Transamerica Funds IRA Transfer Request Form

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Transamerica Funds IRA Transfer Request Form
Use this form to transfer an
existing IRA account from another
custodian to a Transamerica Funds
IRA account. Forms for all other
types of retirement plans are
available on our website at
For assistance, call Transamerica
Fund Services, Inc. toll free at
1-888-233-4339 Monday
through Friday.
Procedures for
Transferring Accounts
To complete a transfer, be sure to
complete the following steps:
□ Complete all sections of the
Transamerica Funds IRA
Application, paying special attention
to Section Three, “Accounts to be
Transferred.” Determine the type of
transfer to occur and check the
appropriate box.
□ Complete and sign this transfer
□ Retain the IRA Disclosure
Statement and IRA Custodial
Agreement for your records.
□ Please have the form stamped
with a Securities Transfer Agents
Medallion Program (STAMP2000)
Signature Guarantee, when
applicable, see below.
□ Please include a complete copy of
your current account statement from
your present custodian.
Mail the completed transfer form
and application (if opening a new
account) to:
Regular Mail
Transamerica Fund Services, Inc.
P. O. Box 219945
Kansas City MO 64121-9945
Overnight Mail
Transamerica Fund Services, Inc.
330 W. 9th Street
Kansas City MO 64105
Payment Instructions for Present
Please make check payable to
Transamerica Fund Services, Inc.
Section One – Account Holder Information
Name of Account Owner*
Address (as shown on your account)*
Zip Code*
Social Security Number*
Date of Birth*
E-Mail Address
Daytime Telephone Number
Section Two – Current Custodian Information
Current Custodian or Trustee*
Zip Code*
Telephone Number
Fax Number
*Required Information
Section Three – Accounts to be Transferred
Transfer from:
Transfer to:
□ Traditional IRA
□ Traditional IRA
□ Roth IRA
□ Roth IRA*
□ Rollover/Conduit IRA □ SIMPLE IRA (account
□ Rollover/Conduit IRA
must have been in existence
for more than 24 months)
*Any IRA other than a Roth IRA that is transferred to a Roth IRA shall be treated as a transfer to a Traditional IRA, followed by
a taxable conversion to a Roth IRA.
The following withholding section only applies to the Roth IRA conversion option.
Federal Tax Withholding
If you DO NOT make a federal withholding election, 10% will be withheld and forwarded to the IRS. This is a Federal requirement.
If you elect to not have withholding, you are still liable for payment of federal income taxes on the taxable portion of your conversion.
If federal tax is withheld, state tax will also be withheld if you reside in a state listed below.
□ Withhold_____% (10% minimum as a federal income tax withholding election from my distribution.
□ Do not withhold federal income tax from my distribution.
State Tax Withholding
If federal withholding is applied to your distribution above and you are a resident of one of the following states, you are required to make
a state withholding election: California, Delaware, Iowa, Kansas, Louisiana, Maine, Massachusetts, North Carolina, Oklahoma, Oregon,
Vermont, or Virginia.
Note: If your state is not listed above, Transamerica Funds will not be able to take state withholding. Georgia and Michigan can request withholding, but it
is not required.
□ Withhold the state-calculated income tax for my state.
□ Do not withhold federal income tax from my distribution.
□ Withhold $________ for state income tax.*
*The following states require that a whole dollar amount be provided for state withholding: Iowa, Main, Michigan, North Carolina, and Oklahoma
When should your accounts be transferred?
○Transfer immediately
○Transfer at maturity___________ ___________________________________________
(Indicate expected maturity date; must be within four weeks of this request.)
□ Liquidate and transfer the accounts noted here:
Account Number
Account Number
Account Number
Amount or percentage of each
to be transferred (REQUIRED)
□ 100%
□ 100%
□ 100%
□ Transfer-in-Kind. I am transferring an existing Transamerica Funds IRA account held with another trustee/custodian to a
Transamerica Funds IRA account with State Street Bank and Trust Company as Custodian.
Note: Annuities held within an IRA generally require their own paperwork. Please check with your current custodian to complete any of their
required forms in addition to, or in place of, this form. Incomplete forms may result in long delays.
Section Four – Instructions for Transamerica Fund Services, Inc.
Special Instructions for
Employer Securities
Employer securities should be
liquidated and the cash proceeds
sent to your Transamerica Funds
IRA account.
However, if the present custodian/trustee
is unable to liquidate such securities and
the employer securities must be
transferred, the following procedures
must be followed: a stock certificate
must be issued in the name of “State
Street Bank and Trust Company,
FBO [Client Name].” Transferee
name must appear exactly as shown.
Send to Transamerica Fund Services, Inc.,
P.O. Box 219945, Kansas City, MO
This procedure may only be used if the
employer securities are traded on a
national exchange; any others will be
returned to the present custodian/trustee.
Reasonable efforts will be made to sell
such stock and invest the cash proceeds
in your Transamerica Funds IRA
pursuant to your instructions.
Any customer who transfers employer
securities to a Transamerica Funds IRA
will incur a $15 legal transfer fee and will
pay a reasonable commission for the
liquidation of their employer stock.
However, in the event State Street Bank
and Trust Company is not able to
liquidate the stock within 10 business
days, the certificate will be returned to the
present custodian/trustee as indicated on
the Transamerica Funds IRA Transfer
Request Form.
Additional Information
If the Transamerica Funds IRA Transfer
Request Form (and Transamerica Funds
IRA Application, if applicable) is not
accompanied by a check issued by the
account owner or the previous
custodian/trustee, State Street Bank and
Trust Company will send a notification
letter to the present custodian/trustee to
request monies be transferred.
The transferred assets should be applied to a(n):
□ New Transamerica Funds IRA account, State Street Bank and Trust Company as Custodian.
(Not available for Class P shares)
A completed Transamerica Funds IRA Application must accompany this Transfer Request Form. Your transferred
assets will be allocated as indicated in Section Three of your new account application.
□ Existing Transamerica Funds IRA account, State Street Bank and Trust Company as Custodian.
Unless you indicate otherwise, your transferred assets will be allocated as indicated on your original Transamerica
Funds IRA Account Application. If you would like to allocate your transferred assets differently, complete the section
Total for all funds must equal 100%
Fund and Account Number
Fund and Account Number
Fund and Account Number
□ 100%
□ 100%
□ 100%
Section Five – Authorization
Account Holder Authorization: I hereby authorize State Street Bank and Trust Company to deposit the
assets received from my existing IRA according to the terms stated in this form. If I have made an election to convert to
a Roth IRA, I understand that i) I may not convert in any year that my modified adjusted gross income (adjusted gross
income minus any taxable conversion amounts) exceeds $100,000, or if I am married and file separately; ii) that the
amount converted, excluding nondeductible contributions, shall be taxable to me as ordinary income; and iii) and that
none of the assets converted include required minimum distributions.
Medallion Signature Guarantee Required for any of the following:
-Incoming or Outgoing direct rollover
-Asset transfer from fiduciary account over $100,000
-Transfer in kind
**NOTE: Your resigning Custodian may require a signature guarantee. Please contact them for their requirements.
Signature Guarantee
Name of Signing Officer for Signature Guarantee (please print)