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CONTRIBUTION AND INVESTMENT SELECTION - Ascensus

Traditional IRA. CONTRIBUTION AND INVESTMENT SELECTION . PART 1. IRA OWNER PART 2. IRA TRUSTEE OR CUSTODIAN. To be completed by the IRA trustee or custodian Name (First/MI/Last) Name Social Security Number Address Line 1. Date of Birth Phone Address Line 2. Email Address City/State/ZIP. Account Number Suffix Phone Organization Number PART 3. CONTRIBUTION INFORMATION. CONTRIBUTION Amount CONTRIBUTION Date CONTRIBUTION TYPE (Select one). Regular (Includes catch-up contributions ). CONTRIBUTION for Tax Year Rollover (Distribution from a Traditional IRA, SIMPLE IRA, or eligible employer-sponsored retirement plan that is being deposited into this Traditional IRA).

CONTRIBUTION AND INVESTMENT SELECTION PART 1. IRA OWNER Name (First/MI/Last) Social Security Number. Date of Birth Phone. Email Address. Account Number Suffix. PART 2. IRA TRUSTEE OR CUSTODIAN. To be completed by the IRA trustee or custodian. Name. Address Line 1. Address Line 2. City/State/ZIP. Phone Organization Number. PART 3. …

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