subject to federal income tax withholding. You may, however, elect

not to have withholding apply to your inherited IRA withdrawal. If

withholding is applied to your withdrawal, not less than 10 percent of

the amount withdrawn must be withheld.

D. Early Distribution Penalty Tax – No 10 percent early distribution

penalty tax will apply to the inherited IRA distribution because the

distribution is due to the death of the original owner.

E. Rollovers and Transfers – Your inherited IRA may receive multiple

rollover contributions from inherited qualified retirement plans,

403(a) annuity plans, 403(b) tax-sheltered annuity plans, or 457(b)

governmental deferred compensation plans, or multiple transfers

from inherited Traditional IRAs. In order to combine these inherited

retirement assets in the same inherited IRA, you must have inherited

the assets from the same owner and they must have been subject to

the same beneficiary payment elections and calculation methods as

under the receiving inherited IRA. Rollover is a term used to describe

a tax-free movement of cash or other property to your inherited IRA

from a qualified retirement plan, 403(a) annuity plan, 403(b) tax-

sheltered annuity, or 457(b) eligible governmental deferred

compensation plan that you have inherited as a beneficiary. The

general rollover and transfer rules are summarized below. These

transactions are often complex. If you have any questions regarding a

rollover or transfer, please see a competent tax advisor.

1. Traditional IRA-to-Inherited Traditional IRA Transfers. Assets you

have inherited from a deceased Traditional IRA owner may be

transferred to an inherited IRA. A transfer must be done directly

between IRAs. You may not take constructive receipt of the assets

in a transfer.

Page 9 of 11

2. Employer-Sponsored Retirement Plan-to-Inherited IRA Rollovers.

If you are a nonspouse beneficiary or the trustee of an eligible type

of trust named as the beneficiary of a deceased employer-

sponsored retirement plan participant, you may directly roll over

any inherited assets eligible for rollover from a qualified retirement

plan, 403(a) annuity, 403(b) tax-sheltered annuity, or 457(b)

governmental deferred compensation plan to an inherited IRA, as

permitted by the IRS. If you are a spouse beneficiary, you may

either directly or indirectly roll over assets from an eligible

inherited employer-sponsored retirement plan to an inherited IRA.

Regardless of the method of rollover, the IRA must be maintained

as an inherited IRA, subject to the beneficiary distribution

requirements.

Written Election. At the time you make a rollover to an inherited

IRA, you must designate in writing to the custodian your election

to treat that contribution as a rollover. Once made, the rollover

election is irrevocable.

LIMITATIONS AND RESTRICTIONS

A. Deduction of Rollovers and Transfers – A deduction is not allowed for

rollover or transfer contributions to an inherited IRA.

B. Gift Tax – Transfers of your inherited IRA assets to a beneficiary made

during your life and at your request may be subject to federal gift tax

under IRC Sec. 2501.

C. Special Tax Treatment – Capital gains treatment and 10-year income

averaging authorized by IRC Sec. 402 do not apply to inherited IRA

distributions.

D. Prohibited Transactions – If you or any successor beneficiary engage

in a prohibited transaction with your inherited IRA, as described in IRC

Sec. 4975, your inherited IRA will lose its tax-deferred status, and you

must include the value of your account in your gross income for that

taxable year. The following transactions are examples of prohibited

transactions with your inherited IRA. (1) Taking a loan from your

inherited IRA (2) Buying property for personal use (present or future)

with inherited IRA assets (3) Receiving certain bonuses or premiums

because of your inherited IRA.

E. Pledging – If you pledge any portion of your inherited IRA as collateral

for a loan, the amount so pledged will be treated as a distribution and

will be included in your gross income for that year.

OTHER

A. IRS Plan Approval – Articles I through VII of the agreement used to

establish this inherited IRA have been approved by the IRS. The IRS

approval is a determination only as to form. It is not an endorsement

of the plan in operation or of the investments offered.

B. Additional Information – For further information on IRAs, you may wish

to obtain IRS Publication 590-A, Contributions to Individual Retirement

Arrangements (IRAs), or Publication 590-B, Distributions from Individual

Retirement Arrangements (IRAs), by calling 800-TAX-FORM, or by

visiting www.irs.gov on the Internet.

C. Important Information About Procedures for Opening a New

Account – To help the government fight the funding of terrorism and

money laundering activities, federal law requires all financial

organizations to obtain, verify, and record information that identifies

each person who opens an account. Therefore, when you open an

inherited IRA, you are required to provide your name, residential

address, date of birth, and identification number. We may require

other information that will allow us to identify you.

D. Qualified Charitable Distributions – If you are age 70½ or older, you

may be eligible to take tax-free inherited IRA distributions of up to

$100,000 per year and have these distributions paid directly to certain

charitable organizations. Special tax rules may apply. For further

detailed information you may obtain IRS Publication 590-B,

Distributions from Individual Retirement Arrangements (IRAs), from

the IRS or refer to the IRS website at www.irs.gov.

