Fillable IRA TRANSFER REQUEST ROTH PART 1. RECIPIENT PART (Georgia's Own Credit Union)

Fill Online, Printable, Fillable, Blank IRA TRANSFER REQUEST ROTH PART 1. RECIPIENT PART (Georgia's Own Credit Union) Form

Use Fill to complete blank online GEORGIA'S OWN CREDIT UNION pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

IRA TRANSFER REQUEST ROTH PART 1. RECIPIENT PART (Georgia's Own Credit Union)

On average this form takes 16 minutes to complete

The IRA TRANSFER REQUEST ROTH PART 1. RECIPIENT PART (Georgia's Own Credit Union) form is 2 pages long and contains:

  • 0 signatures
  • 6 check-boxes
  • 62 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your Georgia's Own Credit Union forms online.

BROWSE GEORGIA'S OWN CREDIT UNION FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Page 1 of 2
6302 / 2425 (Rev. 10/2015) ©2015 Ascensus, Inc.
PART 1. RECIPIENT
Individual requesng the transfer
Name (First/MI/Last) _________________________________________
Date of Birth_____________________ Phone _____________________
Email Address _______________________________________________
Account Number__________________________________ Sux _____
ACCEPTING ACCOUNT TYPE (Select one)
Roth IRA            Inherited Roth IRA
PART 2.
ACCEPTING ROTH IRA TRUSTEE OR CUSTODIAN
To be completed by the Roth IRA trustee or custodian receiving the assets
Name ______________________________________________________
Address Line 1 _______________________________________________
Address Line 2 _______________________________________________
City/State/ZIP _______________________________________________
Phone_______________________ Organizaon Number ____________
Contact Name _______________________________________________
PART 4. CURRENT ROTH IRA OWNER
Name (First/MI/Last) _________________________________________
Social Security Number _______________________________________
Account Number__________________________________ Sux _____
CURRENT ACCOUNT TYPE (Select one)
Roth IRA          Inherited Roth IRA
PART 5. CURRENT ROTH IRA TRUSTEE OR CUSTODIAN
Name ______________________________________________________
Address Line 1 _______________________________________________
Address Line 2 _______________________________________________
City/State/ZIP _______________________________________________
Phone _____________________________________________________
TRANSFER REQUEST
PART 6. LIFE EXPECTANCY PAYMENT INSTRUCTIONS
IF YOU ARE A BENEFICIARY RECEIVING LIFE EXPECTANCY PAYMENTS, COMPLETE THE FOLLOWING.
Distribute my life expectancy payment to me before transferring the Roth IRA assets.
Retain my life expectancy payment amount. I understand that I am responsible for sasfying my life expectancy payment.
Include the amount that represents my life expectancy payment in the transfer. I understand that I am responsible for sasfying my life
expectancy payment.
PART 3. RELATIONSHIP OF RECIPIENT TO CURRENT ROTH IRA OWNER
RELATIONSHIP TYPE (Select one)
I am the current Roth IRA owner.
I am the former spouse of the current Roth IRA owner.
I am the spouse beneciary of the original Roth IRA owner transferring assets to my own Roth IRA.
I am the beneciary of the original Roth IRA owner transferring assets to an inherited Roth IRA.
ROTH
IRA
Page 2 of 2
6302 / 2425 (Rev. 10/2015) ©2015 Ascensus, Inc.
PART 8. SIGNATURES
I authorize the transfer of these Roth IRA assets and cerfy that all informaon provided by me is true and accurate. I understand that I am responsible
for determining that this Roth IRA transfer qualies under the rules that apply to such transfers and agree to comply with those rules. I assume
responsibility for any consequences that may result from this transfer and I agree that the trustee or custodian is not responsible for any
consequences that may arise from execung this transfer request.
The trustee or custodian signing below agrees to accept the assets being transferred.
X_________________________________________________________________________________________________ ______________________________________
Signature of Recipient Date (mm/dd/yyyy)
X_________________________________________________________________________________________________ ______________________________________
Notary Public/Signature Guarantee (If required by the trustee or custodian) Date (mm/dd/yyyy)
X_________________________________________________________________________________________________ ______________________________________
Authorized Signature of Accepng Trustee or Custodian Date (mm/dd/yyyy)
PART 7. TRANSFER INSTRUCTIONS
TRANSFER OPTIONS (Select one)
One-Time Transfer
Transfer Amount ____________________________ Transfer Date ________________
Enre Roth IRA Balance   This Transfer Will Close the Current Roth IRA
Recurring Transfer
Transfer Amount ____________________________ Transfer Start Date ________________
Frequency (Select one)  
Monthly   Quarterly   Semi-Annually   Annually   Other _______________________________________
MAKE PAYABLE TO 
(If the accepng IRA type is an inherited Roth IRA, the Name of Recipient must idenfy both the recipient and the original Roth IRA owner.)
_______________________________________________________________________ as Trustee or Custodian of
Name of Accepng Roth IRA Trustee or Custodian
___________________________________________________________________________ Roth IRA
Name of Recipient
ASSET HANDLING (Investments idened below will be liquidated immediately unless otherwise specied in the Special Instrucons secon.)
Asset Descripon Amount to be Transferred Special Instrucons
__________________________________________ _____________________ ___________________________________________________________________
__________________________________________ _____________________ ___________________________________________________________________
__________________________________________ _____________________ ___________________________________________________________________
Name of Recipient ______________________________________________________________, Account Number ______________________________
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

IRA TRANSFER REQUEST ROTH PART 1. RECIPIENT PART (Georgia's Own Credit Union)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 23 December 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document