ERISA Plan Account To IRA Rollover/ Transfer Disclosure Form

Transcription

1 Member of Advisor Group ERISA Plan Account To IRA Rollover/ Transfer Disclosure Form Advisor Name: Advisor Rep #: Client Name: New IRA Acc. #: It is the advisor s recommendation that the client roll over assets from his or her ERISA plan account (401(k), Profit Sharing, Money Purchase, ERISA 403(b), or I-401(k)) to an IRA. 1. EXISTING ERISA PLAN ACCOUNT INFORMATION The triggering event for this recommended distribution is: Attainment of age 59½ Death of account owner Disability Distribution pursuant to a qualified domestic relations order (QDRO) Voluntary separation of employment (Client s sole decision) Involuntary separation of employment Termination of the plan From available information and as provided by the client, the distribution (forms of payment) options available to the client from the ERISA plan account are (select all that apply): Annuity Leave assets in the plan (no change) Partial Lump sum payment 100% Lump sum payment What is the client s ERISA Plan Account distribution election? (check all that is elected) Annuity (monthly payments) Leave assets in the plan (no change) Cash out payment Partial Lump sum payment to another employer s Retirement Plan 100% Lump sum payment to rollover IRA 100% Lump sum payment to roll over to another employer s Retirement Plan Yes No Did the client make the distribution election based on his/her independent research/analysis? Yes No Did the advisor help the client make the distribution election? Yes No Was this an involuntary (where lump sum value is $5k or less) Lump sum payment? Yes No Was the client in possession of the distribution check or funds prior to meeting with the RR/IAR to discuss their options?

2 2. IRA INFORMATION The proposed IRA is a: SEP/SARSEP IRA Traditional IRA ROTH IRA Inherited/Beneficiary IRA Spousal IRA 3. DISCUSSIONS WITH THE CLIENT The advisor must ensure each topic below related to the distribution/rollover/transfer recommendation has been discussed with client. Yes No N/A Is company stock included in the investment assets to be rolled over? Yes No N/A Has the net unrealized appreciation of the company stock been reviewed and discussed with the client? Yes No N/A Does the ERISA plan account have an outstanding loan? Yes No N/A If yes, have the loan repayment options been reviewed and discussed with the client? Yes No N/A If no, is client in need of a loan, including a loan for the purchase of his or her principal residence? Yes No N/A Have all distribution options available from the ERISA plan account been discussed with the client? Yes No N/A Have the tax consequences of taking the lump sum/cash out distribution option been discussed with the client? Yes No N/A Have the pre-, after-tax and ROTH contributions made to the ERISA plan account been reviewed and discussed with the client along with how each will be handled? Yes No N/A Have the anticipated income/withdrawal needs or requirements been discussed with the client including any difference in treatment between the ERISA plan account and IRA? Yes No N/A Has the option to utilize a 72(t) penalty-free withdrawal from the rollover IRA been discussed with the client including distribution methods and potential tax consequences? Yes No N/A Has the option to utilize the age 55 penalty-free withdrawal from the ERISA plan account been discussed with the client if the client separated from service (employment) after the age of 55? Yes No N/A Is the client over the age of 70½ and not a 5% or more owner in the employer sponsoring the ERISA plan? Yes No N/A If yes, then has a Required Minimum Distribution discussion occurred? Yes No N/A Has the client been informed a rollover may result in a loss of protection from creditors, lawsuits and judgments? Yes No N/A Have the client s current investments and available investment options in the ERISA plan account been obtained and reviewed against the investment options available in the proposed IRA and discussed with the client? Yes No N/A Have the current expenses the client pays in the ERISA plan account been obtained and reviewed against the proposed IRA expenses and discussed with the client? Yes No N/A From available information and as provided by the client, have the services currently offered under the ERISA plan account been reviewed against the services offered by the financial advisor through the proposed IRA and has this been discussed with the client? Yes No N/A Is there an option to rollover the existing ERISA plan account to another employer sponsored ERISA plan account? Yes No N/A If yes, then has a review of the investments, expenses and services offered through the new employersponsored ERISA plan account and proposed IRA been completed and discussed with the client? Yes No N/A Have the IRA estate-planning options available to the client and to client s beneficiaries been discussed with the client?

