MainStay Funds IRA/SEP/Roth IRA Distribution Form

Transcription

1 MaiStay Fuds IRA/SEP/Roth IRA Distributio Form Do ot use for IRA Trasfers or SIMPLE IRA INSTRUCTIONS Before completig this form, please refer to the applicable Custodial Agreemet ad Disclosure Statemet regardig distributio eligibility ad applicable rules. This form must be completed by the Accout Ower or, if deceased, the Accout Ower s beeficiary. If there is more tha oe beeficiary, each should complete a separate form, but all beeficiaries directios for a sigle accout must be submitted together. The rules goverig IRA post-death distributios are complex ad ivolve a umber of key dates ad deadlies. Beeficiaries should cosult their tax advisor or the Iteral Reveue Service with ay questios. If a ew IRA is to be established usig the distributed amout, please attach a completed MaiStay Fuds IRA Applicatio to this form (e.g. registratio chage due to death of shareholder or due to divorce decree or settlemet agreemet). If proceeds from the IRA are to be distributed i cash to a beeficiary, a completed IRS Form W-9 is also required i additio to this form. If you do ot complete Sectio 8, federal icome tax (ad state icome tax i the listed states) will be withheld from all distributios. A completed IRS Form W4-P is required oly for periodic distributios. For distributios over $100,000 ad/or for distributios ivolvig a differet payee or address, follow the istructios for a Medallio Sigature Guaratee i Sectio 9. You ca chage your choice of tax withholdig o your systematic withdrawal pla at ay time, eve if you are ot requestig a ew distributio at the time. To chage your choice of tax withholdig complete oly Sectio 1, Sectio 4, Sectio 8, ad Sectio 9. You ca chage your bak iformatio by completig Sectio 1, Sectio 4, Sectio 6, ad Sectio 9. For a rollover to a Qualified Pla, choose Rollover to a Qualified Pla i Sectio 2 ad choose Sigle Distributio i Sectio 3, Part A. Provide the Qualified Pla s payee ame ad address i Sectio 5. Idicate o withholdig i Sectio 8 ad sig Sectio 9. Complete Sectio 1 also. There will be a madatory 10% withholdig o distributios from a Traditioal IRA that are mailed to a P.O. Box if you are a U.S. citize ad have o physical address o file. Ay questios you may have cocerig withholdig or distributios should be directed to your tax advisor or the Iteral Reveue Service. 1 CURRENT ACCOUNT INFORMATION s Name of Idividual s Street Address City State Zip Code s Accout Ower s Date of Birth MM/DD/YYYY Social Security Number 2 REASON FOR DISTRIBUTION (Check oe type of distributio oly.) l Early Distributio with Exceptio (Substatially equal periodic paymets. 10% early distributio pealty does ot apply. See Sectio 3, Part B.) l Early Distributio (uder age , o exceptio to 10% early distributio pealty applies) l Normal Distributio (age or over) l Disability (attach siged physicia s statemet) l Death (attach a certified copy of Accout Ower s Death Certificate ad all pertiet documets as oted i istructios) l Required Miimum Distributio after age (IRAs ad SEPs) l Required Miimum Distributio (Iherited IRAs ad Iherited Roth IRAs) l Withdrawal of excess cotributio for the tax year (eter either the curret year or previous year) l Trasfer of all or a portio of this accout to a IRA of a former spouse uder a decree or uder a writte istrumet to such divorce (attach court certified documetatio). Medallio Sigature Guaratee required. See Sectio 9. l Rollover to a Qualified Pla 1

