Retirement Account Transfer/rollover Form
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Retirement Account Transfer/Rollover Form
Use this form to transfer or rollover eligible retirement assets to an Invesco Traditional, Roth, SEP,
SIMPLE, or SARSEP IRA, convert assets from another custodian to an Invesco Roth IRA, or to trans-
fer a beneficiary IRA. We recommend that you speak with a tax or financial advisor regarding the
consequences of this transaction.
• Do not use this form to transfer or rollover assets into an Invesco 403(b), qualified plan, or
Coverdell ESA.
• Do not use this form to convert or recharacterize assets already held with Invesco.
For more information, please see the Additional Information section on page 4 of this form.
Start
PLEASE USE BLUE OR BLACK INK
PLEASE PRINT CLEARLY IN BLOCK CAPITAL LETTERS
here >.
Use
1 | Depositor Information
"Tab"
key to
Full Name
move to
next
field.
Social Security Number (Required)
Date of Birth (Required) (mm/dd/yyyy)
Mailing Address
City
State
ZIP
Primary Phone Number
Email Address
2 | Assets Are Moving from This Account (Required)
Important Note: Some trustees/custodians/employers require pre-liquidation of assets, payment of fees, and/or completion of
their own forms prior to transferring assets to Invesco. To expedite your request, please contact your current trustee, custodian
or employer to verify their requirements.
Yes, I have contacted the current trustee/custodian/employer. I have met their requirements for transferring or rolling over
assets, and have filed the necessary paperwork.
No, I have not contacted the current trustee/custodian/employer.
Name of Current Trustee/Custodian/Employer
Account Number at Current Trustee/Custodian/Employer
Mailing Address of Current Trustee/Custodian/Employer
City
State
ZIP
Trustee/Custodian/Employer Phone Number
Trustee/Custodian/Employer Fax Number
Attention
1 of 4
AIM-FRM-22 02/16
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