Fillable Inherited IRA Application (BlackRock)

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Inherited IRA Application (BlackRock)

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The Inherited IRA Application (BlackRock) form is 7 pages long and contains:

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123 other fields

Country of origin: UK
File type: PDF

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BlackRock Inherited IRA Application – For Beneficiaries of an IRA Page 2 of 8

Inherited IRA Application

For Beneficiaries of an IRA

INSTRUCTIONS FOR COMPLETING THIS FORM

The purpose of this form is to establish an Inherited IRA account held directly at BlackRock. If you are the spouse

of a deceased IRA owner, you may treat the IRA as your own. To do so, please use the BlackRock New IRA Account

Application.

The following instructions will help you complete this application, however if you have any questions we encourage

you to call us for assistance at 1-800-441-7762.

Important Notes Regarding this Form:

 The minimum initial investment is $1,000 per fund.

 When opening a BlackRock Account and adding Bank

Instructions please make sure to attach a bank

statement or voided check.

 You will also need to complete the IRA Spousal or

Non-Spousal Beneficiary Claim form if you are

looking to move your portion of an existing BlackRock

IRA account after the owner has passed.

 If you would like to setup a systematic withdrawal for

your required minimum distribution “RMD” then

please complete the BlackRock IRA Systematic

Withdrawal Form.

ditional Documentation

Certain requests may require additional

documentation to complete, including but not limited

to:

 Trust accounts – copy of pertinent trust pages,

showing trust name, date, trustees’ names,

signature & certification pages, etc.

 Power of Attorney – a recently dated copy of the

power of attorney document; if adding the POA to

the account, the BlackRock Power of Attorney Form

must also be provided.

 Estates – document naming the

executor/executrix, administrator, etc. of the estate

of the deceased shareholder.

 Business / Foundations, etc. – document naming

the authorized signers for the entity

Sections that are required on this application:

 Sections 1, 2, 3, 5, 7, and 8 are required to setup

a new account at BlackRock.

 Section 4 (Investment Dealer) is required to add

any financial professional on your account.

 Please note: Applications submitted without an

Investment Dealer may only invest in Investor A

Share.

 Section 7 provides space for 3 beneficiaries; you

can add additional copies of that page for up to

six beneficiaries.

rvices

If you don’t see a service option or need an additional

form to complete your request, you can locate more on

our website at www.blackrock.com

on our “Forms &

Applications” page, or by calling us.

 Financial Professionals: Sign In to our “Advisor

Center” www.blackrock.com

for enhanced tools,

investment ideas, account access (through

AdvisorCentral©) and more.

To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires all financial

institutions to obtain, verify, and record information that identifies persons opening accounts; To comply, BlackRock requires the

participant’s name, address, date of birth and government-issued identification number (generally, a Social Security Number) and

other information that may help identify the participant; and may ask for copies of related documentation and may consult third-

party databases to help verify the participant’s identity. I have read and I understand the prospectus which explains the risks of

opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in

accordance with U.S. Government requirements.

Questions?

Call us at

1-800-441-7762

, Monday through Friday between 8:00 AM and 6:00 PM ET or visit us online at www.blackrock.com.

BlackRock Inherited IRA Application – For Beneficiaries of an IRA Page 3 of 8

Inherited IRA Application

For Beneficiaries of an IRA

Use this application to open a BlackRock Inherited IRA.

Be sure to use the right application! Business / Institutional

clients, SIMPLE IRAs, Non-retirement, and BlackRock

CollegeAdvantage

529 accounts have their own applications.

 All information provided on each person listed on the

account will be verified as required by the USA PATRIOT Act.

Mail this application, along with any other

required documents, to:



Regular mail:



Overnight mail:

BlackRock Funds BlackRock Funds

P.O. Box 9819 4400 Computer Drive

Providence, RI 02940 Westborough, MA 01581

Fax: 844-569-5573

Questions? Call us at 1-800-441-7762, Monday through Friday between 8:00 AM and 6:00 PM ET or visit us online at www.blackrock.com.

1. Current Account Information

First, please tell us about the account(s) that you wish to request the transfer or redemption from:

__________________________________________________

Full name of primary account owner

__________________________ __________________________

Social Security Number BlackRock account number(s)

__________________________

Date of death (mm/dd/yyyy)

__________________________

Reference number (if a

pplicable)

2. Beneficiary Information

a. Tell us which account type you will be opening:

Non-Spo

use (includes a spouse who would like to be treated as a non-spouse beneficiary)

tate Custodial/Responsible Individual for Minor Trust, Charity, Foundation, Business, etc.

b. Please provide us with the following information about the beneficiary:

Individuals or Trustees

Entities

(Trust, Charity, Foundation, Business, etc.)

__________________________________________

Ful

l name of beneficiary or trustee

________________________ _____________________

cial Security number

Date of birth (mm/dd/yyyy)

__________________________________________________

If t

he beneficiary is a minor

, name of responsible individual

________________________

_______________________

Cellphone number Home phone number

_______ _____________________________

treet # Street name

________________________ _____

________

City State ZIP Code

________________________________________________

ull name of trust, foundation, estate, business entity etc.

___________________________________________

Ful

l name of trustee, authorized signer, partner, etc.

_________________________ __________________

Title (trustee, officer, executor, etc.) Federal tax ID (entity’s)

_______________________ _______________________

Date of trust (mm/dd/yyyy) Contact telephone number

_______ _____________________________

treet # Street name

________________________ _____

________

City State ZIP Code

BlackRock Inherited IRA Application – For Beneficiaries of an IRA Page 4 of 8

Other Account Information

Sign Me Up For eDelivery!

By adding your email address, we will sign you up for

eDelivery of prospectus, (including supplements &

amendments) annual-/semi-annual reports & general

mailing. For your security, you will need to Access Your

Account online at blackrock.com

to add quarterly

statements, daily confirms, and tax forms.

__________________________________________

Email address

Mailing Address

Complete ONLY if you want the address on your

account to be different from the address given above.

BlackRock will send ALL mail to this address, including

any redemptions by check.

_______ ___________________________

Street # Street name

____

____________________ _____ ________

City State ZIP Code

2. Investment Dealer

Your Financial Professional will have this information available. They should help complete it and review it for accuracy.

Some Investment Dealers have their own internal application process (Principal and / or Financial Professional signature

may be needed).

NOTE: We will carry over the exi sting Investment Dealer information from the original account

unless you complete this section to add a new investment dealer.

___________________________________________________

Name of dealer firm

__________________

_______________

Dealer number Branch number

______________

___ ___________________________________

PO Box # / Street # Street name

_______________________

___________ _____ ________

City State Zip Code

___________________________________

Full name of financial professional(s)

__________________

___

Representative’s number

__________________

Contact telephone #

_______________________

_________

Email address

ptional: BIN (Provided by Financial Professional):

__________________ Network level: ____

If required by the Investment Dealer firm: I (the above Financial Professional) have complied with my firm’s

policies and procedures in regard to opening this account.

_________________________________________ __________________ _______________________

Signature of Financial Professional Date

(month/day/year) Principal Approval (if required)

3. Investment Directions

a. Investment Type and Allocation

Minimum initial investment*: For Investor A & C Shares, $1,000 per fund .

Investor A & C Shares: Investor A Shares are generally subject to a front-end sales charge, while Investor C Shares are

generally subject to a contingent deferred sales charge. NOTE: If you do not have an Investment Dealer on your account,

you may not invest in Investor C Shares. If you do not elect a class of shares or if you do not list an Investment Dealer on

your account, your purchase will be made in Investor A Shares. Availability of Investor C Shares may depend on the

policies and procedures of your Investment Dealer.

*For Institutional & Class K Shares: In IRAs, these classes are generally for a transfer-in-kind of the same shares of BlackRock funds. Please review the Fund’s

prospectus for minimum investment requirements and eligibility (Class K Shares are not available on every fund). If you select Institutional or Class K Shares and do

not qualify, your investment may be rejected

Tell us how you would like to invest. First, indicate how you will fund your account by checking the appropriate box(es):

Transfer from existing BlackRock IRA listed in Section 1 in kind A check (payable to BlackRock Funds) will follow

Funds will be transferred or rolled over from another institution/qualified plan

BlackRock Inherited IRA Application – For Beneficiaries of an IRA Page 6 of 8

4. Account Options

a. Telephone Exchange and Redemption

Your account will automatically allow redemptions and exchanges via telephone unless you check the box below.

Details about the Telephone Redemption and Telephone Exchange privileges are available in the Fund’s prospectus.

NOTE: Checking the box below will also turn off exchanges & redemptions made via the internet.

