Fillable Transamerica Funds Ira Direct Rollover Request Form printable pdf download

Clear Form

Print Form

Transamerica Funds IRA Direct Rollover Request Form

Section One – Account Holder Information

Use this form to roll over your

existing Qualified Plan, 401(k), 403(b),

403(b)(7) tax-sheltered annuity or

____________________________________________________________________________________________________________

annuity, or other such retirement plan

Name of Account Owner*

directly to a Transamerica Funds IRA

____________________________________________________________________________________________________________

or Transamerica Funds

Address (as shown on your account)*

Rollover/Conduit IRA. Forms for all

other types of accounts are available

____________________________________________________________________________________________________________

on our website at

City*

State*

Zip Code*

For assistance, call Transamerica

____________________________________________________________________________________________________________

Fund Services, Inc. toll free at

Social Security Number*

Date of Birth*

1-888-233-4339 Monday through Friday.

____________________________________________________________________________________________________________

E-Mail Address

Daytime Telephone Number

Procedures for Rolling Over Accounts

To complete a rollover, be sure to

Section Two – Current Custodian Information

complete the following steps:

____________________________________________________________________________________________________________

□ Complete all sections of the

Current Custodian or Trustee*

Transamerica Funds IRA Application,

paying special attention to Section

____________________________________________________________________________________________________________

Four, “Source of Funds.” Determine

Address*

the type of rollover to occur and check

____________________________________________________________________________________________________________

the appropriate box.

City*

State*

Zip Code*

□ Complete and sign the direct rollover

____________________________________________________________________________________________________________

form.

Telephone Number*

Fax Number

□ Carefully read and retain the IRA

Note: Most plan custodians/trustees require their own forms be completed prior to any distribution or rollovers. Please check

Disclosure Statement and IRA

with your current plan Custodian or Trustee, or with your former employer, to complete any of their required forms, in addition to or in

Custodial Agreement for your records.

place of this form. Incomplete or incorrect forms may result in long delays.

□ Please have the form stamped with

*Required Information

a Securities Transfer Agents

Medallion Program (STAMP2000)

Section Three – Accounts to be Rolled Over

Signature Guarantee.

Rollover from:

□ Please include a complete copy of

□

Qualified Plan (401(k), Profit Sharing Plan, Money Purchase Pension Plan, etc.)(703)

your current account statement from

□

your present custodian.

403(b) or 403(b)(7) Tax Sheltered Account or Annuity(703)

□

Governmental 457 Plan (703)

Mail the completed rollover form and

○

I have completed the necessary forms from my previous employer or current Custodian/Trustee to roll over my qualified

application (if opening a new account) to:

plan retirement assets to a Transamerica Funds IRA account.

○

I have not completed the necessary forms from my previous employer or current Custodian/Trustee to roll over my

Regular Mail

qualified plan retirement assets to a Transamerica Funds IRA account.

Transamerica Fund Services, Inc.

Rollover to:

P. O. Box 219945

□

Traditional IRA

Rollover/Conduit IRA

Traditional IRA and immediately convert to a Roth IRA

Kansas City MO 64121-9945

The following withholding section only applies to the Roth IRA conversion option.

Overnight Mail

Federal Tax Withholding (not required for Non-IRA accounts)

Transamerica Fund Services, Inc.

If you DO NOT make a federal tax withholding election, 10% will be withheld and forwarded to the IRS. This is a Federal requirement. If you elect to not

330 W. 9

Street

have withholding, you are still liable for payment of federal income taxes on the taxable portion of your distribution.

If federal tax is withheld, state tax will be withheld if you reside in a state listed below.

Kansas City MO 64105

□

Withhold _____% (10% minimum) as a federal income tax withholding election from my distribution.

□

Payment Instructions for Present

Do not withhold federal income tax from my distribution.

Custodians

State Tax Withholding

Residents of the following states will also have applicable state taxes withheld when federal tax withholding applies: CA, DE, IA, KS, LA, ME, MA, NC, OK,

Please make check payable to

OR, VT, OR VA. If federal tax withholding does not apply, state taxes at the applicable rate will be withheld unless you elect otherwise below. If your

Transamerica Fund Services, Inc.

resident state is not listed, we are unable to take state withholding. (Exception: GA and MI)

□

Do not withhold state income tax.

□

Withhold _____% (in whole dollar amount) for state income tax.

□

Liquidate and roll over the accounts noted here:

Amount or percentage

of each to be rolled over (REQUIRED)

□

100%