Fillable Ira Distribution Request (Page 2 of 3) in pdf

4. Method of distribution

Please complete Part A or Part B. If you are removing an excess contribution, please skip to Section 6.

I hereby direct the custodian to make the following distribution:

A. Immediate payments

Please select one of the following.

Total distribution and account termination

Partial distribution: Amount: $

or number of shares:

For Class B and Class C shares subject to a contingent deferred sales charge (CDSC), please select one of the following. If you do not select either

option, your distribution will be processed as gross.

Net: The applicable CDSC is taken from your account balance. Your check will be issued for the amount requested, minus applicable taxes and fees.

Gross: The applicable CDSC is taken from the requested amount. Your check will be issued for the amount requested, minus the applicable CDSC,

taxes, and fees.

B. Future payments:

New payment request

Update existing payment

Please select one of the following.

Systematic withdrawal payments: Payments in the amount of $

will be made on the

day of each month.

of each month.)

Date payments are to begin:

Specify frequency:

Monthly

Quarterly

Semiannually

Annually

Month/year

Life expectancy payments: Payments based on the life expectancy noted below will be determined from the appropriate IRS annuity tables and

Payments will be made on the

of each month.)

Date payments are to begin:

Specify frequency:

Monthly

Quarterly

Semiannually

Annually

Month/year

Payments will be based on

single life expectancy or

spouse

(MM/DD/YYYY)

Your prior year-end value is needed to calculate your life expectancy payment. If your IRA assets were not held with John Hancock Investments as of

December 31 of last year, please provide the year-end value of your assets: $

5. Income tax

Federal taxes

Federal income taxes may not be applicable to some Roth IRA distributions. Federal income taxes will automatically be withheld from your IRA/Roth IRA distribution

at a rate of 10% unless you elect NOT to have taxes withheld or select a greater rate below. If you elect to have no federal taxes withheld from your distribution

payments, or if you do not have enough federal income tax withheld from your distributions, you are still liable for the payment of federal income tax. You may

also incur penalties under the estimated tax rules if your withholding and estimated tax payments are not sufficient. If taxes are withheld on the distribution, the

amount you requested in Section 4 will decrease by the amount withheld. Federal income taxes will not be withheld from Coverdell ESA distributions.

If your distribution is delivered to a post office box and you do not have a U.S. residential address on file with us, or to an address outside of the United States or

one of its possessions, and you are a U.S. person (including a U.S. resident alien) with a valid IRS Form W-9 on file, we are required to withhold 10% in federal

taxes. This withholding may not be waived. If you are not a U.S. person, federal income tax will be withheld at a rate of 30%, unless a valid IRS Form W-8BEN is

on file claiming a reduced tax treaty rate.

No, do not withhold federal income tax from my distribution.

Yes, withhold federal income tax at a rate of

% (not less than 10%) and any applicable state taxes.

State taxes

If you live in one of the mandatory withholding states and request federal taxes to be withheld from your distribution, John Hancock will also withhold your state’s

minimum required tax. The mandatory withholding states include AR, CA, DC, DE, IA, KS, MA, ME, MI*, MS, NC, NE, OK, OR, VA, and VT (the list of states may

change as a result of changing legislation). If state tax is withheld from the distribution, the amount you requested in Section 4 will decrease by the amount withheld.

* Residents of Michigan will have state income taxes withheld regardless of federal income-tax withholding. John Hancock will withhold the state’s minimum

required tax from your distribution unless you select “Do not withhold Michigan state taxes” below.

Do not withhold Michigan state taxes.

IRADRFM (2/17)

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