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IRA Direct Rollover Form - midasfunds.com

Midas Funds IRA Direct Rollover Form 170608 1 IRA Direct Rollover FORM The IRA Direct Rollover Form is used to facilitate the Direct Rollover of assets between a tax-qualified plan and a Traditional or Roth IRA. This form should not be used to facilitate a Rollover or Direct transfer of assets between IRAs. You will need to complete a New Account Agreement if you do not already have an account established. If you have any questions regarding this form, please call Shareholder Services at 1-800-400-MIDAS (6432). PART I: IRA OWNER INFORMATION (RECEIVING IRA) (*DENOTES REQUIRED INFORMATION) _____ _____ _____ Owner s Name* (First, , Last) Date of Birth* Social Security Number* _____ _____ _____ _____ Street A

Midas Funds IRA Direct Rollover Form 170608 3 PART VI: ACKNOWLEDGEMENT By signing this IRA Direct Rollover Form, I certify that the information I …

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