I do NOT want Telephone Redemption or Exchange

b. Bank Instructions

By adding your bank instructions to your account will enable purchases and redemptions to/from your checking or

savings via telephone or online. Complete this section below and attach a bank statement, voided check, or savings

deposit slip (showing the bank account number & registration). For redemptions, it may take up to 10 days to test the

bank instructions with your bank during the “pre-note” period.

Redemptions by ACH Yes No

Enables you to make purchases from, or send redemption

proceeds to, your checking or savings account. There is no fee

for this service.

Wire Redemptions Yes No

Funds may be wired to your bank account via the Federal

Reserve. (Your bank may have a different ABA # for wires).

There is a fee of $7.50 (per fund) for this service.

____

______________________________

Full Name of Bank Account Owner

__________________________________

Full Name of Joint Bank Account Owner

If different from the BlackRock account owner(s), the

signature of the other bank account owner is required:

____________________

___________________

Signature of other Bank Account Owner

__________________________________________

Name of Bank

Checking Savings

____

_________________________________

ABA routing number (9 digits)

_____________________________________

Account number at your bank

c. Tax Withholding Election (REQUIRED)

Distributions from IRAs and qualified retirement plans that are not eligible for rollover are subect to federal income tax

witholding and may be subject to state withholding. You may affirmatively elect additonal withholding or opt to NOT have

withholding applied to your distributions. Federal tax withholding is required for accounts with a foreign address. Please

consult a tax professional or your states’s tax authority for additonal information on your state requirements.

 Federal Tax Withholding

Federal income tax withholding is taken on any distribution, subject to the IRS withholding rules, at the rate of 10% from the

gross payment amount even if it is excluded from gross income, unless an election is provided. The withholding procedure may

result in excess payments to the IRS. Electing to have no federal taxes withheld from distributions or not having enough federal

income tax withheld from distributions may cause you to be responsible for estimated tax. Under the estimated tax rules you

may incur penalties if the estimated tax withholding payment is not sufficient. Please complete the section below, your election

will remain in effect until the Custodian is notified in writing of a change.

Select one of the following:

I elect NOT to withhold federal income tax Withhold 10% federal income tax Withhold_____% federal income tax

(Must be greater than 10% minimum)

 State Withholding

State income tax withholding requirements are determined by the state of your residence, if any. States with mandatory

withholding may require state income tax to be withheld if withholding is taken for federal taxes or may mandate a fixed amount

regardless of your federal tax election. Voluntary states allow you to determine if you would like state taxes withheld. Certain

states are non-participatory and do not require income tax on retirement payments.

For Mandatory States Only:

For Voluntary States Only:

I elect NOT to withhold state income Tax

Withholding $_______or _________% state income tax

I elect to take _______% in addition to the Mandatory Withholding

BlackRock Inherited IRA Application – For Beneficiaries of an IRA Page 7 of 8

5. Beneficiary Selection

In the event of my death, the balance in the account shall be paid to the Primary Beneficiaries who survive me in equal shares (or in the specified shares, if

indicated). If none of the Primary Beneficiaries survive me, the balance in the account shall be paid to the Contingent Beneficiaries who survive me in equal

shares (or in the specified shares, if indicated). I understand that, unless I have specified otherwise, if I name multiple Primary Beneficiaries and a

beneficiary does not survive me, such interest is terminated and that percentage will be divided proportionately among the remaining Primary Beneficiaries.

Similarly, unless I have specified otherwise, if no Primary Beneficiary survives me and I have named multiple Contingent Beneficiaries and a beneficiary does

not survive me, such interest is terminated and that percentage will be divided proportionately among the remaining Contingent Beneficiaries. I understand

that I may change my beneficiaries at any time by giving written notice to the Custodian. If I do not designate a beneficiary, or if all designated beneficiaries

predecease me, my surviving spouse will become the beneficiary of my IRA. If I do not have a surviving spouse at the time of my death, my estate will become

the beneficiary of my IRA.

Per Stirpes Beneficiary Designations: The Custodian shall accept as complete and accurate all written instructions provided in good order by the

estate/executor with regard to the identification of the beneficiaries and allocations thereto.

Participant’s Designation: In the event of my death, I hereby designate the following individuals as the Primary and Contingent Beneficiary(ies) to receive all

benefits that may become due and payable under my IRA. If I name a beneficiary that is a Trust, I understand that I must provide certain information

concerning the Trust to the Custodian.

Beneficiary 1 Primary Contingent Relationship: ______________________ Percentage: _____%

________________________________________

Name of beneficiary

________________________________________

_________

OR Name of trust, foundation, other legal entity;

OR If a beneficiary is a minor, full name of responsible individual

_______ _____________________________

Street # Street name

________________________

_____ __________

City State ZIP Code

______________________

______ _________________________

Social Security number or tax ID Date of birth /date of trust

Beneficiary 2 Primary Contingent Relationship: ______________________ Percentage: _____%

________________________________________

Name of beneficiary

________________________________________

OR Name of trust, foundation, other legal entity;

OR If a beneficiary is a minor, full name of responsible individual

_______ _____________________________

Street # Street name

________________________

_____ ________

City State ZIP Code

______________________

________ _________________________

Social Security number or tax ID Date of birth / date of trust

Beneficiary 3 Primary Contingent Relationship: ______________________ Percentage: _____%

________________________________________

Name of beneficiary

________________________________________

OR Name of trust, foundation, other legal entity;

OR If a beneficiary is a minor, full name of responsible individual

_______ _____________________________

Street # Street name

________________________

_____ ________

City State ZIP Code

______________________

________ _________________________

Social Security number or tax ID Date of birth /date of trust

Total Percentage for all Beneficiaries (must equal 100%): _______%

Disclaimer for Community and Marital Property States: The Participant’s spouse may have a property interest in the account

and the right to dispose of the interest by will. Therefore, any sponsors, issuers, depositories and other persons or entities

associated with the investments and the Custodian specifically disclaim any warranty as to the effectiveness of the Participant’s

beneficiary designation or as to the ownership of the account after the death of the Participant’s spouse. For additional

information, please consult your legal advisor. I consent to the Beneficiary Designation

______________________________________ ___________________

Signature of Spouse Date (mm/dd/yyyy)

BlackRock Inherited IRA Application – For Beneficiaries of an IRA Page 8 of 8

6. Signature(s), Taxpayer Identification Certification and Authorization

I, the Participant, acknowledge receiving and reading the Traditional and Roth IRA Application and Adoption Agreement

Instructions, the Traditional IRA and Roth IRA Combined Disclosure Statement, the Traditional IRA Custodial Account

Agreement, the Roth IRA Custodial Account Agreement and the Privacy Notice (the “Account Documents”). I

acknowledge receiving and reading the current prospectus for each Mutual Fund I may have designated for investment.

The Custodian, upon proper instructions from me, is authorized to exchange a Mutual Fund for any other Mutual Fund

and to purchase a Mutual Fund with the proceeds of any redemption.

I agree that this IRA becomes effective only upon written acceptance by the Custodian and that such written acceptance

will consist of a confirmation of transaction statement.

I agree that the Custodian may amend (add to, delete from or revise) any term of the Agreement at any time by notice to

me and that my sole remedy if I disagree with the amendment is to transfer funds in the IRA Account to another

custodian. I agree that the Agreement is binding on me and on my successors in interest.

Each contribution to my IRA will be invested in accordance with the written instructions I provide with respect to that

contribution. In the event that this is a rollover contribution, the undersigned hereby irrevocably elects, pursuant to the

requirements of Section 1.402(a)(5)-1T of the IRS regulations, to treat this contribution as a rollover contribution.

Custodial Fees: $15.00 annual maintenance fee per year. This fee is owed and due for each full and partial calendar year

that the IRA Account is open. The participant may pay the fee with funds other than those in the IRA Account (“non-

custodial funds”). If the fee for a calendar year is not paid by the participant from non-custodial funds by the date

reasonably designated by the Custodian or prior to closing the IRA Account, the Custodian is authorized to deduct the fee

from funds in the IRA Account at any time immediately after such payment due date or immediately after receiving

instructions to close the IRA Account. Please review the IRA Custodial Disclosure document for additional information.

I direct that all benefits upon my death be paid as indicated on the beneficiary designation. If I named a beneficiary that

is a Trust, I understand I must provide certain information concerning such Trust to the Custodian.

State Unclaimed Property Law Disclosure

The assets in your account are subject to state unclaimed property laws which provide that if no activity occurs in your account

within the time period specified by the particular state law, your assets must be transferred to the appropriate state. We are

required by law to advise you that your assets may be transferred to an appropriate state in compliance with these state laws.

