Non-Retirement Redemption Form

Transcription

1 Prudential Mutual Fund Services LLC a Prudential Financial company Non-Retirement Redemption Form For assistance: Clients: (800) Financial Professionals: (888) Pruco Financial Professionals: (800) What to do to submit your distribution request: 1. Decide You have several options when requesting a redemption. A partial or full redemption from specific funds must be indicated in section 2. If you want a different cost basis method than what is currently selected on your account, provide the cost basis details in section 3. Indicate in section 4 if you want to receive a check, Electronic Funds Transfer (ACH) / Wire Transfer or have the proceeds sent to a special address. If the redemption is due to the death of the account owner, complete section 5. Note: Please also provide the Social Security number, tax identification number, or employee identification number that should be used for tax reporting of the redemption proceeds. 2. Complete Follow the instructions starting on page 6 and complete the applicable sections below. Note that section 5 is only for redemptions due to death.please provide all requested information so that we can process your transaction in a timely manner. 3. Return Send us your completed form. In cases of death, an Inheritance Tax Waiver may also be required, depending on the decedent s state of residence.

2 1. About the Account Provide information about the account. First name Middle initial Last name Entity name (if applicable) Street Address Apt/Suite City State ZIP Code Home phone Mobile phone address Date of birth (mm/dd/yyyy) (Required for UGMA/UTMA accounts otherwise optional) Social Security number, Tax ID or EIN Account number 2. Redemption Information I (we) wish to redeem all or part of my (our) mutual fund position as indicated below. I (we) understand that if redeeming by dollar amount, number of shares or all shares, I (we) will receive a check less any applicable contingent deferred sales charges (Class B and C shares only). Note: If you have certificates for any of the fund shares you list below, please return them unendorsed with this completed form by registered or certified mail. Fund name or number Amount Number of Shares Percentage All Shares 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 MF004 Ed. 7/2017 page 1 of 7

3 3. Cost Basis Election Provide the cost basis method below if you would like the redemption to be processed using a different cost basis method than what is recorded on your account. If the Specific Lot Depletion Method is chosen, please identify the share lots to be used during the transaction. If you do not select an option, the Fund s default method of Average Cost will be recorded as your cost basis method. Average Cost Under this method, we use the average basis of all shares owned at the time of redemption, regardless of how long you owned them. To determine the holding period, the shares sold are considered to be those acquired first. FIFO First In, First Out The earliest shares acquired will be redeemed first. LIFO Last In, First Out The most recent shares acquired will be redeemed first. HIFO Highest Cost In, First Out The highest cost shares will be redeemed first. HILT Highest Cost Long-Term In, First Out The long-term highest cost shares will be redeemed first. HIST Highest Cost Short-Term In, First Out The short-term highest cost shares will be redeemed first. LOFO Lowest Cost In, First Out The lowest cost shares will be redeemed first. LILT Lowest Cost Long-Term In, First Out The long-term lowest cost shares will be redeemed first. LIST Lowest Cost Short-Term In, First Out The short-term lowest cost shares will be redeemed first. SLDM Specific Lot Depletion Method This method allows you to choose which tax lot(s) you are selling. You must specify the particular lot(s) to be sold at the time your redemption is requested. Please indicate the applicable information below for the tax lot(s) you want to redeem. The tax lot(s) you select must be sufficient for the redemption amount. 1. Fund # Acquisition Date Dollar Amount Number of Shares 2. Fund # Acquisition Date Dollar Amount Number of Shares 3. Fund # Acquisition Date Dollar Amount Number of Shares Attach extra sheet, if necessary, to list additional tax lots. MF004 Ed. 7/2017 page 2 of 7

4 4. How to Receive Your Funds Complete this section to indicate how the proceeds should be distributed to you. Select only one method. A. Proceeds are made payable and mailed to the name and address indicated on your account registration. B. Proceeds are sent by ACH or Wire Transfer to your financial institution. Please complete the section below. Redemption Method: Electronic Funds Transfer (ACH) Wire ($500 Minimum) Account Type: Checking Savings Bank Name Bank Account Number Bank routing (ABA) number Name of depositor (first, middle initial, last name) Name of joint depositor (first, middle initial, last name) Tape copy of pre-printed voided check or deposit slip here VOID ABA number (9 digits) Bank account number C. If you want the proceeds made payable to a name and/or address other than the account registration, complete this section. You must also obtain a medallion signature guarantee in section 7. Name of payee (first, middle initial, last name) Account Number Street address City State ZIP Code MF004 Ed. 7/2017 page 3 of 7

