$ Retirement or [X] 2b Taxable amount. 7 Distribution. . rrnsep/ 8 Other copy to your return. code(s) SIKJLE. distribution. .!... J,n?..,QQ...MPJ.
|
|
- Clara Williamson
- 5 years ago
- Views:
Transcription
1 CORRECTE (if checked) - PAYER'S name. street address. city or town, state or province, country, and Gross distribution OMB No istributions From ZP or foreign postal code Pensions, Annuities, 3, CHARLES SCHWAB & CO., NC. $ Retirement or!2 4 2 MAN STREET 2a Taxable amount Profit-Sharing Plans, RAs, nsurance SAN FRANCSCO CA 9405 $ 3, Form 099-R Contracts etc b Taxable amount [X] Total not determined distribution 0 Copy B PAYER'S federal identification number RECPENT'S identification number 3 Capital gain (included 4 Federal income tax Report this income in box2a) ***-* withheld on your federal tax $ $, return. f this form RECPENT'S name, street address (including apt. no.), city or town, state or province. 6 Net unrealizad appreciation shows federal country, and ZP or foreign postal code 5.i.'::&t:r,;, n employefs securities income tax withheld s $ in box 4, attach this CHARLES SCHWAB & CO NC CUST 7 istribution. rrnsep/ 8 Other copy to your return RA ROLLOVER code(s) SKJLE $ % This information is being furnished to 9a Your percentage of total 9b Total employee the nternal WALORF, M distribution contributions % $ Revenue Service. 0 Amount allocable to RR st year of desig. Roth conlrib. 2 Stale tax withheld 3 State/Payes state no. 4 Slate distribution within 5 years.!... J,n?..,QQ......MPJ..?? $ s s Account number (see instructions) 5 local tax withheld 6 Name of locality 7 Local distribution $... G J '"w'"'''''''''''''''''''"''''''''''''''''''"''w'''''''"'''''''"'"'_'_,, Form 099-R 099r epartment of the Treasury - nternal Revenue Service,
2 2/27/ R Codes for Box R Codes for Box 7 Answer ocument 0 0/23/204 07:52AM,,.!'Used Published 02/07/204 0:54 AM Updated p...,..., r,.,,...,...,,, CJ,-----, se Code only if the employee/taxpayer has not reached age 59 /2, and arly distribution, o known xception rou do not know if any of the exceptions under Code 2, 3, or 4 apply. Use pode even if the distribution is made for medical expenses, health -- with )applicable) 'nsurance premiums, qualified higher education expenses, a first-time home L purchase, or a qualified reservist distribution under section 72(t)(2)(B), (), ' ' ' ' ' r P E), (F), or (G). Code must also be used even if a taxpayer is 59 /2 or older! nd he or she modifies a series of substantially equal periodic payments nder section 72(q), (t), or (v) prior to the end of the 5-year period which began! L j ith the first payment.,-----, Use Code 2 only if the employee/taxpayer has not reached age 59 /2 and :=== ou know the distribution is: 2 arly distribution, xception applies A Roth RA conversion (an RA converted to a Roth RA). A distribution made from a qualified retirement plan or RA because of an RS levy under section 633. A section 457(b) plan distribution that is not subject to the additional 0% tax. See Section 457(b) plan distributions on page 2 of the RS instructions for Form 099-R for information on distributions that may be subject to the 0% additional tax. A distribution from a qualified retirement plan after separation from service in or after the year the taxpayer has reached age 55. A distribution from a governmental defined benefit plan to a public safety employee after separation from service in or after the year the employee has reached age 50. A distribution that is part of a series of substantially equal periodic payments as described in section 72(q), (t), (u), or (v). A distribution that is a permissible withdrawal under an eligible automatic contribution arrangement (EACA). Any other distribution subject to an exception under section 72(q), (t), (u), or (v) that is not required to be reported using Code, 3, or 4. t 8 8,, or L j===i=================;:== pisability \for these purposes, see section 72(m)(7). i p Code 4 regardless of the age of the employee/taxpayer to indicate ayment to a decedent's beneficiary, including an estate or trust. Also use it eath. or death benefit payments made by an employer but not made as part of a ension, profit-sharing, or retirement plan. :== se A, 8,, H, L, or rohibited se Code 5 if there was a prohibited transaction involving the account. Code one means the account is no longer an RA. ection 035 se Code 6 to indicate the tax-free exchange of life insurance, annuity, longerm care insurance, or endowment contracts under section 035.,,-----, se Code 7: (a) for a normal distribution from a plan, including a traditional ormal RA, section 40(k), or section 403(b) plan, if the employee/ taxpayer is at east age 59 /2, (b) for a Roth RA conversion if the participant is at least ge 59 /2, and (c) to report a distribution from a life insurance, annuity, or ndowment contract and for reporting income from a failed life insurance ontract under sections 7702(g) and (h). See Rev. Proc , /4