Tax Certification - Under penalties of perjury, I/we certify that:

 The number shown on this form is the correct taxpayer identification number, and

 The investor is not subject to backup withholding because the investor: (a) is exempt from backup withholding, or (b) has

not been notified by the Internal Revenue Service (IRS) that the Investor is subject to backup withholding as a result of a

failure to report all interest or dividends, or (c) the IRS has notified the investor that they are no longer subject to backup

withholding, and

 The applicant is a U.S. person (including a U.S. resident alien) or

 Alternatively, under penalties of perjury, the applicant certifies that they are subject to withholding. If so, check here:

 The FATCA code(s) entered on this form (if any) indicating the investor is exempt from FATCA reporting is correct.

CODE: _______

The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

______________________________________

Signature of IRA owner

(or responsible individual in the case of a minor)

____________________ __________________

Title / Capacity (if any) Date (mm/dd/yyyy)

Questions?

Call us at

1-800-441-7762

, Monday through Friday between 8:00 AM and 6:00 PM ET or visit us online at www.blackrock.com.

Not FDIC Insured | May Lose Value | No Bank Guarantee

trademark of BlackRock, Inc. or its subsidiaries in the United States and

elsewhere. All other trademarks are those of their respective owners.

Lit. No. IRA-APP-INHER-1021

Page 1 of 2

Mutual Fund Range

Not all share classes are available in each fund. For more information on BlackRock Funds, please either visit www.blackrock.com/funds, review the Fund’s prospectus, or call us at 1-800-441-7762.

Equity

LifePath

Multi Asset, Sector, Target

Allocation, etc.

 U.S. Equity

Capital Appreciation

Equity Dividend

High Equity Income

Mid Cap Value

Mid-Cap Growth Equity

Large Cap Focus Value

SMID Cap Growth Equity

Sustainable U.S. Growth Equity

Sustainable U.S. Value Equity

U.S. Impact

 World Equity

China A Opportunities

Emerging Markets

EuroFund

Event Driven Equity

Global Dividend

Global Impact

Global Long/Short Equity

International

International Dividend

International Impact

Latin America

Long-Horizon Equity

Sustainable Emerging Markets Equity

Sustainable High Yield

Sustainable International Equity

Sustainable Total Return

LifePath Index 2025

LifePath Index 2030

LifePath Index 2035

LifePath Index 2040

LifePath Index 2045

LifePath Index 2050

LifePath Index 2055

LifePath Index 2060

LifePath Index 2065

LifePath Index Retirement

 LifePath Dynamic

LifePath Dynamic 2025

LifePath Dynamic 2030

LifePath Dynamic 2035

LifePath Dynamic 2040

LifePath Dynamic 2045

LifePath Dynamic 2050

LifePath Dynamic 2055

LifePath Dynamic 2060

LifePath Dynamic 2065

LifePath Dynamic Retirement

Balanced Capital

Dynamic High Income

Global Allocation

Managed Income

Multi-Asset Income

Retirement Income 2030

Retirement Income 2040

Systematic Multi-Strategy

Tactical Opportunities

Total Factor

 Sector

Commodity Strategies

Energy Opportunities

Health Sciences Opportunities

Natural Resources Trust

Real Estate Securities

Technology Opportunities

 Target Allocation

20/80 Target Allocation

40/60 Target Allocation

60/40 Target Allocation

80/20 Target Allocation

 LifePath ESG Index

LifePath ESG Index 2025

LifePath ESG Index 2030

LifePath ESG Index 2035

LifePath ESG Index 2040

LifePath ESG Index 2045

LifePath ESG Index 2050

LifePath ESG Index 2055

LifePath ESG Index 2060

LifePath ESG Index 2065

LifePath ESG Index Retirement

 Defensive Advantage Series

Defensive Advantage Emerging Markets

Defensive Advantage International

Defensive Advantage U.S.

Advantage ESG Emerging Markets Equity

Advantage ESG U.S. Equity

Advantage ESG International Equity

Advantage Global Advantage International

Advantage Large Cap Core

Advantage Large Cap Growth

Advantage Small Cap Core

Advantage Small Cap Growth

Advantage SMID Cap

 Advantage Series

 LifePath Index

 Multi Asset

Page 2 of 2

iShares Index Funds

Fixed Income

Cash Funds

 U.S. Equity

iShares Russell 1000 Large-Cap Index

iShares Russell 2000 Small-Cap Index

iShares Russell Mid-Cap Index

iShares S&P 500 Index

iShares Small/Mid-Cap Index

iShares Total Stock U.S. Market Index

 World Equity

iShares MSCI EAFE International Index

iShares MSCI Total International Index

 Fixed Income

iShares Short-Term TIPS Bond Index iShares

U.S. Aggregate Bond Index

 Sector

iShares Developed Real Estate Index

 Taxable Fixed Income

Advantage CoreAlpha Bond

Core Bond

Floating Rate Income

GNMA

High Yield Bond

Income

Inflation Protected Bond

Low Duration Bond

Strategic Income Opportunities Total Return

Sustainable Advantage CoreAlpha Bond

Sustainable Emerging Markets Bond

Sustainable Emerging Markets Flexible Bond

Sustainable Low Duration Bond

U.S Mortgage

U.S. Government Bond

 World Fixed Income

Emerging Markets Dynamic

Global Long/Short Credit

Strategic Global Bond

 Municipal Fixed Income

California Municipal Opportunities

High Yield Municipal

National Municipal

New Jersey Municipal Bond

New York Municipal Opportunities

Pennsylvania Municipal

Short-Term Municipal

Strategic Municipal Opportunities

 Multi-Asset

Liquidity Environmentally Aware “LEAF”

Summit Cash Reserves

Short Term Obligations

Wealth Liquid Environmentally Aware

You should consider the investment objectives, risks, charges and expenses of each fund carefully before investing. Each fund’s prospectus and, if available, the summary prospectus contain this and other

information about the fund, and are available, along with information on other BlackRock funds by calling BlackRock or from your financial professional. The prospectus and, if available, the summary

prospectus should be read

carefully before investing.

Questions? Call us at 1-800-441-7762, Monday through Friday between 8:00 AM and 6:00 PM ET or visit us online at www.blackrock.com.

Not FDIC Insured | May Lose Value | No Bank Guarantee

its subsidiaries in the United States and elsewhere. All other trademarks are those of their

respective owners.

Lit. No. RANGECARD-1021

Page 1 of 23

BNY MELLON INVESTMENT SERVICING TRUST COMPANY

Supplement to the Traditional and Roth

Individual Retirement Account (IRA)

Disclosure Statement

Deadline Extension For 2020 Contributions to a Traditional Or Roth IRA

Eligible individuals will have until Wednesday, April 15, 2021, to make contributions to a traditional IRA or Roth IRA for tax year 2020. For more information

please refer to the Internal Revenue Service (IRS) web site

www.irs.gov.

2021 IRA Contribution Limits for Traditional and Roth IRA

The maximum allowable contribution to your IRAs (deductible, non-deductible, and Roth) for the tax year remains unchanged and is the lesser of (a) $6,000 or

(b) 100% of your compensation or earnings from self-employment. For those who have attained or will attain the age of 50 before the close of the taxable

year, the annual IRA contribution limit is increased by $1,000 (total of $7,000 for 2020). Any contribution made to your IRA will be treated as a current year

contribution recorded in the year it is received, unless the contribution is made between January 1 and April 15, 2021, and you have identified the

contribution as a prior year contribution. Please consult IRS Publication 590-A Contributions to Individual Retirement Arrangements (IRAs) for eligibility

requirements and contribution restrictions.

2021 Traditional IRA Income Tax Deduction:

Your contribution to a traditional IRA may be deductible on your federal income tax return. However, there is a phase-out of the IRA deduction if you are an

active participant in an employer-sponsored retirement plan. The IRA deduction is reduced proportionately as modified adjusted gross income increases. If you

are not an active participant in an employer-sponsored retirement plan, there is a phase-out of the IRA deduction if you’re married based on whether or not

your spouse is covered by a workplace retirement plan. Please consult IRS Publication 590-A Contributions to Individual Retirement Arrangements (IRAs) for

assistance in calculating your deductible contribution as it pertains to individual income and employer-sponsored retirement plan circumstances. Your

contribution in excess of the permitted deduction will be considered a non-deductible contribution.

LATE ROLLOVER CONTRIBUTIONS:

The IRS will permit you to deposit a late rollover contribution (exceeding the 60-day time limit), if you meet certain qualifications. All late rollover contribution

deposits must be accompanied by a late rollover self-certification form. It is important to know that self-certification does not constitute an automatic waiver of

the 60-day time limit. The IRS may, during the course of an examination, determine that your contribution does not meet the requirements for a waiver. If it is

determined that you do not meet the requirements, you could be subject to additional income, income taxes and penalties. The IRA custodian is required to

report all late rollover contribution deposits on IRS Form 5498. For more information and a list of qualifying events, please visit the IRS’s web site www.irs.gov

using the search term “Revenue Procedure 2020-46”.Note: The rules regarding tax-free rollovers are complex and subject to frequent change; you should

consult a professional tax advisor if you are considering a rollover.

