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FAX, MAIL, UPLOAD 866-699-0563 Fax Horsham, PA 19044 (Ally Bank)
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Ally Bank

PO Box 951

Horsham, PA 19044

Fax

Subject Line: Operations

Fax Number: 866-699-2969

Ally Bank Member FDIC

QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM

UPDATED 09/2019

IRA ACCOUNT APPLICATION

Product Type Selection

IRA ONLINE SAVINGS ACCOUNT IRA HIGH YIELD 9-MONTH CD

IRA HIGH YIELD 3-MONTH CD IRA HIGH YIELD 3-YEAR CD

IRA RAISE YOUR RATE 2-YEAR CD IRA HIGH YIELD 12-MONTH CD

IRA HIGH YIELD 6-MONTH CD IRA HIGH YIELD 5-YEAR CD

IRA RAISE YOUR RATE 4-YEAR CD IRA HIGH YIELD 18-MONTH CD

TOTAL

Product Type

Special Instructions:

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$ $

Applicant Information

To help the United States government ﬁght terrorism and money laundering, federal law requires us to obtain, verify, and record information that identiﬁes

each person who opens an account. What this means for you: when you open an account, we will ask for your name, a street address, date of birth, and

an identiﬁcation number, such as a Social Security number. We may also ask to see your driver’s license or other identifying documents that will allow us

to identify you.

You authorize us to contact you by using any telephone number you provide to us, including a mobile or cell phone number that you are authorized to

use. In addition to manual calling, we may use text messages, prerecorded or artiﬁcial voice messages, or automatic dialing systems. We will not charge

you for any contact, but your mobile phone service provider may.

If you have a freeze on your credit as a feature of credit security monitoring, we may contact you to lift the freeze temporarily to verify your identity.

We only open accounts for legal U.S. residents. By signing and submitting this application, you are acknowledging that you are a U.S. citizen or resident

alien of the U.S.

Check all that apply:

I am a legal U.S. Resident

I am an existing Ally Bank account owner and would like to use my information already on ﬁle. (Complete only Name, Social Security Number, and

Date of Birth information below.)

FIRST NAME M.I. LAST NAME / SUFFIX SOCIAL SECURITY

DATE OF BIRTH

EMAIL ADDRESS PERSONAL PHONE WORK PHONE (OPTIONAL)

RESIDENTIAL STREET ADDRESS (NO PO BOXES) MAILING STREET ADDRESS (IF DIFFERENT THAN RESIDENTIAL)

RESIDENTIAL ADDRESS LINE 2 (OPTIONAL)

RESIDENTIAL CITY MAILING CITYSTATE STATEZIP ZIP

MAILING ADDRESS LINE 2 (OPTIONAL)

OCCUPATION EMPLOYER

Ally Bank Member FDIC

QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM

UPDATED 09/2019

IRA ACCOUNT APPLICATION

Applicant Information (continued)

Provide a prior residential address if the applicant has been at the above address for less than 5 years. In addition, provide a copy of one of the

following for address veriﬁcation: Driver’s License, state issued ID card or utility bill (not greater than 60 days).

STATE ZIPRESIDENTIAL STREET ADDRESS (NO PO BOXES) RESIDENTIAL CITY

Provide a security question with answer and mother’s maiden name that may be used to identify you when contacting us.

SECURITY QUESTION SECURITY ANSWER MOTHER’S MAIDEN NAME

Fund Account(s)

How are you planning to fund your account?

ACCOUNT NUMBER

Fund my account(s) now by using funds from an existing Ally Interest Checking, Money Market Account, Online Savings Account, or IRA Online

Savings Account (must be under the same IRA plan) on which I am the signer.

Detailed, IRA funding instructions will be provided to you in your New Account Welcome Kit.

Rollover from another retirement account

Regular contribution

Recharacterization

Transfer from an IRA from another ﬁnancial institution OR within a different IRA plan at Ally Bank

Account Agreement

By signing below, you agree that if you use and do not close your account(s) within 30 days of opening, it will constitute your agreement to the terms of

the Ally Bank Deposit Agreement that will be sent to you after your account is opened. You authorize us to obtain a consumer report from a consumer

reporting agency to verify information provided in this application or for any legitimate business purpose in connection with the Ally Bank account(s).

Acceptance of Terms and Conditions

PRIMARY ACCOUNT HOLDER’S SIGNATURE DATE

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IRA APPLICATION TO PARTICIPATE

TRADITIONAL SEP

Print your responses in the ﬁelds below, including the Spousal Consent section (if applicable).

If you have any questions regarding this form, contact a Customer Care Associate at 877-247-ALLY (2559).

