Fill - TreasuryDirect Redemption and Bank Change Request (Department of the Treasury

FS Form 5512 Department of the Treasury | Bureau of the Fiscal Service 1

OMB No. 1530-0071 FS Form 5512 (Revised February 2021)

TreasuryDirect® Redemption and

Bank Change Request

IMPORTANT: Follow instructions in filling out this form. Making any false, fictitious, or fraudulent claim or statement to the United States is a crime and

may be prosecuted. Print in ink or type all information.

Use this form to redeem savings bonds or add (or edit) bank information in your TreasuryDirect account.

1. TREASURYDIRECT ACCOUNT INFORMATION

reasuryDirect Account Number: _________________________________________

reasuryDirect Account Name: _____________________________________________________________________

Taxpayer Identification Number (SSN or EIN): _______________________________________________

2. REDEEM EE OR I SAVINGS BONDS AND/OR C OF I

Complete a separate copy of this section (section 2) for each separate redemption request and/or if the number of savings

bonds to be redeemed is more than can be described in the space provided.

I request redemption of the following EE or I savings bonds held in TreasuryDirect.

Description of Savings Bonds to be redeemed (select one box):

Redeem ALL my savings bonds listed in the requested TreasuryDirect account.

Redeem only the savings bonds listed below by confirmation number:

Confirmation numbers

___________________ ___________________ ___________________ ___________________

_______

____________ ___________________ ___________________ ___________________

_______

____________ ___________________ ___________________ ___________________

Check if redeeming C of I to the extent of $ ________________________.

Payee information:

Name: __________________________________________________________________________________

______________________________________ or __________________________________________

(Social Security Number of Payee) (Employer Identification Number of Payee)

Direct Deposit instructions – I request that the proceeds from the redemption be deposited to:

_______

_________________________________________________________________________________

(Name(s) on the Bank Account)

Bank Routing No. (nine digits): _______________________________

_______

__________________________________ Type of Account

Checking Savings

(Depositor’s Account No.)

_______

____________________________________________ ______________________________

(Financial Institution’s Name) (Financial Institution’s Phone No.)

RESET

For official use only: Customer Name

Case or SR#

Customer No

FS Form 5512 Department of the Treasury | Bureau of the Fiscal Service 2

3. ADD (EDIT) BANK INFORMATION

Provide the bank account you want added to your TreasuryDirect account(s). If you want to edit any bank account

information already listed in your TreasuryDirect account(s), such as correcting an account or routing number, complete all

of the following fields as if you were adding a new bank account. We will add all of the information as a new bank account.

You can then access your TreasuryDirect account and delete the unwanted bank account.

Please add the following bank information to my TreasuryDirect account:

Bank Name: ______________________________________________________________

Bank Routing No. (nine digits): _____________________

Account Number: _________________________________________ Type of Account Checking Savings

Name(s) on Account: _________________________________________________________________________________

Make this my Primary Bank information for purchases and payments.

______________________________________ or __________________________________________

(Social Security Number of Payee) (Employer Identification Number of Payee)

Select one: Please apply this information to all of my TreasuryDirect accounts.

Please apply this information to the TreasuryDirect accounts listed below (these can be Primary,

Custom, Conversion, or Minor Linked accounts):

________________________ ________________________ ________________________

Complete the following if you want to add another bank to your TreasuryDirect account:

Bank Name: ______________________________________________________________

Bank Routing No. (nine digits): _____________________

Account Number: _________________________________________ Type of Account Checking Savings

Name(s) on Account: _________________________________________________________________________________

You will receive an e-mail once we have added the bank account(s) to your TreasuryDirect account.

IMPORTANT NOTICES

• Only original signatures will be accepted (stamped signatures are not acceptable).

• If you are a corporation with a governing body, a resolution or a FS Form 1010 must accompany this form.

• If any person signing this form is acting in a fiduciary capacity, failure to provide legal evidence may delay processing.

• This form will not be accepted with alterations or corrections.

KEEP PAGE 6 OF THIS FORM FOR REFERENCE

It contains instructions for

• deleting an unwanted bank account

• changing the source of funds on pending purchases

• changing the payment destination for interest and/or maturity payments

FS Form 5512 Department of the Treasury | Bureau of the Fiscal Service 3

4. SIGNATURES AND CERTIFICATIONS

Under penalties of perjury, I certify that the information provided on this form is true, correct, and complete. I certify that I

have the authority to authorize financial transactions using the bank information described on this form. I agree to indemnify

and hold the United States harmless in the event of any loss that results from this request.

Sign in ink in the presence of a certifying officer and provide the requested information. Notary certification is not acceptable.

Instructions to Certifying Officer: 1. Name(s) of the person(s) who appeared and date of appearance MUST be completed.