References to the "Custodian" mean BNY Mellon Investment Servicing Trust Company

Page 2 of 23

Deduction Limit—Effect of Modified AGI on Deduction—Covered by a Retirement Plan at Work

Tax Year 2021

Full deduction if

modified AGI is:

Partial deduction if

modified AGI is:

No deduction if

modified AGI is:

Single Filers or Head of Household

$66,000 or less

More than $66,000

but less than

$76,000

$76,000 or more

Married—filing jointly or Qualified

Widow(er)

$105,000 or less

More than

$105,000 but less

than $125,000

$125,000 or more

Married—filing separately

N/A

Less than $10,000

$10,000 or more

Deduction Limit—Effect of Modified AGI on Deduction—You are NOT Covered by a Retirement Plan

at Work (Spousal Coverage Considered)

Tax Year 2021

Full deduction if

modified AGI is:

Partial deduction if

modified AGI is:

No deduction if

modified AGI is:

Married—jointly—spouse covered at

work

$198,000 or less

More than

$198,000 but less

than $208,000

$208,000 or more

Married—filing separately—spouse

covered at work

N/A

Less than $10,000

$10,000 or more

2021 Roth IRA Contribution Eligibility

For 2021, your Roth IRA contribution limit is reduced (phased out) based on your modified AGI as follows:

Tax Year 2021 Full deduction if

modified AGI is:

Partial deduction if

modified AGI is:

No deduction if

modified AGI is:

Married—filing jointly or Qualified

Widow(er)

Less than $198,000

More than $198,000

but less than

$208,000

$208,000 or more

Married—filing separately

N/A

Less than $10,000

$10,000 or more

Single, Head of Household or

Married—filing separately and you did

not live with your spouse at any time

during the year

Less than $125,000

More than $125,000

but less than

$140,000

$140,000 or more

These limits may be adjusted from time to time by the IRS; please refer to Publication 590-A Contributions to Individual

Retirement Arrangements (IRAs) for current year limits.

REPURCHASE OF CORONAVIRUS-RELATED DISTRIBUTIONS:

The CARES Act permitted Coronavirus-Related Distributions from IRAs and retirement plans including 401(k) plans, 403(b) plans, and governmental 457(b)

plans in 2020 up to $100,000 by eligible individuals:

Individuals who have been diagnosed with “the virus SARS-CoV-2” or “coronavirus disease 2019 (COVID-19)”; individuals whose spouse or dependent is

diagnosed with such virus or disease, and individuals who experience adverse financial consequences as a result of:

• being quarantined, furloughed or laid off or having reduced working hours due to the virus/disease,

• being unable to work due to lack of child care due to the virus/disease,

• closing or reducing hours of a business owned or operated by the individual due to the virus/disease, or

• other factors as determined by Treasury.

Coronavirus-Related Distributions may be repaid in multiple payments over a three year period beginning on the day the distribution was received. The

repayments must be in the form of a rollover to a qualified plan or an IRA account that can accept rollovers. These repayments are not subject to the one

rollover per 12 month rule or the rule that requires rollovers within 60 days. If you wish to make a repayment of all or a portion of a Coronavirus-Related

Distribution you received in 2020 please use the Certification of Rollover form and indicate this is the reason for the rollover.

EARLY DISTRIBUTIONS FROM A TRADITIONAL IRA:

Your receipt or use of any portion of your account (excluding any amount representing a return of non-deducted contributions) before you attain age 59½ is

considered an early or premature distribution. The distribution is subject to a penalty tax equal to 10% of the distribution unless one of the following

exceptions applies to the distribution:

• used specifically for deductible medical expenses which exceed 7.5% of your adjusted gross income, or

EARLY DISTRIBUTIONS FROM A ROTH IRA:

The earnings portion of distributions made prior to the end of the five-year holding period, or which fail to meet the criteria as outlined in “Taxation of Roth IRA

Distributions”, are subject to ordinary income taxes. The earnings portion of the distribution is also subject to the 10% penalty tax on early distributions unless

one of the following exceptions applies to the distribution:

• used specifically for deductible medical expenses which exceed 7.5% of your adjusted gross income, or

EXTENSION OF NON-COVID RELATED DISASTER DISTRIBUTIONS:

On December 27, 2020, the President signed H.R. 133, the “Consolidated Appropriations Act, 2021” (‘CAA’) which includes provisions relating to “Qualified

Disaster Distributions”, which will apply as follows:

1.IRA account owners and qualified retirement plan participants who reside in a “qualified disaster area” not related to the COVID-19 epidemic and who

suffered an economic loss related to the qualified disaster may request Qualified Disaster Distributions of up to $100,000 as late as 180 days following the

enactment of the Act. A “qualified disaster area” is an area in which:

a. The President declared the area a major disaster area during the time period beginning on or after January 1, 2020, and ending 60 days following

enactment of the Act (on or around February 25, 2021), and

b. The disaster incident period began on or after December 28, 2019 and on or before the enactment of the Act (December 27, 2020).

Qualified Disaster Distributions will have the following temporary tax relief:

• Qualified Disaster Distributions to individuals under age 59 ½ will not be subject to a 10% early withdrawal penalty.

• Qualified Disaster Distributions may be repaid over a three year period beginning on the day the distribution was received in the form of one or more

rollovers to a qualified plan or IRA account eligible to accept rollovers. These repayments are not subject to the one rollover per 12 month rule and are

not subject to normal requirement to complete a rollover within 60 days of receipt of the assets.

• Qualified Distributions received that must be included as taxable income for the participant default to being included ratably over the 3-taxable year

period beginning with the taxable year the distribution is received, alternately a participant may elect to include the amount in its entirety as taxable

income in the year received.

Required federal income tax withholding on escheated tradi

tional IRA accounts:

Effective as of January 1, 2020, for any Traditional IRA Account that becomes dormant and subject to escheatment under state unclaimed property law, the

Internal Revenue Service requires reporting of the amount escheated on IRS Form 1099R and income tax withholding at the time of escheatment to the state.

You agree and authorize the Custodian to liquidate sufficient assets in your custodial account to provide for the withholding to the IRS. The Custodian will

remit withholding to the IRS in accordance with any prior withholding election. If you have not made a prior withholding election, the Custodian will remit

withholding at a rate of ten percent (10%).

Income Tax Withholding:

Also, as noted above, effective as of January 1, 2020, for any Traditional IRA Account that becomes dormant and subject to escheatment under state

unclaimed property law, the Internal Revenue Service requires reporting of the amount escheated on IRS Form 1099R and income tax withholding at the

time of escheatment to the state. You agree and authorize the Custodian to liquidate sufficient assets in your custodial account to provide for the

withholding to the IRS. The Custodian will remit withholding to the IRS in accordance with any prior withholding election. If you have not made a prior

withholding election, the Custodian will remit withholding at a rate of ten percent (10%). REPURCHASE OF CORONAVIRUS-RELATED DISTRIBUTIONS:

Description of available options for your contributions:

In Article VIII, Section 24 of the TRADITIONAL IRA CUSTODIAL ACCOUNT AGREEMENT and Article IX, Section 26 of the ROTH IRA CUSTODIAL ACCOUNT

AGREEMENT ("Sections 26"), both of which constitute an important part of the APPLICATION and ADOPTION AGREEMENT, you authorize the Custodian to

act in its discretion for your benefit in situations where assets in your custodial account are liquidated and the Custodian has not received instructions from

you in a timely manner regarding the disposition of such proceeds or where the only instructions received from you cannot reasonably or practicably be

carried out. For example, a Mutual Fund may take actions which result in that Mutual Fund, or in your investment in that Mutual Fund, being involuntarily

liquidated. The Mutual Fund or the prospectus for that Mutual Fund may direct that the proceeds of the liquidation be placed in an asset not available to you

under the APPLICATION and ADOPTION AGREEMENT or provide solely that the cash or other property resulting from the liquidation be distributed directly

to shareholders. If the Custodian does not receive timely instructions from you that it can reasonably and practicably carry out (for example, in-kind property

distributed by the Mutual Fund may not be a permissible asset for your IRA), then in both Sections 24 and 26 you authorize the Custodian to exercise its

discretion in acting on your behalf, including taking such actions as placing the proceeds in a money market mutual fund, an FDIC-insured bank account or

money market account, distributing the proceeds to you or holding the proceeds uninvested. Other examples may exist involving different liquidation

circumstances and different restrictions or limitations regarding the disposition of the proceeds. The Custodian expressly disclaims any liability for any

action taken or omitted under the authority of either Section 24 or 26, unless the Internal Revenue Code or regulations implementing the Internal Revenue

Code require otherwise.