IRA Owner Information

Married (including legally separated) Unmarried (single, divorced, widowed)

NAME SSN / TAX ID NUMBER DATE OF BIRTH

ADDRESS PERSONAL PHONE WORK PHONE (OPTIONAL)

CITY STATE ZIP CODE

Beneﬁcary Designation

Primary Beneﬁciary

NAME ADDRESS CITY STATE ZIP CODE

PERCENTAGE (%) DATE OF BIRTH SSN / TAX ID NUMBER RELATIONSHIP

Primary Beneﬁciary Contingent Beneﬁciary

NAME ADDRESS CITY STATE ZIP CODE

PERCENTAGE (%) DATE OF BIRTH SSN / TAX ID NUMBER RELATIONSHIP

Primary Beneﬁciary Contingent Beneﬁciary

NAME ADDRESS CITY STATE ZIP CODE

PERCENTAGE (%) DATE OF BIRTH SSN / TAX ID NUMBER RELATIONSHIP

All Primary and/or Contingent beneﬁciary allocations must equal 100% for each beneﬁciary type.

Primary Beneﬁciary Contingent Beneﬁciary

NAME ADDRESS CITY STATE ZIP CODE

PERCENTAGE (%) DATE OF BIRTH SSN / TAX ID NUMBER RELATIONSHIP

Ally Bank Member FDIC

QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM

UPDATED 09/2019

OCCUPATION EMPLOYER

Contingent Beneﬁciary

IRA APPLICATION TO PARTICIPATE

Beneﬁcary Designation (continued)

Primary Beneﬁciary Contingent Beneﬁciary

NAME ADDRESS CITY STATE ZIP CODE

PERCENTAGE (%) DATE OF BIRTH SSN / TAX ID NUMBER RELATIONSHIP

Primary Beneﬁciary Contingent Beneﬁciary

NAME ADDRESS CITY STATE ZIP CODE

PERCENTAGE (%) DATE OF BIRTH SSN / TAX ID NUMBER RELATIONSHIP

Signatures

I, the undersigned IRA Owner, hereby designate the above persons/entities as my primary and contingent beneﬁciary(ies) for this IRA Plan, payable

by reason of my death. (If a trust is a named beneﬁciary, a copy of the trust document must be provided.) If primary or contingent is not indicated, each

beneﬁciary will be designated a primary. Unless otherwise requested herein, each payment made pursuant to this designation: (a) shall be paid to the

primary beneﬁciary(ies) who are living at the time of my death; or (b) if no primary beneﬁciary(ies) shall be living at the time of my death, such payment

shall be made to the contingent beneﬁciary(ies) who are then living. I have the right to change this beneﬁciary designation at any time. If a beneﬁciary is

not properly designated or if no primary or contingent beneﬁciary survives the IRA owner, payments shall be made to my surviving spouse or, if I do not

have a surviving spouse, to my estate.

I certify that the information provided by me is true, complete and accurate, and that I have received a copy of the Application to Participate, Custodial

Account Agreement and Disclosure Statement, Financial Disclosure and the Deposit Account Agreement (collectively the “Documents”). I have read the

Documents and agree to be bound by their terms and conditions. I understand that the designation of the tax year for my contribution and my election to

treat a contribution as a rollover (if applicable) are irrevocable. I have not received any tax or legal advice from Ally Bank (“Custodian”) and assume sole

responsibility for all tax consequences associated with my contributions and distributions, determining that I am eligible for all IRA deposits (contributions,

transfers or rollovers) to this IRA, and ensuring that such deposits are in compliance with all tax laws. I will seek the advice of my tax professional when

appropriate. I understand that within seven (7) days from the date I open this IRA I may revoke it without penalty as described in the Documents. I will

not, nor will my spouse, heir, beneﬁciaries, or any other party, hold the Custodian liable for any adverse consequences that may result from my actions

or designations. I release the Custodian and agree to hold the Custodian harmless against any and all claims and situations arising from actions taken

by me.

SIGNATURE OF IRA OWNER DATE

Ally Bank Member FDIC

QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM

UPDATED 09/2019

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IRA APPLICATION TO PARTICIPATE

Spousal Consent

For use in community/marital property states AZ, CA, ID, LA, NV, NM, TX, WA, WI (marital property state)

and AK (a married couple can make a community property election)

IRA OWNER

I am married. I understand that if I want to name a primary beneﬁciary other than my spouse, my spouse’s notarized signature appears below.

I am not married. I understand that if I become married in the future, I must complete an IRA Change of Beneﬁciary form which includes spousal

consent documentation.

IRA OWNER SPOUSE (IF APPLICABLE)

I acknowledge and agree that my spouse, the IRA Owner, has and will name a primary beneﬁciary or a percentage of less than 100% to someone other

than me for the IRA Plan noted above. By signing below, I transfer any and all interest I may have in this IRA Plan to my spouse, the IRA owner.

I agree to seek the advice of a legal or tax professional, as needed.

SIGNATURE OF SPOUSE DATE

State of

County of

The foregoing Spousal Consent was signed and acknowledged before me this day of , 20

by .