2 3 DISTRIBUTION FREQUENCY (Select oe, A - E below. Complete Sectio 4 to list accouts to be distributed.) A. l Sigle Distributio Idicate amout to be redeemed i Sectio 4 ad complete Sectio 5. Uless idicated otherwise, the proceeds will be mailed via check to your address of record. B. l Periodic Distributios (Choose oe.) Complete oe of the optios below ad complete Sectios 4 ad 5. Uless idicated otherwise, the proceeds will be mailed via check to your address of record. The frequecy chose below will apply to all accouts listed i Sectio 4. Begi my distributio the 5th or the followig busiess day of s Date MM/YYYY Frequecy: l Mothly l Quarterly l Semiaually l Aually l Systematic Withdrawal Pla Miimum fud/accout value for Ivestor Class, Class B, ad Class C shares: $10,000. (Miimum $100 per frequecy. Idicate dollar amout i Sectio 4.) l Required Miimum Distributio After Age 70 1 / 2 1 Idicate your IRA accout balace at the ed of the year precedig the year for which the required miimum distributio is to be calculated. You should cosult with your tax advisor to determie if this amout should be adjusted to reflect certai outstadig rollovers ad recharacterizatios of Roth IRA coversios. Your required miimum distributio amout will be calculated usig the IRS s Uiform Lifetime Table uless you are married ad your spouse is the sole desigated beeficiary of your IRA ad is more tha 10 years youger, i which case the amout will be calculated usig the IRS s Joit Life ad Last Survivor Expectacy Table. (To view these tables, visit ad view IRS Publicatio 590.) Accout Value as of December 31 of prior year: $ l Spouse beeficiary who is more tha 10 years youger. l Substatially Equal Periodic Paymets Calculatio Method (Check oe box.) l Life Expectacy Method. Aually recalculate my distributio usig the followig IRS life expectacy table: (Check oe box) l Uiform Lifetime Table l Sigle Life Expectacy Table l Joit Life ad Last Survivor Expectacy Table (complete beeficiary s date of birth i Sectio 5) l Fixed Distributio Method. I have calculated my fixed aual distributio i the amout idicated below usig a method for determiig substatially equal periodic paymets described i IRS Reveue Rulig (which, alog with Frequetly Asked Questios o the rulig, ca be foud at Amout to be distributed $ /year C. l Distributio due to the death of the Accout Ower, distributed from the Beeficiary s accout. Based o Sigle Life Expectacy Table. Must supply Accout Ower s Date of Death. D. l Divideds as Credited (Normal Distributio must be checked i Sectio 2, ad No Withholdig must be elected i Sectio 8.) E. l Capital Gais as Credited (Normal Distributio must be checked i Sectio 2, ad No Withholdig must be elected i Sectio 8.) / s Spouse s Date of Birth MM/DD/YYYY s MM/DD/YYYY 1. You caot roll over ay amout to the extet it is a RMD from the distributig IRA. Please refer to IRS Publicatio 590 by visitig ad cosult your persoal tax advisor for further iformatio. 2

3 4 ACCOUNTS TO BE DISTRIBUTED FROM (Use Sectio 7 if additioal space is eeded.) s Fud Name Class Accout Number s Fud Name Class Accout Number s Fud Name Class Accout Number s Fud Name Class Accout Number s Fud Name Class Accout Number $ or All Shares $ or All Shares $ or All Shares $ or All Shares $ or All Shares 5 FORWARD DISTRIBUTION TO (Select oe of eight choices below.) l My address of record via check. l My bak accout via bak wire. MaiStay Fuds charges a fee of $11 for this optio. (Available for sigle distributios oly. You must complete Bak Iformatio i Sectio 6. The receivig bak may charge a fee. Medallio Sigature Guaratee may be required.) l Please take the wire fee from my requested distributio amout. l Please take the wire fee from the remaiig balace of my accout. l My bak accout via the Automated Clearig House (ACH). (For periodic distributios ad redemptios up to $100,000. You must complete Bak Iformatio i Sectio 6.) l IRA of Accout Ower s former spouse l Accout Ower s beeficiary etitled to paymet by reaso of the Accout Ower s death s Beeficiary Name Beeficiary Date of Birth MM/DD/YYYY Beeficiary Relatioship: l Spouse l Other l Special Payee (icludig Qualified Plas) via check or bak wire. Medallio Sigature Guaratee required. (Provide ame ad address below if differet tha accout registratio. Provide bak iformatio for bak wire i Sectio 7.) s Name s Address s City State Zip l A ew MaiStay IRA (MaiStay IRA Applicatio attached) l My o-ira MaiStay Fud Accout s Fud Name Class Accout Number 3