Page 3 of 23

Traditional And Roth IRA

Combined Disclosure Statement

The following information is the disclosure statement required by federal tax regulations. You should read this Disclosure Statement, the Custodial Account Agreement and

the prospectuses for the mutual funds in which your Individual Retirement Account (“IRA”) contributions will be invested. The rules governing IRAs are subject to change. You

should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site www.irs.gov

for updated rules and requirements.

Important Information About U.S. Government

Requirements That May Affect Your Account

BNY Mellon Investment Servicing Trust Company (“BNY Mellon”, “we”, or “us”),

provides custodial and administrative services for your retirement or savings

account. As a result of this role, persons who open a retirement or savings account

are considered ‘customers’ of BNY Mellon (“you” or “your”).

To help the U.S. Government fight the funding of terrorism and money laundering

activities, Federal law requires BNY Mellon, as a financial institution, to obtain,

verify, and record information that identifies each person who opens an account.

All accounts we open are opened on a conditional basis – conditioned on our

ability to verify your identity in accordance with Federal law.

When establishing an account, you are required to provide your full legal name,

address, government issued identification number (e.g. social security number),

date of birth, and other information within your account-opening application that

will allow us to identify you. We may also request a copy of your driver’s license or

other identifying documents and may consult third-party databases to help verify

your identity. If the account you are opening will be registered in the name of a

beneficiary, trust, or estate or charity, we may require additional identifying

documentation.

If you fail to provide any requested identifying information or documentation

when opening your account, your new account application may be rejected.

If we open your account, and you subsequently fail to provide all identification

materials we request or if we are subsequently unable to adequately verify your

identity as required by U.S. Government regulations, we reserve the right to take

any one or more of the following actions:

• We may place restrictions on your account which block all purchase

transactions and we may place additional restrictions on your account

blocking other transactional activities if we determine such additional

restrictions are appropriate under Federal law or regulation.

• We may close your account, sell (i.e., "liquidate") the assets in your account in

the prevailing market at the time, and send you a check representing the

cash proceeds of your account. This distribution will be reported to the

Internal Revenue Service and may result in unfavorable consequences to

you under Federal and state tax laws.

You May Incur Losses

. Despite being opened as a conditional account, your

account will be invested as you instruct and you will be subject to all market risks

during the period between account opening and any liquidation necessitated by

your failure to furnish requested identifying information or by an inability to

adequately verify your identity. You may also be subject to additional market risks

if the additional transactional restrictions discussed above are placed on your

account. In addition, the closing of your account may subject you to fees and

charges imposed by a sponsor, issuer, depository or other person or entity

associated with one or more of the assets in which you are invested, and any sales

charges you may have paid in connection with your purchases will not be

refunded.

You Assume All Responsibility For These Losses

. BNY Mellon expressly disclaims

any responsibility or liability for losses you incur as a result of your failure to

furnish identification materials we request, including investment losses and any

other loss or damage (including but not limited to lost opportunities and adverse

tax consequences). If you proceed with the account opening process, you accept

all risks of loss resulting from any failure of yours to furnish the identification

materials we request or from a subsequent inability to adequately verify your

identity in accordance with Federal law or regulation.

State Unclaimed Property Law Disclosure

The assets in your custodial account are subject to state unclaimed property laws

which provide that if no activity occurs in your account within the time period

specified by the particular state law, your assets must be transferred to the

appropriate state. We are required by law to advise you that your assets may be

transferred to an appropriate state in compliance with these state laws.

Required Federal Income Tax Withholding On

Escheated Traditional IRA Accounts

Effective as of January 1, 2020, for any Traditional IRA Account that becomes

dormant and subject to escheatment under state unclaimed property law, the

Internal Revenue Service requires reporting of the amount escheated on IRS Form

1099R and income tax withholding at the time of escheatment to the state. You

agree and authorize the Custodian to liquidate sufficient assets in your custodial

account to provide for the withholding to the IRS. The Custodian will remit

withholding to the IRS in accordance with any prior withholding election. If you

have not made a prior withholding election, the Custodian will remit withholding at

a rate of ten percent (10%).

Revocation Of Your IRA

You have the right to revoke your IRA and receive the entire amount of your initial

investment by notifying the Custodian in writing within seven (7) days of

establishing your IRA (account open date). If you revoke your IRA within seven

days, you are entitled to a return of the entire amount contributed, without

adjustment for such items as sales commissions, administrative expenses, or

fluctuations in market value. If you decide to revoke your IRA, notice should be

delivered or mailed to the address listed in the application instructions. This notice

should be signed by you and include the following:

1. The date.

2. A statement that you elect to revoke your IRA.

3.Your IRA account number.

4.The date your IRA was established.

5.Your signature and your name printed or typed.

Mailed notice will be deemed given on the date that it is postmarked, if it is

properly addressed and deposited either in the United States mail, first class

postage prepaid, or with an IRS approved overnight service. This means that when

you mail your notice, it must

be postmarked on or before the seventh day after

your IRA was opened. A revoked IRA will be reported to the IRS and the Depositor

on IRS Forms 1099-R and 5498.

Page 4 of 23

Contributions

For 2021, the maximum allowable contribution to your individual retirement

accounts (deductible, non-deductible, and Roth) is the lesser of (a) $6,000 or (b)

100% of your compensation or earnings from self-employment.

Age 50 or above catch-up contributions – For those who have attained the age of

50 before the close of the taxable year, the annual IRA contribution limit is

increased by $1,000.

For tax years after 2020, the above limits may be subject to Internal Revenue

Service (“IRS”) cost-of-living adjustments, if any. Please read the Traditional and

Roth Individual Retirement Account (IRA) Combined Disclosure Statement

carefully or consult IRS Publication 590 or a qualified tax professional for more

information about eligibility requirements and contribution restrictions.

Making an IRA contribution on behalf of your spouse - If you have earned

compensation, are married and file a joint federal income tax return, you may

make an IRA contribution on behalf of your working or nonworking spouse. The

total annual contribution limit for both IRAs may not exceed the lesser of the

combined compensation of both spouses or the annual IRA contribution limits as

set forth by the IRS. Contributions made on behalf of a spouse must be made to a

separate IRA account established by your spouse.

Any contribution made to your IRA will be treated as a contribution for the year it is

received, unless the contribution is made between January 1 and the April 15

postmark deadline and you have identified the contribution as a prior year

contribution.

• Traditional IRA Contribution Restriction - You cannot make contributions to

your traditional IRA for any taxable year after you attain age 72.

• Roth IRA Contribution - Contributions can continue to be made to a Roth

IRA at any age as long as the requirements of earned income are met.

Description of Available Options for Your Contributions

The assets in your custodial account will be invested in accordance with

instructions communicated by you (or following your death, by your beneficiary) or

by your (or following your death, your beneficiary’s) authorized agent. Account

contributions may be invested in shares of one or more mutual funds made

available to you in connection with this IRA account (the “Mutual Funds”), or in

other investments that are eligible for investment under section 408(a) of the

Internal Revenue Code and that are acceptable to the Custodian as investments

under the Individual Retirement Account (IRA) Application and Adoption

Agreement.

Mutual Fund

Investments

: An investment in any of the Mutual Funds involves

investment risks, including possible loss of principal. In addition, growth in the

value of your Mutual Funds is neither guaranteed nor protected due to the

characteristics of a mutual fund investment. Detailed information about the

shares of each Mutual Fund available to you for investment of your IRA

contributions must be furnished to you in the form of a prospectus. The method

for computing and allocating annual earnings is set forth in the prospectus. (See

the section of each prospectus entitled "Dividends.") The prospectus also sets

forth the costs and expenses you incur by being invested in a particular Mutual

Fund; such costs and expenses reduce any yield you might obtain from the Mutual

Funds. (See the section of the prospectus entitled "Expense Table" and the

sections referred to therein.) For further information regarding expenses, earnings,

and distributions of a particular Mutual Fund, see that Mutual Fund's financial

statements, prospectus and/or statement of additional information.

