Common use of CERTIFICATIONS AND SIGNATURES Clause in Contracts

CERTIFICATIONS AND SIGNATURES. If the Depositor has indicated a Traditional IRA Rollover or Direct Rollover above, Depositor certifies that, if the distribution is from another Traditional IRA, that Depositor has not made another rollover within the one-year period immediately preceding this rollover; that such distribution was received within 60 days of making the rollover to this Account. If Depositor has elected to perform an eligible transfer of an amount that includes a required minimum distribution, Depositor acknowledges responsibility to request the withdrawal by the deadline and to provide information needed to calculate such withdrawal. If Depositor has indicated a Conversion, Transfer or a Rollover of an existing Traditional IRA to a Xxxx XXX, Depositor acknowledges that the amount converted will be treated as taxable income (except for any prior nondeductible contributions) for federal income tax purposes, and certifies that no portion of the amount converted, transferred or rolled over is a required minimum distribution under applicable rules. If Depositor has elected to convert an existing Traditional IRA with Xxxxxx Xxxxxxx Xxxxxxx Funds as custodian to a Xxxx XXX (Item 5 above) and has elected no withholding, Depositor understands that Depositor may be required to pay estimated tax and that insufficient payments of estimated tax may result in penalties. If Depositor has indicated a rollover from another Xxxx XXX (Item 5 above), Depositor certifies that the information given in Item 5 is correct and acknowledges that adverse tax consequences or penalties could result from giving incorrect information. Depositor certifies that any rollover contribution to the Xxxx XXX was completed within 60 days after the amount was withdrawn from the other IRA. Depositor has received and read the applicable sections of the “State Street Bank and Trust Company Universal Individual Retirement Account Disclosure Statement" relating to this Account (including the Custodian's fee schedule), the Custodial Account document, and the "Instructions" pertaining to this Adoption Agreement. Depositor acknowledges receipt of the Universal Individual Retirement Custodial Account document and Universal IRA Disclosure Statement at least 7 days before the date inscribed below and acknowledges that Depositor has no further right of revocation. Depositor certifies the accuracy of the information in the Adoption Agreement. The custodian may change the fee schedule at any time. Depositor acknowledges that it is his/her sole responsibility to report all contributions to or withdrawals from the Account correctly on his or her tax returns, and to keep necessary records of all the Depositor’s IRAs (including any that may be held by another custodian or trustee) for tax purposes. All forms must be acceptable to the Custodian and dated and signed by the Depositor. Depositor understands the Funds’ objectives and policies and agrees to be bound to the terms of the prospectus. Before Depositor requests an exchange, Depositor will obtain the current prospectus for each Fund. Depositor acknowledges and consents to the householding (i.e. consolidation of mailings) of documents such as prospectuses, shareholder reports, proxies, and other similar documents. Depositor may contact the Funds to revoke my consent. Depositor agrees to notify the Funds of any errors or discrepancies within 45 days after the date of the statement confirming a transaction. The statement will be deemed to be correct, and the Funds and its transfer agent shall not be liable if Depositor fails to notify the Funds within such time period. Depositor certifies that Depositor is of legal age and has the legal capacity to make this purchase. Depositor certifies that the Social Security Number shown on this application is correct. Depositor authorizes the Fund to perform a credit check in the event that one is needed to verify or establish identity. X Signature of Depositor Date (mm/dd/yy) Custodian Acceptance. State Street Bank and Trust Company will accept appointment as Custodian of the Depositor's Account. However, this Agreement is not binding upon the Custodian until the Depositor has received a statement confirming the initial transaction for the Account. Receipt by the Depositor of a confirmation of the purchase of the Fund shares indicated above will serve as notification of State Street Bank and Trust Company's acceptance of appointment as Custodian of the Depositor's Account. STATE STREET BANK AND TRUST COMPANY, CUSTODIAN Certain requests to sell shares must include a medallion guarantee. Please refer to the prospectus for further details. RETAIN A PHOTOCOPY OF THE COMPLETED ADOPTION AGREEMENT FOR YOUR RECORDS Before you mail, have you: Completed all USA PATRIOT Act required information? - Social Security or Tax ID Number in Section 2? - Full name in Section 2? - Birth date in Section 2? - Permanent street address in Section 3? Enclosed your check made payable to Xxxxxx Xxxxxxx Xxxxxxx Funds? Signed your application in Section 10? Enclosed additional documentation, if applicable?

