Pioneer Investments Retirement Plans. Pioneer Investments Retirement Plans

Transcription

1 Pioneer Investments Retirement Plans IRA Application Pioneer Investments Retirement Plans (For Traditional, Rollover, Roth, Beneficiary, Inherited, and SEP IRAs) It s Easy to Open a Pioneer IRA. 1. Select the Pioneer mutual fund(s) you wish to invest in for your IRA. 2. Complete and sign this application. 3. Make your contribution check payable to PIMSS as IRA Custodian for (your name). If including a $75 lifetime fee, see section 7. Pioneer does not accept third-party checks, starter checks, or cash equivalents. 4. If you are transferring assets from another IRA or retirement plan, complete all forms required by employer maintaining your current plan. Also, complete the (Rollover/Transfer/Conversion Form). Pioneer will arrange the transfer for you. 5. Mail both the check and completed application to Pioneer Investment Management Shareholder Services, Inc. (PIMSS) P.O. Box Boston, MA Overnight Address: Pioneer Investment Management Shareholder Services, Inc. (PIMSS) 30 Dan Road Canton, MA USA PATRIOT Act Information Important Information About Opening a New Account To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver s license or other identifying documents. Please talk to your investment professional or call Pioneer at if you have any questions about completing this application. For information about Pioneer s privacy policy, see the Privacy of Customer Information brochure, which is mailed upon confirming the new account opening and annually thereafter. If you opened your account through a brokerage firm, you can also view the privacy brochure at us.pioneerinvestments.com. Check each fund s prospectus or summary prospectus for information about the share classes available and which is suitable for your investment. Pioneer Funds (U.S. domiciled) are available for purchase only in the United States and its territories. The Funds will only accept accounts and purchases from U.S. citizens with a U.S. address, (including U.S. territories and military post offices), and a U.S. issued taxpayer identification number, or resident aliens with a U.S. address and U.S. taxpayer identification number.

2 Special Rules for Inherited IRAs: Non-spouse beneficiaries of qualified plans, 403(b) arrangements, and governmental 457 plans may be eligible to rollover directly from the former plan, provided that the plan allows. Additional restrictions apply. Contact the plan administrator. Note: This option is not available to non-spouse beneficiaries on IRAs. Enter one name only. If you and your spouse are each establishing IRAs, please use separate applications. Please print in blue or black ink. 1 Name and Address Complete only one section. This section must be completed in full in order for this application to be processed. If you are providing a P.O. Box as a mailing address, you must also provide a residential address. You must be a U.S. citizen or resident alien with a valid U.S. tax identification number and a valid U.S. mailing address to open an account. A. Your Name and Address First Name, Middle Initial, Last Name Date of Birth (mo/day/yr) Social Security Number Residential Address (Required) Telephone Number City State Zip Mailing Address (if different from above) Residency (Select one.) U.S. citizen Resident alien. If resident alien, indicate country of origin. B. Attorney-in-Fact or Conservator s Name and Address (Pioneer s Power of Attorney (POA) Form is required to establish an attorney-in fact account. A court-certified appointment of conservatorship is required to establish a conservatorship account.) First Name, Middle Initial, Last Name Date of Birth (mo/day/yr) Social Security Number Residential Address (Required) Telephone Number City State Zip Mailing Address (if different from above) Residency (Select one.) U.S. citizen Resident alien. If resident alien, indicate country of origin. 2

3 Please print in blue or black ink. 2 Type of IRA Check one box: Traditional IRA Rollover IRA Beneficiary Traditional IRA Beneficiary Roth IRA SEP-IRA Roth IRA Inherited Traditional IRA* Inherited Roth IRA* Deceased Participant Shareholder Information First Name, Middle Initial, Last Name Date of Birth (mo/day/yr) Date of Death (mo/day/yr) *Inherited IRAs are only available for non-spouse beneficiaries of qualified plans, i.e. Money Purchase Pension Plan or Profit Sharing Retirement Plan. Note: You cannot rollover any amounts attributable to required minimum distributions. Contact the plan administrator or a qualified tax advisor for additional information. Employer Information (SEP-IRAs only) Name of Employer Sponsoring Plan Street Address Employer Tax I.D. Number Telephone Number City State Zip Contact Person If the employer signed one of the following documents to establish the SEP and/or SARSEP arrangement, check the box below. IRS Form 5305-SEP or 5305A-SEP 3 Initial IRA Investment Check appropriate boxes. Contribution for tax year * $ Transfer from another account (Complete Section 4) $ Rollover or conversion from another account (Complete Section 4) $ *Only needed for Traditional and Roth IRAs. Make checks payable to PIMSS as IRA Custodian for (your name). See your tax advisor or call Pioneer for current contribution limits. 4 Source of Rollover/Transfer Complete this section only if you are moving assets from another retirement account. I am moving assets from a(n) (check one): Traditional IRA Rollover IRA Roth IRA SEP-IRA/SARSEP 403(b)/ORP Thrift Savings Plan Governmental 457 plan Employer-sponsored retirement plan (including 401(k), pension, and profit sharing) Other: Check here if you have made Roth contributions to your existing employer-sponsored retirement account. Total Roth amount included in transfer/rollover: $ Date of first Roth contribution Check one: I am enclosing a check representing a rollover that has been distributed from another account within the past 60 days.* I am not enclosing a check but have attached a Pioneer Rollover/Transfer/Conversion Form. I understand that Pioneer will arrange the rollover/transfer. Prior to completing the form, please complete all forms required by the employer/custodian/trustee maintaining your current plan. (If any forms require Pioneer s signature, submit them along with this form.) A rollover from an existing Pioneer account, account number. I have included all necessary paperwork. * Please note that you may roll over only one IRA distribution received by you into an IRA within any 12-month period. As Pioneer cannot provide tax advice, please consult with your financial advisor or your qualified tax advisor before attempting an indirect or 60-day rollover. 3

