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APP13581-08
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©2019 Charles Schwab & Co., Inc. All rights reserved. Member SIPC.
CC2211955 (1018-8P9E) APP13581-08 (08/19)
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List all securities to be transferred, in order of preference. Schwab will transfer securities in order of preference; however, actual amounts of securities
transferred may vary in order to satisfy the total amount of the recharacterization or excess. Additional securities should be listed on a separate sheet.
1. Name of Security # of Shares 2. Name of Security
# of Shares
or $ Amount or $ Amount
3. Name of Security # of Shares 4. Name of Security
# of Shares
or $ Amount or $ Amount
5. Name of Security
# of Shares
6. Name of Security
# of Shares
or $ Amount or $ Amount
8. Tax Withholding Election
This section is only required for the removal of excess contribution requests.
Distributions from your IRA (excluding those from Roth IRAs) are generally subject to federal (and possibly state) income tax. Even if you elect in writing
not to have federal and/or state income tax withheld, you are liable for payment of federal and state income taxes, if applicable, on the taxable portion
of your distribution. You may also be subject to tax penalties under the estimated tax payment rules if your withholding and payment of estimated tax, if
any, are not adequate. For more information, see IRS Publication 590-B.
Your tax withholding election will remain in effect on all distributions from this IRA until you change or revoke it. You may change or revoke your tax
withholding election at any time by submitting your request to Schwab.
Note:
• U.S. citizens who are foreign residents are subject to a 10% minimum withholding rate and cannot opt out of withholding.
• Non-resident aliens are subject to a 30% tax withholding rate and must submit a valid IRS Form W-8BEN to obtain an available reduced tax treaty rate.
• Generally, Roth IRA distributions are not taxable. Unless you have an existing election on le or elect to withhold on this form, we will not withhold
taxes from your Roth IRA distribution.
A. Federal Income Tax Withholding: Schwab is required to withhold 10% from your gross distribution for payment of federal income tax unless you
choose not to have federal income tax withheld. You may elect not to have withholding apply to your distribution by selecting the option below, and
signing and dating this form. If you elect not to have withholding apply to your distribution, or if you do not have enough tax withheld, you may be
responsible for payment of estimated taxes. You may also incur penalties under the estimated tax rules if your withholding and estimated tax payments
are not sufcient.
Choose one:
I do not want federal income tax withheld.
I want federal income tax withheld at the rate of
______________
%.
(Federal tax withholding must be a whole number, at least 10%, and not more than
99% when combined with state income tax withholding.)
Percentage
B. State Income Tax Withholding: State income tax withholding from your distribution may be required. In some cases, you may elect not to have
withholding apply, or you may elect to increase the rate of withholding. In other cases, state income tax withholding may not be available. Refer to the
State Income Tax Withholding Information sheet for specic information concerning your state’s withholding rates.
While Schwab makes every effort to obtain information about state tax laws from sources believed to be reliable, Schwab cannot guarantee the accuracy
or timeliness of state tax withholding information because state tax laws are subject to constant change and interpretation. We recommend that you
contact your tax advisor regarding your tax withholding elections and to answer any questions that you may have.
If you do not make an election, Schwab will apply withholding (if required) at the minimum rate based on the laws for your state of residency as
determined by the legal address of record on your account.
Choose one:
I do not want state income tax withheld.
I want state income tax withheld at the rate of
______________
%.
(State tax withholding must be at least your state’s minimum tax rate and not
more than 99% when combined with federal income tax withholding.)
Percentage
Note: If you move between states with different withholding laws, Schwab will apply withholding (if required) at the rate you have provided above or at
the minimum rate based on the laws for your new state of residency, whichever is greater.
7. Assets to Transfer or Distribute (Continued)
ST