Sworn to and subscribed before me this day of ,

Notary Public:

My commission expires:

Ally Bank Member FDIC

QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM

UPDATED 09/2019

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signature

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Introduction

The Depositor named on the Application to Participate is establishing a Traditional Individual

Retirement Account under section 408(a) to provide for his or her retirement and for the support of

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ARTICLE I

Except in the case of a rollover contribution described in section 402(c), 403(a)(4), 403(b)(8),

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ARTICLE II

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ARTICLE III

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ARTICLE IV

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2. The Depositor’s entire interest in the custodial account must be, or begin to be, distributed not

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HQGRIWKHFDOHQGDU\HDUIROORZLQJWKH\HDURIWKH'HSRVLWRUVGHDWK,IKRZHYHUWKH

GHVLJQDWHGEHQH¿FLDU\LVWKH'HSRVLWRUVVXUYLYLQJVSRXVHWKHQWKLVGLVWULEXWLRQLVQRW

UHTXLUHGWREHJLQEHIRUHWKHHQGRIWKHFDOHQGDU\HDULQZKLFKWKH'HSRVLWRUZRXOGKDYH

UHDFKHGDJHò%XWLQVXFKFDVHLIWKH'HSRVLWRUVVXUYLYLQJVSRXVHGLHVEHIRUH

GLVWULEXWLRQVDUHUHTXLUHGWREHJLQWKHQWKHUHPDLQLQJLQWHUHVWZLOOEHGLVWULEXWHGLQ

DFFRUGDQFHZLWKSDUDJUDSKDLLDERYHEXWQRWRYHUWKHSHULRGLQSDUDJUDSKDLLL

HYHQLIORQJHURYHUVXFKVSRXVHVGHVLJQDWHGEHQH¿FLDU\VOLIHH[SHFWDQF\RULQDF

FRUGDQFHZLWKSDUDJUDSKLLEHORZLIWKHUHLVQRVXFKGHVLJQDWHGEHQH¿FLDU\

(ii) 7KHUHPDLQLQJLQWHUHVWZLOOEHGLVWULEXWHGE\WKHHQGRIWKHFDOHQGDU\HDUFRQWDLQLQJ

WKH¿IWKDQQLYHUVDU\RIWKH'HSRVLWRU¶VGHDWK

4.,IWKH'HSRVLWRUGLHVEHIRUHKLVRUKHUHQWLUHLQWHUHVWKDVEHHQGLVWULEXWHGDQGLIWKHGHVLJQDWHGEHQH¿

FLDU\LVQRWWKH'HSRVLWRUVVXUYLYLQJVSRXVHQRDGGLWLRQDOFRQWULEXWLRQVPD\EHDFFHSWHGLQWKHDFFRXQW

5.7KHPLQLPXPDPRXQWWKDWPXVWEHGLVWULEXWHGHDFK\HDUEHJLQQLQJZLWKWKH\HDUFRQWDLQLQJ

WKH 'HSRVLWRUV UHTXLUHG EHJLQQLQJ GDWH LV NQRZQ DV WKH UHTXLUHG PLQLPXP GLVWULEXWLRQ DQG LV

Traditional Individual Retirement Custodial Account

(Under section 408(a) of the Internal Revenue Code)

General Instructions

6HFWLRQUHIHUHQFHVDUH WRWKH ,QWHUQDO5HYHQXH &RGHXQOHVV RWK

HUZLVHQRWHG

Purpose of Form

)RUP$LVDPRGHOFXVWRGLDODFFRXQWDJUHHPHQWWKDWPHHWVWKH

UHTXLUHPHQWVRIVHFWLRQD+RZHYHURQO\$UWLFOHV,WKURXJK9,,

KDYHEHHQUHYLHZHGE\WKH,56$7UDGLWLRQDO,QGLYLGXDO5HWLUHPHQW

$FFRXQW7UDGLWLRQDO,5$LVHVWDEOLVKHGDIWHUWKHIRUPLVIXOO\H[

HFXWHGE\ERWKWKHLQGLYLGXDO'HSRVLWRUDQGWKH&XVWRGLDQ7RPDNH

DUHJXODUFRQWULEXWLRQWRD7UDGLWLRQDO,5$IRUD\HDUWKH,5$PXVWEH

established no later than the due date of the individual’s income tax

UHWXUQIRUWKHWD[\HDUH[FOXGLQJH[WHQVLRQV7KLVDFFRXQWPXVWEH

FUHDWHGLQWKH8QLWHG6WDWHVIRUWKHH[FOXVLYHEHQH¿WRIWKH'HSRVLWRU

DQGKLVRUKHUEHQH¿FLDULHV

Do not ¿OH )RUP $ ZLWK WKH ,56 ,QVWHDG NHHS LW ZLWK

\RXUUHFRUGV

GHWHUPLQHGDVIROORZV

(a)