4 5 Select Your Funds Select the Class of shares you are purchasing and indicate the amount or percentage to be invested per fund. Call or visit us.pioneerinvestments.com for most current fund availability. Asset Allocation Funds CLASS A CLASS C Indicate $ OR % Indicate $ OR % Pioneer Solutions - Conservative Fund (066) (166) Pioneer Solutions - Growth Fund (057) (157) Pioneer Solutions - Balanced Fund (056) (156) Equity Funds Pioneer Core Equity Fund (002) (102) Pioneer Disciplined Growth Fund (090) (182) Pioneer Disciplined Value Fund (065) (165) Pioneer Equity Income Fund (011) (111) Pioneer Fund (001) (101) Pioneer Fundamental Growth Fund (040) (140) Pioneer Mid Cap Value Fund (010) (110) Pioneer Real Estate Shares (014) (114) Pioneer Select Mid Cap Growth Fund (060) (160) Fixed Income Funds Pioneer Dynamic Credit Fund (7015) (7115) Pioneer AMT-Free Municipal Fund (061) (161) Pioneer Bond Fund (003) (103) Pioneer Cash Reserves Fund (077) Not Available Pioneer Floating Rate Fund (095) (195) Pioneer Global Multisector Income Fund (7000) (7100) Pioneer Global High Yield Fund (028) (128) Pioneer Government Income Fund (074) (174) Pioneer High Income Municipal Fund (083) (183) Pioneer High Yield Fund (024) (124) Pioneer Multi-Asset Ultrashort Income Fund (7016) (7116) Pioneer Short Term Income Fund (055) (155) Pioneer Strategic Income Fund (022) (122) Balanced/Flexible Funds Pioneer Classic Balanced Fund (067) (167) Pioneer Flexible Opportunities Fund (7014) (7114) Pioneer Multi-Asset Income Fund (7017) (7117) International Equity Funds Pioneer Emerging Markets Fund (015) (115) Pioneer Global Equity Fund (080) (180) Pioneer International Value Fund (007) (107) Alternative Funds Pioneer Absolute Return Bond Fund (7021) (7121) Pioneer Long/Short Bond Fund (7019) (7119) Pioneer Long/Short Opportunistic Credit Fund (7020) (7120) Other Total Investment Amount (if applicable) $ $ The minimum initial purchase is $250 per fund. If you are participating in an Automatic Investment Plan, the minimum purchase is $50 per fund, $100 for Pioneer Cash Reserves Fund. Class A shares of equity, international equity and asset allocation funds have a maximum 5.75% sales charge at the beginning of the period. Class A shares of fixed income* and balanced/flexible* funds have a maximum 4.50% sales charge at the beginning of the period. * Class A shares of Pioneer Multi-Asset Ultrashort Income Fund and Pioneer Short Term Income Fund have a maximum 2.50% sales charge at the beginning of the period. Class A shares of Pioneer Cash Reserves Fund do not have a sales charge. Class C shares of all funds** have a 1% contingent deferred sales charge that applies to redemptions made within one year of purchase. ** Class C shares of Pioneer Multi-Asset Ultrashort Income Fund and Pioneer Short Term Income Fund do not have a 1% contingent deferred sales charge. Payment Method (Do not send cash, third-party checks, starter checks, or cash equivalents.) Check (made payable to PIMSS) Broker/Dealer Order (Confirmation Number ) Other 4

5 6 Telephone & Online Transactions* I understand PIMSS will accept and act upon telephone instructions from me (or any person purporting to act on my behalf either online or through Pioneer s FactFone SM system) unless indicated otherwise below. Do not accept telephone or online exchanges Do not accept telephone or online purchases Do not accept telephone redemptions *To establish online transaction privileges, you MUST complete the online registration found on us.pioneerinvestments.com. Online purchases are not available for SEP-IRAs. 7 Custodial Fee The IRA custodial fee of $15 for a single fund or $20 per year for two or more funds will be automatically deducted from your account(s) unless otherwise indicated below. I have enclosed a separate check for the one-time lifetime fee of $75, made payable to PIMSS. No custodial fees are due. I have previously paid the lifetime fee on my existing IRA(s). Account Number 8 Your Beneficiaries Designate one or more beneficiaries who will inherit your IRA assets upon your death. In accordance with your designation, your assets will pass directly to your chosen beneficiary(ies). If you are naming a trust as beneficiary, the complete name of the trust must be listed and date of the trust must be included. If you have additional beneficiaries, attach a separate sheet and include all information requested here. This additional sheet must be signed and dated by the account owner to be considered in good order. To the extent your beneficiary designations do not adequately dispose of your account at the time of your death, your beneficiary will be your surviving spouse, followed by your estate. Check here if you are attaching additional information. Percentages must Primary Beneficiaries: Upon my death, pay the value of my IRA to the following: total 100% % Full name of beneficiary Relationship Date of Birth (mo/day/yr) Share % Full name of beneficiary Relationship Date of Birth (mo/day/yr) Share % Full name of beneficiary Relationship Date of Birth (mo/day/yr) Share % Full name of beneficiary Relationship Date of Birth (mo/day/yr) Share Secondary Beneficiaries: If no primary beneficiary survives me, pay the value of my IRA to the following: Full name of beneficiary Relationship Date of Birth (mo/day/yr) Share Full name of beneficiary Relationship Date of Birth (mo/day/yr) Share Full name of beneficiary Relationship Date of Birth (mo/day/yr) Share Full name of beneficiary Relationship Date of Birth (mo/day/yr) Share If any primary (or secondary) beneficiary predeceases me, pay that person s share to the other primary (or secondary) beneficiary(ies) in proportion to the shares indicated (per capita). Note: If you would like to elect a different distribution option, please contact Pioneer. Note: Once the beneficiary information has been updated on your new account(s), you will receive written confirmation. 9 Reduced Sales Charges For purchases of Class A shares Percentages must total 100% % % % % A. Right of Accumulation (ROA) Use the value of your Pioneer account(s) and your immediate family s (you, your spouse, and children under 21 of a family and their trusts) existing Pioneer accounts to qualify for the lowest possible sales charge on Class A shares. List your qualifying accounts. Account Number Account Number Account Number Relationship Relationship Relationship B. Letter of Intent (LOI)* Use the value of purchases made in the past 90 days and planned future purchases to qualify for the lowest possible sales charge on Class A shares. Note: The LOI must be fulfilled within 13 months of the date of the initial purchase. Certain restrictions may apply if you are linking a SEP IRA, SIMPLE IRA, and/or Uni-K Plan. Call for more information. Open a new LOI for $50,000 $250,000 $100,000 $500,000 Change an existing LOI to $100,000 $500,000 $250,000 *Review each fund s prospectus for LOI breakpoint details. 5