In Article VIII, Section 24 of the TRADITIONAL IRA CUSTODIAL ACCOUNT

AGREEMENT and Article IX, Section 26 of the ROTH IRA CUSTODIAL ACCOUNT

AGREEMENT ("Sections 26"), both of which constitute an important part of the

APPLICATION and ADOPTION AGREEMENT, you authorize the Custodian to act in

its discretion for your benefit in situations where assets in your custodial account

are liquidated and the Custodian has not received instructions from you in a timely

manner regarding the disposition of such proceeds or where the only instructions

received from you cannot reasonably or practicably be carried out. For example, a

Mutual Fund may take actions which result in that Mutual Fund, or in your

investment in that Mutual Fund, being involuntarily liquidated. The Mutual Fund

or the prospectus for that Mutual Fund may direct that the proceeds of the

liquidation be placed in an asset not available to you under the APPLICATION and

ADOPTION AGREEMENT or provide solely that the cash or other property

resulting from the liquidation be distributed directly to shareholders. If the

Custodian does not receive timely instructions from you that it can reasonably and

practicably carry out (for example, in-kind property distributed by the Mutual

Fund may not be a permissible asset for your IRA), then in both Sections 24 and

26 you authorize the Custodian to exercise its discretion in acting on your behalf,

including taking such actions as placing the proceeds in a money market mutual

fund, an FDIC-insured bank account or money market account, distributing the

proceeds to you or holding the proceeds uninvested. Other examples may exist

involving different liquidation circumstances and different restrictions or

limitations regarding the disposition of the proceeds. The Custodian expressly

disclaims any liability for any action taken or omitted under the authority of either

Section 24 or 26, unless the Internal Revenue Code or regulations implementing

the Internal Revenue Code require otherwise.

Beneficiary Designations

Per Stirpes Beneficiary Designations:

The Custodian shall accept as complete and

accurate all written instructions provided in good order by the estate/executor

with regard to the identification of the beneficiaries and the allocations thereto.

In the event of your death, the balance of your custodial account shall be paid to

the primary beneficiaries who survive you in equal shares (or in the specified

shares, if indicated). If none of the primary beneficiaries survive you, the balance

of your account shall be paid to the contingent beneficiaries who survive you in

equal shares (or in the specified shares, if indicated). If you name multiple primary

beneficiaries and a beneficiary does not survive you, such interest is terminated

and that percentage will be divided proportionately among the remaining primary

beneficiaries. Similarly, unless you have specified otherwise, if no primary

beneficiary survives you and you have named multiple contingent beneficiaries

and a beneficiary does not survive you, such interest is terminated and that

percentage will be divided proportionately among the remaining contingent

beneficiaries.

You may change your beneficiaries at any time by giving written notice to the

Custodian. If you do not designate a beneficiary, or if all designated beneficiaries

predecease you, your surviving spouse will become the beneficiary of your IRA. If

you do not have a surviving spouse at the time of your death, your estate will

become the beneficiary of your IRA. If a trust is designated as a beneficiary, you

must provide both the date of the trust and the name(s) of the trustee(s).

Spousal Beneficiary Designation in the Event of

Divorce

In the event of a divorce or legal separation, the Custodian will not automatically

remove the former spouse as the designated beneficiary without court

appointment. If your life circumstances have changed, we suggest you submit an

IRA Beneficiary Designation Form. The current beneficiary designation on file with

the Custodian will be deemed valid and in full force until such date as the

Custodian receives a signed IRA Beneficiary Designation Form, in good order.

Page 5 of 23

Spousal Provisions For Same Sex Couples

In accordance with federal regulations, where an individual is lawfully married to

another individual, regardless of sex, both individuals shall be treated as a

“spouse” for federal tax purposes. Individuals in a civil union or domestic

partnership will not be treated as spouses for federal tax purposes.

Tax Refund Direct Deposit IRA Contributions

Taxpayers who qualify for a tax refund may elect to directly deposit their refund

into their IRA account. The amount of the refund deposited to your IRA cannot

exceed annual IRA limits as set forth by the Internal Revenue Service. You must

contact the Custodian in advance of completing IRS Form 8888 to obtain the

proper routing instructions. All tax refund contributions will be recorded as current

year contributions for the year received.

Health Savings Account (“HSA”) Funding Distribution

You are allowed a one-time, tax-free transfer from an IRA (other than a SEP or

SIMPLE IRA) to use toward your annual Health Savings Account (“HSA”)

contribution. Eligible individuals may make an irrevocable one-time, tax-free

“qualified HSA funding distribution” from an IRA and move it directly into an HSA,

subject to strict requirements. The HSA funding distribution must be directly

transferred from the IRA custodian or trustee to the HSA custodian or trustee. The

amount of the transfer cannot exceed the maximum HSA contribution limit for the

year that the amount is transferred. The deposited amount is counted toward the

individual’s total HSA annual contribution limit.

Non-Spouse Beneficiaries of Employer Plans

Eligible non-spouse beneficiary distributions from an employer’s retirement plan

can be directly rolled over into a beneficiary/inherited IRA. To accomplish the

direct rollover, the plan administrator must distribute the benefit payable to the

trustee or custodian and mail it directly to the receiving institution. If the

distribution is paid directly to the non-spouse beneficiary, a rollover will not be

permitted.

The beneficiary/inherited IRA account must be registered in both the non-spouse

beneficiary’s name and the decedent’s name. A non-spouse beneficiary may

include a trust beneficiary that meets the special “look through” rules under the

IRS regulations. Non-qualified trusts, estates or charities are not eligible for the

direct rollover provision.

ualified Reservist Distributions

Early distributions paid to certain military reservists called to active duty after

September 11, 2001 (“Qualified Reservist Distributions”) are eligible to be repaid

to an IRA within a two-year period after the end of active duty. This provision

applies to distributions made after September 11, 2001. Repayments cannot

exceed the amount of your Qualified Reservist Distributions. Repayment cannot

be made after the date that is two years after your active duty period ends. The

repayments are not treated as rollovers.

aver’s Tax Credit

The Saver’s Tax Credit rewards low to moderate income taxpayers who contribute

toward their retirement savings with a non-refundable dollar for dollar tax credit

that could reduce their federal income tax liability. Eligibility to participate in the

program is based on your filing status and adjusted gross income. For more

information about the Saver’s Credit, check the IRS website www.irs.gov

under the

term “Retirement Savings Contributions Credit” or “Saver’s Credit”.

Qualified Charitable Distributions (“QCDs”)

Certain taxpayers may transfer funds from their IRA to an eligible charitable

organization. To qualify the IRA owner must be age 70½ or older. QCDs may be

made from a traditional IRA or a Roth IRA and may be used to satisfy a

participant’s required minimum distribution (“RMD”) for the tax year. The

maximum annual amount that may be distributed each year is $100,000

regardless of how many IRAs the participant owns. For married individuals filing a

joint return, the limit is $100,000 for each individual IRA owner. More information

about QCDs can be found in IRS Publication 590-B Distributions from Individual

Retirement Arrangements (IRAs).

Prohibited Transactions

If you or your beneficiary engages in any prohibited transaction as described in

the Internal Revenue Code (IRC) Section 4975(c) (such as any sale, exchange,

borrowing, or leasing of any property between you and your IRA; or any other

interference with the independent status of the account), the account will lose its

exemption from tax and be treated as having been distributed to you in the tax

year in which you or your beneficiary engaged in the prohibited transaction. The

distribution may also be subject to additional penalties including a 10% penalty

tax if you have not attained age 59½. See Publication 590 for further instructions

on calculating taxable gain, reporting amounts in income and prohibited

transaction penalty taxes. In addition, if you or your beneficiary use (pledge) all or

any part of your IRA as security for a loan, then the portion so pledged will be

treated as if distributed to you, and will be taxable to you. Your distribution may

also be subject to a 10% penalty tax if you have not attained age 59½ during the

year which you make such a pledge.

Fees and Sales Charges

There is an annual custodial maintenance fee for each IRA account as set forth on

the Application. The Custodian may also charge a service fee in connection with

any distribution from your IRA.

Estate Tax

Amounts payable to your spouse, as your named beneficiary, may qualify for a

marital tax deduction for federal estate tax purposes.

Income Tax Withholding

The Custodian is required to withhold federal income tax from any taxable

distribution from your IRA at the rate of 10% unless you choose not to have tax

withheld. You may elect out of withholding by advising the Custodian in writing,

prior to the distribution, that you do not want tax withheld from the distribution.

This election may be made on any distribution request form provided by the

Custodian. If you do not elect out of tax withholding, you may direct the Custodian

to withhold an additional amount of tax in excess of 10%.

State income tax withholding may also apply to distributions from your IRA

account when federal income tax is withheld. Please contact your tax advisor or

state tax authority for information about your state’s income tax withholding

requirements.

Also, as noted above, effective as of January 1, 2020, for any Traditional IRA

Account that becomes dormant and subject to escheatment under state

unclaimed property law, the Internal Revenue Service requires reporting of the

amount escheated on IRS Form 1099R and income tax withholding at the time of

escheatment to the state. You agree and authorize the Custodian to liquidate

sufficient assets in your custodial account to provide for the withholding to the

IRS. The Custodian will remit withholding to the IRS in accordance with any prior

withholding election. If you have not made a prior withholding election, the

Custodian will remit withholding at a rate of ten percent (10%).

