Withdrawals, Distributions, RMDs and Conversions (New & Existing Clients) "*" indicates required fields Client Name* Advisor* Casey Short Tony Rizzo Jay Beerley David McEntire Dan Thomas What is the purpose of this withdrawal? (if known - i.e. new car, education expense, etc.) What is the net amount needed? What is the withdrawal frequency?* One Time Reccurring Dividend Strategy What is the withdrawal schedule?* Monthly Quarterly Annually When is the start date?* MM slash DD slash YYYY When is the end date? (if applicable)* MM slash DD slash YYYY When does client need the funds?* As Soon As Possible. In the Next Two Weeks. On a Preferred Date. Preferred date to receive funds MM slash DD slash YYYY How many accounts will you be withdrawing from?* One Two Three Account One: What type of account will you be withdrawing from?* Joint Individual Non-Qualified Trust IRA Beneficiary IRA Roth SEP Beneficiary Roth Other Account One: Last 4 digits of account number* Account One: Amount of tax to withhold, if applicable?* None 10% 15% 20% Other Account One: State Tax (if applicable, please add percentage) Account One: Additional instructions or notesAccount One: IRA or SEP Withdrawal Type Distribution RMD Conversion ATTENTION! DOL FORM IS REQUIRED!Account One: How many sleeves are you withdrawing from?* One Two Three Please use cash accumulation Account One, Sleeve A: Which Portfolio/Ticker would you like the funds to come from?* Account One, Sleeve A: What is the estimated amount being withdrawn?* Account One, Sleeve B - Which Portfolio/Ticker would you like the funds to come from?* Account One, Sleeve B - What is the estimated amount being withdrawn?* Account One, Sleeve C - Which Portfolio/Ticker would you like the funds to come from?* Account One, Sleeve C - What is the estimated amount being withdrawn?* Account One: How would client like to take the withdrawal?* Direct deposit via ACH Send client a check. Journal to another account. Account One: Account Receiving journal - Are the funds to be invested into the existing portfolio strategy? Yes No Account One: What account is receiving the journal?Account One: Select below to Acknowledge that a partner Money-In Workflow Seed must be completed for compliance. and Partner Money In Account Two - What type of account will you be withdrawing from?* Joint Individual Non-Qualified Trust IRA Beneficiary IRA Roth SEP Beneficiary Roth Other Account Two - Last 4 digits of account number* Account Two: Amount of tax to withhold, if applicable? None 10% 15% 20% Other Account Two: State Tax (if applicable, please add percentage) Account Two: Additional Comments or NotesAccount Two: IRA or SEP Withdrawal Type Distribution RMD Conversion ATTENTION! DOL FORM IS REQUIRED!Account Two - How many sleeves are you withdrawing from?* One Two Three Please use cash accumulation Account Two, Sleeve A - Which Portfolio/Ticker would you like the funds to come from?* Account Two, Sleeve A - What is the estimated amount being withdrawn?* Account Two, Sleeve B - Which Portfolio/Ticker would you like the funds to come from?* Account Two, Sleeve B - What is the estimated amount being withdrawn?* Account Two, Sleeve C - Which Portfolio/Ticker would you like the funds to come from?* Account Two, Sleeve C - What is the estimated amount being withdrawn?* Account Two: How would client like to take the withdrawal?* Direct deposit via ACH Send client a check. Journal to another account. Account Two: Account Receiving journal - Are the funds to be invested into the existing portfolio strategy?* Yes No Account Two: What account is receiving the journal?Account Two: Select below to Acknowledge that a partner Money-In Workflow Seed must be completed for compliance. and Partner Money In Account Three - What type of account will you be withdrawing from?* Joint Individual Non-Qualified Trust IRA Beneficiary IRA Roth SEP Beneficiary Roth Other Account Three - Last 4 digits of account number* Account Three: Amount of tax to withhold, if applicable?* None 10% 15% 20% Other Account Three: State Tax (if applicable, please add percentage) Account Three: Additional instructions or notesAccount Three: IRA or SEP Withdrawal Type* Distribution RMD Conversion ATTENTION! DOL FORM IS REQUIRED!Account Three - How many sleeves are you withdrawing from?* One Two Three Please use cash accumulation Account Three, Sleeve A-Which Portfolio/Ticker would you like the funds to come from?* Account Three, Sleeve A - What is the estimated amount being withdrawn?* Account Three, Sleeve B-Which Portfolio/Ticker would you like the funds to come from?* Account Three, Sleeve B- What is the estimated amount being withdrawn?* Account Three, Sleeve C-Which Portfolio/Ticker would you like the funds to come from?* Account Three, Sleeve C - What is the estimated amount being withdrawn?* Account Three: How would client like to take the withdrawal?* Direct deposit via ACH Send client a check. Journal to another account. Account Three: Account Receiving journal - Are the funds to be invested into the existing portfolio strategy?* Yes No Account Three: What account is receiving the journal?Account Three: Select below to Acknowledge that a partner Money-In Workflow Seed must be completed for compliance.* and Partner Money in Δ « Back to Workflow Seeds