6 10 Automatic Investment Plan Optional. Automatically withdraw from your bank account to invest in your Pioneer retirement account. (Complete Section 12.) Invest $ Amount In Pioneer fund Start Date* ($50 minimum, $100 minimum for Cash Reserves) the (day) of (month) every month or quarter the (day) of (month) every month or quarter the (day) of (month) every month or quarter *If no start date is provided, the option will be established the day it is received, and the bank account will be drafted the following month. Note: Please note that all contributions made into a SEP IRA should come from the employer. 11 Systematic Exchange Automatically exchange shares from one Pioneer fund into another Pioneer fund with the identical registration and share class. (The originating fund must have a minimum balance of $5,000 to establish this service. Automatic exchanges will continue until the balance of the originating fund is zero, unless you advise Pioneer otherwise.) Exchange $ Amount or Shares Indicate $ OR % From Fund/Account # Into Fund/Account # Start Date* the (day) of (month) every or month ($250 min.) quarter ($500 min.) the (day) of (month) every or month ($250 min.) quarter ($500 min.) the (day) of (month) every or month ($250 min.) quarter ($500 min.) the (day) of (month) every or month ($250 min.) quarter ($500 min.) *If no start date is provided, the option will be established the day it is received, and automatic exchanges will take place the following month. 12 Bank Information Required to establish bank instructions to redeem and/or purchase from your bank checking or savings account. Attach a preprinted check marked Void (Starter checks are not accepted for bank information) OR Complete the fields below using your bank account information and routing numbers obtained from your bank. Checking Account Savings Account Name on Bank Account (First, Middle initial, Last) Bank Account Number Bank ABA Routing Number Bank Name Bank Telephone Number Note: To update or add bank information at a later date, use the Retirement Plans Accounts Options Form. Additional documentation will be required to add or update this information at a later date. 6

7 13 Your Signature USA PATRIOT Act Certification: By signing below, I certify that I have received, read, and understand the USA PATRIOT Act information provided by Pioneer and that the information that I am providing is true and accurate. I understand that Pioneer will not accept money and/or open this account on my behalf if my identity cannot be properly verified. I authorize Pioneer to inquire from any source, including a consumer reporting agency, as to my identity (as required by federal law) at account opening, at any time throughout the life of the account, and thereafter for debt collection or investigative purposes. Please be advised that pursuant to state Unclaimed Property Laws, your account assets may be escheated to the state of residence on your account if the following occurs: 1. Mail sent to your address of record is returned and attempts to r to you are unsuccessful; and 2. You do not contact us to maintain a current address; and 3. Your account remains dormant, which is generally defined by state law(s) as inactive for an extended period of time (usually three to five years), in which no contact has been made with the shareowner. I hereby establish a Pioneer IRA, Roth IRA, Inherited IRA, or SEP-IRA; incorporate the terms and conditions of the Pioneer Individual Retirement Plan and Custody Agreement; and appoint Pioneer Investment Management USA Inc. to serve as custodian. I verify that (1) I have received a current prospectus for each fund selected in this application and agree to be bound by its terms and the terms of this application; (2) any contribution designated as a rollover qualifies for rollover treatment and constitutes an irrevocable election to have such amount treated as a rollover contribution for federal income tax purposes; and additionally; if I am enclosing a check representing a rollover that has been distributed from another IRA within the past 60 days, I further certify that I have not rolled over any IRA distribution to any other IRA account registered in my name within a 12-month period; (3) under penalties of perjury, my social security number shown on this application is correct; (4) I consent to the custodian s fee; and (5) I understand that my account is automatically eligible for telephone and online transactions unless indicated otherwise in Section 6 and that the fund(s) will allow reasonable procedures to confirm that each telephone or online transaction is genuine. I understand that each telephone transaction will be tape-recorded, authorized by my personal identification number (PIN), and confirmed in writing. If these or similar procedures are not followed, the fund(s) may be liable for any loss due to unauthorized or fraudulent instructions. In all other cases, I bear the risk of loss for unauthorized or fraudulent telephone and/or online transactions, and none of the Pioneer mutual funds, Pioneer Investment Management Shareholder Services, Inc., or their affiliated companies, or their directors, trustees, or employees will be liable for any loss, damage, or expense as a result of action upon, and will not be responsible for the authenticity of any telephone and/or online instructions that they reasonably believe to be authentic and authorized. I understand that special rules apply to Inherited IRAs and that it is my sole responsibility to determine if I am eligible to establish an Inherited IRA. Additionally, I assume responsibility for determining if I am eligible to base payouts for the Inherited IRA on life expectancy. I understand and consent that if I have federal income tax withheld for any distribution and my state of residence requires tax withholding, Pioneer will withhold the applicable state tax from my distribution. Under penalties of perjury: (1) The Taxpayer Identification Number (Social Security Number) shown on this form is correct. (2) I am not subject to backup withholding because (a) I am exempt from backup withholding; or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of failure to report all interest or dividends; or (c) the IRS has notified me that I am no longer subject to backup withholding. (3) I am a U.S. citizen or other U.S. person (as defined by the IRS on Form W-9). (4) I am exempt from FATCA reporting (if applicable). Certification instructions: You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding. The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. X Signature of Individual X Signature of Attorney-in-Fact or Conservator Date (Month/Day/Year) Date (Month/Day/Year) Spousal Consent and Agreement to Treat Plan Account as Separate Property I hereby give to the Plan Owner any interest I have in the assets held in this Plan and consent to the above designation. I hereby agree and acknowledge that I understand that the assets in the Plan are the separate property of the Plan Owner and that any community property interest in such assets is extinguished by this agreement X Signature of Spouse* Date (Month/Day/Year) *Required only if you reside in a community property state (AZ, CA, ID, LA, NV, NM, PR, TX, WA, WI) and have named a primary beneficiary other than your spouse 14 To Be Completed by Investment Representative Representative Number Branch Number Telephone Number Representative Name (First, Middle Initial, Last) Firm Name (or Clearing Firm, if applicable) Street Address City State Zip X Authorized Signature Representative Authorized Signature - Principal (if required by your broker/dealer) 7

