TDA 266 F 07/20
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5. TAX WITHHOLDING ELECTION (COMPLETION REQUIRED EXCEPT FOR QUALIFIED CHARITABLE DISTRIBUTIONS)
If this election is not completed, IRS regulations require federal income tax to be withheld at the rate of 10% from your withdrawal
requested on this form.
Form W-4P/OMB No. 1545-0074 Dept. of Treasury, Internal Revenue Service
Important notice: Any withdrawal from your Custodial IRA is subject to federal income tax withholding unless you elect not to have withholding
apply. Withholding will apply to the entire withdrawal, since the entire withdrawal may be included in your income that is subject to federal
income tax. You may elect not to have withholding apply to your withdrawal payments by completing and dating this election and returning it to
TD Ameritrade Clearing, Inc.
If you elect not to have withholding apply to your withdrawal payments, or if you do not have enough federal income tax withheld from your
withdrawal, you may be responsible for payment of estimated tax. If you do not waive withholding or elect an alternative withholding amount,
ten percent will be withheld from your nonperiodic IRA distribution. You may incur penalties under the estimated tax rules if your withholding
and estimated tax payments are not sucient. Even if you elect not to have federal income tax withheld, you are liable for payment of federal,
state and local income tax on the taxable portion of your withdrawal from all IRAs you own. You may also be subject to tax penalties under the
estimated tax payment rules if your payments of estimated tax and withholding, if any, are not adequate.
Also note, if you are a U.S. citizen or resident alien receiving an IRA distribution that is delivered outside the United States or its possessions,
withholding is required. That is, you may not waive withholding. If you are a non-resident alien you may not use Form W-4P to withhold income
tax or to waive withholding. A foreign person should refer to IRS Publication 515 and to Form W-8BEN.
Please make your election below.
M I elect NOT to have federal income tax withheld.
M Please withhold taxes from my distribution at a rate of 10%.
M Please withhold taxes from my distribution at a rate of: ________ % or $________________ (not less than 10% of total distribution).
State Withholding Election
In some cases, you may elect not to have to the extent permitted by state law, or you may tell us how much you would like us to withhold. In other
cases, TD Ameritrade Clearing, Inc. is required by federal and/or state statutes to withhold a percentage of your IRA distribution for income
If you do not make an election, we will automatically apply withholding (if required) at the minimum rate based on your state of
residency. For your reference, we have posted state withholding guidelines at http://www.tdamerirade.com/taxwithholding.
I declare my permanent state of residence is (state): ______________________, and that my election should reﬂect the requirements of that state.
If a permanent state of residence is not noted, we will default to the state on record.
Please make your election below:
M I elect NOT to have state income tax withheld.
M Please withhold taxes from my distribution at a rate of: ________ % or $________________.
TD Ameritrade Clearing, Inc. advises you to contact your tax professional before making any election regarding state withholding
elections. State law is subject to change, and TD Ameritrade Clearing, Inc. is not responsible for changes in state law that occur after the
publication date of this form.
6. 72(t) SUBSTANTIALLY EQUAL PERIODIC PAYMENTS EXCEPTIONS
If I choose to elect 72(t), in consideration of TD Ameritrade, Inc. reporting this series of distributions on Tax Form 1099-R Box 7 as a code 2,
please review the following:
Once this payment series begins, generally, the payment schedule may not be altered for a period of ﬁve years (60 months) or attainment of
age 59½, whichever is longer.
• Funds may not be added or subtracted from the account in any way, including contributions, transfers in or out, and distributions from the
account other than the calculated payment once the payment period has commenced.
The account you are requesting this payment schedule for must have sucient cash funds for the distribution. A missed payment not corrected
by year’s end constitutes an alteration of the schedule and will terminate the exception.
• Please consult with a ﬁnancial or tax professional before submitting this request.
TD Ameritrade Account #:______________________