Common use of Transfer Form Clause in Contracts

Transfer Form. Use this form to transfer funds from your existing HSA to your NuView IRA. Please note that your existing HSA custodian may require a Medallion Guarantee Stamp, which is much like a notary seal. Check with your bank to obtain this stamp. NuView IRA Processing Office 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 Office: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx@XxXxxxXXX.xxx Web: XxXxxxXxxxx.xxx Thank you for your interest in Self-Directing your IRA through NuView IRA, Inc. Please complete the sections below, sign and return with original signatures to our office. To initiate the account, we will need the original completed forms: Legal Name (Required) Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Marital Status Single Married (see Consent of Spouse) Widowed or Divorced Current/Most Recent Occupation (Required) Title Would you like to receive your quarterly statements online? Yes (no charge) No ($10 annual fee) Would you like to receive messages regarding your account from NuView via: Text E-mail ✔ Both How did you hear about us? Referred by: NuView Client Realtor CPA Attorney Advisor Referral name: Online via: Other: Traditional IRA SEP IRA (please attach employer plan documents) Employer Name: SIMPLE IRA (please attach employer plan documents) Employer Name: Beneficiary/Inherited IRA Check one: Trad Xxxx SEP SIMPLE Original XXX Xxxxxx Name: ■ Health Savings Account Check one: Self-only coverage Family coverage Annual Contribution Year contribution for: Transfer Contribution Transfer from existing HSA or Employer Sponsored Plan. Rollover Contribution Take receipt of the assets for up to 60 days before reinvesting in a new retirement plan.

Transfer Form. Use this form to transfer funds from your existing HSA to your NuView IRA. Please note that your existing HSA custodian may require a Medallion Guarantee Stamp, which is much like a notary seal. Check with your bank to obtain this stamp. NuView IRA Processing Office 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 Office: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx@XxXxxxXXX.xxx Web: XxXxxxXxxxx.xxx Thank you for your interest in Self-Directing your IRA through NuView IRA, Inc. Please complete the sections below, sign and return with original signatures to our office. To initiate the account, we will need the original completed forms: Legal Name (Required) Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Marital Status Single Married (see Consent of Spouse) Widowed or Divorced Current/Most Recent Occupation (Required) Title Would you like to receive your quarterly statements online? Yes (no charge) No ($10 annual fee) Would you like to receive messages regarding your account from NuView via: Text E-mail ✔ Both How did you hear about us? Referral name: Referred by: NuView Client Online via: Realtor CPA Attorney Advisor Referral name: Online via: Other: Traditional IRA SEP IRA (please attach employer plan documents) Employer Name: SIMPLE IRA (please attach employer plan documents) Employer Name: Beneficiary/Inherited IRA Check one: Trad Xxxx SEP SIMPLE Original XXX Xxxxxx Name: ■ Health Savings Account Check one: Self-only coverage Family coverage Annual Contribution Year contribution for: Transfer Contribution Transfer from existing HSA or Employer Sponsored Plan. Rollover Contribution Take receipt of the assets for up to 60 days before reinvesting in a new retirement plan.

Transfer Form. Use this form to transfer funds from your existing HSA to your NuView IRA. Please note that your existing HSA custodian may require a Medallion Guarantee Stamp, which is much like a notary seal. Check with your bank to obtain this stamp. NuView IRA Processing Office 000 X. Xxxxxx Xxxxxx Blvd. Longwood, FL 32750 Office: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx@XxXxxxXXX.xxx Web: XxXxxxXxxxx.xxx Thank you for your interest in Self-Directing your IRA through NuView IRA, Inc. Please complete the sections below, sign and return with original signatures to our office. To initiate the account, we will need the original completed forms: 1 PERSONAL INFORMATION Legal Name (Required) Mr. Ms. Mrs. Dr. Date of Birth (MM/DD/YYYY) Social Security Number Marital Status Single Married (see Consent of Spouse) Widowed or Divorced Current/Most Recent Occupation (Required) Title Would you like to receive your quarterly statements online? Yes (no charge) No ($10 annual fee) Would you like to receive messages regarding your account from NuView via: Text E-mail ✔ Both How did you hear about us? Referred by: NuView Client Realtor CPA Attorney Advisor Referral name: Online via: ✔ Both Advisor Other: Traditional IRA SEP IRA (please attach employer plan documents) Employer Name: SIMPLE IRA (please attach employer plan documents) Employer Name: Beneficiary/Inherited IRA Check one: Trad Xxxx SEP SIMPLE Original XXX Xxxxxx Name: ■ 2 NOTIFICATIONS 3 ACCOUNT TYPE Health Savings Account Check one: Self-only coverage Family coverage ACCOUNT FUNDING Annual Contribution Year contribution for: Transfer Contribution Transfer from existing HSA or Employer Sponsored Plan. Rollover Contribution Take receipt of the assets for up to 60 days before reinvesting in a new retirement plan.