IRA Rollover Contribution

Document Sample
IRA Rollover Contribution Powered By Docstoc
					To print a blank form, check here:                                                 Print             Clear

           IRA Rollover Contribution
             Sub Firm #         BR Code          FA Code             Account Number


            (Office Use Only)
            A rollover is a way to move money or property from one eligible retirement plan (Traditional IRA, Roth IRA, Education Savings Account,
            Qualified Retirement Plan) to another eligible retirement plan. The Internal Revenue Code (IRC) limits how many rollovers may be taken, how
            quickly rollovers must be completed and how the Custodian/Trustee must report the transaction. By completing this form, you are certifying
            that you are aware of and have satisfied the rules and conditions applicable to a rollover transaction. Before completing this form, review the
            rollover eligibility requirements outlined on page two and consult with a tax or legal professional. All sections below must be completed.
            IRA Holder Name                                                                                                                  Date of this Rollover Contribution


            Type Of Rollover Contribution - (check only one box)
            After reading the eligibility requirements on the next page, check the applicable box. A separate form is required for each rollover.
                 Rollover to a Traditional IRA, SEP IRA or SAR-SEP IRA
                     From:        Traditional IRA        SEP IRA       SAR-SEP IRA              Qualified Retirement Plan *
                                  SIMPLE IRA (option available two years from the date of first deposit)
                 Rollover/Conversion to a Roth IRA
                     From:      Roth IRA SIMPLE IRA (option available two years from the date of first deposit)
                                 Traditional IRA, SEP IRA or SAR-SEP        Qualified Retirement Plan*          Roth 401(k)
                 Rollover to a SIMPLE IRA from a SIMPLE IRA
                 Rollover to a Coverdell Education Savings account from a Coverdell Education Savings Account
                 Rollover/Conversion by a Non-Spouse Beneficiary from 401(k), 403(b), or 457 Plan
                     To:     Inherited IRA       Inherited Roth IRA
                 Rollover/Conversion by a Spouse Beneficiary
                     From:       Qualified Retirement Plan*
                                  To:       Inherited IRA        Inherited Roth IRA, or
                                        Spouse's own:         Traditional IRA       SEP IRA                          SAR-SEP IRA or                 Roth IRA
                     From:       Decedent Traditional, SEP or SAR-SEP IRA or Roth IRA
                                  To:       Inherited IRA, or
                                         Spouse's own:        Traditional IRA        SEP IRA                         SAR-SEP IRA or                 Roth IRA
                     From:       Inherited Traditional IRA, SEP IRA or SAR-SEP IRA
                                  To: Spouse's own:           Traditional IRA        SEP                             SAR-SEP or                     Roth IRA
            Description of Rollover
            CASH AMOUNT               $
           Quantity               Description of Assets                                            Quantity               Description of Assets


           Quantity               Description of Assets                                            Quantity               Description of Assets


                    Check this box if additional assets are listed on a separate signed page using the same format as above.
            Age 70½ Rollover Restriction (check only one box)
            Not applicable to Inherited IRA Rollovers.
                I am or will be age 70½ or older in this calendar year. I certify that I am not rolling over any amounts required to be distributed under the
               Internal Revenue Code Sections 408(a)(6) and 401(a)(9). My minimum distributions from my prior IRA or qualified retirement plan were
               calculated based on the following information:

                Beneficiary Relationship:                Spouse     Spouse Birthdate: _____________________
                                                         Non-Spouse

                I am not nor will I be 70½ or older in this calendar year.
            Signature and Verification (Completion Required)
            I have read and understand the rollover rules and conditions outlined in this form and have determined that I meet the requirements for making
            a rollover contribution to a First Clearing, LLC ("FCC") Self-Directed Individual Retirement Account. Due to the important tax consequences of
            rolling over funds or property, I understand that I should seek guidance from a professional tax advisor. I assume full responsibility for this
            rollover transaction and release, indemnify and hold FCC harmless against any adverse consequences that I may incur because of this
            transaction. By signing this agreement, I understand that I have irrevocably designated this contribution as a rollover contribution.
            Signature of IRA Holder, Beneficiary or the Responsible Individual             Print Name                                                          Date



            Investment and Insurance Products:
             Not Insured by FDIC or any Federal Government Agency                  May Lose Value        Not a Deposit of or Guaranteed by a Bank or Any Bank Affiliate
            Wells Fargo Advisors, LLC is a registered broker-dealer and separate non-bank affiliate of Wells Fargo & Company
                                                                                                                                                     SR #