5 5. Redemptions due to death of the account owner Provide information for the person redeeming if the account owner is deceased. Social Security number or Employer identification number (to be used for tax reporting of the redemption proceeds.) Date of death Name of payee (first, middle initial, last name) Street address City State ZIP Code Home phone Mobile phone 6. Tax Certification Please complete any applicable portions of A or B below. A. Under penalties of perjury, I certify that: I am a U.S. Person (including resident alien); The Social Security/Tax ID number provided in Section 1 or 5 on this form is my correct SSN/TlN; I am not subject to backup withholding due to failure to report interest or dividend income (see Backup Withholding in the Tax Certification information section); and I am not subject to FATCA reporting. Check the boxes below, if applicable: I am subject to backup withholding due to the failure to report interest or dividend income. I am subject to FATCA reporting. B. I am not a U.S. citizen or other U.S. person (including a U.S. resident alien). I am a citizen of. Attach the applicable IRS Form W-8 (BEN, BEN-E, ECI, EXP, IMY). MF004 Ed. 7/2017 page 4 of 7

6 7. Authorization and Signature Guarantee You must have your signature medallion signature guaranteed under the following circumstances: If the distribution exceeds $10,000 and is payable to a special payee or is mailed to a special address (other than Prudential). If the distribution exceeds $100,000. If the distribution is mailed to a special address that is a P.O. Box, regardless of the dollar amount. If the distribution is made by ACH or wire and payable to a special payee (other than Prudential), regardless of the dollar amount. If the distribution is due to death of the account owner or on behalf of the account owner, a medallion signature guarantee is required, regardless of the dollar amount. For the purpose of processing a claim or distribution of assets in an efficient and prompt manner, I authorize Prudential to consolidate and disclose completed forms and documents to appropriate associates for each and every one of Prudential Financial, Inc. s affiliates or business units to which a claim for payment or request for distribution is presented. The medallion signature guarantee may be obtained from an authorized officer from a bank, broker, dealer, securities exchange or association, clearing agency, savings association, or credit union participating in one of the recognized medallion programs (STAMP, SEMP, or NYSE MSP). The medallion signature guarantee must be appropriate for the dollar amount of the transaction. Prudential Mutual Fund Services LLC reserves the right to reject transactions exceeding the value of the surety coverage indicated on the medallion imprint. By signing below, I certify and acknowledge that the information provided on this form is correct. The IRS does not require your consent to any provision of this document other than certification required to avoid backup withholding. 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. Administrator Appointee under POA Conservator / Guardian Custodian Executor Former Minor Surviving Joint Owner Trustee Other, please specify X Account owner s signature X Joint owner s signature, if applicable / / Date (mm/dd/yyyy) / / Date (mm/dd/yyyy) X Authorized signature (e.g. trustee), if applicable Place medallion signature guarantee here / / Date (mm/dd/yyyy) MF004 Ed. 7/2017 page 5 of 7