7KHUHTXLUHGPLQLPXPGLVWULEXWLRQXQGHUSDUDJUDSKEIRUDQ\\HDUEHJLQQLQJZLWKWKH\HDU

WKH'HSRVLWRUUHDFKHV DJHòLV WKH'HSRVLWRUV DFFRXQWYDOXHDW WKHFORVHRIEXVLQHVVRQ

'HFHPEHURIWKHSUHFHGLQJ\HDUGLYLGHGE\WKHGLVWULEXWLRQSHULRGLQWKHXQLIRUPOLIHWLPH

WDEOHLQ5HJXODWLRQVVHFWLRQD+RZHYHULIWKH'HSRVLWRUVGHVLJQDWHGEHQH¿FLDU\

LVKLVRUKHUVXUYLYLQJVSRXVHWKHUHTXLUHGPLQLPXPGLVWULEXWLRQIRUD\HDUVKDOOQRWEHPRUH

WKDQWKH'HSRVLWRUVDFFRXQWYDOXHDWWKHFORVHRIEXVLQHVVRQ'HFHPEHURIWKHSUHFHGLQJ\HDU

GLYLGHGE\WKHQXPEHULQWKHMRLQWDQGODVWVXUYLYRUWDEOHLQ5HJXODWLRQVVHFWLRQD

7KHUHTXLUHGPLQLPXPGLVWULEXWLRQIRUD\HDUXQGHUWKLVSDUDJUDSKDLVGHWHUPLQHGXVLQJWKH

'HSRVLWRUVRULIDSSOLFDEOHWKH'HSRVLWRUDQGVSRXVHVDWWDLQHGDJHRUDJHVLQWKH\HDU

(b)

7KHUHTXLUHGPLQLPXPGLVWULEXWLRQXQGHUSDUDJUDSKVDDQGELIRUD\HDUEHJLQQLQJZLWK

WKH\HDUIROORZLQJWKH\HDURIWKH'HSRVLWRUVGHDWKRUWKH\HDUWKH'HSRVLWRUZRXOGKDYHUHDFKHG

age 70½, if applicable under paragraph 3(b)(i)) is the account value at the close of business on