Appears in 1 contract

Samples: imgpfunds.com

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CERTIFICATIONS AND SIGNATURES. If In the Depositor has indicated case of a Traditional Rollover IRA Rollover or Direct Rollover aboveIRA, Depositor certifies that, that the contribution does not include any employee contributions to any qualified plan (other than accumulated deductible employee contributions) or 403(b) arrangement; that any assets transferred in kind by Depositor are the same assets received by the Depositor in the distribution being rolled over; if the distribution is from another Traditional an IRA, that Depositor no rollover into such IRA has not been made another rollover within the one-year period immediately preceding this rollover; that such distribution was received within 60 days of making the rollover to this the Account. If Depositor has elected to perform an eligible transfer of an amount that includes a required minimum distribution, Depositor acknowledges responsibility to request the withdrawal by the deadline ; and to provide information needed to calculate such withdrawal. If Depositor has indicated a Conversion, Transfer or a Rollover of an existing Traditional IRA to a Xxxx XXX, Depositor acknowledges that the amount converted will be treated as taxable income (except for any prior nondeductible contributions) for federal income tax purposes, and certifies that no portion of the amount converted, transferred or rolled over is a required minimum distribution under applicable the required distribution rules. If Depositor has elected to convert an existing Traditional IRA with Xxxxxx Xxxxxxx Xxxxxxx Funds as custodian to a Xxxx XXX (Item 5 above) and has elected no withholding, Depositor understands that Depositor may be required to pay estimated tax and that insufficient payments of estimated tax may result in penalties. If Depositor has indicated a rollover from another Xxxx XXX (Item 5 above), Depositor certifies that the information given in Item 5 is correct and acknowledges that adverse tax consequences or penalties could result from giving incorrect information. Depositor certifies that any rollover contribution to the Xxxx XXX was completed within 60 days after the amount was withdrawn from the other IRA. Depositor has received and read the applicable sections of the “State Street Bank and Trust Company Universal Individual Retirement Account "IRA Disclosure Statement" relating to this Account (including the Custodian's fee schedule), the Custodial Account document, and the "Instructions" pertaining to this Adoption Agreement. Depositor acknowledges receipt of the Universal Individual Retirement Custodial Account document and Universal IRA Disclosure Statement at least 7 days before the date inscribed below and acknowledges that Depositor has no further right of revocation. Depositor certifies the accuracy of the information in the Adoption Agreement. The custodian may change the fee schedule at any time. Depositor acknowledges that it is his/her sole responsibility to report all contributions to or withdrawals from the Account correctly on his or her tax returns, and to keep necessary records of all the Depositor’s IRAs (including any that may be held by another custodian or trustee) for tax purposes. All forms must be acceptable to the Custodian and dated and signed by the Depositor. Depositor understands the Funds’ objectives and policies and agrees to be bound to the terms of the prospectus. Before Depositor requests an exchange, Depositor will obtain the current prospectus for each Fund. Depositor acknowledges and consents to the householding (i.e. consolidation of mailings) of documents such as prospectuses, shareholder reports, proxies, and other similar documents. Depositor may contact the Funds to revoke my consent. Depositor agrees to notify the Funds of any errors or discrepancies within 45 days after the date of the statement confirming a transaction. The statement will be deemed to be correct, and the Funds and its transfer agent shall not be liable if Depositor fails to notify the Funds within such time period. Depositor certifies that Depositor is of legal age and has the legal capacity to make this purchase. Depositor certifies that the Social Security Number shown on this application is correct. Depositor authorizes the Fund to perform a credit check in the event that one is needed to verify or establish identity. X ---------------------------------------- Signature of Depositor Date (mm/dd/yy) ----------------------------------- Custodian Acceptance. State Street Bank and Trust Company will accept appointment as Custodian of the Depositor's Account. However, this Agreement is not binding upon the Custodian until the Depositor has received a statement confirming of the initial transaction for the Accounttransaction. Receipt by the Depositor of a confirmation of the purchase of the Fund shares indicated above will serve as notification of State Street Bank and Trust Company's acceptance of appointment as Custodian of the Depositor's Account. STATE STREET BANK AND TRUST COMPANY, CUSTODIAN Certain requests to sell shares must include a medallion guarantee. Please refer to the prospectus for further details. By ------------------------------------- Date ----------------------------------- RETAIN A PHOTOCOPY OF THE COMPLETED ADOPTION AGREEMENT FOR YOUR RECORDS Before you mail, have you: Completed all USA PATRIOT Act required information? - Social Security or Tax ID Number in Section 2? - Full name in Section 2? - Birth date in Section 2? - Permanent street address in Section 3? Enclosed your check made payable to Xxxxxx Xxxxxxx Xxxxxxx Funds? Signed your application in Section 10? Enclosed additional documentation, if applicable?ORBITEX GROUP OF FUNDS State Street Bank and Trust Company Individual Retirement Custodial Account Transfer of IRA Assets Form ------------------------------------------------------------------------------------------------------------------------------------ 1. NAME AND ADDRESS OF DEPOSITOR Name -------------------------------------------------------------------------------------------------- Address ------------------------------------------------------------------------------------------------ Street City State Zip