Page 10 of 11

INHERITED IRA FINANCIAL DISCLOSURE

The term IRA will be used below to mean Traditional IRA or Roth IRA, unless otherwise specified.

The financial organization should complete the financial disclosure using Method I, Method II, or Method III. If the growth of the inherited IRA can reasonably

be projected, use either Method I or Method II. The account values projected using Method I or Method II must be reduced by all applicable fees and penalties.

If annual fees are assessed, such as an annual service fee, use Method II. If no projection of growth of the inherited IRA can reasonably be shown, use Method III.

METHOD I Growth can be projected (Do not use Method I if an annual fee is charged. Instead, use Method II for financial projections.)

Your Age on Your Birth Date This Year Length of Time Deposit (If applicable)

The charts below give projections of the value of your inherited IRA by showing the amount available at the end of each year. These projections assume

an interest rate of .25%, compounded annually. If you have invested your inherited IRA in a time deposit, a loss-of-earnings penalty may be charged

against a withdrawal before maturity. A transaction fee may also apply to your inherited IRA.

The Rollover or Transfer chart assumes that a one-time deposit of $1,000 is made on the first day of the first year.

Indicate the projected account value for each of the years, taking into consideration any applicable loss of earnings penalty or other fees assessed if the

inherited IRA owner received a distribution at the end of the year for which the projection is being made. First, circle the year-end projected inherited IRA

value that is applicable for each of the first five years. Next, circle the applicable inherited IRA value for the years in which the inherited IRA owner will

attain ages 60, 65, and 70. Subtract the inherited IRA owner’s age indicated above from 60, 65, and 70 to locate the appropriate number of years

(NO. YRS) rows.