3 : 227/ R Codes for Box 7 " 7 istribution.r.b. 60, available at RB/ar9.html. Generally, la B, or se Code 7 if no other code applies. o not use Code 7 for a Roth RA. ote: Code must be used even if a taxpayer is 59 2 or older and he or he modifies a series of substantially equal periodic payments under section 72(q), (t). or (v) prior to the end of the 5-year period which began with the first ==================================================== 8 '----J xcess.. se Code 8 for an RA distribution under section 408(d)(4), unless Code P ontnbutlons plus :. pplies. Also use this code for corrective distributions of excess deferrals, amingslexcess, 2, 4, B, xcess contributions, and excess aggregate contributions, unless Code P, eferrals (and/or r J pplies. See Corrective istributions and RA Revocation or Account Closure amings) taxable n the RS instructions for Form 099-R for more information. n 203.;ost of current se Code 9 to report premiums paid by a trustee or custodian for current life E ife insurance pr other insurance protection. See the instructions for box 2a in the RS one protection nstructions for Form 099-R for more information. r,---, i se Code A only for participants born before January 2, 936, or their ;====; A '----J neficiaries to indicate the distribution may be eligible for the 0-year tax ay be eligible fo pption method of computing the tax on lump-sum distributions (on Form 4972, la J'f or 7 0-year tax option ax on Lump-Sum istributions). To determine whether the distribution may, eligible for the tax option, you need not consider whether the recipient usedl his method (or capital gain treatment) in the past. Roth se Code B for a distribution from a designated Roth account. But use Code. 2, 4, 7, esignated account for a section 45 distribution under EPCRS (see Code E) or Code H for a. G, L, P, distribution irect rollover to a Roth RA. pr U,---, Annuity payments rom nonqualified nnuities and istributions from.. se Code for a distribution from any plan or arrangement not described in fe nsurance actions 40(a). 403(a), 403(b), 408, 408A. or457(b). pontracts that may be subject to ax under section 4 i!, 2, 3, 4, jor7 E nder Employee. ee istributions under Employee Plans Compliance Resolutions System lans Compliance EPCRS) in the RS instructions for Form 099-R for more information. esolution ystem (EPCRS) ============================= haritable gift ee Charitable gift annuities in the RS instructions for Form 099-R for more nformation. =====::; se Code G for a direct rollover from a qualified plan, section 403(b) plan or a one ovemmental section 457(b) plan to an eligible retirement plan (another ualified plan, a section 403(b) plan, a governmental section 457(b) plan, or an pirect rollover and RA). See irect Rollovers in the RS instructions for Form 099-R for more G rollover nformation. Also use Code G for RA rollover contributions to an accepting or 8 ontribution mployer plan and for RRs. ote: o not use Code G for a direct rollover from a designated Roth account o a Roth RA. Use Code H. L. j - ==:::;,---, pirect rollover of H designated Roth ccount istribution to a se Code H for a direct rollover of a distribution from a designated Roth ccount to a Roth RA. i se.custhel p. com /applanswers/detai /a _i d/489/-/ 099-r-codes-for-box-7 :r 2/4
4 2/27/ R Codes for Box 7 t= UfothiRA J se Code J for a distribution from a Roth RA when Code Q or Code T does arty distribution B ot apply. But use Code 2 for an RS levy and Code 5 for a prohibited or P rom a Roth RA ransaction. :::se;eated as po not use Code L to report a loan offset. See Loans Treated as istributions 4 8 distributions unde n the RS instructions for Form 099-R for more information. : ' ' or ection 72(p) i echaracterized se CodeN for a recharacterization of an RA contribution made for 203 andl ' '===== RA contribution echaracterized in 203 to another type of RA by a trustee-to-trustee transfer one made for 2o3 lor with the same trustee.,...---,excess p ee the explanation for Code 8. The RS suggests that anyone using Code P r-----, pontributions plus or the refund of an RA contribution under section 408(d)(4), including excess L. ' 2, 4, B, ramings/excess oth RA contributions, advise payees, at the time the distribution is made, jorj eferrals taxable hat the earnings are taxable in the year in which the contributions were n 202 ad e. :====== se Code Q for a distribution from a Roth RA if you know that the participant:== eets the 5-year holding period and: Q ualified stribution from a oth RA The participant has reached age 59 /2, The participant died, or The participant is disabled. ote: f any other code, such as 8 or P, applies, use Code J Recharacterized se CodeR for a recharacterization of an RA contribution made for 202 and! RA contribution echaracterized in 203 to another type of RA by a trustee-to-trustee transfer i one made for 202 pr with the same trustee.,...---, arty distribution! f.jse Code S only if the distribution is from a SMPLE RA in the first 2 years, F"'-'-"'-'-"--' rom a SMPLE he employee/taxpayer has not reached age 59 /2, and none of the s RAin first 2 xceptions under section 72(t) are known to apply when the distribution is ears, no known ade. The 2-year period begins on the day contributions are first deposited in.., xception he individual's SMPLE RA. o not use CodeS if Code 3 or 4 applies.,...---, se Code T for a distribution from a Roth RA if you do not know if the 5-year olding period has been met but: T oth RA stribution, xception applies The participant has reached age 59 /2, The participant died, or The participant is disabled. ote: f any other code, such as 8 or P, applies, use Code J. ========================================,...---, se Code U for a distribution of dividends from an employee stock ownership ividends plan (ESOP) under section 404(k). These are not eligible rollover distributions.j istributed from u ote: o not report dividends paid by the corporation directly to plan i n ESOP under articipants or their beneficiaries. Continue to report those dividends on Form action 404(k) 099-V. w '---- === harges or ayments for urchasing long- se Code W for charges or payments for purchasing qualified long-term care : erm care nsurance ontracts under ombined rrangements nsurance contracts under combined arrangements which are excludible underj action 72(e)() against the cash value of an annuity contract or the cash urrender value of a life insurance contract. 34
5 2/27/ R Codes for Box 7 se.custhel p.com/applanswers/detai /a _i d/489/-/ 099-r- codes-for- box-7 4/4
