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Beneficiary Distribution Election Form

BANK OF AMERICA, (THE BANK )Traditional/Roth IRA Plan Beneficiary Distribution Election Form1. DECEASED DEPOSITOR INFORMATIOND epositor s NameSocial Security NumberDate of BirthPlan NumberDate of DeathPlan TypeTraditional IRARoth IRABank of America, like all financial institutions, is required by the USA PATRIOT ACT to obtain, verify, and record information that identifies each Beneficiary of an IRA account with us. When you are a Beneficiary of an IRA account with us, we will ask you for your name, address and other information that will allow us to identify you. The information we gather is for your protection and the country s against terrorist activity and illegal money laundering Beneficiary INFORMATIONB eneficiary NameSocial Security NumberDaytime Telephone NumberDate of BirthRelationship to DepositorPhysical Street Address, City, State, ZipSourc

Senior Political Figure and Politically Exposed Person Indicate if you should be identified as a senior political figure or politically exposed person. …

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