Ira Transfer Form - Doubleline Funds Ira
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3IRA Transfer Form
[If this is for a new IRA Account, an IRA Application must accompany this form.]
Mail to: DoubleLine Funds
Overnight Express Mail To: DoubleLine Funds
c/o U.S. Bancorp Fund Services, LLC
c/o U.S. Bancorp Fund Services, LLC
PO Box 701
615 E. Michigan St., FL3
Milwaukee, WI 53201-0701
Milwaukee, WI 53202-5207
!
There may be penalties for withdrawing certain investments before their maturity (i.e., certificates of deposit or annuities).
Please contact your current custodian or plan administrator prior to submitting this form to determine the applicable time
frames and penalties, if any, or if you need a signature guarantee in Section Six to order this transfer. U.S. Bancorp Fund
Services, LLC will initiate your request upon receipt of this form.
1
Investor Information
FIRST NAME
M.I.
LAST NAME
SOCIAL SECURITY NUMBER
ADDRESS
CITY / STATE / ZIP
DAYTIME PHONE NUMBER
EVENING PHONE NUMBER
2
Instructions to Current IRA Custodian or Plan Administrator
Please include a copy of your current account statement.
CURRENT CUSTODIAN OR PLAN ADMINISTRATOR
ACCOUNT NUMBER
CONTACT PERSON
CONTACT NUMBER
STREET ADDRESS
CITY / STATE / ZIP
Consider this your authorization to redeem my investment and transfer my Traditional IRA, SEP IRA, SIMPLE IRA,
: *
Roth IRA, or Inherited IRA, or to directly rollover my qualified retirement plan as directed below
All Assets OR
$
or
%
Please process this request:*
Immediately OR
At Maturity
(month / day / year)
* If no option is selected, please transfer all assets immediately.
Type of account being transferred/rolled-over:
Pension
Profit Sharing Plan
401(k)
403(b)
Roth 401(k)
Roth 403(b)
Traditional IRA
SEP IRA
SIMPLE IRA
Roth IRA
Inherited IRA
Other
Original Roth IRA funding year (if applicable):
Original SIMPLE IRA funding date (if applicable):
Send the check representing the assets payable to “The DoubleLine Funds FBO [Shareholder’s Name]” along with
a copy of this form to the address at the top of page one.
DL-IRA-TRANN
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