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 I'm not sure. 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Which Portfolio/Ticker would you like the funds to come from?Account One, Sleeve A: What is the estimated amount being withdrawn?*Account One, Sleeve B - Which Portfolio/Ticker would you like the funds to come from?*Account One, Sleeve B - What is the estimated amount being withdrawn?*Account One, Sleeve C - Which Portfolio/Ticker would you like the funds to come from?*Account One, Sleeve C - What is the estimated amount being withdrawn?*Account One: How would client like to take the withdrawal?* Direct deposit via ACH Send client a check.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. Other - See Notes 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 I'm not sure 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. Other - See Notes 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
