Eaton Vance Mutual Funds Non-Retirement Redemption Authorization Form

Transcription

1 Eaton Vance Mutual Funds Eaton Vance Mutual Funds Non-Retirement Redemption Authorization Form Return to: Eaton Vance Funds, P.O. Box 9653, Providence, RI Overnight Mail: Eaton Vance Funds, 4400 Computer Drive, Westborough, MA IMPORTANT INFORMATION ABOUT THIS FORM This form should only be used to request a redemption from an Eaton Vance non-retirement account. Do not use this form for retirement accounts such as IRAs, Roth IRAs, SEP-IRAs, Simple-IRAs, 401(k)s, or 403(b)s. Please complete all sections of this form. Account Information Please provide information on the account(s) you would like to redeem: Account #1 Account Owner/Entity Name: Address Account Number(s): Fund Amount Dollars Shares (%) Percent Account #2 Account Owner/Entity Name: Address Account Number(s): Fund Amount Dollars Shares (%) Percent Please attach additional pages for more accounts and funds. Eaton Vance Management

2 Eaton Vance Mutual Funds 2 Cost Basis Reporting Method Important Information: IRS regulations require us to report cost basis on mutual fund purchases made on or after January 1, Complete this section to elect or change the cost basis method(s) to be used for this redemption. If you do not make a selection, Eaton Vance will utilize the existing cost basis method on the account. If no cost basis method has been selected previously, we will apply our default method of Average Cost to all of your funds and accounts. Please note that the cost basis method used on this redemption will be applied to all future redemptions on the account(s) listed below. Revocation of Average Cost Method: If you elect Average Cost or the default to Average Cost was applied, you have the option to revoke this election, in writing, prior to the first redemption, transfer, or exchange of any covered shares from the fund in your account. If a change request is received after the first redemption, transfer, or exchange, those shares purchased under the Average Cost method must retain the basis of Average Cost. IRS Regulations do not allow the change of a cost basis election after a sale of shares has been executed. Please note: Cost basis does not apply to money market accounts. The election you make below will only apply to the accounts specified on page one of this form. The election you make below will apply to all future transactions unless you change your election. If you do not elect a cost basis depletion method, your account(s) will default to the Average Cost method. Eaton Vance offers 10 choices for cost basis depletion. The tax implications may be different for each. Please consult with your Tax Advisor and/or Financial Professional before making important tax elections for your account(s). Additional information regarding cost basis methods, including detailed examples of depletion calculations, is available on the Tax Information page at For my account(s) listed above, I elect: (please fill out section A or B below) A. One Method for all shares in all accounts shown on page 1 above (please select one): B. Different methods for individual funds and/or accounts: Fund# or All Funds Account Number: Fund# or All Funds Account Number: *If Specific Lot is selected, please specify specific purchase lot(s) to deplete (purchase date/shares/dollars). Attach additional sheets as needed to specify lots or to select cost basis method for more accounts.

3 Eaton Vance Mutual Funds 3 Payee & Mailing Instructions Choose one option: A. Make check payable to account registration and mail to account address of record. B. Make check payable to a special payee and/or mail to a special address, as provided below. (Requires Medallion Signature Guarantee on page 4 May require certification on Page 5) Check Payee First Name M.I. Last Name Address City State Zip C. Wire or ACH proceeds to an existing bank account on file. D. Wire or ACH proceeds to a bank account. I have attached a voided check and/or deposit slip. (Requires Medallion Signature Guarantee on page 4 May require certification on Page 5) Bank Name Bank Phone Number Name(s) on Account Bank Account Number Bank Routing Number Account Type: Checking Savings / Money Market Please attach a voided check here. John Sample Smith 123 Street Name Anytown, USA Your Bank Your Town USA Pay to the Order of $ Memo : : Bank Routing Number Bank Account Number Check Number Authorization A Medallion Signature Guarantee will be required on the following page if: An individual other than the account owner is completing this form and has capacity to act on behalf of the owner(s). All account owners are not signing. The check is being made payable to a different name or mailing address than on the existing account. The redemption is over $100,000. The proceeds are being sent via bank instructions that do not currently exist on the account. There been an address change on the account within the past 30 days.

4 Eaton Vance Mutual Funds 4 Please provide information about who is requesting this redemption and the reason for this redemption. ALL authorized signers must sign the below section and include a Medallion Signature Guarantee for each signature if required (see below). Signer #1 Information If you are acting on behalf of the owner, please check the appropriate capacity in which you are acting. If not listed, please check Other and specify your capacity. Shareholder Attorney-in-Fact (POA) Custodian Executor(trix) Former Minor Joint Tenant Trustee Beneficiary named on Account Other, please specify: Reason for Redemption*: *If redemption is due to death, the death date must be entered below. Depending on the Decedent s state of residence, an Inheritance Tax Waiver may also be required. Date of Death: Signature Date Medallion Signature Guarantee (if required) Please place Medallion Signature Guarantee here. The signature(s) must be guaranteed by an eligible bank, broker, dealer, credit union, national securities exchange, registered securities association, clearing agency, or savings association. Medallion Signature Guarantees shall be accepted in accordance with policies established by Eaton Vance. Notarization by a Notary Public is not acceptable in lieu of a Medallion Signature Guarantee provided by one of the eligible guarantor institutions listed above. Signer #2 Information If you are acting on behalf of the owner, please check the appropriate capacity in which you are acting. If not listed, please check Other and specify your capacity. Shareholder Attorney-in-Fact (POA) Custodian Executor(trix) Former Minor Joint Tenant Trustee Beneficiary named on Account Other, please specify: Signature Date Medallion Signature Guarantee (if required) Please place Medallion Signature Guarantee here. The signature(s) must be guaranteed by an eligible bank, broker, dealer, credit union, national securities exchange, registered securities association, clearing agency, or savings association. Medallion Signature Guarantees shall be accepted in accordance with policies established by Eaton Vance. Notarization by a Notary Public is not acceptable in lieu of a Medallion Signature Guarantee provided by one of the eligible guarantor institutions listed above. Please attach additional pages for more signatures.

5 Eaton Vance Mutual Funds 5 Certification And Signature Complete this section if: 1. Option B or D is selected in the Payee and Mailing Instructions section on page 3 AND 2. The Tax Identification Number of the recipient differs from the Tax Identification Number registered to this account. Please provide tax identification information for the recipient of the redemption. The tax identification information furnished here will be reported to the IRS for this redemption. Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 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 a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (including a U.S. resident alien). 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. 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 because you have failed to report all interest and dividends on your tax return. Certification Type - Please check one: Tax ID Number/U.S. Citizen (incl. U.S. resident alien) Non-Resident Alien (permanent resident of ) Please provide IRS Form W-8BEN with this form Limited Liability Company: Enter the tax classification (C=C corporation, S=S corporation, P=partnership C Corporation S Corporation Trust/Estate Other: The IRS does not require your consent to any provision of this Redemption Form other than the certifications required to avoid backup withholding. For tax-exempt entities, please provide a completed IRS Form W-9 with this form. Name of person, business or entity Tax-ID Number Address of person, business or entity Print Name of Authorized Signer Signature of Authorized Signer Date If you have any questions about this form, please call between 8:30am and 5:30pm Eastern Time. Visit our website at eatonvance.com