Page 6 of 23

Additional Information

Distributions under $10 will not be reported on IRS Form 1099-R (as allowed

under IRS regulations). However, you must still report these distributions to the

IRS on your Form 1040 (as well as other forms that may be required to properly

file your tax return).

For more detailed information, you may obtain IRS Publication 590, Individual

Retirement Arrangements (IRAs) from any district office of the Internal Revenue

Service or by calling 1-800-TAX-FORM.

Filing With the IRS

Contributions to your IRA must be reported on your tax return (Form 1040 or

1040A, and Form 8606 for nondeductible traditional IRA contributions) for the

taxable year contributed. If you are subject to any of the federal penalty taxes due

to excess contributions, premature distributions, or missed required minimum

distributions, you must file IRS Form 5329.

Traditional IRA

Disclosure Statement

You have opened an Individual Retirement Account (IRA), which is a traditional or

SEP IRA for the exclusive benefit of you and your beneficiaries, created by a

written instrument (the Custodial Account Agreement). The following

requirements apply to your IRA:

1. Contributions, transfers and rollovers may be made only in "cash" by check,

draft, or other form acceptable to the Custodian.

2. The Custodian must be a bank, trust company, savings and loan association,

credit union or a person who is approved to act in such capacity by the

Secretary of the Treasury.

3. No part may be invested in life insurance contracts.

4. Your interest must be nonforfeitable.

5. The assets of the custodial account may not be mixed with other property

except in a common investment fund.

6. You must begin receiving distributions from your account no later than April

1 of the year following the year in which you attain age 72 and distributions

must be completed over a period that is not longer than the joint life

expectancy of you and your beneficiary.

Traditional IRA Eligibility

You are permitted to make a regular contribution to your traditional IRA for any

taxable year prior to the taxable year you attain age 72. if you receive

compensation for such taxable year. Compensation includes salaries, wages,

tips, commissions, bonuses, alimony, royalties from creative efforts and “earned

income” in the case of self-employment. The amount which is deductible

depends upon whether or not you are an active participant in a retirement plan

maintained by your employer; your modified adjusted gross income; your

marital status; and your tax filing status.

Note: The rules regarding tax-free rollovers are complex and subject to frequent

change; you should consult a professional tax advisor if you are considering a

rollover.

Traditional IRA Income Tax Deduction

Your contribution to a traditional IRA may be deductible on your federal income

tax return. However, there is a phase-out of the IRA deduction if you are an active

participant in an employer-sponsored retirement plan. The IRA deduction is

reduced proportionately as adjusted gross income increases. Adjusted gross

income levels are subject to change each year. Please consult IRS Publication 590

for calculating your deductible contribution as it pertains to individual income and

employer-sponsored retirement plan circumstances. Your contributions in excess

of the permitted deduction will be considered non-deductible contributions.

A deductible IRA contribution can be made to your spouse’s IRA even if you are an

active participant in an employer-sponsored retirement plan, if your joint adjusted

gross income for the tax year does not exceed the limits as set forth by the IRS. The

IRA deduction is reduced proportionally as your joint adjusted gross income

increases.

Traditional IRA Taxation and Rollover

The income of your IRA is not taxed until the money is distributed to you.

Distributions are taxable as ordinary income when received, except the amount of

any distribution representing non-deducted contributions or the return of an

excess contribution is not taxed.

Restriction on Indirect (60-Day) Rollover

An IRA participant is allowed only one rollover from one IRA to another (or the

same IRA) across all IRAs (Traditional, Rollover, Roth, SEP, SARSEP and SIMPLE)

in aggregate that a taxpayer owns in any 12-month or 365-day period. As an

alternative, a participant can make an unlimited number of trustee-to-trustee

transfers where the proceeds are delivered directly to the receiving financial

institution, successor custodian or trustee. You must contact the receiving

institution to initiate a trustee-to-trustee transfer. For more information please

visit the Internal Revenue Service’s web site www.irs.gov

using the search term

“IRA One-Rollover-Per-Year Rule”.

In general, you may “rollover” a distribution from another IRA, an eligible rollover

distribution from your employer’s qualified plan, or distributions from certain tax

deferred annuities or accounts. If a distribution is rolled over (i.e. deposited in your

IRA within 60 calendar days), the amount rolled over is not taxable. The IRS strictly

enforces the 60-day time limit. You may rollover a portion of a distribution in

which case the remainder will be subject to tax. The IRS requires 20% of any

distribution from your employer’s qualified plan to be withheld for federal income

tax unless your distribution is transferred (as a direct rollover) to an eligible

retirement plan such as another qualified plan or IRA.

Late Rollover Contributions

The Internal Revenue Service (IRS) will permit you to deposit a late rollover

contribution (exceeding the 60-day time limit), if you meet certain qualifications.

All late rollover contribution deposits must be accompanied by a late rollover self-

certification form. It is important to know that self-certification does not constitute

an automatic waiver of the 60-day time limit. The IRS may, during the course of an

examination, determine that your contribution does not meet the requirements for

a waiver. If it is determined that you do not meet the requirements, you could be

subject to additional income, income taxes and penalties. The IRA custodian is

required to report all late rollover contribution deposits on IRS Form 5498. For

more information and a list of qualifying events, please visit the Internal Revenue

Service’s web site www.irs.gov

using the search term “Revenue Procedure 2016-

47”.

Page 7 of 23

Converting to a Roth IRA

You may also “convert” all or a portion of your traditional, SEP or SIMPLE (after the

required two year holding period) IRA to a Roth IRA. You may not convert any

portion of a required minimum distribution (RMD). A conversion is a type of

distribution and is not tax-free. Distributions are taxable as ordinary income when

received, except any amount representing the return of non-deducted

contributions is not taxed. The 10% penalty tax on early distributions does not

apply to conversion amounts unless an amount attributable to a conversion is

distributed from the Roth IRA prior to five years from the date of the conversion.

Your traditional IRA may be converted to a Roth IRA by means of an in-house

direct transfer (within the same financial institution) or as a direct transfer

between two different financial institutions.

A conversion is reported as a distribution from your traditional IRA (IRS Form

1099-R) and a conversion contribution to your Roth IRA (IRS Form 5498). The

rules regarding conversions to Roth IRAs are complex and you should consult a

professional tax advisor prior to a conversion.

Recharacterization of Roth IRA Conversion is Now

Prohibited (Correction Process)

Effective January 1, 2018, a Roth IRA conversion cannot be recharacterized back

to a traditional IRA, SEP or SIMPLE IRA. In addition, amounts contributed to an

employer sponsored qualified plan that were converted to a Roth IRA cannot be

recharacterized back to the employer plan. A Roth IRA conversion is now deemed

an irrevocable election and cannot be “reversed” or “corrected”.

Prior to January 1, 2018, you could correct a Roth IRA conversion made in error

by recharacterizing the conversion back to a traditional IRA, SEP or SIMPLE IRA.

The recharacterization had to take place prior to the due date, including

extensions, for filing your federal income tax return for the tax year in which the

conversion was originally made. According to the IRS, you can recharacterize a

Roth IRA conversion that took place in tax year 2017, provided that the

recharacterization is completed by October 15, 2018. For more information,

please visit the IRS web site www.irs.gov

using the search term “IRA FAQs –

Recharacterization of Roth Rollovers and Conversions”.

Recharacterizing Traditional IRA Contributions

If you are eligible to contribute to a Roth IRA, all or part of a contribution you make

to your traditional IRA, along with allocable earnings or losses, may be

recharacterized and treated as if made to your Roth IRA on the date the

contribution was originally made to your traditional IRA. Recharacterization of a

contribution is irrevocable and must be completed on or before the due date,

including extensions, for filing your federal income tax return for the tax year for

which the contribution was originally made.

A recharacterized contribution is reported as a distribution from the first IRA (IRS

Form 1099-R) and a recharacterization contribution to the second IRA (IRS Form

5498) for the tax year in which the recharacterization occurs. The rules regarding

recharacterization are complex and you should consult a professional tax advisor

prior to any recharacterization. A recharacterization form is available from the

Custodian and should be used for all recharacterization requests.

Excess Contributions

Amounts contributed to your traditional IRA in excess of the allowable limit will be

subject to a non-deductible excise tax of 6% for each year until the excess is used

up (as an allowable contribution in a subsequent year) or returned to you. The 6%

excise tax will not apply if the excess contribution and earnings allocable to it are

distributed by your federal income tax return due date, including extensions. If

such a distribution is made, only the earnings are considered taxable income for

the tax year in which the excess was contributed to the IRA. The return of earnings

may also be subject to the 10% penalty tax on early distributions discussed in the

section titled “Early Distributions from a Traditional IRA”. If you make an excess

contribution to your IRA and it is not corrected on a timely basis, an excise tax of

6% is imposed on the excess amount. This tax will apply each year to any part or

all of the excess that remains in your account.

