Non-Retirement Redemption Form

Transcription

1 Prudential Mutual Fund Services LLC (PMFS) A Prudential Financial company. Instructions Mailing Instructions 1 Account Non-Retirement Redemption Form For assistance: Clients (800) Pruco Financial Professionals (800) Financial Professionals (888) Use this form to redeem fund shares from non-retirement accounts. Please print using blue or black ink. Standard Prudential Mutual Fund Services LLC mail to: PO Box 9658 Providence, RI Overnight Prudential Mutual Fund Services LLC mail to: 4400 Computer Drive Westborough, MA Print account ownership information exactly as it appears on your account statement. In cases of death, an Inheritance Tax Waiver may also be required, depending on the decedent s state of residence. (required) Social Security number* (optional) or Employer identification number (optional) Account owner name (first, middle initial, last name) or entity Daytime telephone number Extension Home telephone number *Note: Please provide minor s Social Security number for UGMA/UTMA account. 2 Redemption (All information in this section is required.) 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. Amount To Be Redeemed (The amount must be rounded to the nearest whole dollar, share, or percent.) 1. Fund name 2. Fund name 3. Fund name Page 1 of 5

2 3 Cost Basis Election Check One: If you have previously elected a cost basis method, that method will be used to process the redemption(s) requested in section 2. If you have not elected a cost basis method, PMFS default cost basis method will be used to process your redemption if the shares are acquired on or after January 1, PMFS default method is Average Cost for most Prudential mutual funds and it is First In First Out (FIFO) for the Prudential Jennison MLP Fund. If you want your redemption to be processed using a different cost basis method than your existing cost basis selection, if applicable, or different from PMFS default method, then check one method from the list below.* Please consult your tax professional to determine which cost basis method is best for your personal tax situation. For additional information on cost basis regulations, please visit our Tax Center at www. prudentialfunds.com/taxcenter. You should also refer to IRS Publication 550, Investment Income and Expenses, which can be accessed at Note: Shares acquired before January 1, 2012 are considered pre-effective shares and are not subject to cost basis reporting to the IRS. However, in most cases, PMFS will provide this information to you as a service. o 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. o First In First Out (FIFO) - The earliest shares acquired will be redeemed first. o Last In First Out (LIFO) - The most recent shares acquired will be redeemed first. o Highest Cost In, First Out (HIFO) - The highest cost shares will be redeemed first. o Highest Cost Long-Term In, First Out (HILT) - The long-term highest cost shares will be redeemed first. o Highest Cost Short-Term In, First Out (HIST) - The short-term highest cost shares will be redeemed first. o Lowest Cost In, First Out (LOFO) - The lowest cost shares will be redeemed first. o Lowest Cost Long-Term In, First Out (LILT) - The long-term lowest cost shares will be redeemed first. o Lowest Cost Short-Term In, First Out (LIST) - The short-term lowest cost shares will be redeemed first o Specific Lot Depletion Method (SLDM) - This method allows you to choose which tax lot(s) you are selling, thereby giving you more control over whether you will generate a gain or loss on the transaction. You must specify the particular lot(s) to be sold at the time your redemption is requested. The gain or loss will vary, depending on which shares you choose. Please indicate the applicable information below for the tax lot(s) you want to redeem. 1. Fund/Acct. Number Date Acquired Dollar Amount Number of Shares 2. Fund/Acct. Number Date Acquired Dollar Amount Number of Shares 3. Fund/Acct. Number Date Acquired Dollar Amount Number of Shares Note: 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. * For the Prudential Jennison MLP Fund, the only allowable cost basis methods are FIFO, LIFO and SLDM Page 2 of 5

3 4 Payee Unless otherwise indicated, proceeds are made payable and mailed to the name and address indicated on your account registration. If you want redemption proceeds made payable or mailed to a name and/or address other than the shareholder of record or sent by ACH or federal wire transfer, please complete this section as well as section 4. A. If you want a check, please complete this section: Name of payee (first, middle initial, last name) Street Apt. City State Zip code B. If you want the proceeds to be sent by ACH to your financial institution, please complete this section: The minimum redemption amount for ACH is $ Your financial institution must be a member of the Automated Clearing House (ACH) system. The money will generally be received by your financial institution within three business days of the redemption. You may find ACH the more cost-effective option to send proceeds to your bank. Bank name Bank account number Bank telephone number ABA routing number (To ensure accuracy, verify with your bank.) Name of depositor on bank records Name of joint depositor on bank records Attach voided check here. Ü Ý Name on bank account Check no Street address City, State ZIP DATE PAY TO THE ORDER OF $ FOR Ü ABA number (9 digits) VOID Ý Bank account number DOLLARS Page 3 of 5

4 4 Payee C. If you want the proceeds to be sent by federal wire transfer to your financial institution, please complete this section: 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. Main bank s name Main bank s account number Bank telephone number Main bank s ABA routing number (To ensure accuracy, verify with your bank.) Name of depositor on bank records Name of joint depositor on bank records Branch s ABA routing number (To ensure accuracy, verify with your bank.) For further credit account number For further credit depositor name For further credit joint depositor name 5 Current Account Owner(s) Signature Guarantee (All shareholders named in the account must sign.) 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. Page 4 of 5

5 5 Current Account Owner(s) Signature Guarantee Place medallion signature guarantee here 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 that is 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 where the value of the transaction exceeds the value of the surety coverage indicated on the medallion imprint. Account owner s signature Joint owner s signature, if applicable Authorized signature (e.g. trustee), if applicable 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. o Administrator o Executor o Surviving Joint Owner o Appointee under POA o Former Minor o Trustee o Conservator / Guardian o Other, please specify o Custodian 6 Tax Certification (We cannot process this form without your signature.) Complete this section if you would like the tax reporting for the redemption proceeds to be done under a Social Security number or Employee identification number that is not listed on the account. Note: This section is required for redemptions due to the death of the account owner if the account is registered as an individual account or a Transfer on Death (TOD) individual account. Social Security number or Employer identification number By signing below, I certify and acknowledge that the information provided on this form is correct. Under penalties of perjury, I certify that (cross out any item that is not true): (1) The number shown on this form is my correct Social Security/Tax ID number, (2) I am not subject to backup withholding due to failure to report interest or dividend income, (3) I am a U.S. citizen or other U.S. person (including a U.S. resident alien), and (4) I am not subject to FATCA reporting If you crossed out item 3 above, please indicate country of citizenship and attach applicable IRS Form W-8(BEN,BEN-E,EP, ECI,IMY). The IRS does not require your consent to any provision of this document other than certification required to avoid backup withholding. Joint owner s / authorized signature, if applicable Page 5 of 5