Form Pd F 1455 - Request By Fiduciary For Distribution Of United States Treasury Securities

Download a blank fillable Form Pd F 1455 - Request By Fiduciary For Distribution Of United States Treasury Securities in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Pd F 1455 - Request By Fiduciary For Distribution Of United States Treasury Securities with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

RESET
For official use only:
Customer Name
Customer No.
PD F 1455 E
REQUEST BY FIDUCIARY FOR DISTRIBUTION OF
OMB No. 1535-0012
Department of the Treasury
UNITED STATES TREASURY SECURITIES
Bureau of the Public Debt
(Revised June 2008)
Visit us on the Web at
IMPORTANT: Follow instructions in filling out this form. You should be aware that the making of any false, fictitious, or fraudulent claim or
statement to the United States is a crime that is punishable by fine and/or imprisonment.
PRINT IN INK OR TYPE ALL INFORMATION
One or more fiduciaries (individual or corporate) must use this form to establish entitlement and request distribution of United States
Treasury Securities and/or related payments to the person lawfully entitled (e.g., termination of trust, distribution of an estate, attainment
of majority, restoration to competency).
PART A – REASON FOR DISTRIBUTION
I/We request distribution of the securities and/or related payments for the following reason:
Termination of trust
Distribution of an estate
Payment to the estate (Fiduciary must sign the back of the bonds or submit a PD F 1522)
Reissue to the estate
Distribution to person(s) entitled*
*If payment is requested by person(s) entitled a PD F 1522 is required.
If reissue is requested by person(s) entitled a PD F 4000 is required.
Attainment of majority
Restoration to competency
Other: __________________________________
PART B – DISTRIBUTION OF SECURITIES AND PAYMENTS
I/We request that the securities and/or related payments be distributed as follows:
1. Distribute to:
(Name)
OR
(Social Security Number)
(Employer Identification Number)
(Address and Telephone Number)
2. Description of securities and/or related payments:
ISSUE
TITLE OF SECURITY
FACE AMOUNT
IDENTIFYING NUMBER
REGISTRATION
DATE
In full
3.
Extent of distribution:
(Amount, Fractional Share, or Percentage)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 5