           556437 (Rev 09) Page 1 of 3


                                                                                   Print              Clear
                                          ROLLOVER ELIGIBILITY REQUIREMENTS
When you sign this form, you will be making an irrevocable election; therefore it is extremely important that you read all applicable
sections to ensure that funds are eligible for rollover.
Rollover from a Qualified Retirement Plan
  •   If you have elected to receive a distribution from a qualified retirement plan, 457 Plan, or tax sheltered 403(b) plan in the form of a "direct
      rollover," the distribution may be transferred directly from the qualified retirement plan, 457 Plan, or a tax sheltered 403(b) plan by the
      plan trustee upon receiving authorization and instructions from you. Even though the distribution is transferred directly, it is a reportable
      distribution.
  •   You must be a participant in a qualified retirement plan or a tax sheltered 403(b) plan, the surviving beneficiary of a deceased participant
      in such plan, or an alternate payee under a qualified domestic relations order (QDRO) to be able to rollover a distribution.
  •   If you are a spouse beneficiary, the distribution is eligible for rollover into an Inherited IRA or the assets may be rolled over into an IRA in
      your own name. If you are a non-spouse beneficiary, the distribution is eligible for rollover into an Inherited IRA account only. An Inherited
      IRA is an IRA titled in the name of the deceased plan participant with you named as the beneficiary.
  •   The distribution must be from a qualified retirement plan, 457 Plan, or 403(b) plan to be eligible for rollover. Examples of the most
      common qualified retirement plans are pension, profit sharing, 401(k), and stock bonus plan. CREF funds under teacher retirement plans
      may be eligible for rollover.
  •   Most distributions from qualified plans, 457 Plans, and 403(b) plans are eligible for rollover treatment; however, there are exceptions.
      They are: (1) substantially equal periodic payments paid at least once a year over your or your beneficiaries lifetime or life expectancy,
      (2) installment payments over a period of ten years or more, (3) required minimum distributions, (4) hardship distributions, (5) the cost of
      life insurance coverage, (6) dividends on employer securities, and (7) certain corrective payments and deemed distributions.
  •   A rollover from a qualified retirement plan must consist only of the cash distributed, the specific property distributed, or the proceeds from
      the sale of the distributed property. You cannot keep the property and substitute your own funds for the property. The rollover
      contributions may not contain any death benefit exclusion amounts.
  •   A rollover contribution may contain both pre-tax and after-tax contributions.
  •   Amounts held in a Roth 401(k) are eligible to be rolled over into a Roth IRA.
Rollover to a Traditional, SEP or SAR-SEP IRA
  •   Amounts from one Traditional, SEP or SAR-SEP IRA can be rolled over into another Traditional, SEP or SAR-SEP IRA. Amounts held in
      a SIMPLE IRA can also be rolled over into a Traditional, SEP or SAR-SEP IRA after two years from the first deposit.
  •   The rollover must be completed within 60 days from the day of receipt.
  •   Generally, you may make only one rollover during a 365-day period with respect to distributions from a single IRA. Direct transfers
      between IRA custodians are not subject to this limitation.
  •   The same property you receive in an IRA distribution must be the same property you roll over. For example, if you receive a distribution
      from a Traditional IRA of property, such as stocks, that same stock must be rolled over. You cannot sell the stock from an IRA distribution
      and rollover the cash proceeds.
  •   If you are an IRA beneficiary, upon death of the participant, you may NOT roll over this IRA into your own IRA unless you are the spouse
      of the decedent, but the IRA may be eligible to remain in the name of the decedent with you, the beneficiary, taking lifetime payouts.
      Check with your tax advisor for more information.
  •   If you are age 70½ or older, your Required Minimum Distribution (RMD) is not eligible for rollover.

Rollover or Conversion to a Roth IRA
  •   You may rollover amounts you withdraw from a Roth IRA to another Roth IRA as long as you have not rolled over those amounts in the
      previous twelve months.
  •   All or part of a Traditional, SEP or SAR-SEP IRA may be rolled over/converted to a Roth IRA. Additionally, all or part of a SIMPLE IRA
      may be rolled over/converted to your Roth IRA on the same terms as a conversion from a Traditional IRA, except that you may only
      convert amounts if you have participated in the SIMPLE IRA for at least two years. Beginning in 2008, you may convert any eligible
      rollover distribution from an employer retirement plan directly to your Roth IRA if the rollover and conversion rules are otherwise satisfied.
  •   You are NOT eligible to make a rollover to a Roth IRA if either (a) your modified adjusted gross income exceeds $100,000 or (b) you are
      married and filing a separate federal income tax return. For tax years after 2009, the 100,000 limit and married filing separately
      prohibition will be eliminated.
  •   If you are age 70½ or older, you cannot rollover/convert the required minimum distribution for that year.
  •   If you have started taking substantially equal periodic payments from an IRA, you can convert the amounts in the IRA to a Roth IRA and
      then continue the periodic payments. The 10% additional tax on early distributions will not apply as long as they are part of a series of
      substantially equal periodic payments. See your tax or legal professional for more information.
  •   You may make only one rollover contribution in the same 365-day period from a single Roth IRA. However, there is no limit on rollovers
      from Traditional, SEP, SAR-SEP or SIMPLE IRAs to Roth IRAs or on trustee-to-trustee Roth IRA transfers.
  •   A spousal beneficiary may rollover an Inherited IRA to their own Inherited Roth IRA or a Traditional IRA as a conversion.
  •   Amounts held in a Roth 401(k) are eligible to be rolled over into a Roth IRA.