Earnings will be removed with the excess contribution, if corrected before your

federal income tax return due date (including extensions), pursuant to Internal

Revenue Code Section 408(d)(4) and IRS Publication 590. The IRS may impose a

10% early distribution penalty on the earnings if you are under age 59½. An IRS

Form 1099-R will be issued for the year in which the distribution occurred, not the

year in which the excess contribution was made. If you are subject to a federal

penalty tax due to an excess contribution, you must file IRS Form 5329.

For the purpose of the excess contribution, we will calculate the net income

attributable to that contribution (Net Income Attributable or "NIA") using the

method provided for in the IRS Final Regulations for Earnings Calculation for

Returned or Recharacterized Contributions

This method calculates the NIA based

on the actual earnings and losses of the IRA during the time it held the excess

contribution. Please note that a negative NIA is permitted and, if applicable, will be

deducted from the amount of the excess contribution.

Excess contributions (plus or minus the NIA) that are distributed by your federal

income tax return due date (including extensions) will be considered corrected,

thus avoiding an excess contribution penalty.

Page 8 of 23

Early Distributions From a Traditional IRA

Your receipt or use of any portion of your account (excluding any amount

representing a return of non-deducted contributions) before you attain age 59½

is considered an early or premature distribution. The distribution is subject to a

penalty tax equal to 10% of the distribution unless one of the following

exceptions applies to the distribution:

1. due to your death, or

2. made because you are disabled, or

3. used specifically for deductible medical expenses which exceed 7.5% of

your adjusted gross income, or

4. used for health insurance cost due to your unemployment, or

5. used for higher education expenses defined in section 529(e)(3) of the

Internal Revenue Code, or

6. used toward the expenses of a first time home purchase up to a lifetime limit

of $10,000, or

7. part of a scheduled series of substantially equal periodic payments over your

life, or over the joint life expectancy of you and a beneficiary. If you request a

distribution in the form of a series of substantially equal periodic payments,

and you modify the payments before 5 years have elapsed and before

attaining age 59½, the penalty tax will apply retroactively to the year

payments began through the year of such modification, or

8. required because of an IRS levy, or

9. the distribution is a Qualified Reservist Distribution.

The 10% penalty tax is in addition to any federal income tax that is owed at

distribution. For more information on the 10% penalty tax and the exceptions

listed above, consult IRS Publication 590. If you are subject to a federal penalty

tax due to a premature distribution, you must file IRS Form 5329.

Required Distributions from a Traditional IRA

You are required to begin receiving minimum distributions from your IRA by your

required beginning date (April 1 of the year following the year you attain age

72). The year you attain age 72 is referred to as your "first distribution calendar

year". Your required minimum distribution for each year, beginning with the

calendar year you attain age 72, is generally based upon the value of your

account at the end of the prior year divided by the factor for your age (derived

from the IRS Uniform Lifetime Distribution Period Table). This table assumes you

have a designated spouse beneficiary exactly 10 years younger than you.

However, if your spouse is your sole beneficiary and is more than 10 years younger

than you, your required minimum distribution for each year is based upon the joint

life expectancies of you and your spouse. The account balance that is used to

determine each year's required minimum distribution amount is the prior year end

fair market value (value as of December 31

), adjusted for outstanding rollovers,

transfers and recharacterizations (that relate to a conversion or failed conversion

made in the prior year). You are responsible for notifying the Custodian of any

outstanding amounts.

If the amount distributed during a taxable year is less than the minimum amount

required to be distributed, you will be subject to a penalty tax equal to 50% of the

difference between the amount distributed and the amount required to be

distributed. You are responsible for monitoring this schedule from year to year to

make sure that you are withdrawing the required minimum amount. If you are

subject to a federal penalty tax due to a missed required minimum distribution,

you must file IRS Form 5329.

However, no payment will be made from this IRA until you provide the Custodian

with a proper distribution request acceptable by the Custodian. Upon receipt of

such distribution request, you may switch to a joint life expectancy in determining

the required minimum distribution if your spouse was your sole beneficiary, as of

the January 1

of the calendar year that contains your required beginning date,

and such spouse is more than 10 years younger than you. The required minimum

distribution for the second distribution calendar year and for each subsequent

distribution calendar year must be made by December 31 of each such year.

required minimum distribution election form is available from the Custodian.

Traditional IRA Distribution Due to Death

If, prior to your death, you have not started to take your required distributions and

you properly designated a beneficiary(ies), the entire value of your IRA must be

distributed to your beneficiaries within five years after your death, unless the

designated beneficiary elects in writing, no later than September 30

of the year

following the year in which you die, to take distributions over their life expectancy.

These distributions must commence no later than December 31

of the calendar

year following the calendar year of your death. However, if your spouse is your sole

beneficiary, these distributions are not required to commence until the December

of the calendar year you would have attained age 72, if that date is later than

the required commencement date in the previous sentence. If you die before your

required beginning date and you do not have a designated beneficiary, the

balance in your IRA must be distributed no later than the December 31

of the

calendar year that contains the fifth anniversary of your death.

If you die on or after your required beginning date and you have a designated

beneficiary, the balance in your IRA will be distributed to your beneficiary over the

beneficiary's single life expectancy. These distributions must commence no later

than December 31

of the calendar year following the calendar year of your death.

If you die on or after your required beginning date and you do not have a designated

beneficiary, the balance in your IRA must be distributed over a period that does not

exceed your remaining single life expectancy determined in the year of your death.

However, the required minimum distribution for the calendar year that contains the

date of your death is still required to be distributed. Such amount is determined as

if you were still alive throughout that year. If your spouse is your sole beneficiary,

your spouse may elect to treat your IRA as their own IRA, whether you die before or

after your required beginning date. If you die after your required beginning date and

your spouse elects to treat your IRA as his or her own IRA, any required minimum

that has not been distributed for the year of your death must still be distributed to

your surviving spouse and then the remaining balance can be treated as your

spouse's own IRA. After your death, your designated beneficiary may name a

subsequent beneficiary. Any subsequent beneficiaries must take distributions at

least as frequently as the original designated beneficiary. If you do not properly

designate a beneficiary, or all designated beneficiaries have predeceased you, your

spouse shall become the beneficiary or, if no surviving spouse or unmarried, the

distribution will be made to your estate.

Traditional IRA – IRS Approved Form

Your traditional IRA is the Internal Revenue Service's model custodial account

contained in IRS Form 5305-A. Certain additions have been made in Article VIII of

the form. By following the form, your traditional IRA meets the requirements of the

Internal Revenue Code. However, the IRS has not endorsed the merits of the

investments allowed under the IRA. Form 5305-A may also be used by qualifying

employers in conjunction with Form 5305-SEP to establish a Simplified

Employee Pension plan (SEP) on behalf of employees. If your IRA is part of a SEP,

details regarding the plan should also be provided by your employer. IRS Form

5305-A cannot be used in connection with SIMPLE or Roth IRAs or Coverdell

Education Savings Accounts.

Page 9 of 23

Roth IRA

Disclosure Statement

You have opened a Roth Individual Retirement Account (Roth IRA), which is an

account for the exclusive benefit of you and your beneficiaries, created by a

written instrument (the Custodial Account Agreement). The following

requirements apply to your Roth IRA:

1. Contributions, transfers and rollovers may be made only in "cash" by check,

draft, or other form acceptable to the Custodian.

2. The Custodian must be a bank, trust company, savings and loan association,

credit union or a person who is approved to act in such capacity by the

Secretary of the Treasury.

3. No part may be invested in life insurance contracts.

4. Your interest must be nonforfeitable.

5. The assets of the custodial account may not be mixed with other property

except in a common investment fund.

6. There is no age limit on contributions as long as you have earned income.

7. Your adjusted gross income must be within the eligibility limits.

8. There are no mandatory withdrawals during your lifetime.

Roth IRA Eligibility

You are permitted to make a regular contribution to your Roth IRA for any taxable

year if you receive compensation for such taxable year. Compensation includes

salaries, wages, tips, commissions, bonuses, alimony, royalties from creative

efforts and “earned income” in the case of self-employment. Contributions can

continue to be made to a Roth IRA at any age as long as the requirements of

earned income are met.

There is a phase-out of eligibility to make a Roth IRA contribution if your adjusted

gross income is between certain levels. These limits may be adjusted from time to

time by the Internal Revenue Service.

Roth IRA Income Tax Deduction

Your contribution to a Roth IRA is not deductible on your federal income tax return.

Restriction on Indirect (60-Day) Rollovers