Appears in 1 contract

Samples: Orbitex Group of Fund

CERTIFICATIONS AND SIGNATURES. If the Depositor has indicated a Traditional IRA Rollover or Direct Rollover above, the Depositor certifies that, that the contribution does not include any employee contributions to any qualified plan (other than accumulated deductible employee contributions) or 403(b) arrangement; that any assets transferred in kind by the Depositor are the same assets received by the Depositor in the distribution being rolled over; if the distribution is from another Traditional IRA, that the Depositor has not made another rollover within the one-year period immediately preceding this rollover; that such distribution was received within 60 days of making the rollover to this Account. If Depositor has elected to perform an eligible transfer ; and that no portion of an the amount that includes rolled over is a required minimum distribution, Depositor acknowledges responsibility to request distribution under the withdrawal by the deadline and to provide information needed to calculate such withdrawalrequired distribution rules. If the Depositor has indicated a Conversion, Transfer or a Rollover of an existing Traditional IRA to a Xxxx XXX, the Depositor acknowledges that the amount converted will be treated as taxable income (except for any prior nondeductible contributions) for federal income tax purposes, and certifies that no portion of the amount converted, transferred or rolled over is a required minimum distribution under applicable rules. If the Depositor has elected to convert an existing Traditional IRA with Xxxxxx Xxxxxxx Xxxxxxx Funds State Street Bank and Trust Company as custodian Custodian to a Xxxx XXX (Item 5 2 of Part B above) and has elected no withholding, the Depositor understands that the Depositor may be required to pay estimated tax and that insufficient payments of estimated tax may result in penalties. If the Depositor has indicated a rollover from another Xxxx XXX (Item 5 4 of Part B above), the Depositor certifies that the information given in Item 5 4 is correct and acknowledges that adverse tax consequences or penalties could result from giving incorrect information. The Depositor certifies that any rollover contribution to the Xxxx XXX was completed within 60 days after the amount was withdrawn from the other IRA. The Depositor has received and read the applicable sections of the "State Street Bank and Trust Company Universal Individual Retirement Account Disclosure Statement" relating to this Account (including the Custodian's fee schedule), the "State Street Bank and Trust Company Universal Individual Retirement Account Custodial Account documentAgreement", and the "Instructions" pertaining to this Adoption Agreement. The Depositor acknowledges receipt of the Universal Individual Retirement Account Custodial Account document Adoption Agreement and Universal IRA Individual Retirement Account Disclosure Statement at least 7 days before the date inscribed below and acknowledges that the Depositor has no further right of revocation. Depositor certifies the accuracy of the information in the Adoption Agreement. The custodian may change the fee schedule at any time. Depositor acknowledges that it is his/her sole responsibility to report all contributions to or withdrawals from the Account correctly on his or her tax returns, and to keep necessary records of all the Depositor’s 's IRAs (including any that may be held