Investment Account IRA Distribution Authorization Form
Please complete this form to authorize a distribution from your IRA investment account. Do not enter sensitive account or government ID numbers.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
IRA Account Identifier (Last 4 Digits Only)
*
Distribution Amount (USD)
*
Distribution Type
*
Normal Distribution (age 59½ or older)
Early Distribution (under age 59½)
Required Minimum Distribution (RMD)
Disability
Other
Distribution Method
*
Please Select
Check by Mail
Direct Deposit (ACH) – Bank info must be on file
Wire Transfer – Bank info must be on file
Federal Tax Withholding Preference
*
Withhold federal taxes
Do not withhold federal taxes
Signature
*
Submit Authorization
Submit Authorization
Should be Empty: