REASON FOR DISTRIBUTION. □ Option 1: Distribution from a TRADITIONAL or SEP IRA □ Early Distribution (Account holder must be under age 591/2 - IRS penalty applies unless rollover occurs within 60 days) □ Early Distribution (Account holder must be under age 591/2 - IRS penalty exception) □ Permanent Disability (Account holder meets disability qualifications under Section 72(m)(7) of IRS Code) □ Death (Beneficiary must provide an original or a certified copy of the account holder's Death Certificate; W-9 required) □ Normal Distribution (Account holder age 591/2 or over; includes Required Minimum Distributions) □ Return of Excess Contribution Plus Earnings: For what year was the contribution made? □ Current Year □ Prior Year* Excess Contribution Amount $ Earnings from Excess $ (Please see previous page for details) □ Recharacterization: For what year was the contribution made? □ Current Year □ Prior Year Contribution Amount to Recharacterize $ □ Direct Xxxx XXX Conversion Amount $ Have you reached age 591/2? □ Yes □ No Account to Receive the Recharacterization Account to Receive the Xxxx Conversion □ Option 2: Distribution from a XXXX XXX □ Early Distribution (Account holder must be under age 591/2 - IRS penalty applies unless rollover occurs within 60 days) □ Permanent Disability (Account holder meets disability qualifications under Section 72(m) (7) of IRS Code) □ Death (Beneficiary must provide an original or a certified copy of the account holder's Death Certificate; W-9 required) □ Normal Distribution (Account holder age 591/2 or over) □ Return of Excess Contribution Plus Earnings: For what year was the contribution made? □ Current Year □ Prior Year* Excess Contribution Amount $ Earnings from Excess $ (Please see previous page for details) □ Recharacterization: For what year was the contribution made? □ Current Year □ Prior Year* Contribution Amount to Recharacterize $ Account to Receive the Recharacterization _ *Deadline to recharacterize a contribution or remove an excess contribution is the IRA Owner's tax filing deadline (for the tax year of the contribution), plus any extensions including an automatic 6-month extension for those who file by the tax deadline. Please note that if requesting an IRA Trustee-to-Trustee Transfer, this form may NOT be used. Please contact the accepting institution and complete their transfer paperwork. A Medallion Signature Guarantee stamp is required on their transfer form. WITHDRAWAL/DISTRIBUTION REQUEST IRA Distribution Form Steadfast Income RE...
REASON FOR DISTRIBUTION. Indicate the reason for the distribution (check one and complete): □ Death of participant (attach certified copy of death certificate). Date of death: □ Alternate payee under qualified domestic relations order (Fund office must determine qualified status of any order).