2. If a Medallion stamp is used, an original signature is required. 3. Person(s) must sign in your presence.

Sign

Here: __________________________________________________________________________________________________

_____________________________________________________ ______________________________________________

(Print Name) (Social Security Number)

Home Address ________________________________________ ______________________________________________

(Number and Street or Rural Route) (Daytime Telephone Number)

_____________________________________________________ ______________________________________________

(City) (State) (ZIP Code) (E-mail Address)

Sign

Here: __________________________________________________________________________________________________

_____________________________________________________ ______________________________________________

(Print Name) (Social Security Number)

Home Address ________________________________________ ______________________________________________

(Number and Street or Rural Route) (Daytime Telephone Number)

_____________________________________________________ ______________________________________________

(City) (State) (ZIP Code) (E-mail Address)

I CERTIFY that ______________________________________________________________________________ , whose identity(ies)

(Names of Persons Who Appeared)

is/are known or proven to me, personally appeared before me this _________________ day of _______________ __________

(Month) (Year)

at _________________________________________________________ and signed this form.

(City, State)

___________________________

_____________________________

(Signature and Title of Certifying Officer)

________________________________________________________

(Name of Financial Institution)

___________________________

_____________________________

(Address)

___________________________

_____________________________

(City, State, ZIP code)

___________________________

_____________________________

(Telephone)

(Signature)

FS Form 5512 Department of the Treasury | Bureau of the Fiscal Service 4

INSTRUCTIONS

1. TREASURYDIRECT ACCOUNT INFORMATION

Provide the requested information.

2. REDEEM EE OR I SAVINGS BONDS AND/OR C OF I

Description of Savings Bonds – Check either the box to redeem all savings bonds or the box to redeem only some of

your savings bonds. If you are redeeming only some, list the confirmation number for each savings bond you are asking us

to redeem. Check the third box if you want to redeem your C of I, and state the amount you want to redeem.

Payee Information – Furnish the name and taxpayer identification number of the payee. Furnish the Social Security

Number if the payee is an Individual. If payment is being requested to an estate or trust and the IRS has assigned an

Employer Identification Number, provide that number.

Direct Deposit Instructions – Furnish information on the bank account where the payment is to be direct-deposited. All

payments must be made by direct deposit to a designated bank account.

All persons requesting redemption must sign in Part 4 of the form. If payment is to be deposited to a bank account in the

name of a different person, then that person or his or her representative, who can authorize such a deposit, must also sign in

Part 4.

3. ADD (EDIT) BANK INFORMATION

Provide the complete bank information as it should appear. The account must be at a U.S. depository financial institution

that will accept debits and credits using the Automated Clearing House method of payment.

• Bank Name – Show the name of the financial institution.

• Routing Number – Show your financial institution's ABA identifying number. This is the routing/transit number that

identifies the institution. You may need to contact the financial institution to obtain this number.

• Account Number – Show the account number at your financial institution.

• Account Type – Mark the appropriate box to indicate whether the account is "checking" or "savings."

• Name(s) on Account – Show the name or names as they appear on the account at your financial institution.

Mark the box if the bank added is to be your Primary Bank for purchases and payments. A Primary Bank appears first on

the bank information list and in the drop-down boxes throughout TreasuryDirect.

Identify other TreasuryDirect accounts to which you want to apply the bank information.

Complete the fields at the bottom of the section to add another bank.

I CERTIFY that ______________________________________________________________________________ , whose identity(ies)

(Names of Persons Who Appeared)

is/are known or proven to me, personally appeared before me this _________________ day of _______________ __________

(Month) (Year)

at _________________________________________________________ and signed this form.

(City, State)

________________________________________________________

(Signature and Title of Certifying Officer)

________________________________________________________

(Name of Financial Institution)

________________________________________________________

(Address)

________________________________________________________

(City, State, ZIP code)

________________________________________________________

(Telephone)

FS Form 5512 Department of the Treasury | Bureau of the Fiscal Service 5

4. SIGNATURES AND CERTIFICATIONS

The account owner or account manager must appear before and establish identification to the satisfaction of an authorized

certifying officer and sign the application in the officer's presence. The officer must then complete the certification form

provided and imprint the seal or stamp required in certifying requests. For certifications within the United States, the

certifying officer must be authorized to bind his or her institution by his or her acts and guarantee signatures to assignments

of securities or certify assignments of securities. Certification by a notary isn’t acceptable.

If you are a parent of a minor account owner, your signature certifies that you are requesting the transaction on the minor’s

behalf, for the minor’s benefit.

Acceptable seals and stamps:

• The financial

institution’s official seal or stamp, including: Signature Guaranteed seal or stamp; Endorsement

Guaranteed seal or stamp; Corporate seal or stamp (a corporate resolution isn’t required); or Issuing or paying agent

seal or stamp (including name, location, and four-digit identification number or nine-digit routing number).

• The seal or stamp of Treasury-recognized Signature Guarantee Programs or other Treasury-

approved Medallion

Programs.