IRS Reporting Procedures for Tax Year 2016 Release ,
IRS Reporting Procedures for Tax Year 2016 Release - 8.3.5, 8.2.30 Summary: This document describes the required procedures for reporting tax information to the Internal Revenue Service, and for printing
More informationCaution: DRAFT NOT FOR FILING
Caution: DRAFT NOT FOR FILING This is an early release draft of an IRS tax form, instructions, or publication, which the IRS is providing for your information as a courtesy. Do not file draft forms. Also,
More informationAttention: See IRS Publications 1141, 1167, 1179 and other IRS resources for information about printing these tax forms.
Attention: This form is provided for informational purposes only. Copy A appears in red, similar to the official IRS form. Do not file copy A with the IRS. The official printed version of this IRS form
More informationInstructions for Forms 1099-R and 5498
2009 Instructions for Forms 1099-R and 5498 Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless otherwise noted. What s New Form 1099-R Airline
More information2007 Instructions for Forms 1099-R and 5498
2007 Instructions for Forms 1099-R and 5498 Section references are to the Internal Revenue Code unless otherwise noted. What s New Form 1099-R Certain qualified distributions. A TIP has been added on page
More informationALSO IN THIS ISSUE. There are two new exceptions. The IRS has issued Notice to issue temporary guidance until the IRS issues
Published Since 1984 ALSO IN THIS ISSUE January 31, 2017 Deadlines Page 3 Establishing a SEP Page 4 Important Form 1099-R Rules For An IRA Custodian To Follow and Observations Page 5 Deadline for 2016
More informationAttention: See IRS Publications 1141, 1167, 1179, and other IRS resources for information about printing these tax forms.
Attention: Do not download, print, and file Copy A with the IRS. Copy A appears in red, similar to the official IRS form, but is for informational purposes only. A penalty of 50 per information return
More informationSPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS This notice explains how you can continue to defer federal income tax on your retirement plan savings in the Plan and contains important information you will
More informationGuide To Your USAA Life Insurance Company Forms 1099-INT and 1099-R For Tax Year 2018
Guide To Your USAA Life Insurance Company Forms 1099-INT and 1099-R For Tax Year USAA is committed to providing accuracy in reporting tax information related to your life insurance and annuity contracts
More informationFP 1 B 1 1 A **5 DGT
90 FP 1 B 1 1 A 10061 10061 **5 DGT DST 2018 TAX FORMS 1099-R TRAC... CCS-23943... V5... 081018 PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone
More informationSPECIAL TAX NOTICE REGARDING PLAN PAYMENTS (For Participant) A. TYPES OF PLAN DISTRIBUTIONS
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS (For Participant) This notice explains how you can continue to defer federal income tax on your retirement plan savings in the Plan and contains important information
More informationGuide To Your USAA Life Insurance Company Forms 1099-INT and 1099-R For Tax Year 2017
Guide To Your USAA Life Insurance Company Forms 1099-INT and 1099-R For Tax Year 20 USAA is committed to providing accuracy in reporting tax information related to your life insurance and annuity contracts
More informationNORTHERN FUNDS TA X GUIDE 2O14
NORTHERN FUNDS TA X GUIDE 2O14 Contents 1 Mutual Fund Distributions 2 Forms & Statements 4 Form 1099 DIV 5 Form 1099 B 6 Form 1099 R WELCOME TO YOUR NORTHERN FUNDS TAX GUIDE To help you prepare your tax
More informationSPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS This notice explains how you can continue to defer federal income tax on your retirement plan savings in the Plan and contains important information you will
More informationDistribution Request Form. Instructions
Distribution Request Form (Applicable to Plans that do not include Annuity Distribution Options.) A Distribution Request Form must be completed, signed and returned to the Plan Administrator to request
More informationFrequently asked questions
Page 1 of 6 Frequently asked questions Distributions and rollovers from retirement accounts Choosing what to do with your retirement savings is an important decision. Tax implications are just one of several
More informationTax Special Report tax reporting issue. Tax reporting
NOT FDC NSURED NO BANK GUARANTEE MAY LOSE VALUE Tax Special Report Tax reporting 2018 tax reporting issue One easy way to maximize your earning potential is to minimize your taxes. After all, every dollar
More informationSavings Banks Employees Retirement Association
Savings Banks Employees Retirement Association IN-PLAN ROTH CONVERSION ELECTION FORM PLEASE NOTE: Your Plan must allow In-Plan Roth Rollovers Participant Name: (Please Print) Certificate No. Current Address
More informationLegends Gaming, LLC Employees 401(k) Plan
Legends Gaming, LLC Employees 401(k) Plan ON-LINE DISTRIBUTION FORMS PACKAGE To: Plan Participant From: Retirement Direct The distribution you are entitled to receive from the above Plan is an eligible
More informationFor Payments From a Designated Roth Account
For Payments From a Designated Roth Account YOUR ROLLOVER OPTIONS You are receiving this notice because all or a portion of a payment you are receiving from the [INSERT NAME OF PLAN] (the Plan ) is eligible
More informationInstructions for Completing the BB&T Corporation 401(k) Savings Plan Voluntary Withdrawal Form
Instructions for Completing the BB&T Corporation 401(k) Savings Plan Voluntary Withdrawal Form IMPORTANT: Please read the Special Tax Notices included in this distribution package before making any elections.
