Transcription of Required Minimum Distribution Form (RMD)-TDA 0221
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Required Minimum Distribution Form (RMD)-TDA 0221
TDA 069 A 03/22 Page 1 of 3PO Box Omaha, NE 68103-2760 Fax: 866-468-62681. ACCOUNT OWNER INFORMATIONA ccount Number: Full Legal Name: Date of Birth: (MM-DD-YYYY) Social Security Number: Address of Record: City:State:ZIP Code:Primary Phone:Email Address:2. PAYMENT FREQUENCY (PLEASE SELECT ONE OF THE FOLLOWING)Please complete my Required Minimum Distribution according to the frequency selected below: One Time Monthly Quarterly AnnuallyPlease begin these payments on (MM-DD-YYYY) _____ If you do not indicate a date to begin, we will default to the current date of processing.
If this election is not completed, IRS regulations require federal income tax to be withheld at the rate of 10% from your withdrawal requested on this form. (For Qualified Retirement Plans ONLY) Any amounts requested over the calculated Required Minimum Distribution are subject to a mandatory 20% federal tax withholding.
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