Fillable Form 5305-R - Roth Individual Retirement Trust Account (Page 2 of 2) in pdf

Form 5305-R (Rev. 3-2002)

Page

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.

Grantor’s signature

Date

Trustee’s signature

Date

Witness’ signature

Date

(Use only if signature of the grantor or the trustee is required to be witnessed.)

General Instructions

Definitions

Article V. This article describes how

distributions will be made from the Roth

IRA Conversion Contributions. IRA

Section references are to the Inter nal

IRA after the grantor’s death. Elections

Conversion Contributions are amounts

Revenue Code unless otherwise noted.

made pursuant to this article should be

rolled over, transferred, or considered

reviewed periodically to ensure they

Purpose of Form

transferred from a nonRoth IRA to a

correspond to the grantor’s intent. Under

Roth IRA. A nonRoth IRA is an individual

paragraph 3 of Article V, the grantor’s

Form 5305-R is a model trust account

retirement account or annuity described

spouse is treated as the owner of the

agreement that meets the requirements

in section 408(a) or 408(b), other than a

Roth IRA upon the death of the grantor,

of section 408A and has been

Roth IRA.

rather than as the beneficiary. If the

pre-approved by the IRS. A Roth

Trustee. The trustee must be a bank or

spouse is to be treated as the

individual retirement account (Roth IRA)

savings and loan asociation, as defined

beneficiary, and not the owner, an

is established after the form is fully

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

overriding provision should be added to

executed by both the individual (grantor)

the approval of the IRS to act as trustee.

Article IX.

and the trustee. This account must be

created in the United States for the

Grantor. The grantor is the person who

Article IX. Article IX and any that follow

exclusive benefit of the grantor and his

establishes the trust account.

it may incorporate additional provisions

or her beneficiaries.

that are agreed to by the grantor and

Specific Instructions

trustee to complete the agreement. They

Do not file Form 5305-R with the IRS.

may include, for example, definitions,

Instead, keep it with your records.

Article I. The grantor may be subject to

investment powers, voting rights,

Unlike contributions to traditional

a 6% tax on excess contributions if

exculpatory provisions, amendment and

(1) contributions to other individual

individual retirement arrangements,

termination, removal of the trustee,

retirement arrangements of the grantor

contributions to a Roth IRA are not

trustee’s fees, state law requirements,

deductible from the grantor’s gross

have been made for the same tax year,

beginning date of distributions,

(2) the grantor’s adjusted gross income

income; and distributions after 5 years

accepting only cash, treatment of

exceeds the applicable limits in Article II

that are made when the grantor is 59

⁄

excess contributions, prohibited

for the tax year, or (3) the grantor’s and

years of age or older or on account of

transactions with the grantor, etc. Attach

spouse’s compensation is less than the

death, disability, or the purchase of a

additional pages if necessary.

amount contributed by or on behalf of

home by a first-time homebuyer (limited

them for the tax year. The grantor should

to $10,000), are not includible in gross

income. For more information on Roth

see the disclosure statement or Pub.

590 for more information.

IRAs, including the required disclosures

the trustee must give the grantor, see

Pub. 590, Individual Retirement

Arrangements (IRAs).

5305-R

Form

(Rev. 3-2002)

Form 5305-R - Roth Individual Retirement Trust Account Page 2

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