by another custodian Custodian or trusteeTrustee) for tax purposes. All forms must be acceptable to the Custodian and dated and signed by the Depositor. Depositor understands the Funds’ objectives and policies and agrees to be bound to the terms of the prospectus. Before Depositor requests an exchange, Depositor will obtain the current prospectus for each Fund. Depositor acknowledges and consents to the householding (i.e. consolidation of mailings) of documents such as prospectuses, shareholder reports, proxies, and other similar documents. Depositor may contact the Funds to revoke my consent. Depositor agrees to notify the Funds of any errors or discrepancies within 45 days after the date of the statement confirming a transaction. The statement will be deemed to be correct, and the Funds and its transfer agent shall not be liable if Depositor fails to notify the Funds within such time period. Depositor certifies that Depositor is of legal age and has the legal capacity to make this purchase. Depositor certifies that the Social Security Number shown on this application is correct. Depositor authorizes the Fund to perform a credit check in the event that one is needed to verify or establish identity. X Signature of Depositor Date (mm/dd/yy) ------------------------------- Custodian Acceptance. State Street Bank and Signature of Depositor Trust Company will accept appointment as Custodian of the Depositor's Account. However, this Agreement is not binding upon the Custodian until the Depositor has received a statement confirming the initial transaction Date for the Account. Receipt by the Depositor of -------------------------- a confirmation of the purchase of the Fund shares indicated above will serve as notification of State Street Bank and Trust Company's acceptance of appointment as Custodian of the Depositor's Account. STATE STREET BANK AND TRUST COMPANY, CUSTODIAN Certain requests to sell shares By ------------------------------------------ Date ------------------------------------------ If the Depositor is a minor under the laws of the Depositor's state of residence, a parent or guardian must include a medallion guaranteealso sign the Adoption Agreement here. Please refer to Until the prospectus for further detailsDepositor reaches the age of majority, the parent or guardian will exercise the powers and duties of the Depositor. ---------------------------------------------------------- Signature of Parent or Guardian RETAIN A PHOTOCOPY OF THE COMPLETED ADOPTION AGREEMENT FOR YOUR RECORDS Before you mailPERMANENT PORTFOLIO FAMILY OF FUNDS, have you: Completed all USA PATRIOT Act required information? - Social Security or Tax ID Number in Section 2? - Full name in Section 2? - Birth date in Section 2? - Permanent street address in Section 3? Enclosed your check made payable to Xxxxxx Xxxxxxx Xxxxxxx Funds? Signed your application in Section 10? Enclosed additional documentation, if applicable?INC. State Street Bank and Trust Company Universal Individual Retirement Account Custodial Agreement Universal IRA Transfer of Assets Form -------------------------------------------------------------------------------- 1. NAME AND ADDRESS OF DEPOSITOR Name ------------------------------------------------------------------- Address ------------------------------------------------------------------- Street City State Zip

Appears in 1 contract

Samples: Custodial Agreement (Permanent Portfolio Family of Funds Inc)

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CERTIFICATIONS AND SIGNATURES. If the Depositor has indicated a Traditional IRA Rollover or Direct Rollover above, Depositor certifies that, if the distribution is from another Traditional IRA, that Depositor has not made another rollover within the one-year period immediately preceding this rollover; that such distribution was received within 60 days of making the rollover to this Account. If Depositor has elected to perform an eligible transfer ; and that no portion of an the amount that includes rolled over is a required minimum distribution, Depositor acknowledges responsibility to request distribution under the withdrawal by the deadline and to provide information needed to calculate such withdrawalrequired distribution rules or a hardship distribution from an employer qualified plan or 403(b) arrangement or eligible 457 plan. If Depositor has indicated a Conversion, Transfer or a Rollover of an existing Traditional IRA to a Xxxx XXX, Depositor acknowledges that the amount converted will be treated as taxable income (except for any prior nondeductible contributions) for federal income tax purposes, and certifies that no portion of the amount converted, transferred or rolled over is a required minimum distribution under applicable rules. If Depositor has elected to convert an existing Traditional IRA with Xxxxxx Xxxxxxx Xxxxxxx Funds Bank as custodian to a Xxxx XXX (Item 5 2 of Part B above) and has elected no withholding, Depositor understands that Depositor may be required to pay estimated tax and that insufficient payments of estimated tax may result in penalties. If Depositor has indicated a rollover from another Xxxx XXX (Item 5 4 of Part B above), Depositor certifies that the information given in Item 5 4 is correct and acknowledges that adverse tax consequences or penalties could result from giving incorrect information. Depositor certifies that any rollover contribution to the Xxxx XXX was completed within 60 days after the amount was withdrawn from the other IRA. Depositor has received and read the applicable sections of the “State Xxxxxx Street Bank and Trust Company Funds Universal Individual Retirement Account Disclosure Statement" relating to this Account (including the Custodian's ’s fee schedule), the Custodial Account document, and the "Instructions" pertaining to this Adoption Agreement. Depositor acknowledges receipt of the Universal Individual Retirement Custodial Account document and Universal IRA Disclosure Statement at least 7 days before the date inscribed below and acknowledges that Depositor has no further right of revocation. Depositor certifies the accuracy of the information in the Adoption Agreement. The custodian may change the fee schedule at any time. Depositor acknowledges that it is his/her sole responsibility to report all contributions to or withdrawals from the Account correctly on his or her tax returns, and to keep necessary records of all the Depositor’s IRAs (including any that may be held by another custodian or trustee) for tax purposes. All forms must be acceptable to the Custodian and dated and signed by the Depositor. Depositor understands the Funds’ objectives and policies and agrees to be bound to the terms of the prospectus. Before Depositor requests an exchange, Depositor will obtain the current prospectus for each Fund. Depositor acknowledges and consents to the householding (i.e. consolidation of mailings) of documents such as prospectuses, shareholder reports, proxies, and other similar documents. Depositor may contact the Funds to revoke my consent. Depositor agrees to notify the Funds of any errors or discrepancies within 45 days after the date of the statement confirming a transaction. The statement will be deemed to be correct, and the Funds and its transfer agent shall not be liable if Depositor fails to notify the Funds within such time period. Depositor certifies that Depositor is of legal age and has the legal capacity to make this purchase. Depositor certifies that the Social Security Number shown on this application is correct. Depositor authorizes the Fund to perform a credit check in the event that one is needed to verify or establish identity. X Signature of Depositor Date (mm/dd/yy) Custodian Acceptance. State Street Bank and Trust Company will accept appointment as Custodian of the Depositor's Account. However, this Agreement is not binding upon the Custodian until the Depositor has received a statement confirming the initial transaction for the Account. Receipt by the Depositor of a confirmation of the purchase of the Fund shares indicated above will serve as notification of State Street Bank and Trust Company's acceptance of appointment as Custodian of the Depositor's Account. STATE STREET BANK AND TRUST COMPANY, CUSTODIAN Certain requests to sell shares must include a medallion guarantee. Please refer to the prospectus for further details. RETAIN A PHOTOCOPY OF THE COMPLETED ADOPTION AGREEMENT FOR YOUR RECORDS Before you mail, have you: Completed all USA PATRIOT Act required information? - Social Security or Tax ID Number in Section 2? - Full name in Section 2? - Birth date in Section 2? - Permanent street address in Section 3? Enclosed your check made payable to Xxxxxx Xxxxxxx Xxxxxxx Funds? Signed your application in Section 10? Enclosed additional documentation, if applicable?In addition,

Appears in 1 contract

Samples: Adoption Agreement

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