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

Page 1 of 11

Roth IRA Simplifier

INHERITED ROTH INDIVIDUAL RETIREMENT ACCOUNT APPLICATION

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

owner’s account.

PART 1. INHERITED ROTH 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 ROTH IRA CUSTODIAN

To be completed by the inherited Roth IRA custodian

Name

Address Line 1

Address Line 2

City/State/ZIP

Phone Organization Number

This is an amendment to an existing inherited Roth 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 Roth 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 Roth IRA)

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

Page 2 of 11

This is page 2 of the inherited Roth 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 Roth 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 Roth IRA.)

Internal Account

Account Number Type (e.g., checking, savings, Roth 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, Roth 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 Roth 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 Roth IRA. The balance in the account will be payable to

these beneficiaries if all primary beneficiaries have predeceased the inherited Roth 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 Roth IRA

PART 8. SIGNATURES

Important: Please read before signing.

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

contribution. I have received a copy of the Inherited Roth IRA Application, the 5305-RA Custodial Account Agreement, the Financial Disclosure, and

the Disclosure Statement. I understand that the terms and conditions that apply to this inherited Roth 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 Roth 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 Roth 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 Roth 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

Page 3 of 11

ROTH INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT AGREEMENT

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

The depositor named on the application is establishing a Roth individual

retirement account (Roth IRA) under section 408A 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 qualified rollover contribution described in section

408A(e) or a recharacterized contribution described in section 408A(d)(6),

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

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

1. The annual contribution limit described in Article I is gradually reduced

to $0 for higher income levels. For a depositor who is single or treated

as a single, the annual contribution is phased out between adjusted

gross income (AGI) of $118,000 and $133,000; for a married depositor

filing jointly, between AGI of $186,000 and $196,000; and for a

married depositor filing separately, between AGI of $0 and $10,000.

These phase-out ranges are for 2017. For years after 2017, the phase-

out ranges, except for the $0 to $10,000 range, will be increased to

reflect a cost-of-living adjustment, if any. Adjusted gross income is

defined in section 408A(c)(3).

2. In the case of a joint return, the AGI limits in the preceding paragraph

apply to the combined AGI of the depositor and his or her spouse.

ARTICLE III

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

nonforfeitable.

ARTICLE IV

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 V

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

him or her and the depositor’s surviving spouse is not the designated

beneficiary, the remaining interest will be distributed in accordance

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

beneficiary, in accordance with paragraph (b) below:

(a) The remaining interest will be distributed, starting by the end of the

calendar year following the year of the depositor’s death, over the

designated beneficiary’s remaining life expectancy as determined in

the year following the death of the depositor.

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

year containing the fifth anniversary of the depositor’s death.

2. The minimum amount that must be distributed each year under

paragraph 1(a) above 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

designated beneficiary using the attained age of the beneficiary in the

year following the year of the depositor’s death and subtracting one

from the divisor for each subsequent year.

3. If the depositor’s surviving spouse is the designated beneficiary, such

spouse will then be treated as the depositor.

ARTICLE VI

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

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

408A(d)(3)(E), Regulations sections 1.408-5 and 1.408-6, or other

guidance published by the Internal Revenue Service (IRS).

2. The custodian agrees to submit to the IRS and depositor the reports

prescribed by the IRS.

ARTICLE VII

Notwithstanding any other articles which may be added or incorporated,

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

Any additional articles inconsistent with section 408A, the related

regulations, and other published guidance will be invalid.

ARTICLE VIII

This agreement will be amended as necessary to comply with the

provisions of the Code, the related Regulations, and other published

guidance. Other amendments may be made with the consent of the

persons whose signatures appear on the application.

ARTICLE IX

9.01 Definitions – In this part of this agreement (Article IX), the words

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

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

Roth IRA owner” mean the individual establishing this inherited

Roth IRA with either a direct rollover contribution from an eligible

inherited employer-sponsored retirement plan or a transfer from

an inherited Roth IRA. The word “Code” means the Internal

Revenue Code, and “regulations” means the Treasury regulations.

9.02 Notices and Change of Address – Any required notice regarding

this inherited Roth 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.

9.03 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

Page 4 of 11

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

with your inherited Roth 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 Roth 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.

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

subcontractors to assist in administering your inherited Roth IRA.

We may release nonpublic personal information regarding your

inherited Roth 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.