3 4. REASONS FOR THE RECOMMENDATION Identified below are specific reasons for concluding that the recommendation to roll over to an IRA is in the client s best interest and meets the Best Interest Standard. Select all that have been identified: Investment Options: It has been concluded that certain investments offered through an IRA would be beneficial for the following reasons: Generally, there is a broader range of investment solutions that are available within the IRA in comparison to those available in the ERISA plan account (or if applicable, another employer-sponsored ERISA plan account). In my view, the overall quality of the investment options (performance and fees) available within the IRA is better in comparison to those available in the ERISA plan account (or if applicable, another employer-sponsored ERISA plan account). The following particular investment(s) is/are available through the IRA but not through the ERISA plan account (or if applicable, another employer-sponsored ERISA plan account) and meet the client s objectives and goals. S e r v i c e s : It has been concluded that certain additional services, stated below, which are not available under the ERISA plan account (or if applicable, another employer-sponsored ERISA plan account), will become available to the client through the financial advisor. Active management through an investment advisory agreement Non-discretionary investment advice Discretionary investment management Asset allocation planning, implementation and monitoring Income needs analysis, distribution planning and execution Ongoing consultation surrounding overall investment needs and strategy Personalized service around overall financial needs, investment objectives and risk profile Recommendations and monitoring of investment strategy or modeling Third party money managers through a co-advisory services agreement Other: Other: Other Reason(s): There is/are reason(s) other than those above or reason(s) in addition to those above as to why the recommended IRA is beneficial. Complete the following: Fees and Expenses: It has been concluded due to the benefits of the additional services and/or investments to be received from the proposed IRA, the cost of the IRA is either comparable to or is not unreasonably greater than those of the ERISA plan account (or if applicable, another employer-sponsored ERISA plan account). Expenses associated with the client s ERISA plan account: Plan administrative/record-keeping fee: Loan origination/set up fee: Loan maintenance fee:

4 Withdrawal Processing fee: Managed Account Program fee: QDRO fee: Minimum Required Distribution fee: Mailing fee: Other fees: If the client was not able to obtain the expenses, then the average plan expenses the client would pay for a similar size plan: Expenses associated with the proposed IRA: (If a Pershing/NFS brokerage account): For Brokerage Commission IRA or Fee-based IRA fees: (See attached fee chart) Advisor Fee (if applicable): (If a product vendor account): For Direct IRA Account fees: Annual Maintenance (Custodial) Fee: Distribution Fee: Account Termination Fee: Advisor Commissions: Product Fee: TPMM Solicitor Fee: TPMM Management Fee: Expenses associated with another employer-sponsored ERISA plan account (if applicable): Plan administrative/record-keeping fee: Loan origination/set up fee: Loan maintenance fee: Withdrawal Processing fee: Managed Account Program fee: QDRO fee: Minimum Required Distribution fee: Mailing fee: Other fees: If the client was not able to obtain the expenses, then the average plan expenses the client would pay for a similar size plan:

5 ATTESTATION: I (Registered Representative or Investment Advisor Representative RR/ IAR ) hereby attest that I have and will retain all documentation relating to the information above and any research/analysis I have performed as it relates to my recommendation to the client to roll over assets from his/her ERISA plan. The information above is accurate to the best of my knowledge. Based upon the information above and other data, research and analysis I have performed, I attest that my recommendation to the client meets the Best Interest Standard (as defined below) for retirement advisors. Under the Best Interest Standard, your recommendation to the client must, at the time of such investment recommendation, reflect the care, skill, prudence, and diligence under the circumstances then prevailing that a prudent person acting in a like capacity and familiar with such matters would use in the conduct of an enterprise of a like character and with like aims, based on the client s investment objectives, risk tolerance, financial circumstances, and needs, without regard to the financial or other interests of yourself, the registered investment adviser that you represent, or any other party. Signature of RR/IAR: Name of RR/IAR: Date: ATTESTATION: I (Client) hereby attest that Registered Representative/Investment Advisor Representative has made a diligent and prudent effort to obtain information about my ERISA plan, including the review of Form 5500 and the participant fee disclosure. Where Registered Representative/ Investment Advisor Representative was unable to obtain necessary information, and after the significance of such information was explained to me, Registered Representative/Investment Advisor Representative relied upon alternative data sources with respect to typical fees and expenses for the existing ERISA plan. I acknowledge and understand that Registered Representative/Investment Advisor Representative does not provide tax, legal or accounting advice and that I should consult with my own tax, legal and accounting professionals. I have reviewed and discussed with the Registered Representative/Investment Advisor Representative the information above and research/analysis performed as it relates to the recommendation to roll over assets from my ERISA plan. I hereby attest the recommendation is in my best interest based on the information above ( Reasons for the Recommendation ). Client Signature: Name of Client: Date: Royal Alliance Associates, Inc. is a registered broker-dealer and Registered Investment Advisor, member FINRA/SIPC. Advisor Group is a holding company. Royal Alliance Associates, Inc. 10 Exchange Place, Suite 1410 Jersey City, NJ RAA-2-ERISA-IRA-TD-0517