Form Irabenfm - (Ira) Beneficiary Designation Form
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IRA and retirement plan
beneficiary designation
Introduction
Instructions
Questions about this form?
Contact us:
See the end of this document for
return instructions
1. Shareholder information
(For Coverdell ESAs, please use child’s information)
Owner’s name (First)
(MI)
(Last)
Social Security number
Date of birth (MM/DD/YYYY)
Address
City
State
Zip code
Please update my current address on file to the new address listed here.
Phone number
2. Account type
Traditional IRA
Roth IRA
SIMPLE IRA
SEP/SARSEP
Add to all retirement accounts
Coverdell ESA
Money purchase plan
Profit-sharing plan
403(b)(7)
3. Beneficiary designation
provided on this form.
previously stated otherwise.
For trusts, please list the trust name, the name of the trustees, and the trust establishment date.
IRABENFM (9/16)
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Parent category: Business