8 Securities offered through Pioneer Funds Distributor, Inc., 60 State Street, Boston, MA Underwriter of Pioneer mutual funds, Member SIPC 2015 Pioneer Investments us.pioneerinvestments.com

9 Pioneer Investments Retirement Plans IRA Rollover/Transfer/Conversion Form Use this form to initiate a direct rollover, transfer, or conversion to a Pioneer IRA. To avoid a delay in processing your request, contact the current custodian/trustee/plan administrator for their requirements prior to completing this form. Mail to Pioneer Investment Management Shareholder Services, Inc. (PIMSS), P.O. Box 55014, Boston, MA Overnight Address: 30 Dan Road, Canton, MA If you have any questions, please call Pioneer s Employer-Sponsored Plan Department at Note: Pioneer requires the original form in order to process your request. Faxed copies will not be accepted. Rolling over an Employer-sponsored plan, 403(b), or Governmental 457 plan to a Pioneer IRA: To initiate a direct rollover, first complete all forms required by the employer maintaining your current plan. (If any forms require Pioneer s signature, submit them along with this form.) If your employer has already issued your distribution check, simply send the check within 60 days of receipt to Pioneer along with your retirement plan application. Converting to a Pioneer Roth IRA: To initiate a conversion to a Roth IRA, complete the entire form, ensuring that Section 5 - Tax Withholding Election is completed. See special instruction above if assets are being directly converted from an Employer-sponsored plan, 403(b), or Governmental 457 plan to Pioneer. Please complete all sections. Please print in blue or black ink. 1 Investor Information First Name, Middle Initial, Last Name Birthdate (mo/day/yr) Social Security Number Street Address Daytime Telephone Number Evening Telephone Number City State Zip Code Please check this box if you are over age 70½ and need to set up required minimum distributions. (Contact Pioneer to obtain a Required Minimum Distribution Form.) 2 Current Retirement Account Information Check here if your existing retirement account is invested at Pioneer. If assets are already invested in Pioneer mutual funds, they will not be liquidated but will be transferred in kind and reregistered with Pioneer Investment Management, Inc., as custodian/trustee. A. Current Custodian/Trustee Name of Current Custodian/Trustee/Employer Sponsoring Plan Telephone Number Street Address Contact Person City State Zip Code B. Type of Retirement Account Traditional IRA SEP-IRA 403(b)/ORP Coverdell ESA Rollover IRA Roth IRA SIMPLE IRA* Governmental 457 plan Other Employer-sponsored retirement plan** (including 401(k), pension, and profit sharing) C. Account Information Fund Number(s) and Account Number(s) All accounts under my Social Security Number (Indicate each fund and account number.) Please attach a copy of your most recent account statement. *May only be transferred to another SIMPLE IRA during the first two years of participation in order to avoid IRS penalty. **Rollovers from employer-sponsored plans may require additional paperwork; please check with your employer. 3 Amount Transfer/Rollover/Conversion All assets from the retirement account(s) listed in Section 2 Only $ or % of the retirement account(s) listed in Section 2 Total Roth amount included in transfer/rollover/conversion: $ Date of First Roth Contribution: (please complete reverse side)

10 4 What Type of Pioneer Individual Retirement Account Do You Want? Complete A and B. Check here if you are converting non-roth IRA accounts to a Pioneer Roth IRA. Current custodian, please note: Pioneer will accept the assets as a direct conversion. A. Please check type of Pioneer Individual Retirement Account: Traditional IRA Roth IRA SEP-IRA Coverdell ESA Other Rollover IRA Inherited-IRA SIMPLE IRA Beneficiary IRA B1. Invest in a new Pioneer IRA as indicated above. I have attached a completed Pioneer IRA application. OR B2. Invest in my existing Pioneer IRA(s) listed below: Fund Name/Account Number % of Proceeds Fund Name/Account Number % of Proceeds Fund Name/Account Number % of Proceeds 5 Tax Withholding Election Complete this section only if you are converting non-roth IRA to a Roth IRA. If neither box is checked, Option A will apply. A. I elect not to have federal income tax withheld from the converted amount. I understand that I will be liable for payment of income tax due on the taxable amount resulting from the conversion. B. I elect to have a minimum of 10% withheld from the converted amount for payment of federal income tax due on the taxable amount resulting from the conversion; or % (indicate higher percentage if desired). Important: If you choose Option B and are under age 59½, an early withdrawal penalty tax may apply to the amount of withholding. Important state tax withholding information: If you elect to have federal income tax withheld from your retirement plan distribution (or if Pioneer is required to withhold 20% mandatory withholding), and your state of residence requires mandatory state tax withholding, Pioneer is also required to withhold state income tax. Please contact your state Department of Revenue or a qualified tax advisor for additional information. There can be no assurance that current state tax laws and IRS rules will remain constant. 6 Signature PATRIOT Act Certification: By signing below, I certify that I have received, read and understand the PATRIOT Act information provided by Pioneer and that the information I am providing is true and accurate. I understand that Pioneer will not accept money and/or open this account on my behalf if my identity cannot be properly verified. I authorize Pioneer to inquire from any source, including a consumer reporting agency, as to my identity (as required by federal law), creditworthiness, and ongoing eligibility for the account (and that of my spouse if I live in a community property state) at account opening, at any time throughout the life of the account, and thereafter for debt collection or investigative purposes. I authorize the liquidation of the account(s) specified in Section 2 in the amount(s) indicated and the rollover/transfer or conversion of all proceeds to Pioneer as successor custodian/trustee. For conversion to a Roth IRA, I certify that I am eligible to convert any amount designated as a conversion to a Roth IRA. I understand that a conversion is a taxable event and authorize the current custodian to withhold taxes as indicated in Section 5; and (2) that if I elect to have federal income tax withheld from my distribution (or if Pioneer is required to withhold 20% mandatory withholding), and my state of residence requires mandatory state tax withholding, I understand and consent to Pioneer s withholding state income tax. If I am converting a Pioneer IRA to a Pioneer Roth IRA, I understand and acknowledge that all elections and designations (e.g., fund selection, beneficiaries, etc.) made under the existing Pioneer IRA may remain in effect on the new Roth IRA upon conversion (unless I instruct otherwise) and any contingent deferred sales charge (CDSC) will be transferred pro-rata to the new Roth IRA. X Your Signature (required) Date Ask your present custodian or trustee if a Medallion Signature Guarantee or any additional paperwork is required to complete your transfer. For your protection, a Medallion Signature Guarantee is required for certain redemption requests. A Medallion Signature Guarantee may be obtained from a U.S. domestic bank or trust company, broker/dealer, clearing agency, or savings association. Notarized signatures will not be accepted. 7 Acceptance Pioneer will complete this section and send it to your current custodian or trustee. Pioneer Investment Management USA, Inc., as Custodian of the IRA indicated in Section 4 of this form, will accept the transfer/rollover described above. Please remit as follows: 1. Make check payable to Pioneer Investment Management USA, Inc. as IRA Custodian for (account owner s name) 2. Include the following account number on the check: 3. Send a copy of this form with the check to PIMSS, P.O. Box 55014, Boston, MA X Authorized Pioneer Signature (required) 2014 Pioneer Funds Distributor, Inc., Underwriter of Pioneer mutual funds, Member SIPC P.O. Box 55014, Boston, Massachusetts us.pioneerinvestments.com

