Retirement Account Transfer/rollover Form Page 2
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4PLEASE USE BLUE OR BLACK INK
PLEASE PRINT CLEARLY IN BLOCK CAPITAL LETTERS
3 | Instructions to Delivering Trustee/Custodian (Complete sections A and B. Required.)
A. Transfer/Rollover assets from my: (Select one.)
Traditional IRA
Rollover IRA
Roth IRA
SEP IRA
SARSEP IRA
SIMPLE IRA
401(k)
Roth 401(k)
403(b)
Roth 403(b)
Other employer retirement plan
Beneficiary IRA - Decedent’s Name
Distribution Reason for Rollover from Qualified Plan: (Select one, if applicable.)
Termination of employment
Death
Attainment of retirement age (typically 59½)
Plan termination
B. Distribution Instructions: (Select one.)
Option 1: Transfer “in kind”
ALL existing Invesco funds held in the account(s) listed in section 2.
PARTIAL shares in the amount of
shares of Invesco
Fund.
shares of Invesco
Fund.
shares of Invesco
Fund.
Option 2: Liquidate — Please liquidate the account(s) listed in section 2 and issue a check payable to ITC.
All
or
Partial liquidation: $
,
.
Liquidate immediately
Liquidate at maturity (mm/dd/yyyy)
4 | Assets Are Moving to The Following Invesco IRA Account (Complete sections A and B. Required)
A. Transfer/Rollover assets to my: (Select one.)
Traditional IRA
Roth IRA
SEP IRA
SARSEP IRA
SIMPLE IRA
Beneficiary IRA*
* Assets transferred from a beneficiary IRA to an existing Invesco beneficiary IRA must be from the same deceased depositor.
New Invesco Account OR
Existing Invesco Account or Plan ID
B. Investment Allocation:
• If transfer in kind was selected above, your fund selection will remain the same. You may request an exchange separately.
• For IRAs: if no fund is selected, Cash Reserve Shares of Invesco Money Market Fund will be purchased. If no class of
shares is indicated, Class A Shares will be purchased. If no fund is selected for SIMPLE and SARSEP IRAs, shares of the
fund allocations on file will be selected.
Please indicate fund and investment percentages below, rounded to whole percentages. Total percentages must equal 100%.
Fund Number
Fund Name
Class of Shares
Whole Percentage
1
0
0
Please attach a separate page for additional allocations, if necessary.
TOTAL
2 of 4
AIM-FRM-22 02/16
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