More informationCOLLIERS INTERNATIONAL USA, LLC And Affiliated Employers 401(K) Plan NOTICE OF DISTRIBUTION ELECTION
COLLIERS INTERNATIONAL USA, LLC And Affiliated Employers 401(K) Plan NOTICE OF DISTRIBUTION ELECTION To: (Participant) Date: As a terminated participant in the Colliers International USA, LLC and Affiliated
More information403(b) ROLLOVER OPTIONS
You are receiving this notice because all or a portion of the non-systematic distribution you are to receive from your TCA by E*TRADE account (the Plan ) is eligible to be rolled over to an IRA or an employer
More informationSpecial Tax Notice Regarding Payments YOUR ROLLOVER OPTIONS. Where may I roll over the payment?
Special Tax Notice Regarding Payments Products and financial services provided by American United Life Insurance Company a OneAmerica company One American Square, P.O. Box 368 Indianapolis, IN 46206-0368
More informationSPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS This notice explains how you can continue to defer federal income tax on your retirement plan savings in the Plan and contains important information you will
More informationInstructions: Distribution Request Form
Instructions: Distribution Request Form Before Requesting a Distribution You may wish to consult an investment or tax advisor to discuss how taking a distribution may impact your retirement savings and/or
More informationTRADITIONAL IRA DISCLOSURE STATMENT
TRADITIONAL IRA DISCLOSURE STATMENT The Traditional Individual Retirement Account ( Traditional IRA ) presented with this Disclosure Statement is a retirement plan made available to individuals. An individual
More informationIf we receive request by 4:00pm ET on a business day, the transaction will be processed on that day unless you specify a future date below:
Jefferson National Life Insurance Company Regular Delivery: P.O. Box 36750, Louisville, KY 40233 Overnight: 9920 Corporate Campus Drive, Louisville, KY 40223 P: 866.667.0561 F: 866.667.0563 PARTIAL WITHDRAWAL
More informationDistribution Election Form
IMPORTANT INFORMATION Distribution Election Form Please complete the form in its entirety. Missing pages and/or incomplete forms will delay processing. After completion, please return form to Pension Inc.
More informationEnclosure(s) # CVNR(11)TRS A 09/06/17
Dear Alternate Payee: The enclosed materials are to assist you with your request for a distribution from the Marsh & McLennan Companies 401(k) Savings & Investment Plan as an alternate payee under a Qualified
More informationWe are committed to providing accuracy in reporting tax information related to your mutual fund account(s) and help in understanding how it is used.
Guide To Your USAA Investment Management Company Forms 1099-R (mutual fund IRAs), 1099-Q (mutual fund Coverdell ESAs), USAA 529 College Savings Plan accounts and 1099-SA For Tax Year We are committed to
More informationT. Rowe Price Traditional and Roth IRA Disclosure Statement and Custodial Agreement T. Rowe Price Privacy Policy
T. Rowe Price Traditional and Roth IRA Disclosure Statement and Custodial Agreement T. Rowe Price Privacy Policy March 2018 TABLE OF CONTENTS DISCLOSURE STATEMENT Introduction 3 Section I Revocation 3
More informationT. Rowe Price Traditional and Roth IRA Disclosure Statement and Custodial Agreement T. Rowe Price Privacy Policy
T. Rowe Price Traditional and Roth IRA Disclosure Statement and Custodial Agreement T. Rowe Price Privacy Policy Effective November 2016 TABLE OF CONTENTS DISCLOSURE STATEMENT Introduction 3 Section I
More informationGovernmental 457(b) Tax-Deferred Retirement Plan Distribution Booklet. Learn about taking distributions from your plan
Governmental 457(b) Tax-Deferred Retirement Plan Distribution Booklet Learn about taking distributions from your plan Table of Contents Important Information About Distributions From Your Governmental
More informationMailing Address: P.O. Box 9394 Des Moines, IA FAX (866)
Mailing Address: P.O. Box 9394 Des Moines, IA 50306-9394 FAX (866) 704-3481 Principal Life Insurance Company Complete this form to withdraw part of your retirement funds while still employed. Participant
More informationPlease Note: Attached are two special tax notices regarding rollover options for payments from the Plan.