Sample

certification for a financial institution:

Acceptable certification for a brokerage:

SIGNATURE GUARANTEED

ABC National Bank

Hillview Branch

SIGNATURE GUARANTEED

MEDALLION GUARANTEED

Generic Brokerage

Authorized Signature

XXXXXXXX

SECURITIES TRANSFER AGENTS MEDALLION PROGRAM

[Bar Code]

Additional Evidence – The Commissioner of the Fiscal Service, as designee of the Secretary of the Treasury, reserves the

right, in any particular case, to require the submission of additional evidence.

Where To Send – Send the form, as well as any other forms and evidence, to:

Treasury Retail Securities Services

PO Box 7015

Minneapolis, MN 55480-7015

Legal evidence or documentation you submit cannot be returned.

NOTICE UNDER PRIVACY ACT AND PAPERWORK REDUCTION ACT

The collection of the information you are requested to provide on this form is authorized by 31 U.S.C. CH. 31 relating to the

public debt of the United States. The furnishing of a Social Security Number, if requested, is also required by Section 6109

of the Internal Revenue Code (26 U.S.C. 6109).

The purpose of requesting the information is to enable the Bureau of the Fiscal Service and its agents to issue securities,

process transactions, make payments, identify owners and their accounts, and provide reports to the Internal Revenue

Service. Furnishing the information is voluntary; however, without the information, the Fiscal Service may be unable to

process transactions.

Information concerning securities holdings and transactions is considered confidential under Treasury regulations (31 CFR,

Part 323) and the Privacy Act. This information may be disclosed to a law enforcement agency for investigation purposes;

courts and counsel for litigation purposes; others entitled to distribution or payment; agents and contractors to administer

the public debt; agencies or entities for debt collection or to obtain current addresses for payment; agencies through

approved computer matches; Congressional offices in response to an inquiry by the individual to whom the record pertains;

as otherwise authorized by law or regulation.

We estimate it will take you about 10 minutes to complete this form. However, you are not required to provide information

requested unless a valid OMB control number is displayed on the form. Any comments or suggestions regarding this form

should be sent to the Bureau of the Fiscal Service, Forms Management Officer, Parkersburg, WV 26106-1328. DO NOT

SEND the completed form to this address; send to the address shown in "Where To Send" in the instructions.

FS Form 5512 Department of the Treasury | Bureau of the Fiscal Service 6

INSTRUCTIONS YOU MAY NEED FOLLOWING THE ADDITION OF A BANK ACCOUNT

--KEEP THIS PAGE FOR FUTURE REFERENCE--

Adding a bank account to your TreasuryDirect account is only that—the addition of a bank account. It does not delete any

previously entered bank accounts nor does it change the source of funds for pending purchases or the destination for

interest and/or maturity payments. After we add a bank account to your TreasuryDirect account, you may need to do one or

more of the following:

• Delete a Bank Account – You can access your TreasuryDirect account and delete any bank as long as it is not the

Primary Bank. If you would like us to designate a different bank already listed in your TreasuryDirect account as your

Primary Bank, e-mail us by clicking the Contact Us link in your TreasuryDirect account.

• Change the Source of Funds for Pending Purchases – You may change the source of funds on pending

purchases by accessing your TreasuryDirect account and deleting the previous bank. The system will then prompt

you to choose a bank from a drop-down list. If you do not wish to delete the previous bank, you can change the

source of funds by deleting the purchases and re-scheduling them using another bank.

• Change the Payment Destination for Interest & Maturity Payments (Treasury Bills, Notes, Bonds, Floating

Rate Notes, and TIPS) – You may change the interest and/or maturity payment destination(s) to a different bank by

accessing your TreasuryDirect account and deleting the previous bank. The system will then prompt you to choose

a bank from a drop-down list. If you do not wish to delete the previous bank, you can change the payment

destination(s) by clicking the Edit Payment Destination button on the Current Holdings Detail page for each security.

HOW A CLOSED BOOK PERIOD CAN AFFECT YOUR REQUEST

Four business days prior to a scheduled interest and/or maturity payment, TreasuryDirect imposes a Closed Book Period

that locks applicable marketable securities so we can schedule upcoming payments. This rule applies to interest payments,

maturity payments, and reinvestments for bills, notes, bonds, Floating Rate Notes, and TIPS.

TreasuryDirect's Closed Book Period starts at 12:00 midnight Eastern Time on the fourth business day prior to the

security's interest payment date and/or final maturity date, and it ends at 12:00 midnight Eastern Time on the interest

payment/maturity date.

TreasuryDirect will not allow the following during the Closed Book Period:

• Changes to registration

• Changes to the payment destination

• Changes to View/Transact Rights

• Internal and external transfers

• Changes to reinvestments

If the security is in a Closed Book Period because of maturity of the security, any online transactions scheduled but not

processed will be cancelled. If the security is simply paying interest, the scheduled transactions will be processed as soon

as the security is out of the Closed Book Period.

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