'HFHPEHURIWKHSUHFHGLQJ\HDUGLYLGHGE\WKHOLIHH[SHFWDQF\LQWKHVLQJOHOLIHWDEOHLQ

5HJXODWLRQVVHFWLRQDRIWKHLQGLYLGXDOVSHFL¿HGLQSDUDJUDSKVDDQGEL

(c) 7KHUHTXLUHGPLQLPXPGLVWULEXWLRQIRUWKH\HDUWKHGHSRVLWRUUHDFKHVDJHòFDQEHPDGH

DVODWHDV$SULORIWKHIROORZLQJ\HDU7KHUHTXLUHGPLQLPXPGLVWULEXWLRQIRUDQ\RWKHU\HDU

PXVWEHPDGHE\WKHHQGRIVXFK\HDU

6.7KHRZQHURIWZRRUPRUH7UDGLWLRQDO,5$VPD\VDWLVI\WKHPLQLPXPGLVWULEXWLRQUHTXLUHPHQWV

GHVFULEHGDERYHE\WDNLQJIURPRQH7UDGLWLRQDO,5$WKHDPRXQWUHTXLUHGWRVDWLVI\WKHUHTXLUHPHQW

IRUDQRWKHULQDFFRUGDQFHZLWKWKHUHJXODWLRQVXQGHUVHFWLRQD

ARTICLE V

1.7KH'HSRVLWRUDJUHHVWRSURYLGHWKH&XVWRGLDQZLWKDOOLQIRUPDWLRQQHFHVVDU\WRSUHSDUHDQ\

UHSRUWVUHTXLUHGE\VHFWLRQLDQG5HJXODWLRQVVHFWLRQVDQG

2.7KH&XVWRGLDQDJUHHVWRVXEPLWWRWKH,QWHUQDO5HYHQXH6HUYLFH,56DQG'HSRVLWRUWKHUHSRUWV

SUHVFULEHGE\WKH,56

ARTICLE VI

1RWZLWKVWDQGLQJDQ\RWKHUDUWLFOHVZKLFKPD\EHDGGHGRULQFRUSRUDWHGWKHSURYLVLRQVRI$UWLFOHV

,WKURXJK,,,DQGWKLVVHQWHQFHZLOOEHFRQWUROOLQJ$Q\DGGLWLRQDODUWLFOHVLQFRQVLVWHQWZLWKVHFWLRQ

DDQGWKHUHODWHGUHJXODWLRQVZLOOEHLQYDOLG

ARTICLE VII

7KLVDJUHHPHQWZLOOEHDPHQGHGDVQHFHVVDU\WRFRPSO\ZLWKWKHSURYLVLRQVRIWKH&RGHDQGWKH

UHODWHGUHJXODWLRQV2WKHUDPHQGPHQWVPD\EHPDGHZLWKWKHFRQVHQWRIWKHSHUVRQVZKRVHVLJQDWXUHV

DSSHDURQWKH$SSOLFDWLRQWR3DUWLFLSDWH

ARTICLE VIII

1. Amendments—7KH&XVWRGLDQKDVWKHULJKWWRDPHQGWKLV&XVWRGLDO$JUHHPHQWDWDQ\WLPHWR

FRPSO\ZLWKQHFHVVDU\ODZVDQGUHJXODWLRQVZLWKRXWWKHFRQVHQWRIWKH'HSRVLWRU6XFKDPHQGPHQWV

PD\EHPDGHUHWURDFWLYHO\WRFRPSO\ZLWKVWDWXWRU\RUUHJXODWRU\FKDQJHV7KH&XVWRGLDQDOVRKDV

WKHULJKWWRDPHQGWKLV&XVWRGLDO$JUHHPHQWIRUDQ\RWKHUUHDVRQ7KH'HSRVLWRULVGHHPHGWRKDYH

DXWRPDWLFDOO\FRQVHQWHGWRDQ\DPHQGPHQWXQOHVVWKH'HSRVLWRUQRWL¿HVWKH&XVWRGLDQLQZULWLQJ

WKDWWKH'HSRVLWRUGRHVQRWFRQVHQWWRWKHDPHQGPHQWZLWKLQGD\VDIWHUWKH&XVWRGLDQPDLOVDFRS\

RIWKHDPHQGPHQWWRWKH'HSRVLWRU

2. Responsibilities—The &XVWRGLDQVKDOOUHFHLYHDOOFRQWULEXWLRQVVKDOOPDNHGLVWULEXWLRQVDQG

SD\EHQH¿WVIURPWKHFXVWRGLDODFFRXQWVKDOO¿OHVXFKVWDWHPHQWVRUUHSRUWVDVPD\EHUHTXLUHGDQG

GRRWKHUWKLQJVDVPD\EHUHTXLUHGRID7UDGLWLRQDO,5$FXVWRGLDQ,IDSSOLFDEOHDQGXQOHVVRWKHUZLVH

VSHFL¿HGE\WKH'HSRVLWRUKLVVSRXVHRUKLVEHQH¿FLDULHVWKH&XVWRGLDQDWLWVVROHGLVFUHWLRQIURP

WLPHWRWLPHVKDOOFDVWDQ\YRWHVWKDWPD\EHDWWULEXWDEOHWRWKH'HSRVLWRU¶VLQWHUHVWXQGHUWKLVDJUHH

PHQW7KH&XVWRGLDQVKDOOXVHUHDVRQDEOHFDUHVNLOOSUXGHQFHDQGGLOLJHQFHLQWKHDGPLQLVWUDWLRQDQG

LQYHVWPHQWRIWKHFXVWRGLDODFFRXQWDQGLQH[HFXWLQJDQ\ZULWWHQLQVWUXFWLRQVE\WKH'HSRVLWRUDQG

VKDOOEHHQWLWOHGWRUHO\RQLQIRUPDWLRQVXEPLWWHGE\WKH'HSRVLWRU7KH&XVWRGLDQVKDOOKDYHQRGXWLHV

XQGHUWKLVDJUHHPHQWDQGQRUHVSRQVLELOLW\IRUWKHDGPLQLVWUDWLRQRIWKHFXVWRGLDODFFRXQWH[FHSWIRU

VXFKGXWLHVLPSRVHGE\ODZRUWKLVDJUHHPHQW7KH&XVWRGLDQLVDXWKRUL]HGWRLQYHVWDOORUSDUWRIWKH

SODQ¶VDVVHWVLQGHSRVLWVRIWKH¿QDQFLDORUJDQL]DWLRQDFWLQJDV&XVWRGLDQRIWKLV7UDGLWLRQDO,5$7KH

&XVWRGLDQKDVQRUHVSRQVLELOLW\RUGXW\WRGHWHUPLQHZKHWKHUFRQWULEXWLRQVWRRUGLVWULEXWLRQVIURP

WKLV,5$FRPSO\ ZLWKWKHODZV RUUHJXODWLRQV RUWKLV&XVWRGLDO$JUHHPHQW7KH&XVWRGLDQ LVQRW

UHVSRQVLEOHIRUWLPHO\SD\LQJWKHUHTXLUHGPLQLPXPGLVWULEXWLRQ,IWKH&XVWRGLDQIDLOVWRHQIRUFHDQ\

RIWKHSURYLVLRQVRIWKLV$JUHHPHQWVXFKIDLOXUHVKDOOQRWEHFRQVWUXHGDVDZDLYHURIVXFKSURYLVLRQV

RURIWKH&XVWRGLDQVULJKWWKHUHDIWHUWRHQIRUFHHDFKDQGHYHU\VXFKSURYLVLRQ

3. Resignation, Removal and Appointment of Custodian—7KH&XVWRGLDQPD\UHVLJQDWDQ\WLPH

E\JLYLQJGD\VSULRUZULWWHQQRWLFHRIVXFKUHVLJQDWLRQWRWKH'HSRVLWRU7KH'HSRVLWRUVKDOO¿OODQ\

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tions to Individual Retirement Arrangements (IRAs), and Pub. 590-

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'H¿QLWLRQV

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Depositor. The 'HSRVLWRULVWKHSHUVRQZKRHVWDEOLVKHVWKHFXV

WRGLDODFFRXQW

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spouse must be made to a separate IRA custodial account established

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Article IV. 'LVWULEXWLRQVPDGHXQGHUWKLVDUWLFOHPD\EHPDGHLQ

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reaches age 70½ to ensure that the requirements of section 408(a)

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Article VIII.$UWLFOH9,,,DQGDQ\WKDWIROORZLWPD\LQFRUSRUDWH

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SDJHVLIQHFHVVDU\

(Rev. April 2017)

