Fillable Brokerage Transfer Form - T. Rowe Price printable pdf download

Brokerage Transfer

Mail to:

Express delivery only:

✓ Use this form to:

• Transfer assets to T. Rowe Price Brokerage from another

T. Rowe Price

T. Rowe Price Mail Code 17150

institution.

P.O. Box 17150

4515 Painters Mill Road

Baltimore, MD 21297-1150

Owings Mills, MD 21117-4903

✗ Do not use this form to:

• Exchange between T. Rowe Price funds.

This stamp indicates a signature guarantee is required.

• Change ownership. Use the

Change Ownership

form.

This paper clip indicates you may need to attach documentation.

Trust, Estate, Corporation, or Other Entity Name (if applicable)

TIN

T. Rowe Price Account

A separate form is required for each account type or delivering institution.

Delivering Firm Name

Phone

Check One Account Type:

¨ Individual

¨ Traditional or Rollover IRA ¨ Profit Sharing Plan (PSP)

Delivering Firm Address

¨ Joint

¨ Roth or Roth Rollover IRA ¨ Money Purchase

¨ Trust

¨ Inherited IRA

Pension Plan (MPP)

¨ Estate

¨ Roth Inherited IRA

¨ Individual 401(k)

City

State

ZIP Code

¨ UGMA/UTMA

¨ SIMPLE IRA

¨ SEP-IRA

¨ Corporate or Other Entity

For a new account, visit

to get an account

¨ For more owners, check this box and attach a

separate

page.

number or write “new” and enclose one of these forms:

•

Brokerage New Account

Transfer Instructions

•

Brokerage IRA New Account

•

Brokerage Employer-Sponsored Retirement Plan New Account

NOTE: Your current firm may charge a fee for transferring assets.

T. Rowe Price Brokerage Account Number

Phone

Check one:

¨ Full transfer. Transfer all identically registered assets in kind.

Assets are moved as is and not sold. Money market funds will be

Owner Name (as it appears on statement)

Social Security Number (SSN)

liquidated and transferred as cash.

¨ Liquidate in full and transfer proceeds.

¨ Partial transfer. Transfer only the assets below. Tax lots will be

Joint Owner Name (if applicable)

SSN

based on the delivering account’s tax lot disposition method.

NOTE: Skip if full transfer was checked.

Trust, Estate, Corporation, or Other Entity Name (if applicable)

Tax ID Number (TIN)

Security Name

Symbol

Share Amount

NOTE: If ownership in Sections 1 and 2 does not match, complete Section

In Kind

Liquidate

All Shares

4B and provide the required signature guarantee

in Section 4C.

Account Being Transferred

In Kind

Liquidate

All Shares

Account Statement Required to Process: Enclose a complete copy

In Kind

Liquidate

All Shares

of your most recent statement dated within the last 12 months.

¨ For more securities, check this box and attach a

separate signed

Statement Date (mm/dd/yyyy):

page.

Check One Account Type:

Certificate of deposit (CD). Liquidate and transfer proceeds.

¨ Individual

¨ Traditional or Rollover IRA

¨ Profit Sharing Plan (PSP)

Full Liquidation

¨ Joint

¨ Roth or Roth Rollover IRA

¨ Money Purchase

¨ Trust

¨ Inherited IRA*

Pension Plan (MPP)

% or $

Partial Liquidation

¨ Estate

¨ Roth Inherited IRA*

¨ Individual 401(k)

Liquidation time frame:

¨ UGMA/UTMA

¨ SIMPLE IRA

¨ SEP-IRA

(two years since

Immediately. I agree to pay any early withdrawal fees.

¨ Corporate or Other Entity

first contribution)

Upon maturity (mm/dd/yyyy)

* NOTE: The deceased person and beneficiary must be the same on

the account being transferred and the account receiving the transfer.

I understand that in order to transfer at the maturity date, this

form must be received within 15–30 days of maturity.

Account Number

¨ For more CDs, check this box and attach a

separate

page.

Owner Name (as it appears on statement)

SSN

Joint Owner Name (if applicable)

SSN

FBR2BTRF

Questions?

| 800-225-7720

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Brokerage Transfer Form - T. Rowe Price

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