Please Note: Attached are two special tax notices regarding rollover options for payments from the Plan. There are two notices included because this plan allows for Roth elective deferrals. The first notice
More informationSPECIAL TAX NOTICE (For Payments From a Designated Roth Account) YOUR ROLLOVER OPTIONS
SPECIAL TAX NOTICE (For Payments From a Designated Roth Account) YOUR ROLLOVER OPTIONS You are receiving this notice because all or a portion of a payment you are receiving from your retirement plan is
More informationTRADITIONAL IRA DISCLOSURE STATEMENT
TRADITIONAL IRA DISCLOSURE STATEMENT RIGHT TO REVOKE YOUR IRA ACCOUNT The W-2 form will have a check in the "retirement plan" box if you are covered by a retirement plan. You can also obtain IRS Notice
More informationNORTHERN FUNDS TA X GUIDE 2O12
NORTHERN FUNDS TA X GUIDE 2O12 Contents 1 Mutual Fund Distributions 2 Forms & Statements 4 Form 1099 DIV 5 Form 1099 B/Cost Basis 6 Form 1099 R 7 Form 1099 Q 8 Form 5498 IRA 9 Form 5498 ESA WELCOME TO
More informationRoth Individual Retirement Account Disclosure Statement
Roth Individual Retirement Account Disclosure Statement This Disclosure Statement contains important information about traditional Individual Retirement Accounts ( traditional IRA ) described in Section
More informationYour Rollover Options For Payments Not From a Designated Roth Account
This document combines two Rollover Options notices. The first notice describes the rollover and other tax rules that apply to payments from the Plan that are not from a designated Roth account. The second
More informationParticipant Distribution Notice
Participant Distribution Notice Plan Name: CITGO Petroleum Corporation Employees' Retirement and Savings Plan Plan Number: 87084 Date Generated: October 16, 2014 The CITGO Petroleum Corporation Employees'
More informationEaton Vance 2010 Tax Guide
aton Vance 2010 Tax uide aton Vance nvestment Managers o n t e n t s aton Vance unds P.O. ox 9653 Provience, R 02940 (800) 262-1121 www.eatonvance.com 2010 orm 1099-V 2 2010 orm 1099-NT 4 2010 orm 1099-6
More informationDeath Benefit Distribution Claim Form Spousal Beneficiary
Death Benefit Distribution Claim Form Spousal Beneficiary READ THE ATTACHED IRS SPECIAL TAX NOTICE: IF THE PLAN ALLOWS FOR AN ANNUITY OPTION, READ THE WRITTEN EXPLANATION OF QUALIFIED JOINT AND 50% CONTINGENT
More informationRetirement and Savings Plan Payment Rights Notice
Retirement and Savings Plan Payment Rights Notice Federal law requires that you receive information about any rights that you may have associated with a payment from the Cummins RSP. Please review the
More informationSPECIAL TAX NOTICE REGARDING PAYMENTS FROM QUALIFIED PLANS Excerpted from IRS Notice
SPECIAL TAX NOTICE REGARDING PAYMENTS FROM QUALIFIED PLANS Excerpted from IRS Notice 2002-3 This notice explains how you can continue to defer federal income tax on your retirement savings in your Employer
More informationSPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS This Special Tax Notice Applies to Distributions from Section 401(a) Plans, Section 403(a) Annuity Plans, Section 403(b) Tax Sheltered Annuities and Section 457
More informationUSAA TRADITIONAL / ROTH IRA
USAA TRADITIONAL / ROTH Disclosure Statements and Custodial Agreements 49630-1215 Table of Contents USAA Traditional Disclosure Statement 2 USAA Roth Disclosure Statement 11 USAA Traditional Custodial
More informationTraditional Individual Retirement Account Disclosure Statement and Custodial Agreement
Traditional Individual Retirement Account Disclosure Statement and Custodial Agreement Effective November 11, 2016 Page 1 of 26 Table of Contents Section I: Disclosure Statement A. Introduction... B. Contributions
More informationWellington Retirement Solutions, Inc. HARDSHIP APPLICATION
Wellington Retirement Solutions, Inc. HARDSHIP APPLICATION Instructions: Send a copy of your completed form to the Plan Sponsor for authorization. The 1099-R for this distribution will be attached to the
More informationNational Administration Inc. APPLICATION FOR BENEFITS. Accurate. Reliable. Flexible
National Administration Inc. APPLICATION FOR BENEFITS Accurate Flexible Reliable APPLICATION FOR BENEFITS PAGE 1 OF 2 COMPANY NAME Section 1 DATE As a Participant in the above Plan, I hereby request payment
More informationInstructions for Requesting an In-Service Withdrawal
Instructions for Requesting an In-Service Withdrawal Diocese of Metuchen 403(b) Plan Enclosed are the following items needed to request an In-Service Withdrawal from your retirement plan. Please review
More information1. T YPE OF IRA ACCOUNT
INDIVIDUAL RETIREMENT ACCOUNT APPLICATION Account Number (If known) For assistance with this form, please call 1-800-635-2886 or 1-800-742-7272. Return your completed application to: William Blair Funds,
More informationThe statutory requirements for a traditional IRA, which are described in section 408(a) of the Internal Revenue Code (Code), are as follows:
Page 1 of 9 This Disclosure Statement is provided in accordance with the tax laws applicable to your individual retirement account (IRA). It provides only a summary of the rules that apply to your IRA.