Department of the Treasury

Internal Revenue Service

Form

DO NOT File

With the Internal

Revenue Service

5305-A

Traditional Individual Retirement Custodial Account Disclosure Statement

Introduction

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pation, contributions, adjusted gross income, rollovers, correction of contributions, required

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Rollover Contributions

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Penalty for Excess Accumulations. $IWHU\RXUHDFKDJHòVWDUWLQJLQDJHRUGLH

LIWKHUHTXLUHGPLQLPXPGLVWULEXWLRQVGHVFULEHGLQWKHVHFWLRQVWLWOHG³5HTXLUHG'LVWULEXWLRQV´

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Financial Disclosure

Projection of Future Balance. The balance in an individual retirement account increases as a

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\RXU7UDGLWLRQDO,5$LIDSURMHFWLRQFDQEHUHDVRQDEO\PDGHThese amounts are projections only

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Time Deposit Account. ,I\RXUFRQWULEXWLRQVDUHLQYHVWHGLQD¿[HGWHUPWLPHGHSRVLWDFFRXQW

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Custodial Fees. 7KH&XVWRGLDQPD\FKDUJHUHDVRQDEOHIHHV IRUDGPLQLVWHULQJWKH&XVWRGLDO

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are not limited to, opening fees, administration fees, transaction fees, transfer fees, closing fees,

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IHHVDUHELOOHGGLUHFWO\WR\RX

Projection of Future Balance (Use Method 1 or Method 2)

