Form 5305-Ra - Roth Individual Retirement Custodial Account Page 2
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Form 5305-RA (Rev. 3-2002)
Page
2. The custodian agrees to submit to the IRS and depositor 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, and other published
guidance will be invalid.
Article VIII
This agreement will be amended as necessary to comply with the provisions of the Code, the related regulations, and other
published guidance. Other amendments may be made with the consent of the persons whose signatures appear below.
Article IX
Article IX 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.
Depositor’s signature
Date
Custodian’s signature
Date
Witness’ signature
Date
(Use only if signature of the depositor or the custodian is required to be witnessed.)
General Instructions
see Pub. 590, Individual Retirement
contributed by or on behalf of them for
Arrangements (IRAs).
the tax year. The depositor should see
Section references are to the Inter nal
the disclosure statement or Pub. 590 for
Definitions
Revenue Code unless otherwise noted.
more information.
IRA Conversion Contributions. IRA
Article V. This article describes how
Purpose of Form
Conversion Contributions are amounts
distributions will be made from the Roth
Form 5305-RA is a model custodial
rolled over, transferred, or considered
IRA after the depositor’s death. Elections
account agreement that meets the
transferred from a nonRoth IRA to a
made pursuant to this article should be
requirements of section 408A and has
Roth IRA. A nonRoth IRA is an individual
reviewed periodically to ensure they
been pre-approved by the IRS. A Roth
retirement account or annuity described
correspond to the depositor’s intent.
individual retirement account (Roth IRA)
in section 408(a) or 408(b), other than a
Under paragraph 3 of Article V, the
is established after the form is fully
Roth IRA.
depositor’s spouse is treated as the
executed by both the individual
owner of the Roth IRA upon the death of
Custodian. The custodian must be a
(depositor) and the custodian. This
the depositor, rather than as the
bank or savings and loan association, as
account must be created in the United
beneficiary. If the spouse is to be treated
defined in section 408(n), or any person
States for the exclusive benefit of the
as the beneficiary, and not the owner, an
who has the approval of the IRS to act
depositor and his or her beneficiaries.
overriding provision should be added to
as custodian.
Article IX.
Do not file Form 5305-RA with the
Depositor. The depositor is the person
IRS. Instead, keep it with your records.
Article IX. Article IX and any that follow
who establishes the custodial account.
it may incorporate additional provisions
Unlike contributions to traditional
Specific Instructions
that are agreed to by the depositor and
individual retirement arrangements,
custodian to complete the agreement.
contributions to a Roth IRA are not
Article I. The depositor may be subject
They may include, for example,
deductible from the depositor’s gross
to a 6% tax on excess contributions if
definitions, investment powers, voting
income; and distributions after 5 years
(1) contributions to other individual
rights, exculpatory provisions,
that are made when the depositor is
retirement arrangements of the depositor
amendment and termination, removal of
59
1
⁄
years of age or older or on account
2
have been made for the same tax year,
the custodian, custodian’s fees, state
of death, disability, or the purchase of a
(2) the depositor’s adjusted gross
law requirements, beginning date of
home by a first-time homebuyer (limited
income exceeds the applicable limits in
distributions, accepting only cash,
to $10,000), are not includible in gross
Article II for the tax year, or
treatment of excess contributions,
income. For more information on Roth
(3) the depositor’s and spouse’s
prohibited transactions with the
IRAs, including the required disclosures
compensation is less than the amount
depositor, etc. Attach additional pages if
the custodian must give the depositor,
necessary.
5305-RA
Form
(Rev. 3-2002)
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