More informationRollover Distribution Notice
Rollover Distribution Notice GENERAL INFORMATION This notice contains important information you need before you decide how to receive your retirement plan benefits. This notice is provided to you by your
More informationIRA Custodian Disclosure Statement and Plan Agreement
IRA Custodian Disclosure Statement and Plan Agreement Retain these pages for your records. Custodian disclosure statement The following information is provided to you by the Custodian (as specified on
More informationSPECIAL TAX NOTICE REGARDING PLAN PAYMENTS YOUR ROLLOVER OPTIONS
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS YOUR ROLLOVER OPTIONS You are receiving this notice because all or a portion of a payment you are receiving from your employer s retirement plan (the Plan ) is
More informationSpecial Tax Notice Regarding Plan Payment (the Plan )
Special Tax Notice Regarding Plan Payment (the Plan ) SUMMARY This notice explains how you can continue to defer federal income tax on your retirement savings in Plan and contains important information
More informationILWU Longshore, Ship Clerk and Walking Boss/Foreman Locals
December 22, 2016 TO: FROM: SUBJECT: ILWU Longshore, Ship Clerk and Walking Boss/Foreman Locals Jacquie Gasparro, Manager, Pension Plans INFORMATION FOR PENSIONERS Medicare Part B Premium Reimbursement
More informationRSOL-SIMPLE Custodial Account Agreement
UMB Bank, n.a. Custodian SIMPLE IRA Custodial Account Agreement Lincoln Investment Planning, LLC Agent Form 5305-SA-SIMPLE Individual Retirement Custodial Account (Rev. March 2002) Department of the Treasury,
More informationYOUR ROLLOVER OPTIONS
For Payments Not From a Designated Roth Account YOUR ROLLOVER OPTIONS You are receiving this notice because all or a portion of a payment you are receiving from the [INSERT NAME OF PLAN] (the Plan ) is
More informationThe kit contains the following material: Beneficiary and Alternate Payee Distribution Form Legal Notices Regarding Plan Benefits
The enclosed materials are to assist you with your request for a distribution from the Local No. 8 IBEW Retirement Plan and Trust as a beneficiary of a deceased participant or as an alternate payee under
More informationTAX NOTICE (For Payments Not From a Designated Roth Account)
TAX NOTICE (For Payments Not From a Designated Roth Account) YOUR ROLLOVER OPTIONS You are receiving this notice because all or a portion of a payment you are receiving from your employer s qualified retirement
More informationHILL BROTHERS CONSTRUCTION COMPANY, INC. STOCK OWNERSHIP PLAN
HILL BROTHERS CONSTRUCTION COMPANY, INC. STOCK OWNERSHIP PLAN As you may know, the Hill Brothers Construction Company, Inc. Stock Ownership Plan (the Plan ) is being terminated. As a result of the termination,
More informationQUALIFIED RETIREMENT PLAN AND 403(b)(7) CUSTODIAL ACCOUNT DISTRIBUTION REQUEST FORM
QUALIFIED RETIREMENT PLAN AND 403(b)(7) CUSTODIAL ACCOUNT DISTRIBUTION REQUEST FORM The Employee Retirement Income Security Act of 1974 (ERISA) requires that you receive the information contained in this
More informationQP/401(k) DISTRIBUTION NOTICE
QP/401(k) DISTRIBUTION NOTICE Important Information About Your Qualified Retirement Plan Distribution INTRODUCTION As a participant in your employer s qualified retirement plan, you have accumulated a
More informationROTH IRA DISCLOSURE STATMENT
ROTH IRA DISCLOSURE STATMENT The Roth Individual Retirement Account ( Roth IRA ) presented with this Disclosure Statement is a retirement plan made available to individuals. An individual who establishes
More informationYOUR ROLLOVER OPTIONS
YOUR ROLLOVER OPTIONS You are receiving this notice because all or a portion of a payment you receive from the Plan is eligible to be rolled over to an IRA or an employer plan. This notice is intended
More informationIN-PLAN ROTH CONVERSION ACCOUNT WITHDRAWAL FORM
Marsh & McLennan Companies 401(k) Savings & Investment Plan IN-PLAN ROTH CONVERSION ACCOUNT WITHDRAWAL FORM Use this form to request a withdrawal of your in-plan Roth account while you are employed. IMPORTANT.