Method 2

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ZKLFK\RXDWWDLQDJHVDQG7KHVHEDODQFHVDUHQRWJXDUDQWHHG7KHDFWXDOEDODQFHV

ZLOOGHSHQGRQPDQ\IDFWRUVLQFOXGLQJWKHLQWHUHVWUDWHVDQGWHUPVRIIXWXUHLQYHVWPHQWV7KH

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5HJXODU7UDGLWLRQDO,5$$VVXPLQJDQDQQXDOGHSRVLWPDGHRQWKH¿UVWGD\RIHDFK

\HDU

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WKH¿UVW\HDU

,QYHVWPHQWDQQXDOSHUFHQWDJH\LHOG

3HQDOW\IRUHDUO\ZLWKGUDZDORILQYHVWPHQW

(QGRI\HDU



$FFRXQW9DOXH

(QGRI\HDU

\RXDWWDLQDJH

$FFRXQW9DOXH



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Account Values

Number

of Years

Number

of Years

Penalty

1-Month

Penalty

3-Month

Penalty

6-Month

Penalty

1-Month

Penalty

3-Month

Penalty

6-Month

Penalty

$1,001.00

$2,003.00

$3,006.00

$4,010.01

$5,015.02

$6,021.04

$7,028.06

$8,036.08

$9,045.12

$10,055.17

$11,066.22

$12,078.29

$13,091.37

$14,105.46

$15,120.56

$16,136.68

$17,153.82

$18,171.97

$19,191.14

$20,211.34

$21,232.55

$22,254.78

$23,278.03

$24,302.31

$25,327.62

$26,353.94

$27,381.30

$28,409.68

$29,439.09

$30,469.53

$31,501.00

$32,533.50

$33,567.03

$34,601.60

$35,637.20

$36,673.84

$37,711.51

$38,750.22

$39,789.97

$40,830.76

$41,872.59

$42,915.47

$43,959.38

$45,004.34

$46,050.34

$47,097.39

$48,145.49

$49,194.64

$50,244.83

$51,296.08

$52,348.37

$53,401.72

$1,000.92

$2,002.83

$3,005.75

$4,009.68

$5,014.60

$6,020.53

$7,027.47

$8,035.42

$9,044.37

$10,054.33

$11,065.30

$12,077.28

$13,090.28

$14,104.28

$15,119.30

$16,135.34

$17,152.39

$18,170.46

$19,189.55

$20,209.65

$21,230.78

$22,252.93

$23,276.10

$24,300.29

$25,325.51

$26,351.75

$27,379.02

$28,407.31

$29,436.64

$30,466.99

$31,498.37

$32,530.79

$33,564.24

$34,598.72

$35,634.23

$36,670.78

$37,708.37

$38,747.00

$39,786.66

$40,827.36

$41,869.11

$42,911.89

$43,955.72

$45,000.59

$46,046.51

$47,093.47

$48,141.48

$49,190.54

$50,240.65

$51,291.81

$52,344.02

$53,397.28

$1,000.75

$2,002.50

$3,005.25

$4,009.01

$5,013.77

$6,019.53

$7,026.30

$8,034.08

$9,042.86

$10,052.65

$11,063.46

$12,075.27

$13,088.10

$14,101.93

$15,116.79

$16,132.65

$17,149.53

$18,167.43

$19,186.35

$20,206.29

$21,227.24

$22,249.22

$23,272.22

$24,296.24

$25,321.29

$26,347.36

$27,374.46

$28,402.58

$29,431.74

$30,461.92

$31,493.13

$32,525.37

$33,558.65

$34,592.96

$35,628.30

$36,664.68

$37,702.09

$38,740.54

$39,780.03

$40,820.56

$41,862.14

$42,904.75

$43,948.40

$44,993.10

$46,038.84

$47,085.63

$48,133.47

$49,182.35

$50,232.28

$51,283.27

$52,335.30

$53,388.38

$1,000.50

$2,002.00

$3,004.50

$4,008.01

$5,012.52

$6,018.03

$7,024.55

$8,032.07

$9,040.60

$10,050.14

$11,060.69

$12,072.25

$13,084.83

$14,098.41

$15,113.01

$16,128.62

$17,145.25

$18,162.90

$19,181.56

$20,201.24

$21,221.94

$22,243.66

$23,266.41

$24,290.17

$25,314.96

$26,340.78

$27,367.62

$28,395.49

$29,424.38

$30,454.31

$31,485.26

$32,517.25

$33,550.26

$34,584.31

$35,619.40

$36,655.52

$37,692.67

$38,730.87

$39,770.10

$40,810.37

$41,851.68

$42,894.03

$43,937.42

$44,981.86

$46,027.34

$47,073.87

$48,121.44

$49,170.07

$50,219.74

$51,270.45

$52,322.23

$53,375.05

$1,001.00

$1,002.00

$1,003.00

$1,004.01

$1,005.01

$1,006.02

$1,007.02

$1,008.03

$1,009.04

$1,010.05

$1,011.06

$1,012.07

$1,013.08

$1,014.09

$1,015.11

$1,016.12

$1,017.14

$1,018.15

$1,019.17

$1,020.19

$1,021.21

$1,022.23

$1,023.25

$1,024.28

$1,025.30

$1,026.33

$1,027.35

$1,028.38

$1,029.41

$1,030.44

$1,031.47

$1,032.50

$1,033.53

$1,034.57

$1,035.60

$1,036.64

$1,037.67

$1,038.71

$1,039.75

$1,040.79

$1,041.83

$1,042.87

$1,043.92

$1,044.96

$1,046.00

$1,047.05

$1,048.10

$1,049.15

$1,050.19

$1,051.24

$1,052.30

$1,053.35

$1,000.92

$1,001.92

$1,002.92

$1,003.92

$1,004.93

$1,005.93

$1,006.94

$1,007.94

$1,008.95

$1,009.96

$1,010.97

$1,011.98

$1,012.99

$1,014.01

$1,015.02

$1,016.04

$1,017.05

$1,018.07

$1,019.09

$1,020.11

$1,021.13

$1,022.15

$1,023.17

$1,024.19

$1,025.22

$1,026.24

$1,027.27

$1,028.30

$1,029.32

$1,030.35

$1,031.38

$1,032.42

$1,033.45

$1,034.48

$1,035.52

$1,036.55

$1,037.59

$1,038.63

$1,039.66

$1,040.70

$1,041.74

$1,042.79

$1,043.83

$1,044.87

$1,045.92

$1,046.96

$1,048.01

$1,049.06

$1,050.11

$1,051.16

$1,052.21

$1,053.26

$1,000.75

$1,001.75

$1,002.75

$1,003.76

$1,004.76

$1,005.76

$1,006.77

$1,007.78

$1,008.78

$1,009.79

$1,010.80

$1,011.81

$1,012.83

$1,013.84

$1,014.85

$1,015.87

$1,016.88

$1,017.90

$1,018.92

$1,019.94

$1,020.96

$1,021.98

$1,023.00

$1,024.02

$1,025.05

$1,026.07

$1,027.10

$1,028.12

$1,029.15

$1,030.18

$1,031.21

$1,032.24

$1,033.28

$1,034.31

$1,035.34

$1,036.38

$1,037.41

$1,038.45

$1,039.49

$1,040.53

$1,041.57

$1,042.61

$1,043.65

$1,044.70

$1,045.74

$1,046.79

$1,047.84

$1,048.88

$1,049.93

$1,050.98

$1,052.03

$1,053.09

$1,000.50

$1,001.50

$1,002.50

$1,003.50

$1,004.51

$1,005.51

$1,006.52

$1,007.52

$1,008.53

$1,009.54

$1,010.55

$1,011.56

$1,012.57

$1,013.58

$1,014.60

$1,015.61

$1,016.63

$1,017.65

$1,018.66

$1,019.68

$1,020.70

$1,021.72

$1,022.74

$1,023.77

$1,024.79

$1,025.81

$1,026.84

$1,027.87

$1,028.90

$1,029.92

$1,030.95

$1,031.99

$1,033.02

$1,034.05

$1,035.08

$1,036.12

$1,037.16

$1,038.19

$1,039.23

$1,040.27

$1,041.31

$1,042.35

$1,043.39

$1,044.44

$1,045.48

$1,046.53

$1,047.57

$1,048.62

$1,049.67

$1,050.72

$1,051.77

$1,052.82

Method 1

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Rollover Traditional IRA Projection

Zs͘ϭϮͬϮϬϭϵ

ΞϮϬϭϵWDEŽĐŽƉǇƌŝŐŚƚĐůĂŝŵŝƐďĞŝŶŐŵĂĚĞƚŽƚŚĞh͘^͘ŐŽǀĞƌŶŵĞŶƚǁŽƌŬ͕/ŶƚĞƌŶĂůZĞǀĞŶƵĞ^ĞƌǀŝĐĞ&ŽƌŵϱϯϬϱͲ͘