556437 (Rev 09) Page 2 of 3
 Rollover to a SIMPLE IRA
   •   Only amounts withdrawn from other SIMPLE IRAs can be rolled into a SIMPLE IRA.
   •   Amounts distributed from a Traditional, SEP or SAR-SEP IRA, Roth IRA, Coverdell Education Savings Account, employer retirement
       plan, or a Health Savings Account (HSA) may NOT be rolled over to a SIMPLE IRA at any time.
   •   Distributions from a SIMPLE IRA may be rolled into a Traditional, SEP or SAR-SEP IRA, Roth IRA, or an employer retirement plan if, (1)
       you have participated in the SIMPLE IRA for at least two years; (2) have not rolled over those amounts in the previous twelve months;
       and, (3) if the employer's plan permits. The 2-year period begins on the first day on which contributions were first deposited into the
       SIMPLE IRA. If, during the 2-year period, funds are withdrawn from the SIMPLE IRA, a 25% tax will apply. The two-year requirement
       does not apply, if the 25% early distribution penalty does not apply.
   •   A tax-free rollover from one SIMPLE IRA to another SIMPLE IRA is neither subject to the 2-year waiting period or the 25% penalty.
   •   The Rollover must be completed within 60 days from the day of receipt.
   •   You may have only one such rollover during a 365-day period. Direct transfers between IRA Custodians are not subject to this limitation.
   •   The same property you receive in a distribution must be the same property you roll over. For example, if you receive a distribution from a
       SIMPLE IRA of property, such as stocks, that same stock must be rolled over. You cannot sell the stock from a SIMPLE distribution and
       rollover the cash proceeds.
   •   If you are the Beneficiary of the SIMPLE IRA, upon death of the participant, you may NOT roll over this SIMPLE IRA into your own IRA
       unless you are the spouse of the decedent, but the IRA may be eligible to remain in the name of the decedent with you, the beneficiary,
       taking lifetime payouts. Check with your tax advisor for more information.
   •   If you are age 70½ or older, your Required Minimum Distribution (RMD) is not eligible for rollover.

 Education Savings Account To Education Savings Account Rollover
   •   In 2001, after the passage of the Economic Growth and Tax Relief Reconciliation Act (EGTRRA), Education IRAs were re-named
       "Coverdell Education Savings Accounts" and are commonly referred to as an "Education Savings Account" or "ESA".
   •   Only amounts withdrawn from other Education Savings Accounts/Education IRAs can be rolled into an Education Savings Account.
   •   Rollover contributions to an Education Savings Account may NOT be made from a qualified plan, 403(b) or 403(b)(7) plan, or from any
       other type of IRA that is not an Education Savings Account.
   •   The Rollover must be completed within 60 days from the day of distribution. (Not the date of receipt.)
   •   You may have only one such rollover during a 365-day period. In accordance with the FCC Education Savings Account Custody
       Agreement, direct transfers between IRA custodians are not permitted.
   •   The same property you receive in a distribution must be the same property you roll over. For example, if you receive a distribution from
       an Education Savings Account of property, such as stocks, that same stock must be rolled over. You cannot sell the stock from an
       Education Savings Account distribution and rollover the cash proceeds.
   •   Amounts may be withdrawn from an Education Savings Account and rolled over to another Education Savings Account for the benefit of
       the same designated beneficiary (child) or a member of the designated Beneficiary's family. This may be done only if the new designated
       beneficiary is under age 30 on the date of the rollover contribution.
   •   If the "Designated Beneficiary" of an Education Savings Account dies before reaching age 30, the remaining assets must generally be
       distributed within 30 days after the date of death. The assets can only be distributed to the estate of the designated beneficiary/child (if no
       beneficiary is named) or to the beneficiary named by the "Designated Beneficiary" on the FCC Coverdell Education Savings Account
       Cash Agreement, Enrollment and Change of Beneficiary form. Only a surviving spouse or other family member under age 30 may inherit
       the Education Savings Account and transfer it into an Education Savings Account in their own name.




This information may answer some of your questions, but it is not intended as a comprehensive analysis of this complex topic. We periodically
provide clients with information concerning retirement planning. No one should infer that because of this service, we assume any fiduciary
duties. In addition, such service should not be relied upon as your only source of information. Competent tax and legal advice should always be
obtained.


556437 (Rev 09) Page 3 of 3

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:5
posted:7/26/2011
language:English
pages:3