9.05 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 Roth 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 Roth 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 Roth 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 Roth IRA.

Any brokerage commissions attributable to the assets in your

inherited Roth IRA will be charged to your inherited Roth IRA. You

cannot reimburse your inherited Roth IRA for those commissions.

9.06 Restrictions on Contributions to the Inherited Roth IRA – Your

inherited Roth 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

Roth IRAs. In order to combine these inherited retirement assets

in the same inherited Roth 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 Roth IRA. You may not make regular

contributions to this inherited Roth IRA.

9.07 Investment of Amounts in the Inherited Roth IRA – You have

exclusive responsibility for and control over the investment of the

assets of your inherited Roth 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 Roth IRA assets, subject to the same conditions that

applied to you during your lifetime under this agreement (including,

without limitation, Section 9.03 of this article). We will have no

discretion to direct any investment in your inherited Roth IRA. We

assume no responsibility for rendering investment advice with

respect to your inherited Roth 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 Roth

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 Roth IRA unless you

provide timely written directions acceptable to us.

You will select the investment for your inherited Roth 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

investment in inherited Roth IRAs (e.g., term share accounts,

passbook accounts, certificates of deposit, money market accounts).

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

law, to name successor beneficiaries for your inherited Roth 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 Roth 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 inherited Roth IRA assets by

December 31 of the year following the year of death.

9.09 Required Minimum Distributions – You are required to take

minimum distributions from your inherited Roth IRA. The options

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

deceased Roth IRA owner are determined according to the type of

plan you have inherited. Any payment elections you either made

or defaulted to under the plan you inherited generally carry over

to the inherited Roth IRA.

Page 5 of 11

9.10

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 Roth IRA to another financial organization.

If you do not complete a transfer of your inherited Roth IRA within

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

to transfer your inherited Roth IRA assets to a successor inherited

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

or we may pay your inherited Roth 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

Roth 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

Roth IRA

• Any penalties or surrender charges associated with the early

withdrawal of any savings instrument or other investment in

your inherited Roth 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 Roth IRA to you in cash or property if the

balance of your inherited Roth IRA drops below the minimum

balance required under the applicable investment or policy

established.

9.11 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 Roth IRA)

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

will automatically become the trustee or custodian of your

inherited Roth IRA, but only if it is the type of organization

authorized to serve as a inherited Roth IRA trustee or custodian.

9.12 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.

9.13 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.

9.14 Transfers From Other Plans – We can receive amounts transferred

to this inherited Roth IRA from the trustee or custodian of another

inherited Roth 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.

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

your inherited Roth IRA if necessary to make distributions or to

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

chargeable against your inherited Roth 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.

9.16 Restrictions on the Fund – Neither you nor any successor

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

inherited Roth IRA in any manner whatsoever, except as provided

by law or this agreement.

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

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

under this agreement.

9.17 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-RA is a model custodial account agreement that meets the

requirements of section 408A. However, only Articles I through VIII have

been reviewed by the IRS. A Roth individual retirement account (Roth IRA)

is established after the form is fully executed by both the individual

(depositor) and the custodian. 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-RA with the IRS. Instead, keep it with your records.

Unlike contributions to Traditional individual retirement arrangements,

contributions to a Roth IRA are not deductible from the depositor’s gross

income; and distributions after five years that are made when the

depositor is 59½ years of age or older or on account of death, disability,

or the purchase of a home by a first-time homebuyer (limited to $10,000),

are not includible in gross income. For more information on Roth 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.

Page 6 of 11

SPECIFIC INSTRUCTIONS

Article I – The depositor may be subject to a six percent tax on excess

contributions if (1) contributions to other individual retirement

arrangements of the depositor have been made for the same tax year,

(2) the depositor’s adjusted gross income exceeds the applicable limits in

Article II for the tax year, or (3) the depositor’s and spouse’s compensation

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

year.

Article V – This article describes how distributions will be made from the

Roth IRA after the depositor’s death. Elections made pursuant to this

article should be reviewed periodically to ensure they correspond to the

depositor’s intent. Under paragraph three of Article V, the depositor’s

spouse is treated as the owner of the Roth IRA upon the death of the

depositor, rather than as the beneficiary. If the spouse is to be treated as

the beneficiary and not the owner, an overriding provision should be

added to Article IX.

Article IX – Article IX 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.

