Iowa Advisor 529 Plan Withdrawal Request Form Page 2
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Payment amount:
$_________________________ ($100 minimum)
Payment frequency (choose one):
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Monthly, beginning (specific month and date): _______________________
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Periodically, on the (specific date of month) ____________________ of the following months:
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January
February
March
April
May
June
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July
August
September
October
November
December
The SWP will begin as soon as administratively possible following the receipt of this properly completed form. Unless specified
above, distributions will be made on the 25th day of the month. If the date falls on a weekend or holiday, the distribution will occur
on the next business day. If the next business day falls in the next month, the distribution will cycle on the previous business day.
To terminate the SWP, submit a request in writing or call 1-800-774-5127.
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If you take a withdrawal, we’ll send IRS Form 1099-Q by January 31 of the following year. If the withdrawal is sent to the
participant, Form 1099-Q will be sent out under the participant’s Social Security number, individual taxpayer ID number, or
EIN. If the withdrawal is sent to the beneficiary or directly to the school, Form 1099-Q will be sent out under the beneficiary’s
Social Security or individual taxpayer ID number.
Choose ONLY ONE of the following five options.
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A.
Qualified withdrawal to the participant.* My withdrawal will be used to pay for the beneficiary’s qualified
higher-education expenses. (You will receive a check at your address of record.)
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Qualified withdrawal to the beneficiary.* My withdrawal will be used to pay for the beneficiary’s qualified
B.
higher-education expenses. (The beneficiary will receive a check at the address you indicated in Section 2.)
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C.
Qualified withdrawal to an eligible college or university.* (Provide the exact school address below. Please
verify this address with the school, if necessary.)
Name of School (Complete only if the withdrawal is to be sent directly to the school.)
Department/Office
Student ID (A student identification number may be required by some colleges and universities.)
Mailing Address
City
State
Zip
Telephone Number
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Indirect rollover. Send a check to me at my address of record. I will invest it in another qualified 529 plan within
D.
the next 60 days.
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E.
Nonqualified withdrawal to the participant.** My withdrawal will not be used to pay for the beneficiary’s
qualified higher-education expenses. (You will receive a check at your address of record.)
* The IRS may require you to prove that your withdrawal is qualified. Consult the IRS or your tax advisor for current
documentation requirements.
** The earnings portion of a distribution not used for a beneficiary’s qualified higher-education expenses is considered
a nonqualified withdrawal and is subject to federal income tax and a 10% federal penalty tax, as well as state and
local income taxes. Exceptions to this penalty include withdrawals made because the beneficiary has become disabled,
received a tax-free scholarship, attended a U.S. military academy, or died. Contact your tax advisor about how to report a
nonqualified withdrawal.
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