11 Pioneer Investments Retirement Plans TRADITIONAL INDIVIDUAL RETIREMENT ACCOUNT DISCLOSURE STATEMENT PLAN AND CUSTODY AGREEMENT

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13 Traditional Individual Retirement Account DISCLOSURE STATEMENT The following information is provided in accordance with the provisions of Treasury Regulation section Please read this information together with The Pioneer Individual Retirement Plan and Custody Agreement and the prospectus for the Pioneer funds you have selected as the investment for your plan contributions. You are permitted to revoke your Pioneer IRA by mailing or delivering a written notice of revocation, within seven days after the date the account is established (which is the date you signed the application) to: IRA Plan Administrator, Pioneer Investment Management USA Inc., 60 State Street, Boston, MA You may receive more information on revoking your IRA by telephoning (800) A signed and written notice is required to be delivered to the address given in this paragraph; you may not make a revocation by telephone or other means. A mailed notice shall be deemed mailed on the date of the postmark (certification or registration if sent by certified or registered mail). Upon such revocation, your entire contribution without adjustment for sales commissions, administrative expenses or fluctuation in market value will be returned to you. An IRA is a program through which taxpayers may obtain certain income tax benefits by accumulating funds to provide retirement benefits for themselves. As with most other tax-sheltered programs, certain conditions and restrictions apply: A. STATUTORY REQUIREMENTS. Your Pioneer IRA is a custodial account created for your exclusive benefit and is governed by the terms of The Pioneer Individual Retirement Plan and Custody Agreement which provides, among other things: 1. Except in the case of a rollover, or in connection with a simplified employee pension plan ( SEP ) under Section 408(k) of the Internal Revenue Code (the Code ) or a recharacterized contribution described in Section 408A(d)(6) of the Code, your contributions must be made in cash and may not exceed the contribution limit for any taxable year. 2. The custodian must be a bank, federally insured credit union, savings and loan association or a person who is eligible to act as trustee or custodian. (You cannot be your own trustee.) 3. No part of the account assets may be invested in life insurance contracts or certain collectibles. 4. Your interest in the balance in your account is nonforfeitable. 5. Your IRA assets will be maintained by the custodian in a separate account and not commingled with the assets of any other investor. 6. Distribution from your IRA either must be completed or must begin by April 1 of the year following the year in which you reach age 70½. April 1 of the year following the year in which you reach age 70½ is referred to as the required beginning date. You may take distribution in a single lump sum or in installments over a period of time measured by your life expectancy or the combined life expectancy of you and your beneficiary. 7. If you die on or after the required beginning date, then payment of the balance of your IRA must be made over a period no longer than the longer of (i) your life expectancy, or (ii) your beneficiary s life expectancy. If you die before the required beginning date, the payment of the balance of your account must be made over a period no longer than your beneficiary s life expectancy, unless you do not leave a designated beneficiary or, if the designated beneficiary elects not to use the life expectancy rule, the balance of your account must be completely distributed by the end of the calendar year that contains the fifth anniversary of your death. Life expectancy is determined pursuant to tables contained in the applicable Treasury regulations. Distributions will be made only in accordance with your written instructions or the instructions of your representative or beneficiary in the event of your disability or death. Such instructions shall specify the reasons for the distribution and if appropriate the form of payment selected. The Custodian may, however, make distributions without such instructions if ordered to do so by a court or if the account is subject to a levy of any kind. 1