4 6 BANK INFORMATION Your pre-prited voided check or pre-prited savigs deposit slip is required for the ACH ad Bak Wire Redemptio optios. The establishmet of these optios will be delayed without this iformatio. A Medallio Sigature Guaratee may be required if the bak accout registratio does ot exactly match your MaiStay accout registratio. l Bak iformatio chage oly. 7 ADDITIONAL DETAILS OR INSTRUCTIONS Attach Your Pre-Prited Voided Check Or Pre-Prited Savigs Deposit Slip Here. Starter Checks Caot Be Accepted. Medallio Sigature Guaratee May Be Required. 8 CHOICE OF TAX WITHHOLDING (10% federal taxes ad ay applicable state taxes will be withheld if o electio is made.) Federal Withholdig Uder the tax law, federal icome taxes must be withheld at a flat rate of 10% from this distributio, uless you elect o withholdig by markig the appropriate box below. You ca chage this electio at ay time by filig a ew form. Eve if you elect ot to have ay federal icome taxes withheld, you are liable for paymet of taxes o the taxable portio of your distributios. You may also be subject to pealties uder the estimated tax paymet rules if your paymets of estimated tax withholdig are ot adequate. State Withholdig I additio to the federal icome tax withholdig requiremets, some states require withholdig of state icome taxes. Although state laws differ, those states requirig withholdig geerally allow you to elect out of withholdig. The states requirig withholdig as of Jauary 1, 2011, are AR, CA, DE, GA, IA, KS, MA, MD, ME, NC, NE, OK, OR, VA, ad VT. The state withholdig electio o this form relates oly to these states. If you are usure as to whether your state requires withholdig, cosult your tax advisor. l I elect ot to have federal ad state taxes withheld from this distributio. l I elect to oly withhold the miimum of 10% for federal taxes. (This optio may ot be available for residets of the states listed above.) l I elect to oly withhold % for federal taxes. (This optio may ot be available for residets of the states listed above.) l I elect to withhold % for federal taxes ad the miimum for state taxes. (This optio oly available for residets of the states listed above.) l I elect to withhold % for federal taxes ad $ for state taxes. (This optio oly available for residets of the states listed above.) 4

5 9 SIGNATURE By sigig below, you certify that you have read Sectio 8, Choice of Tax Withholdig, ad that the iformatio provided o the form regardig your status with respect to the accout ivolved ad i all other aspects is correct. You also certify that the actio directed o this form fully complies with the terms of the applicable Custodial Agreemet ad Disclosure Statemet goverig your IRA. s Sigature of Accout Ower, or Beeficiary if Accout Ower is deceased Daytime Telephoe Number Date MM/DD/YYYY Medallio Sigature Guaratee required for: 1. All distributios over $100, Differet Payee ad/or Address for: Sigle ad Periodic Distributios Systematic Withdrawal Pla Checks Cash Optio Divided Distributios Cash Optio Capital Gais Distributios Substatially Equal Periodic Paymets 3. Trasfer to former spouse 4. Distributio to your bak via bak wire or ACH if your Bak Registratio differs from the MaiStay Registratio. Exceptio: If your MaiStay Accout registratio is a Idividual Accout ad your Bak accout is a Joit Accout, the Medallio Sigature Guaratee is ot required if the Joit Bak accout has the idividual listed from the MaiStay Accout. 5. Distributio to a Qualified Pla without the Pla s Rollover Acceptace. The sigature(s) must be Medallio Sigature Guarateed by a eligible guarator istitutio as defied uder the Securities Exchage Act to iclude geerally: a bak, broker dealer, muicipal securities dealer or broker, credit uio, atioal securities exchage, registered securities associatio, clearig agecy, or savigs associatio. A otary public is ot acceptable. Eligible guarator istitutios provide Medallio Sigature Guaratee that are covered by surety bods i various amouts. It is your resposibility to esure the Medallio Sigature Guaratee that you acquire is sufficiet to cover the total value of your trasactio(s). If the surety bod amout is ot sufficiet to cover the requested trasactio(s), the Medallio Sigature Guaratee will be rejected. Place Medallio Sigature Guaratee below. 5

6 maistayivestmets.com For Assistace: Call your ivestmet professioal or call toll-free 800-MAINSTAY / optio 2 Mailig Address: MaiStay Ivestmets P.O. Box 8401 Bosto, MA Overight Express Address: MaiStay Ivestmets c/o BFDS 30 Da Road Cato, MA MaiStay Fuds are distributed by NYLIFE Distributors LLC 169 Lackawaa Aveue Parsippay, NJ *MaiStay Ivestmets, a idirect subsidiary of New York Life Isurace Compay, New York, NY 10010, provides ivestmet advisory products ad services. SC MSIRA68-01/11