Fillable Form 5305-Sa - Simple Individual Retirement Custodial Account (Page 2 of 2) in pdf

Form 5305-SA (Rev. 3-2002)

Page

(a) The required minimum distribution under paragraph 2(b) for any year, beginning with the year the participant reaches age 70

⁄

, is the

participant’s account value at the close of business on December 31 of the preceding year divided by the distribution period in the uniform

lifetime table in Regulations section 1.401(a)(9)-9. However, if the participant’s designated beneficiary is his or her surviving spouse, the required

minimum distribution for a year shall not be more than the participant’s account value at the close of business on December 31 of the preceding

year divided by the number in the joint and last survivor table in Regulations section 1.401(a)(9)-9. The required minimum distribution for a year

under this paragraph (a) is determined using the participant’s (or, if applicable, the participant and spouse’s) attained age (or ages) in the year.

(b) The required minimum distribution under paragraphs 3(a) and 3(b)(i) for a year, beginning with the year following the year of the

participant’s death (or the year the participant would have reached age 70

⁄

, if applicable under paragraph 3(b)(i)) is the account value at the

close of business on December 31 of the preceding year divided by the life expectancy (in the single life table in Regulations section

1.401(a)(9)-9) of the individual specified in such paragraphs 3(a) and 3(b)(i).

⁄

can be made as late as April 1 of the following year. The

required minimum distribution for any other year must be made by the end of such year.

6. The owner of two or more IRAs (other than Roth IRAs) may satisfy the minimum distribution requirements described above by taking from

one IRA the amount required to satisfy the requirement for another in accordance with the regulations under section 408(a)(6).

Article V

1. The participant agrees to provide the custodian with all information necessary to prepare any reports required by sections 408(i) and

408(l)(2) and Regulations sections 1.408-5 and 1.408-6.

2. The custodian agrees to submit to the Internal Revenue Service (IRS) and participant the reports prescribed by the IRS.

3. The custodian also agrees to provide the participant’s employer the summary description described in section 408(l)(2) unless this SIMPLE

IRA is a transfer SIMPLE IRA.

Article VI

Notwithstanding any other articles which may be added or incorporated, the provisions of Articles I through III and this sentence will be

controlling. Any additional articles inconsistent with sections 408(a) and 408(p) and the related regulations will be invalid.

Article VII

This agreement will be amended as necessary to comply with the provisions of the Code and the related regulations. Other amendments may

be made with the consent of the persons whose signatures appear below.

Article VIII

Article VIII may be used for any additional provisions. If no other provisions will be added, draw a line through this space. If provisions are

added, they must comply with applicable requirements of state law and the Internal Revenue Code.

Participant’s signature

Date

(If an individual other than the participant signs this form for the participant, indicate the individual’s relationship to the participant.)

Custodian’s signature

Date

Witness’ signature

(Use only if signature of the participant or the custodian is required to be witnessed.)

General Instructions

custodian must give the participant, see

Specific Instructions

Pub. 590, Individual Retirement Arrangements

Section references are to the Internal

(IRAs).

Article IV. Distributions made under this

article may be made in a single sum, periodic

Revenue Code unless otherwise noted.

Definitions

payment, or a combination of both. The

Purpose of Form

distribution option should be reviewed in the

Participant. The participant is the person

year the participant reaches age 70

⁄

who establishes the custodial account.

Form 5305-SA is a model custodial account

ensure that the requirements of section

agreement that meets the requirements of

Custodian. The custodian must be a bank or

408(a)(6) have been met.

sections 408(a) and 408(p) and has been

savings and loan association, as defined in

Article VIII. Article VIII and any that follow it

pre-approved by the IRS. A SIMPLE individual

section 408(n), or any person who has the

may incorporate additional provisions that are

retirement account (SIMPLE IRA) is

approval of the IRS to act as custodian.

agreed to by the participant and custodian to

established after the form is fully executed by

complete the agreement. They may include,

both the individual (participant) and the

Transfer SIMPLE IRA

for example, definitions, investment powers,

custodian. This account must be created in

voting rights, exculpatory provisions,

the United States for the exclusive benefit of

This SIMPLE IRA is a “transfer SIMPLE IRA”

amendment and termination, removal of the

if it is not the original recipient of

the participant and his or her beneficiaries.

custodian, custodian’s fees, state law

contributions under any SIMPLE IRA plan.

Do not file Form 5305-SA with the IRS.

requirements, beginning date of distributions,

The summary description requirements of

Instead, keep it with your records.

accepting only cash, treatment of excess

section 408(l)(2) do not apply to transfer

contributions, prohibited transactions with the

SIMPLE IRAs.

For more information on SIMPLE IRAs,

participant, etc. Attach additional pages if

including the required disclosures the

necessary.

5305-SA

Form

(Rev. 3-2002)

Form 5305-Sa - Simple Individual Retirement Custodial Account Page 2

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