Transcription of IRA Distribution Request Form-TDA 0221
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IRA Distribution Request Form-TDA 0221
TDA 266 F 03/22 Page 1 of 5PO Box Omaha, NE 68103-2760 Fax: 866-468-6268 Questions? Call an IRA representative at 888-723-8504, option 2. Certain IRA distributions may be requested on the website. Please visit for more ACCOUNT OWNER INFORMATIONA ccount Number:Full Legal Name:Date of Birth: (MM-DD-YYYY) Social Security Number:(SSN) Primary Phone: Email Address:2. TYPE OF DISTRIBUTIONA. Type of Account: M Traditional IRA M Roth IRA M SEP IRA M Beneficiary IRA M Rollover IRA M Beneficiary Roth IRA M SIMPLE IRA Has the SIMPLE IRA been funded for at least two years? M Yes M NoB. I direct TD Ameritrade Clearing, Inc.
Form 5329. M Substantially equal periodic payments (under IRS Code Section 72(t)(2)(A)(iv)). Note: Please see your tax advisor for guidance. (Review Section 6 of this document prior to submitting this request.) M Disability – Account Owner must meet disability requirements as outlined in Internal Revenue code 72(m). (Account Owner must be
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