DISCLOSURE STATEMENT

RIGHT TO REVOKE YOUR INHERITED ROTH IRA

You have the right to revoke your inherited Roth 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 Roth 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

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

application.

REQUIREMENTS OF AN INHERITED ROTH 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 Roth 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 Roth IRA.

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

nonforfeitable.

D. Eligible Custodians – The custodian of your inherited Roth 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 Roth 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 Roth IRA may be invested

in life insurance contracts.

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

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

distributions from your inherited Roth 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 Roth IRA generally carry over to this inherited Roth

IRA. Below is a summary of the inherited Roth 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 you are the beneficiary of a deceased employer-sponsored

retirement plan participant, and the original participant died

(a) on or after his or her required beginning date, distributions

must be made to you over the longer of your single life

expectancy, or the original participant’s remaining life

expectancy. If the original participant’s designated beneficiary

Page 7 of 11

was not an individual or qualified trust as defined in the

Treasury Regulations, the original 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 employer-

sponsored retirement plan, distributions will commence using

the original participant’s single life expectancy, reduced by one

in each subsequent year.

(b) before his or her 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 participant’s death, or

(ii) be distributed over your remaining life expectancy.

If the original 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 participant’s death, or December 31

of the year life expectancy payments would be required to

begin. A designated beneficiary of the original participant,

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 participant’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 participant’s death.

Generally, if the original participant’s spouse is the designated

beneficiary, distributions need not commence until December 31

of the year the original participant would have attained age 72

(70½ if the original participant would have attained 70½ before

2020), if later.

If the original participant’s designated beneficiary is not an

individual or qualified trust as defined in the Treasury

Regulations, the original 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 retirement plan, the entire inherited Roth IRA

must be distributed by December 31 of the year containing the

fifth anniversary of the original participant’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 Roth IRA.

2. If you are the beneficiary of a deceased Roth IRA owner, the entire

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

either

(a) be distributed by December 31 of the year containing the fifth

anniversary of the original Roth IRA owner’s death, or

(b) be distributed over your remaining life expectancy.

If you are a spouse who is the sole designated beneficiary of a Roth

IRA owner, you must elect either option (a) or (b) 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. If you are a designated

beneficiary of the original Roth IRA owner, other than a spouse

who is the sole designated beneficiary, you must elect either

option (a) or (b) by December 31 of the year following the year of

the original Roth IRA owner’s death. If no election is made, the

distribution will be calculated in accordance with option (b). In the

case of distributions under option (b), distributions must

commence by December 31 of the year following the year of the

original Roth IRA owner’s death. Generally, if the original Roth IRA

owner’s spouse is the designated beneficiary, distributions need

not commence until December 31 of the year the original Roth IRA

owner would have attained age 72 (70½ if the original Roth IRA

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

If the original Roth IRA owner’s designated beneficiary is not an

individual or qualified trust as defined in the Treasury Regulations,

the original Roth IRA will be treated as having no designated

beneficiaries for purposes of determining the distribution period.

If there is no designated beneficiary of the original Roth IRA, the

entire inherited Roth IRA must be distributed by December 31 of

the year containing the fifth anniversary of the original Roth IRA

owner’s death.

3. 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 Roth 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.

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.

Page 8 of 11

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., the original owner’s estate,

a charity, or a certain type of trust) is named, the original owner will

be treated as having no designated beneficiary of the Roth IRA for

purposes of determining the distribution period. If there is no

designated beneficiary of the Roth IRA, the entire Roth IRA must be

distributed by December 31 of the year containing the fifth anniversary

of the original owner’s death.

INCOME TAX CONSEQUENCES OF ESTABLISHING AN

INHERITED ROTH IRA

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

Roth IRA are not subject to federal income tax as they accumulate in

your inherited Roth IRA. In addition, distributions of your inherited

Roth IRA earnings will be free from federal income tax if you take a

qualified distribution, as described below.

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

distributions depends on whether the distribution is a qualified

distribution or a nonqualified distribution.

1. Qualified Distribution. A qualified distribution is a distribution

that is made after the expiration of a five-year period. Qualified

distributions from your inherited Roth IRA are not included in your

income.

