IRA TRANSFER / DIRECT ROLLOVER AUTHORIZATION and LETTER OF ACCEPTANCE TRANSFER or DIRECT ROLLOVER INSTRUCTIONS SIGNATURE 1. TO: 5. Contact your existing Custodian/Trustee before signing to ask whether a Name of current Trustee/Custodian or Employer if Direct Rollover Signature Guarantee is required. Street Address _______________________________________________ SIGNATURE OF CUSTOMER DATE City State Zip _______________________________________________ 2. RE: SIGNATURE GUARANTEE (if required) DATE Customer’s Name TRANSFER / DIRECT ROLLOVER AUTHORIZATION Street Address ( ) 6. ______________________________________ Current Account Number Daytime Telephone No. Customer’s Name has established an IRA with the Monteagle Funds for which Investors Bank & Trust Company acts as Custodian. The Monteagle Funds Current Account Type: hereby accepts transfer of the funds referenced above for the Traditional IRA SEP-IRA Rollover IRA Custodian. Please make your check payable to: The Monteagle Funds SIMPLE-IRA* Roth IRA Qualified Plan† FBO: __________________________________________________________ * SIMPLE-IRAs must be in existence for at least 2 years to qualify for a IRA Customer’s Name (Traditional, ROTH, SEP, SIMPLE or Rollover IRA) transfer, rollover, or conversion to another kind of IRA ____________________________ † A trustee-to-trustee direct rollover from a qualified employer-sponsored Account Number retirement plan will be subject to IRS reporting. Delivery Address: The Monteagle Funds / Investors Bank & Trust Company, Custodian c/o Ultimus Fund Solutions, 225 Pictoria Drive, Suite 450, AUTHORIZATION INSTRUCTIONS Cincinnati, OH 45246. 3. This is your authorization to transfer, rollover or convert: Note: Trustee-to-Trustee Transfers of Assets between a Traditional IRA and another Traditional IRA, SEP-IRA or SIMPLE-IRA are not reported as a taxable The entire value of the above referenced account, OR distribution. Conversions from a Traditional IRA, SEP-IRA or SIMPLE-IRA to a Roth IRA or a recharacterization are reported as a taxable distribution. See the A partial transfer of Certificate number(s) ____________, or Investors Bank IRA Disclosure Statement for additional information. Consult the IRS or a qualified tax or financial planning professional if you have any questions $ _____________, or ___________ % or __________ shares in kind about the rules applicable to transfers from one IRA to another. The Customer is from my existing account. responsible for compliance of such rules. Please deliver the proceeds to: The Monteagle Funds / Investors Bank & Trust Company, Custodian c/o Ultimus Fund Solutions, 225 Pictoria __________________________________________________ Drive, Suite 450, Cincinnati, OH 45246. Authorized Signature – Investors Bank & Trust Co. Date NEW ACCOUNT TYPE (at MONTEAGLE FUNDS) WITHHOLDING Check one: 4. Please establish the following account(s): 7. Federal tax laws require a 10% withholding of any amount converted Traditional IRA SEP-IRA Rollover IRA from a non-Roth IRA to a Roth IRA, unless the IRA owner elects not to have any amount withheld. If you do not elect to withhold, your SIMPLE-IRA Roth IRA signature above acknowledges that you will pay all taxes due and __________________ penalties that may apply to the insufficient payment of estimated tax. (Consult your tax advisor.) in the following amount(s): Please do not withhold federal income taxes. Please withhold 10% for federal income taxes or withhold ________% MONTEAGLE FUNDS: (elect higher percentage, if desired). Value Equity Growth Equity Gov’t Bond AGE 70 ½ Reminder: _______% _______% ________% If this transfer is occurring during or after the year in which you attain age 70 ½, the required minimum distribution (RMD) under this IRA is still required to by distributed. You are responsible for satisfying your RMD applicable to $______ $______ $_______ this IRA by withdrawing sufficient amounts from another IRA prior to your deadline. Neither Monteagle Funds, nor Investors Bank & Trust Co. or your current trustee/custodian are responsible for making RMD distributions prior to or after your transfer. If you have any questions about completing this form, please call (888) 263-5593.
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