More informationSUMMARY PLAN DESCRIPTION PIXAR Employee's 401(k) Retirement Plan
SUMMARY PLAN DESCRIPTION PIXAR Employee's 401(k) Retirement Plan This information is not intended to be a substitute for specific individualized tax, legal, or investment planning advice. Where specific
More informationDo Not Cut or Separate Forms on This Page Do Not Cut or Separate Forms on This Page
Attention: This form is provided for informational purposes only. Copy A appears in red, similar to the official IRS form. Do not file copy A downloaded from this website. The official printed version
More informationTraditional, SEP or SIMPLE IRA Distribution Form
ACCOUNT INFORMATION Your Name: Account Number: Type of IRA: [ ] Traditional IRA [ ] SEP IRA [ ] SIMPLE IRA Street Address: City: State: Zip Code: Telephone Number: Social Security Number: Date of Birth:
More informationSpecial Tax Notice For Payments From a Designated Roth Account
Special Tax Notice For Payments From a Designated Roth Account YOUR ROLLOVER OPTIONS You are receiving this notice because all or a portion of a payment you are receiving from your retirement plan is eligible
More informationSPECIAL TAX NOTICE REGARDING RETIREMENT PLAN PAYMENTS
CUNA Mutual Retirement Solutions Phone: 800.999.8786 Fax: 608.236.8017 BenefitsForYou.com SPECIAL TAX NOTICE REGARDING RETIREMENT PLAN PAYMENTS Non-Roth Accounts YOUR ROLLOVER OPTIONS You are receiving
More informationQualified DISTRIBUTION NOTICE Retirement Plan Important Information About Your Qualified Retirement Plan Distribution
Qualified DISTRIBUTION NOTICE Retirement Plan Important Information About Your Qualified Retirement Plan Distribution INTRODUCTION As a participant in your employer s qualified retirement plan, you have
More informationRoth Conversion Request Form
Roth Conversion Request Form Note: This form should only be completed after consultation with your personal tax advisor. 1. EMPLOYEE/PARTICIPANT INFORMATION Employer/Plan Name First Name MI Last Name Single
More informationINSTRUCTIONS TO REQUEST A BENEFIT PAYMENT
INSTRUCTIONS TO REQUEST A BENEFIT PAYMENT Participant 1. Read the enclosed notices, including the Notice to Terminated Participants and the Special Tax Notice Regarding Plan Payments. 2. Complete the enclosed
More informationQ 1: What is the rule regarding distributions that may be rolled over to an eligible retirement plan?
1.402(c)-2 Eligible rollover distributions; questions and answers The following questions and answers relate to the rollover rules under section 402(c) of the Internal Revenue Code of 1986, as added by
More informationThe Vanguard SIMPLE IRA Disclosure Statement
The Vanguard SIMPLE IRA Disclosure Statement This Disclosure Statement describes the general requirements of a SIMPLE IRA (Savings Incentive Match Plan for Employees of Small Employers Individual Retirement
More informationSUMMARY PLAN DESCRIPTION Standard Textile 401(k) Profit Sharing Plan
SUMMARY PLAN DESCRIPTION Standard Textile 401(k) Profit Sharing Plan This information is not intended to be a substitute for specific individualized tax, legal, or investment planning advice. Where specific
More informationS U M M A R Y P L A N D E S C R I P T I O N Marvell Semiconductor 401(k) Retirement Plan
S U M M A R Y P L A N D E S C R I P T I O N Marvell Semiconductor 401(k) Retirement Plan This information is not intended to be a substitute for specific individualized tax, legal, or investment planning
More informationSimple Individual Retirement Custodial Account Agreement
Simple Individual Retirement Custodial Account Agreement Form 5305-SA under Section 408(p) of the Internal Revenue Code FORM (Rev. April 2017) The participant named on the application is establishing a
More informationOther Taxes and Payments
Other Taxes and Payments Hint: TaxSlayer provides all the forms and schedules you need in order to figure and report these taxes, and in most cases, performs the calculations. Other Taxes 57 Self-employment
More informationCWA SAVINGS & RETIREMENT TRUST (# )
IN-SERVICE WITHDRAWAL REQUEST PARTICIPANT INFORMATION CWA SAVINGS & RETIREMENT TRUST (#990500050) Name: Social Security Number: Employer: Birth Date: Address: City/State/Zip: Country Email Address: Phone
More informationREQUEST FOR DROP/BACK-DROP DISTRIBUTION
REQUEST FOR DROP/BACK-DROP DISTRIBUTION LOUISIANA DISTRICT ATTORNEYS RETIREMENT SYSTEM 1645 NICHOLSON DRIVE BATON ROUGE, LOUISIANA 70802 (225)267-4824 IMPORTANT: Before completing this form, please read
