Mutual Fund Account Transfer Form (Non-IRAs only)

Transcription

1 Prudential Mutual Fund Services LLC Mutual Fund Account Transfer Form (Non-IRAs only) For assistance: Clients: (800) Financial Professionals: (888) Pruco Financial Professionals: (800) What to do to submit your Transfer of Asset request: 1. Decide You can use this form to request these types of transfers: Transfer of Assets If you want to liquidate and transfer the account proceeds from another institution to PMFS, complete section 3 and the other sections that apply to your request. Transfer-in-Kind If you want to transfer existing PGIM Investments mutual funds and change the custodian to Prudential Trust Company, complete section 4 and the other sections that apply to your request. 2. Complete Read the attached instructions carefully before completing this form. Please provide all requested information in each section to ensure your request is processed in a timely manner. 3. Return Send us your completed form. Return form to: Regular mail Prudential Mutual Fund Services LLC P.O. Box 9658 Providence, RI Express mail Prudential Mutual Fund Services LLC 4400 Computer Drive Westborough, MA 01581

2 1. About You (Please attach only one account type.) If this is for a new PGIM Investments account, you can leave the account number field below blank. PMFS account number Social Security number First name Middle initial Last name Entity name (if applicable) Street Address City State ZIP Code Home phone Mobile phone address 2. About the Account You are Transferring to PMFS A. Sending Institution Information Name of institution/employer-sponsored retirement plan Attention Street address City State ZIP Code Contact name Contact phone B. Account number(s) to be transferred Account number Account number Account number MF1019 Ed. 6/2018 page 1 of 5

3 3. Transfer of Assets All liquidations are done immediately unless special instructions are provided below. A. Liquidate All $ (estimated value) Partial % or $ B. Special instructions for CDs and certain annuity contracts Transfer immediately. I am aware of and acknowledge any penalty I may incur from an early withdrawal. Transfer at maturity (month, day, year): / / (Please submit 4 weeks prior to maturity date.) 4. Transfer-in-Kind Complete this section only if you have existing PGIM Investments mutual funds and want to change your current Trustee/Custodian. Transfer my funds in kind immediately. All Partial $ 5. Mutual Fund Selection and Allocation I am opening a new account and have attached a completed application. Allocation instructions are included in section 4 of my new account application. For this transfer request, invest the amount received into my existing account(s) (indicated in section 1) in the funds and allocations listed below. Note: All allocations by percentage must total 100%. Fund Name Fund Number Share Class Percent or Amount MF1019 Ed. 6/2018 page 2 of 5

4 6. Authorization I authorize the institution designated in section 2 to redeem/transfer-in-kind my account and transfer the proceeds to Prudential Mutual Fund Services LLC (PMFS). I am aware of and acknowledge that penalties may be incurred from early/ late withdrawal. All account owners who are authorized parties must sign below. Attach an additional sheet if necessary. X Account owner s signature Date (mm/dd/yyyy) X Account owner s signature (if applicable) Date (mm/dd/yyyy) Important: If you are acting on behalf of the account owner, please indicate the capacity in which you are acting by checking the appropriate box below. If the correct box is not listed, please check Other and specify your capacity. Appointee under POA Other, please specify Place medallion signature guarantee here 7. Financial Professional Identification and Signature (if applicable) Financial professional s name (first name, MI, last name) (Please print.) Financial professional s signature X Broker/Dealer s name (Please print.) Broker/Dealer number Branch/Agency number Rep./Contract number Branch telephone number Alternate telephone number MF1019 Ed. 6/2018 page 3 of 5

5 Prudential Mutual Fund Services LLC Instructions & Disclosures For assistance: Clients: (800) Pruco Financial Professionals: (800) Financial Professionals: (888) About You Use this form to request a transfer of assets or transfer in kind from another institution to Prudential Mutual Fund Services LLC (PMFS). Complete a separate transfer form for each sending institution. Include a copy of your most recent account statement with this form. Note: Prudential Mutual Fund Services LLC cannot accept stock certificates. Once we receive your transfer request and confirm that it is in good order, we will send a letter to your current institution requesting that the assets be sent to PMFS. Please follow up with your current institution to determine the time frame for transferring your account to PMFS. Also, check with the resigning institution about any financial penalties, suspensions, medallion signature guarantee, federal and state tax withholding elections or other restrictions that could affect the account proceeds that are being transferred to PMFS. If the account you are liquidating is subject to federal and state tax withholdings, then we suggest that you attach a letter of instruction to provide your withholding election for the resigning institution. About the Account(s) You are Transferring to PMFS Indicate the type of account and account number that you currently own which you would like the resigning institution to liquidate or transfer to PMFS. Also, provide the name and address of the financial institution or employer-sponsored retirement plan from which the account will be liquidated or transferred. Transfer of Assets This section must only be completed if you own assets (other than PGIM Investments Mutual Funds) and you want the proceeds to be liquidated and transferred to PMFS. Also, indicate any special instructions about when your account at the resigning institution should be liquidated. Transfer-in-Kind This section should only be completed if you own existing PGIM Investments mutual funds and want to change your current Trustee/ Institution to PMFS. If you own shares of PGIM Investments mutual funds, those shares will not be liquidated. PMFS Account Type State the type of account you want the proceeds to be invested in at PMFS. MF1019 Ed. 6/2018 page 4 of 5

6 Mutual Fund Selection and Allocation If you are opening a new account, attach a completed new account application and we will follow the allocation instructions indicated on your application. You do not need to provide separate allocation instructions in this section of this form. If the transfer proceeds will be invested into an existing account, indicate in this section the fund(s) and the amount that should be allocated to each fund. Note: All allocations by percentage must total 100%. Refer to the fund s prospectus for the fund minimum and other important information about the fund(s) you have selected. Authorization Some resigning custodians require a medallion signature guarantee in order to transfer your account proceeds to PMFS. Please have your signature medallion guaranteed in this section if your current custodian requires a medallion signature. MF1019 Ed. 6/2018 page 5 of 5