14 B. TAX CONSEQUENCES. 1. You may take a Federal income tax deduction for IRA contributions to the extent described in Section d. 2. All distributions from your IRA (other than the portion which represents a return of any nondeductible contributions you made) will be taxed as ordinary income. You cannot use the special 5-year averaging rule that applies to lump sum distributions from qualified employer plans, and no part of the distribution is subject to capital gains treatment. 3. If you receive any taxable distribution from your employer s qualified plan or from a 403(b) annuity or custodial account, other than required minimum distributions, financial hardship distributions, or certain installment obligations being made for life or life expectancy or for 10 years or more, federal income tax on such distribution may be deferred by making a rollover of the distribution into an IRA (or into another qualified plan). The rollover must be made either directly to the IRA (to avoid 20% withholding), or within 60 days after this distribution is received, and be for part or all of the fair market value received. For distributions after December 31, 2001, you can roll over both the taxable and non-taxable part of a distribution from a qualified plan into a traditional IRA. However, if you have both deductible and non-deductible contributions in your IRA, you will have to keep track of your basis so you will be able to determine the taxable amount once distributions from the IRA begin. You may later roll over assets transferred to an IRA, except for after-tax contributions, into a new employer s plan if you do not mix regular IRA contributions or other funds with such assets. 4. Qualified plan distributions eligible for rollover treatment are subject to mandatory income tax withholding at the rate of 20% unless you elect to have them directly rolled over to an IRA (or to a qualified plan). A direct rollover is a direct transfer of funds from the employer plan to an IRA or a qualified plan. If you receive a distribution yourself, you may still roll over the distribution but the payor of the plan distribution must withhold 20% of the distribution. The 20% withheld is treated as received by you and is subject to tax unless you obtain other funds to replace the 20% that is withheld and contribute those funds to an IRA or a qualified plan together with the amounts you did receive. If you roll over only the 80% that you received, you will be taxed on the 20% that is withheld and that is not rolled over. Qualified plan distributions not eligible for rollover treatment are subject to federal income tax withholding but you may elect not to have withholding apply to such distributions. 5. You may withdraw part or all of the assets from your IRA at any time. If you reinvest them in another IRA within 60 days, the transaction will be treated as a tax-free transfer and you will not be currently liable for Federal income tax on the amount rolled over (nor would there be any premature distribution penalty tax). Only one IRA distribution within any 12-month period may be rolled over in an IRA-to-IRA rollover transaction. The 12-month waiting period begins on the date you receive an IRA distribution that you subsequently roll over, not the date you complete the rollover transaction. A custodian to custodian transfer of assets, however, is not a rollover, and is not subject to the once-a-year limitation. 6. You will be subject to an additional tax of 10% on any taxable distribution (including amounts deemed distributed as a result of any prohibited transaction) made to you from your IRA before you attain age 59½ unless such distribution is made: (a) in periodic installments at least once per year over your life expectancy or your and your beneficiary s joint life expectancy; (b) on account of your disability; or (c) to your beneficiary upon your death. If certain conditions are satisfied, the 10% penalty also does not apply to withdrawals for: (i) medical expenses that exceed 7½% of your adjusted gross income, (ii) certain first-time homebuyer expenses (up to a lifetime limit of $10,000), (iii) certain qualified higher education expenses, (iv) certain health insurance premiums if you are unemployed, or (v) distributions pursuant to an IRS levy for payment of overdue taxes. If certain conditions are satisfied, the 10% penalty also does not apply to withdrawals for: (i) medical expenses that exceed the applicable percentage of your adjusted gross income, (ii) certain first-time homebuyer expenses (up to a lifetime limit of $10,000), (iii) certain qualified higher education expenses, (iv) certain health insurance premiums if you are unemployed, (v) distributions pursuant to an IRS levy for payment of overdue taxes, or (vi) distributions that are defined by the Code as qualified reservist distributions. 7. Your IRA is a tax-sheltered account. Not only might you get a tax deduction for contributions to the plan, but also all your earnings (dividends and capital gains) in the account are not currently taxable. Tax is deferred until you receive distributions. 8. If all or a portion of your IRA is transferred to a spouse or former spouse pursuant to a divorce decree or separation agreement, such a transfer will not be taxable as a distribution to you. Your spouse or former spouse shall be treated as the owner of the IRA into which the shares were transferred. 2

15 9. For tax years beginning after December 31, 2001, if you are an eligible individual, you may be able to claim a tax credit for a percentage of your qualified retirement savings contributions, such as contributions to your traditional or Roth IRA or salary reduction contributions to your SEP or SIMPLE. To be eligible, you must be at least 18 years old as of the end of the year, and you cannot be a student or an individual for whom someone else claims a personal exemption. Also, your adjusted gross income (AGI) must be below a certain amount. C. CONTRIBUTIONS. Annual contributions may be made to your IRA subject to the following limitations: 1. For any individual, the maximum allowable regular IRA contribution shall be the lesser of 100% of his/her compensation for the year or the contribution limit. The contribution limit is $5,500 (for tax year 2014 and 2015). The regular IRA contribution amounts are increased annually to reflect a cost-of-living adjustment, if any. Individuals who have reached the age of 50 before the close of the tax year may make an additional catch-up contribution to the IRA for that tax year up to $1, If you are married, file a joint tax return and your compensation is less than your spouse s (including zero), you and your spouse may each fund an IRA according to the limits for funding in Section C; Paragraph 1. However, the total contributions to both of your IRAs may not exceed the combined compensation of you and your spouse. 3. If you participate in your employer s Simplified Employee Pension (SEP) plan, your employer may make SEP contributions to your IRA. You may still contribute to your IRA. However, when your employer makes SEP contributions on your behalf, you are considered covered by an employer retirement plan. Therefore, your ability to deduct your IRA contributions may be limited depending on your modified adjusted gross income (MAGI). 4. An employer may establish a SIMPLE retirement plan under Section 408(p) of the Code. Under such Plan, the employer may make contributions to individual retirement accounts established for each employee. Such individual retirement accounts must, by their terms, be limited to contributions under a SIMPLE retirement program. If you are adopting a Pioneer IRA as part of a SIMPLE plan, you must use the Pioneer SIMPLE form of Individual Retirement Account. 5. An individual may establish a Roth IRA. A Roth IRA is a program through which taxpayers may obtain certain income tax benefits by accumulating funds to provide retirement benefits for themselves. Unlike a traditional IRA, contributions to a Roth IRA cannot be deductible. However, a Roth IRA is a tax-sheltered account and, if certain conditions are met, all distributions from a Roth IRA will be free from federal income taxes. To establish a Pioneer Roth IRA, you must use the Pioneer Roth form of Individual Retirement Account. 6. Any contribution to your IRA by your employer other than to a SEP-IRA will be treated as compensation, and will be includible as income for the year in which contributed whether or not a deduction for such payment is allowed. 7. Divorced individuals may make IRA contributions up to the lesser of the contribution limit or alimony (plus compensation, if any) received during the year. 8. No contribution (other than a rollover or SEP contribution) may be made for any year by an individual on his or her own behalf if the individual attained age 70½ before the close of such year. 9. Contributions for any year may be made no later than the due date (without extensions) for filing that year s Federal tax return. SEP contributions made by the employer may be made up until the due date (including extensions) of the employer s federal tax return. D. DEDUCTIONS. 1. Generally, you will be an active participant for any year in which any contribution was made or required to be made on your behalf to a defined contribution plan or in which you were eligible to participate in a defined benefit plan. 2. If you are an active participant and have: (a) AGI (Adjusted Gross Income) equal to or less then the bottom of the applicable phase-out range in the table below, you will be allowed to deduct your full IRA contribution; (b) AGI equal to or over the top of the applicable range, you will be allowed no deduction; and (c) AGI between the bottom and top of the applicable range, you will be allowed a proportional deduction. 3