2. Nonqualified Distribution. If you have not satisfied the five-year

period for a qualified distribution, any earnings you withdraw from

your inherited Roth IRA will be included in your gross income. When

you take a distribution from the inherited Roth IRA, the amounts the

original owner contributed to a Roth IRA, Roth 401(k), Roth 403(b),

or governmental Roth 457(b) as Roth elective deferrals or Roth IRA

contributions, will be deemed to be removed first, followed by

conversion and employer-sponsored retirement plan rollover

contributions the original owner made to a Roth IRA on a first-in,

first-out basis. Therefore, your nonqualified distributions will not be

taxable to you until your withdrawals exceed the amount of the

regular contributions, conversion, and employer-sponsored

retirement plan rollovers. These “ordering rules” are complex. If you

have any questions regarding the taxation of distributions from your

inherited Roth IRA, see a competent tax advisor.

C. Income Tax Withholding – Any nonqualified withdrawal of earnings

from your inherited Roth IRA may be subject to federal income tax

withholding. You may, however, elect not to have withholding apply

to your inherited Roth 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 Roth IRA distribution because

the distribution is due to the death of the original owner.

E. Rollovers and Transfers – Your inherited Roth 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 Roth IRAs. In order to combine these inherited

retirement assets in the same inherited Roth 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 Roth IRA. Rollover is a term

used to describe a direct movement of cash or other property to your

inherited Roth IRA from an eligible retirement plan that you have

inherited as an eligible beneficiary. The rollover and transfer rules are

generally summarized below. These transactions are often complex. If

you have any questions regarding a rollover or transfer, please see a

competent tax advisor.

1. Roth IRA-to-Inherited Roth IRA Transfers. Assets you have

inherited from a deceased Roth IRA owner may be directly

transferred to an inherited Roth IRA.

2. Rollovers from 401(k) or 403(b) Plans Containing Roth Elective

Deferrals to an Inherited Roth IRA. If you are a nonspouse

beneficiary or the trustee of an eligible type of trust named as

beneficiary of a deceased 401(k), 403(b), or governmental 457(b)

plan participant who had made Roth elective deferrals to the plan,

you may directly roll over the Roth elective deferrals, and their

earnings, to an inherited Roth 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 Roth IRA. Regardless of the method of rollover,

the Roth IRA must be maintained as an inherited Roth IRA, subject

to the beneficiary distribution requirements. Roth elective deferrals

may not be rolled over to an inherited Traditional IRA.

3. Rollovers from Eligible Retirement Plans Without Roth Elective

Deferrals to an Inherited Roth IRA. If you are a nonspouse

beneficiary or the trustee of an eligible type of trust named as

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 Roth 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 Roth IRA, as permitted

by the IRS. The amount of the rollover from the retirement plan

will be treated as a distribution for income tax purposes, and is

includible in your gross income (except for any after-tax

contributions). Although the rollover amount generally is included

in income, the 10 percent early distribution penalty tax will not

apply to rollovers from an eligible retirement plan to an inherited

Roth IRA.

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

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

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

election is irrevocable.

LIMITATIONS AND RESTRICTIONS

A. Gift Tax – Transfers of your inherited Roth IRA assets to a successor

beneficiary made during your life and at your request may be subject

to federal gift tax under IRC Sec. 2501.

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

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

IRA distributions.

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

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

in IRC Sec. 4975, your inherited Roth IRA will lose its tax-deferred or

tax-exempt status, and you generally must include the value of the

earnings in your account in your gross income for that taxable year.

The following transactions are examples of prohibited transactions

Page 9 of 11

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

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

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

because of your inherited Roth IRA.

D. Pledging – If you pledge any portion of your inherited Roth IRA as

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

distribution and may be included in your gross income for that year.

OTHER

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

establish this inherited Roth 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 Roth 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 Roth 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 Roth 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

Download
Save PDF to desktop

Email
Email completed PDF

Send for Signing
Email for others to sign

Print
Print document

NAME

INHERITED ROTH INDIVIDUAL RETIREMENT ACCOUNT APPLICATION (Kinecta)

View Audit Log
Print With Audit Log
Duplicate Document

Fill Online, Printable, Fillable, Blank INHERITED ROTH INDIVIDUAL RETIREMENT ACCOUNT APPLICATION (Kinecta) Form

Related forms

Fillable INHERITED ROTH INDIVIDUAL RETIREMENT ACCOUNT APPLICATION (Kinecta)

Fill Online, Printable, Fillable, Blank INHERITED ROTH INDIVIDUAL RETIREMENT ACCOUNT APPLICATION (Kinecta) Form

Related forms

First 20 documents completely FREE!