7 Prudential Mutual Fund Services LLC a Prudential Financial company Instructions & Disclosures For assistance: Clients: (800) Pruco Financial Professionals: (800) Financial Professionals: (888) About Your Account Use this form to request a redemption from your non-qualified Prudential mutual fund account. This form should also be used to redeem shares from a deceased shareholder s non-retirement account and for beneficiaries to redeem shares from a Transfer on Death account. In cases of death, an Inheritance Tax Waiver may also be required, depending on the decedent s state of residence. If there are multiple beneficiaries and one beneficiary is deceased, we require a letter of instruction that provides the date of the beneficiary s death and the letter must be signed by one of the surviving beneficiaries with a medallion signature guarantee or a signature validation. We would also accept a certified copy of the death certificate for the deceased beneficiary. Please note that we will only use phone numbers and s that we collect to keep you updated on the status of your transaction request. Cost Basis Selection Use this section to change the cost basis calculation method on your non-retirement mutual fund account for shares acquired on or after January 1, You will only need to complete this section if you would like to select a different cost basis method than account default method. PMFS default method is Average Cost for most Prudential mutual funds and is First In First Out (FIFO) for the Prudential Jennison MLP Fund.* If you accept PMFS default method, then no further action is required on your part. Under current IRS regulations, you have up to the date of the first redemption of shares acquired on or after January 1, 2012 to change your election. This information is based on our understanding of tax law. Prudential and its representatives cannot give legal or tax advice, so please consult your tax adviser if you have any questions about the tax law requirements regarding cost basis reporting. You can also obtain a copy of IRS Publication 550 (Investment Income and Expenses) by calling the IRS Forms Distribution Center toll free number at (800) or visiting the IRS website at Notes: The tax lot(s) you have selected must be sufficient to provide the redemption amount(s) you have requested in section 2. Please keep in mind that certain corporate actions, such as fund mergers and return of capital distributions if applicable, may have caused the original cost basis allocated to a specific tax lot(s) to be adjusted. If you would like to redeem additional tax lot(s) or if you would like to select a different cost basis method for each fund you are redeeming, please provide that information on a separate sheet with the date and your signature. The Specific Lot Depletion Method (SLDM) may also be used as a cost basis method. This method allows shareholders to choose which tax lots they are selling, thereby giving the shareholder more control over whether they will generate a gain or loss on the transaction. Shareholders must specify the particular lots to be sold no later than the settlement date of the redemption. The gain or loss will vary, depending on which shares they choose. This method cannot be pre-selected as a default method on your account. Also, this method cannot be selected for systematic transactions such as Systematic Withdrawal Plans (SWPs), systematic exchanges, and exchange rebalancing among multiple funds. * For the Prudential Jennison MLP Fund, the only allowable cost basis methods are FIFO, LIFO and SLDM. MF004 Ed. 7/2017 page 6 of 7

8 How to Receive Your Funds A check with the proceeds from your request will be mailed to the address listed on your account registration unless you indicate one of the other distribution methods. The minimum redemption amount for federal wire transfer is $ Your financial institution must be a member of the Federal Reserve System. The money will generally be received by your financial institution within one business day of the redemption and is immediately available for withdrawal. Check with your financial institution to verify the correct wiring instructions for federal wire transfers and to determine if it charges any fees to receive federal wire transfers. Redemptions Due to Death of the Account Owner This section must be completed if you are requesting a redemption due to the death of the account owner. Please provide the Social Security number or Employee identification number that the proceeds should be reported under if that number is not currently listed on the account registration. Also, provide the account owner s date of death and the name and address of the payee receiving the account proceeds. Tax Certification You must include a TIN for the beneficiary, this is: A Social Security number (SSN) if the beneficiary is an individual or the owner of a sole proprietorship. The employer identification number (ElN) if you represent a trust, estate, corporation, partnership, or tax-exempt organization. The TIN of the grantor/trustee if you represent a grantor/trust, or that of the actual owner of a trust-like entity not recognized as a legal or valid trust under state law. If you are a guardian completing this form for someone else, including a minor, be sure to provide that person s SSN. Backup Withholding You must tell us if the IRS has notified you that you are subject to backup withholding because you didn t report all your taxable interest and dividends on your tax return. You are not subject to backup withholding if either (a) you did not receive such a notice from the IRS, (b) the IRS told you that you are no longer subject to a backup withholding order, or (c) you are exempt from such withholding. If you have been notified that you are subject to backup withholding, please check the box as indicated. Foreign Account Tax Compliance Act (FATCA) Any entity making a payment of U.S. source income must consider whether it is subject to FATCA. A payer must collect documentation about the payee s status or withhold at 30%. Nontaxable payments, such as income tax free death benefits from non-qualified life insurance contracts, are not subject to FATCA. Citizenship You must indicate if you are not a U.S. person (including resident alien). In that case, you must state the country in which you are a citizen and submit the applicable IRS Form W-8(BEN, BEN-E, ECI, EXP, IMY). In most situations, the IRS Form W-8BEN will be the appropriate IRS Form W-8. MF004 Ed. 7/2017 page 7 of 7