More informationLowe s 401(k) Plan SPECIAL TAX NOTICE AND YOUR ROLLOVER OPTIONS
Lowe s 401(k) Plan SPECIAL TAX NOTICE AND YOUR ROLLOVER OPTIONS You are receiving this notice because all or a portion of a payment you are receiving from the Lowe s 401(k) Plan (the Plan ) is eligible
More informationDISTRIBUTION ELECTION FORM
DISTRIBUTION ELECTION FORM (Please Print or Type) Participant Name (Last, First) Social Security No. Mailing Address City State Zip Daytime Phone Marital Status: [ ]Married [ ]Single Reason for distribution
More informationIBEW LOCAL 269 ANNUITY FUND PO BOX 1028 TRENTON NJ Application for Benefits (Please Print or Type)
IBEW LOCAL 269 ANNUITY FUND PO BOX 1028 TRENTON NJ 08628-0230 INSTRUCTIONS: Application for Benefits (Please Print or Type) a. Read and complete all sections of this application. b. Both you and your spouse
More informationWithdrawal Instructions - Eligible for Rollover
Withdrawal Instructions - Eligible for Rollover This form should be completed if: You have been terminated from your Employer for at least sixty (60) days and want to take a distribution of your vested
More informationRoth Individual Retirement Account (Trust) Disclosure Statement
Roth Individual Retirement Account (Trust) Disclosure Statement This Disclosure Statement contains important information about traditional Individual Retirement Accounts ( traditional IRA ) described in
More informationSavings Banks Employees Retirement Association
Savings Banks Employees Retirement Association 401(k) PLAN APPLICATION FOR WITHDRAWAL AT AGE 59 1/2 Participant Name: (Please Print) Current Address (required) SS No. (City, State Zip) Employer's Name:
More informationRETIREMENT PLAN LUMP SUM PAYMENT CALCULATION EXPLANATION
RETIREMENT PLAN LUMP SUM PAYMENT CALCULATION EXPLANATION The NKCH RETIREMENT PLAN is designed to provide participants with a monthly benefit at retirement, payable for their lifetime. The benefit is determined
More informationU.S. Global Investors Mutual Funds-Forms 1099R and 1099Q Guide for Tax Year 2009
U.S. Global Investors Funds U.S. Global Investors Mutual Funds-Forms 1099R and 1099Q Guide for Tax Year 2009 U.S. Global Investors is committed to providing accuracy in reporting tax information related
More informationTAX NOTICE (For Payments Not From a Designated Roth Account)
402(f) Notice Non-Roth YOUR ROLLOVER OPTIONS TAX NOTICE (For Payments Not From a Designated Roth Account) You are receiving this notice because all or a portion of a payment you are receiving from your
More informationAFPlanServ Plan Distribution/Rollover Authorization Form
AFPlanServ Plan Distribution/Rollover Authorization Form Participant Instructions This form can be completed to request a distribution or a rollover from your current or former employer s 403(b) or 457(b)
More informationAddendum to the Traditional IRA Custodial Agreement and Disclosures
Effective January 1, 2018 Addendum to the Traditional IRA Custodial Agreement and Disclosures This Addendum changes the Traditional IRA Custodial Agreement and Disclosures ( Agreement ) document and uses
More informationSIMPLE INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT AGREEMENT. U.S. GLOBAL INVESTORS, INC Callaghan Road San Antonio, Texas 78229
SIMPLE INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT AGREEMENT Sponsored By U.S. GLOBAL INVESTORS, INC. 7900 Callaghan Road San Antonio, Texas 78229 You can revoke your participation in this Account without
More informationQRP Distribution Notice
QRP Distribution Notice Important Information About Your Qualified Retirement Plan Distribution INTRODUCTION As a participant in your employer s qualified retirement plan, you have accumulated a vested
More informationDEFERRED COMPENSATION REQUEST FOR DISTRIBUTION OF FUNDS - City of Costa Mesa, CA
CALIFORNIA 457 BENEFITS Plan Administration & Investment Advice DEFERRED COMPENSATION REQUEST FOR DISTRIBUTION OF FUNDS - City of Costa Mesa, CA IMPORTANT-REMEMBER TO PRINT LEGIBLY IN BLACK OR BLUE INK
More informationTHE CULLEN/FROST BANKERS, INC. 401(K) STOCK PURCHASE PLAN (001332) Termination/Distribution Form
PLDISTRIB THE CULLEN/FROST BANKERS, INC. 401(K) STOCK PURCHASE PLAN () Termination/Distribution Form PARTICIPANT INFORMATION First Name MI Last Name Social Security Number Date Address 1 Address 2 City
More information