Form 5305-RA (Rev. 3-2002) Page 2
2. The custodian agrees to submit to the IRS and depositor the reports prescribed by the IRS.
Article VII
Notwithstanding any other articles which may be added or incorporated, the provisions of Articles I through IV and this
sentence will be controlling. Any additional articles inconsistent with section 408A, the related regulations, and other published
guidance will be invalid.
Article VIII
This agreement will be amended as necessary to comply with the provisions of the Code, the related regulations, and other
published guidance. Other amendments may be made with the consent of the persons whose signatures appear below.
Article IX
Article IX may be used for any additional provisions. If no other provisions will be added, draw a line through this space. If
provisions are added, they must comply with applicable requirements of state law and the Internal Revenue Code.
Depositor’s signature Date
Custodian’s signature Date
Witness’ signature
(Use only if signature of the depositor or the custodian is required to be witnessed.)
Date
General Instructions
Section references are to the Internal
Revenue Code unless otherwise noted.
Purpose of Form
Form 5305-RA is a model custodial
account agreement that meets the
requirements of section 408A and has
been pre-approved by the IRS. A Roth
individual retirement account (Roth IRA)
is established after the form is fully
executed by both the individual
(depositor) and the custodian. This
account must be created in the United
States for the exclusive benefit of the
depositor and his or her beneficiaries.
Do not file Form 5305-RA with the
IRS. Instead, keep it with your records.
Unlike contributions to traditional
individual retirement arrangements,
contributions to a Roth IRA are not
deductible from the depositor’s gross
income; and distributions after 5 years
that are made when the depositor is
59
1
⁄2 years of age or older or on account
of death, disability, or the purchase of a
home by a first-time homebuyer (limited
to $10,000), are not includible in gross
income. For more information on Roth
IRAs, including the required disclosures
the custodian must give the depositor,
see Pub. 590, Individual Retirement
Arrangements (IRAs).
Definitions
IRA Conversion Contributions. IRA
Conversion Contributions are amounts
rolled over, transferred, or considered
transferred from a nonRoth IRA to a
Roth IRA. A nonRoth IRA is an individual
retirement account or annuity described
in section 408(a) or 408(b), other than a
Roth IRA.
Custodian. The custodian must be a
bank or savings and loan association, as
defined in section 408(n), or any person
who has the approval of the IRS to act
as custodian.
Depositor. The depositor is the person
who establishes the custodial account.
Specific Instructions
Article I. The depositor may be subject
to a 6% tax on excess contributions if
(1) contributions to other individual
retirement arrangements of the depositor
have been made for the same tax year,
(2) the depositor’s adjusted gross
income exceeds the applicable limits in
Article II for the tax year, or
(3) the depositor’s and spouse’s
compensation is less than the amount
contributed by or on behalf of them for
the tax year. The depositor should see
the disclosure statement or Pub. 590 for
more information.
Article V. This article describes how
distributions will be made from the Roth
IRA after the depositor’s death. Elections
made pursuant to this article should be
reviewed periodically to ensure they
correspond to the depositor’s intent.
Under paragraph 3 of Article V, the
depositor’s spouse is treated as the
owner of the Roth IRA upon the death of
the depositor, rather than as the
beneficiary. If the spouse is to be treated
as the beneficiary, and not the owner, an
overriding provision should be added to
Article IX.
Article IX. Article IX and any that follow
it may incorporate additional provisions
that are agreed to by the depositor and
custodian to complete the agreement.
They may include, for example,
definitions, investment powers, voting
rights, exculpatory provisions,
amendment and termination, removal of
the custodian, custodian’s fees, state
law requirements, beginning date of
distributions, accepting only cash,
treatment of excess contributions,
prohibited transactions with the
depositor, etc. Attach additional pages if
necessary.
Form 5305-RA (Rev. 3-2002)