ROLLOVER OR TRANSFER

FINANCIAL PROJECTIONS WITH .25% RATE OF INTEREST

NUMBER OF

YEARS

ACCOUNT

VALUE

1 MONTH

PENALTY

3 MONTH

PENALTY

6 MONTH

PENALTY

AMOUNT AFTER

FEES AND

PENALTIES

1 $1,002.50 $1,002.29 $1,001.87 $1,001.25

2 1,005.01 1,004.80 1,004.38 1,003.75

3 1,007.52 1,007.31 1,006.89 1,006.26

4 1,010.04 1,009.83 1,009.41 1,008.78

5 1,012.56 1,012.35 1,011.93 1,011.30

6 1,015.09 1,014.88 1,014.46 1,013.83

7 1,017.63 1,017.42 1,017.00 1,016.36

8 1,020.18 1,019.96 1,019.54 1,018.90

9 1,022.73 1,022.51 1,022.09 1,021.45

10 1,025.28 1,025.07 1,024.64 1,024.00

11 1,027.85 1,027.63 1,027.20 1,026.56

12 1,030.42 1,030.20 1,029.77 1,029.13

13 1,032.99 1,032.78 1,032.35 1,031.70

14 1,035.57 1,035.36 1,034.93 1,034.28

15 1,038.16 1,037.95 1,037.51 1,036.87

16 1,040.76 1,040.54 1,040.11 1,039.46

17 1,043.36 1,043.14 1,042.71 1,042.06

18 1,045.97 1,045.75 1,045.32 1,044.66

19 1,048.58 1,048.37 1,047.93 1,047.27

1,051.21

1,050.99 1,050.55 1,049.89

21 1,053.83 1,053.61 1,053.17 1,052.52

22 1,056.47 1,056.25 1,055.81 1,055.15

23 1,059.11 1,058.89 1,058.45 1,057.79

24 1,061.76 1,061.54 1,061.09 1,060.43

25 1,064.41 1,064.19 1,063.75 1,063.08

26 1,067.07 1,066.85 1,066.41 1,065.74

27 1,069.74 1,069.52 1,069.07 1,068.40

28 1,072.41 1,072.19 1,071.74 1,071.07

29 1,075.10 1,074.87 1,074.42 1,073.75

30 1,077.78 1,077.56 1,077.11 1,076.44

31 1,080.48 1,080.25 1,079.80 1,079.13

32 1,083.18 1,082.95 1,082.50 1,081.82

33 1,085.89 1,085.66 1,085.21 1,084.53

34 1,088.60 1,088.37 1,087.92 1,087.24

35 1,091.32 1,091.10 1,090.64 1,089.96

36 1,094.05 1,093.82 1,093.37 1,092.68

37 1,096.79 1,096.56 1,096.10 1,095.42

38 1,099.53 1,099.30 1,098.84 1,098.15

39 1,102.28 1,102.05 1,101.59 1,100.90

40 1,105.03 1,104.80 1,104.34 1,103.65

41 1,107.80 1,107.56 1,107.10 1,106.41

42 1,110.57 1,110.33

1,109.87

1,109.18

43 1,113.34 1,113.11 1,112.65 1,111.95

44 1,116.12 1,115.89 1,115.43 1,114.73

45 1,118.92 1,118.68 1,118.22 1,117.52

46 1,121.71 1,121.48 1,121.01 1,120.31

47 1,124.52 1,124.28 1,123.81 1,123.11

48 1,127.33 1,127.09 1,126.62 1,125.92

49 1,130.15 1,129.91 1,129.44 1,128.73

50 1,132.97 1,132.74 1,132.26 1,131.56

51 1,135.80 1,135.57 1,135.09 1,134.38

52 1,138.64 1,138.41 1,137.93 1,137.22

53 1,141.49 1,141.25 1,140.78 1,140.06

54 1,144.34 1,144.11 1,143.63 1,142.91

55 1,147.20 1,146.97 1,146.49 1,145.77

56 1,150.07 1,149.83 1,149.35 1,148.64

57 1,152.95 1,152.71 1,152.23 1,151.51

58 1,155.83 1,155.59 1,155.11 1,154.39

59 1,158.72 1,158.48 1,158.00 1,157.27

60 1,161.62 1,161.37 1,160.89 1,160.16

61 1,164.52 1,164.28 1,163.79 1,163.07

62 1,167.43 1,167.19 1,166.70 1,165.97

ADDITIONAL FINANCIAL DISCLOSURE INFORMATION

The account values shown are projections based on many assumptions.

They are not guaranteed, but depend upon many factors, including the

interest rates and terms of future funding instruments.

We may charge you fees in connection with your inherited IRA. If we do

not charge these fees now, we may do so in the future after giving you

notice. If you do not pay these fees separately, they may be paid from the

assets of your inherited IRA.

CURRENT FEES

IRA Trustee Transfer

25.00

IRA Closeout

25.00

Page 11 of 11

METHOD II Growth can be projected

The financial projections below show the amount that would be available

if you were to withdraw your inherited IRA assets at the indicated times.

These projections are based on the following assumptions.

ROLLOVER OR TRANSFER

This projection assumes a one-time $1,000 deposit is made on the first

day of the first year.

Your Age on Your Birth Date in Contribution Year

Investment Instrument

Length of Time Deposit

Rate of Interest %

Compounding Method

FINANCIAL PROJECTIONS

Number of

Years in Inherited

IRA Program

Total

Accumulation of

Inherited IRA Dollars

Amount

After Fees

and Penalties

1 Year

$ $

2 Years

$ $

3 Years

$ $

4 Years

$ $

5 Years

$ $

End of the

Year You

Reach Age

Total

Accumulation of

Inherited IRA Dollars

Amount

After Fees

and Penalties

$ $

ADDITIONAL FINANCIAL DISCLOSURE INFORMATION

The account values shown are projections based on many assumptions.

These projections have been reduced by any applicable fees. They are not

guaranteed, but depend upon many factors, including the interest rates

and terms of future funding instruments.

We may charge you an annual service fee or other fees in connection with

your inherited IRA. If we do not charge these fees now, we may do so in

the future after giving you notice. If you do not pay these fees separately,

they may be paid from the assets of your inherited IRA.

CURRENT FEES

METHOD III Growth cannot be projected

The value of your inherited IRA will be dependent solely upon the

performance of any investment instrument used to fund your inherited

IRA. Therefore, no projection of the growth of your inherited IRA can

reasonably be shown or guaranteed.

Terms and conditions of the inherited IRA that affect your investment are

listed below.

INVESTMENT OPTIONS

Your inherited IRA will be invested in products that we offer directly or

those we offer through a relationship with a registered securities broker-

dealer.

FEES

There are certain fees and charges connected with your inherited IRA

investments. These fees and charges may include the following.

• Sales Commissions

• Investment Management Fees

• Distribution Fees

• Set Up Fees

• Annual Maintenance Fees

• Surrender or Termination Fees

To find out what fees apply, refer to the investment prospectus or contract.

There may be certain fees and charges connected with the inherited IRA

itself. (Select and complete as applicable.)

Annual Service Fee $

Transfer Fee $

Rollover Fee $

Termination Fee $

Other (Explain)

We reserve the right to change any of the above fees after notice to you,

as provided in your inherited IRA agreement.

EARNINGS

The method for computing and allocating annual earnings (e.g., interest,

dividends) on your inherited IRA will differ based on the nature and issuer

of the investments chosen. Refer to the investment prospectus or contract

for the methods used for computing and allocating annual earnings.

OTHER

Other terms or conditions that apply to your inherited IRA include the

following.

IRA Trustee Transfer

25.00

IRA Closeout

25.00

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