16 3. If you are an active participant, married, filing individually and have: (a) AGI of $10,000 or over, you will be allowed no deduction; or (b) AGI between 0 and $10,000, you will be allowed a proportional deduction. (A married individual who files a separate return will be considered an active participant even if he/she is not covered by a pension plan if his/her spouse is covered by a pension plan and they lived together at any time during the year.) 4. The phase-out ranges for single taxpayers and married taxpayers filing jointly are as follows: Tax years beginning in: Single taxpayers 2014 $60,000-$70, $61,000 - $71,000 Tax years beginning in: Married taxpayers filing jointly 2014 $96,000-$116, $98,000 - $118,000 The phase-out ranges for single taxpayers and married taxpayers filing jointly listed above are increased annually to reflect a cost-ofliving adjustment, if any. The phase-out range of 0 to $10,000 of AGI for married and filing separately does not increase. If you are married, filing jointly, and you are not an active participant, but your spouse is an active participant, you may be able to make a deductible contribution subject to a phase-out range of $181,000 and $191,000 for 2014; and $183,000 and $193,000 for This phase-out range will be increased annually to reflect a cost-of-living adjustment, if any. If you are married (and lived together at any time during the year), filing separate returns, and you are not an active participant but your spouse is an active participant, you may be able to make a deductible contribution subject to a phase-out range of $0-$10, AGI (Adjusted Gross Income) is determined before any IRA deduction is taken into account. 6. No deduction is allowed for rollover contributions. E. GENERAL STATEMENTS. 1. For any year in which you (or your beneficiary) engage in a prohibited transaction, that is, any improper use of your IRA, the account will lose its tax exemption as of the first day of such year and the fair market value of the account on such first day must be included in your gross income for that tax year. Some examples of prohibited transactions with an IRA are: borrowing money from it; selling property to it; receiving unreasonable compensation for managing it; and using it as security for a loan. 2. In the event of your death, the entire amount (other than the portion which represents a return of any nondeductible contributions you made) received by your beneficiary will be taxed as ordinary income when received (unless the beneficiary is your spouse who rolls over the distribution). There is no death benefit exclusion from Federal income tax. The entire account is includible in your estate for Federal estate tax purposes but is not subject to Federal gift tax. 3. If you do not begin to take distribution by April 1 of the year following the year you attain age 70½ (or if you take less of a distribution than you should in any year) you will be subject to an excise tax equal to 50% of the amount you should have withdrawn from the account but did not. You or your representative or beneficiary in the event of your disability or death are solely responsible for determining the time and amount of any distribution from the account and compliance with the requirements for required minimum distributions under the Internal Revenue Code and Regulations thereunder. 4. If you contribute for any year an amount in excess of that which you are allowed to contribute, the excess amount will be subject to a 6% excise tax each year until the excess is corrected by a withdrawal or by applying it toward a subsequent year s contribution. 5. You may be required to file Form 5329 (Return for Individual Retirement Arrangement Taxes) for any tax year in which you have made an uncorrected excess contribution to, or taken a premature, insufficient or excess distribution from, your IRA. 4

17 6. The form of the Pioneer Traditional IRA (Articles I through VII) has been approved by the Internal Revenue Service as Form 5305-A. The Internal Revenue Service approval applies only to the form of the IRA and does not constitute approval of the operations of the IRA and does not represent a determination of the merits of the account or the merits of Pioneer Funds. 7. The Internal Revenue Service generally requires that Federal income tax be withheld from all distributions made from an IRA. Some states have similar tax withholding requirements. (A request for distribution from your Pioneer IRA will not be in good order unless you specify whether or not tax is to be withheld.) 8. Further information on ( Individual Retirement Arrangements ( IRAs )) IRAs including IRS Publication 590 can be obtained from any district office of the Internal Revenue Service. F. FINANCIAL DISCLOSURE. See the prospectus(es) for the Pioneer funds you have selected for detailed information about sales charges and other expenses and fees charged against the fund. The Custodian will receive an annual fee for each fund held in your IRA in the amount set forth in the current fee schedule contained in the Application or otherwise available from Pioneer. This fee, if not paid separately, shall, at the discretion of the Custodian, either be charged against your account or your annual contribution. In lieu of paying custodian fees annually, an individual may choose to pay the one-time fee set forth in the fee schedule, in which case no further custodian fees will be charged against the IRA for the lifetime of the individual. Income dividends and capital gains distributions earned on the contributions you invest in any Fund will be computed and allocated on a per share basis and be determined by the number of Fund shares you own on the record date for such dividend or distribution. Earnings or growth in the value of your account, however, can neither be guaranteed nor projected. 5

