Form 5305-Rb - Roth Individual Retirement Annuity Endorsement
Download a blank fillable Form 5305-Rb - Roth Individual Retirement Annuity Endorsement 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 5305-Rb - Roth Individual Retirement Annuity Endorsement 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
1
25305-RB
Roth Individual Retirement Annuity Endorsement
Do not file
Form
with the Internal
(Rev. March 2002)
Revenue Service
(Under section 408A of the Internal Revenue Code)
Department of the Treasury
Internal Revenue Service
Name of issuer
Check if this endorsement supersedes a prior Roth
IRA endorsement
This endorsement is made a part of the annuity contract to which it is attached, and the following provisions apply in lieu of
any provisions in the contract to the contrary.
The annuitant is establishing a Roth individual retirement annuity (Roth IRA) under section 408A to provide for his or her
retirement and for the support of his or her beneficiaries after death.
Article I
Except in the case of a rollover contribution described in section 408A(e), a recharacterized contribution described in section
408A(d)(6), or an IRA Conversion Contribution, the issuer will accept only cash contributions up to $3,000 per year for tax years
2002 through 2004. That contribution limit is increased to $4,000 for tax years 2005 through 2007 and $5,000 for 2008 and
thereafter. For individuals who have reached the age of 50 before the close of the tax year, the contribution limit is increased to
$3,500 per year for tax years 2002 through 2004, $4,500 for 2005, $5,000 for 2006 and 2007, and $6,000 for 2008 and
thereafter. For tax years after 2008, the above limits will be increased to reflect a cost-of-living adjustment, if any.
Article II
1. The contribution limit described in Article I is gradually reduced to $0 for higher income annuitants. For a single annuitant,
the annual contribution is phased out between adjusted gross income (AGI) of $95,000 and $110,000; for a married annuitant
filing jointly, between AGI of $150,000 and $160,000; and for a married annuitant filing separately, between AGI of $0 and
$10,000. In the case of a conversion, the issuer will not accept IRA Conversion Contributions in a tax year if the annuitant’s AGI
for the tax year the funds were distributed from the other IRA exceeds $100,000 or if the annuitant is married and files a
separate return. Adjusted gross income is defined in section 408A(c)(3) and does not include IRA Conversion Contributions.
2. In the case of a joint return, the AGI limits in the preceding paragraph apply to the combined AGI of the annuitant and his
or her spouse.
Article III
The annuitant’s interest in the contract is nonforfeitable and nontransferable.
Article IV
1. The contract does not require fixed contributions.
2. Any dividends (refund of contributions other than those attributable to excess contributions) arising under the contract will
be applied (before the close of the calendar year following the year of the dividend) as contributions toward the contract.
Article V
1. If the annuitant dies before his or her entire interest in the contract is distributed to him or her and the annuitant’s surviving
spouse is not the designated beneficiary, the remaining interest in the contract will be distributed in accordance with (a) below
or, if elected or there is no designated beneficiary, in accordance with (b) below:
(a) The remaining interest in the contract will be distributed, starting by the end of the calendar year following the year of the
annuitant’s death, over the designated beneficiary’s remaining life expectancy, or a period no longer than such remaining life
expectancy, as determined in the year following the death of the annuitant. Life expectancy is determined using the single life
table in Regulations section 1.401(a)(9)-9.
(b) The remaining interest in the contract will be distributed by the end of the calendar year containing the fifth anniversary of
the annuitant’s death.
2. If the annuitant’s surviving spouse is the designated beneficiary, such spouse will then be treated as the annuitant.
Article VI
1. The annuitant agrees to provide the issuer with all information necessary to prepare any reports required by sections 408(i)
and 408A(d)(3)(E), Regulations sections 1.408-5 and 1.408-6, or other guidance published by the Internal Revenue Service (IRS).
2. The issuer agrees to submit to the IRS and annuitant the reports prescribed by the IRS.
Article VII
Notwithstanding any other articles which may be added or incorporated, the provisions of Articles I through IV and this
sentence will be controlling. Any additional articles inconsistent with section 408A, the related regulations, or other published
guidance will be invalid.
5305-RB
Cat. No. 25871H
Form
(Rev. 3-2002)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial