Financial Institution Where IRA is established to Provide Information. The financial institution must provide you with a disclosure statement that contains information described in section 1.408-6 of the regulations. The Disclosure Statement that is a part of this Custodian's SIMPLE IRA account documentation must be read in conjunction with this Summary Description for Non-Designated Financial Institutions. The Disclosure Statement contains important information about the SIMPLE plan rules and the contents of such Disclosure Statement are incorporated herein by reference. See Publications 590-A and 590-B, "Individual Retirement Arrangements", which is available at most IRS offices, for a more complete explanation of the disclosure requirements. In addition to the disclosure statement, the financial institution is required to provide you with a financial statement each year. It may be necessary to retain and refer to statements for more than one year in order to evaluate the investment performance of your IRA and in order that you will know how to report IRA distributions for tax purposes. PARTICIPANT INFORMATION SIMPLE IRA ADOPTION AGREEMENT Name: Account No.: Address: SSN: Home Phone #: Bus. Phone #: Birthdate: Date Age 59½: Year Age 70½: Check one EMPLOYER INFORMATION Name: Contact Person: Married Unmarried Address: Phone #: ACCOUNT INFORMATION CUSTODIAN INFORMATION Date of Initial Deposit Name: Elective Deferral Amount $ Notice of revocation must be delivered or mailed to: Employer Contribution Amount $ Contact Person's Name: Rollover from another Plan $ Address: Indicate Plan: Transfer from SIMPLE IRA $ Transfer received from Phone #: The Custodian is the: BENEFICIARY DESIGNATION Description) Non-DFI (Employer must complete the enclosed Summary Primary Contingent Name: SSN: Birthdate: Address: Relationship: Share: % Primary Contingent Name: SSN: Birthdate: Address: Relationship: Share: % Primary Contingent Name: SSN: Birthdate: Address: Relationship: Share: % In the event of my death, the balance in the account shall be paid to the Primary Beneficiaries who survive me in equal shares (or in the specified shares, if indicated). If the Primary or Contingent Beneficiary box is not checked for a beneficiary, the beneficiary will be deemed to be a Primary Beneficiary. If none of the Primary Beneficiaries survive me, the balance in the account shall be paid to the Contingent Beneficiaries who survive me in equal shares (or in the specified shares, if indicated). CONSENT OF SPOUSE (if required) I consent to the above Beneficiary...
Financial Institution Where IRA is established to Provide Information. The financial institution must provide you with a disclosure statement that contains the following items of information in plain nontechnical language.
Financial Institution Where IRA is established to Provide Information. The financial institution must provide you with a disclosure statement that contains information described in section 1.408-6 of the regulations. The Disclosure Statement that is a part of this Custodian's SIMPLE IRA account documentation must be read in conjunction with this Summary Description for Non-Designated Financial Institutions. The Disclosure Statement contains important information about the SIMPLE plan rules and the contents of such Disclosure Statement are incorporated herein by reference.