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19 Traditional Individual Retirement Account PLAN AND CUSTODY AGREEMENT (Under section 408(a) of the Internal Revenue Code) Form 5305-A (Rev. March 2002) Department of the Treasury, Internal Revenue Service. You do not need to send this Form 5305-A to Pioneer or file it with the IRS. Please keep it for your records. The Depositor whose name appears on the Application (as defined below) is establishing an individual retirement account under Section 408(a) to provide for his or her retirement and for the support of his or her beneficiaries after death. The Custodian named in the Application has given the Depositor the disclosure statement required under Regulation Section The Depositor has assigned the custodial account an initial contribution in cash, as specified on the Application. The Depositor and the Custodian make the following agreement: ARTICLE I Except in the case of a rollover contribution described in section 402(c), 403(a)(4), 403(b)(8), 408(d)(3), or 457(e)(16), an employer contribution to a simplified employee pension plan as described in section 408(k), or a recharacterized contribution described in section 408A(d)(6), the custodian will accept only cash contributions up to $3,000 per year for tax years 2002 through That contribution limit is increased to $4,000 for tax years 2005 through 2007 and $5,000 for 2008 and thereafter. For individuals who have reached the age of 50 before the close of the tax year, the contribution limit is increased to $3,500 per year for tax years 2002 through 2004, $4,500 for 2005, $5,000 for 2006 and 2007, and $6,000 for 2008 and thereafter. For tax years after 2008, the above limits will be increased to reflect a cost-of-living adjustment, if any. ARTICLE II The Depositor s interest in the balance in the custodial account is nonforfeitable. ARTICLE III 1. No part of the custodial account funds may be invested in life insurance contracts, nor may the assets of the custodial account be commingled with other property except in a common trust fund or common investment fund (within the meaning of Section 408(a)(5)). 2. No part of the custodial funds may be invested in collectibles (within the meaning of Section 408(m)) except as otherwise permitted by Section 408(m)(3), which provides an exception for certain gold, silver and platinum coins, coins issued under the laws of any state, and certain bullion. ARTICLE IV 1. Notwithstanding any provision of this agreement to the contrary, the distribution of the Depositor s interest in the custodial account shall be made in accordance with the following requirements and shall otherwise comply with Section 408(a)(6) and regulations thereunder, the provisions of which are herein incorporated by reference. 2. The Depositor s entire interest in the custodial account must be, or begin to be, distributed not later than the Depositor s required beginning date, April 1 following the calendar year in which the Depositor reaches age 70½. By that date, the Depositor may elect, in a manner acceptable to the Custodian, to have the balance in the custodial account distributed in: (a) A single sum or (b) Payments over a period not longer than the life of the Depositor or the joint lives of the Depositor and his or her designated beneficiary. 3. If the Depositor dies before his or her entire interest is distributed to him or her, the remaining interest will be distributed as follows: (a) If the Depositor dies on or after the required beginning date and: (i) the designated beneficiary is the Depositor s surviving spouse, the remaining interest will be distributed over the surviving spouse s life expectancy as determined each year until such spouse s death, or over the period in paragraph (a)(iii) below if 7

20 longer. Any interest remaining after the spouse s death will be distributed over such spouse s remaining life expectancy as determined in the year of the spouse s death and reduced by 1 for each subsequent year, or, if distributions are being made over the period in paragraph (a)(iii) below, over such period. (ii) the designated beneficiary is not the Depositor s surviving spouse, the remaining interest will be distributed over the beneficiary s remaining life expectancy as determined in the year following the death of the Depositor and reduced by 1 for each subsequent year, or over the period in paragraph (a)(iii) below if longer. (iii) there is no designated beneficiary, the remaining interest will be distributed over the remaining life expectancy of the Depositor as determined in the year of the Depositor s death and reduced by 1 for each subsequent year. (b) If the Depositor dies before the required beginning date, the remaining interest will be distributed in accordance with (i) below or, if elected or there is no designated beneficiary, in accordance with (ii) below: (i) The remaining interest will be distributed in accordance with paragraphs (a)(i) and (a)(ii) above (but not over the period in paragraph (a)(iii), even if longer), starting by the end of the calendar year following the year of the Depositor s death. If, however, the designated beneficiary is the Depositor s surviving spouse, then this distribution is not required to begin before the end of the calendar year in which the Depositor would have reached age 70½. But, in such case, if the Depositor s surviving spouse dies before distributions are required to begin, then the remaining interest will be distributed in accordance with (a)(ii) above (but not over the period in paragraph (a)(iii), even if longer), over such spouse s designated beneficiary s life expectancy, or in accordance with (ii) below if there is no such designated beneficiary. (ii) The remaining interest will be distributed by the end of the calendar year containing the fifth anniversary of the Depositor s death. 4. If the Depositor dies before his or her entire interest has been distributed and if the designated beneficiary is not the surviving spouse, no additional contributions may be accepted in the account. 5. The minimum amount that must be distributed each year, beginning with the year containing the Depositor s required beginning date, is known as the required minimum distribution and is determined as follows: (a) The required minimum distribution under paragraph 2(b) for any year, beginning with the year the Depositor reaches age 70½, is the Depositor s account value at the close of business on December 31 of the preceding year divided by the distribution period in the uniform lifetime table in Regulations section 1.401(a)(9)-9. However, if the Depositor s designated beneficiary is his or her surviving spouse, the required minimum distribution for a year shall not be more than the Depositor s account value at the close of business on December 31 of the preceding year divided by the number in the joint and last survivor table in Regulations section 1.401(a)(9)-9. The required minimum distribution for a year under this paragraph (a) is determined using the Depositor s (or, if applicable, the Depositor and spouse s) attained age (or ages) in the year. (b) The required minimum distribution under paragraphs 3(a) and 3(b)(i) for a year, beginning with the year following the year of the Depositor s death (or the year the Depositor would have reached age 70½, if applicable under paragraph 3(b)(i)) is the account value at the close of business on December 31 of the preceding year divided by the life expectancy (in the single life table in Regulations section 1.401(a)(9)-9) of the individual specified in such paragraphs 3(a) and 3(b)(i). (c) The required minimum distribution for the year the Depositor reaches age 70½ can be made as late as April 1 of the following year. The required minimum distribution for any other year must be made by the end of such year. 6. The owner of two or more traditional IRAs may satisfy the minimum distribution requirements described above by taking from one traditional IRA the amount required to satisfy the requirement for another in accordance with the regulations under section 408(a)(6). ARTICLE V 1. The Depositor agrees to provide the Custodian with information necessary for the Custodian to prepare any reports required by Section 408(i) and Regulations sections and The Custodian agrees to submit to the Internal Revenue Service (IRS) and the Depositor the reports prescribed by the IRS. ARTICLE VI Notwithstanding any other articles which may be added or incorporated, the provisions of Articles I through III and this sentence will be controlling. Any additional articles that are not consistent with Section 408(a) and the related regulations will be invalid. 8