Ally Bank Member FDIC

Version 1.5. Last revised on 06/14/2011

Addendum to the Traditional and SEP IRA Custodial Account Disclosure Statement

Right to Revoke

You are entitled to revoke your Traditional IRA Plan for any reason within seven (7) calendar days after your

Traditional IRA Plan is opened. You must revoke by providing us with written notice, by mailing to: Ally Bank,

P.O. Box 951, Horsham, PA 19044. Your notice is considered mailed on the date of the postmark. It must be

placed in the U.S. Mail, first-class postage prepaid. If you successfully revoke, you are entitled to the amount of the

original contribution, without interest. If you have questions about your right to revoke, please call us at 1-877-247-

ALLY (2559).

Tax and Legal Advice

Ally Bank does not provide tax or legal advice or interpret how tax rules affect your individual situation. You

should contact a qualified tax professional before you make any decision regarding IRAs.

Combining IRA Contributions

If you make contributions to other IRAs or Roth IRAs during the same tax year, all of your contributions are

combined for the purposes of the annual contribution limits.

Determining Deductibility of Contributions

You are responsible for managing which parts of your contributions may or may not be deductible. Ally Bank is not

obligated to check whether your management of the deductibility of your contributions is correct and is also not

responsible for reporting whether your contributions are deductible to any person or entity. Once contributed,

regardless of the deductibility of the contribution, all earnings on contributions to your Traditional IRA Plan will be

tax-deferred.

Designation of Beneficiary

You may designate a beneficiary or beneficiaries of your IRA on the form provided by Ally Bank. If you do not

designate a beneficiary or if no primary or contingent designated beneficiary survives you, payments from your IRA

shall be made to your surviving spouse or, if you do not have a surviving spouse, to your estate.

Limits on Recharacterizations

You may not revoke your election to recharacterize a contribution after a transfer. Employer contributions under a

Simplified Employee Pension (SEP) cannot be recharacterized.

Successor Custodian or Trustee

Upon your request or the request of a successor custodian or trustee on your behalf, Ally Bank will distribute to you

for rollover or transfer directly to the successor trustee or custodian all or any portion of the assets of your

Traditional IRA Plan. You are responsible for following the rule that permits only one rollover every 12 months.

When the distribution or rollover is completed, Ally Bank is released from all further responsibility for your

Traditional IRA Plan. We cannot determine or help you determine whether all or a portion of the assets of your

Traditional IRA Plan are eligible to be rolled over to a qualified employer retirement plan.

Creditor Claims

Depending upon the particular facts and circumstances of each situation, and subject to applicable state law, your

Traditional IRA Plan may be subject to the claims of creditors. Ally Bank will not assert defenses on your behalf as

against such creditors. You should consult with your legal advisor for guidance regarding the law that is applicable

to your situation.

Ally Bank Member FDIC

Version 1.5. Last revised on 06/14/2011

Timing of Distributions

You may request to have your Traditional IRA Plan balance distributed in a single sum, monthly, quarterly, semi-

annual or in annual payments over a period you choose. Even if distributions have begun, you may at any time give

superseding instructions to receive a distribution of all or a portion of your Traditional IRA Plan balance.

Reporting of Distributions

We report all distributions on Form 1099-R. But, we will report distributions used to pay for expenses, listed here,

as regular or early distributions, depending upon your age at the time of distribution: 1) medical expenses exceeding

7.5% of your adjusted gross income; 2) health insurance premiums when you have been unemployed and have

received state or federal unemployment compensation for at least 12 weeks; 3) qualified higher education expenses;

or 4) qualified first time home purchases, subject to the $10,000 lifetime limit. It is solely your responsibility to file

documentation supporting the reasons for such distributions with the IRS.

Responsibility for Required Minimum Distributions (RMD)

You are responsible for taking your yearly RMD according to the RMD rules. If you ask us in writing and provide

the necessary information, we will calculate the RMD and make distributions according to your instructions. If you

do not provide us with instructions, we will not distribute any funds. We will assume that you are satisfying the

RMD rules by taking distributions from other Traditional IRAs. We will not be liable in any way (including, but not

limited to, any excise taxes or penalties) for your failure to take an RMD from your Traditional IRA Plan.

Reports

Under your Traditional IRA Plan, we will provide reports to you and the proper taxing authorities as required by

law. You must furnish us with any information that may be required in connection with the preparation of such

reports. If you have objections to any such report, you have 60 days after the date of the report’s postmark to

submit, in writing, details on any matter contained in or omitted from such report. After the 60-day period you are

deemed to have approved the report, and we are released from liability to anyone, including you and your

beneficiaries, with respect to the content of the report.

Special Rules applicable to SEPs:

SEP IRA Contributions

Only employer contributions are allowed to be made to our SEP IRAs. Your individual contributions are not

allowed.

Limits on Rollovers and Transfers

Rollovers and transfers into our SEP IRAs are not allowed.

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Completed 30 July 2020

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