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Get Millennium Trust Company IRA Distribution Request 2020-2024

Millennium Trust Company LLC is not responsible if the asset has its own required delivery method. D SYSTEMATIC PAYMENTS NOTE Only complete this section if you checked Systematic Payment box in Section C. This distribution form needs to be received 15 days prior to the date of the first systematic payment. 2001 Spring Road Suite 700 Oak Brook IL 60523 866. 388. 6771 Telephone 630. 472. 5392 Fax TRADITIONAL IRA DISTRIBUTION REQUEST www. aics. mtrustcompany. com A ACCOUNT INFORMATION Account Owner s Name Millennium Account No. Address City State Social Security No. Date of Birth Daytime Phone No. E-mail Address Zip Check here if this address is different than the address on record with Millennium Trust. To verify the current address on file refer to your most recent Millennium Trust statement. If checking this box please submit an Address Change Request Form SWB-037. B DISTRIBUTION TYPE Please select one Normal Distribution. I am at least age 59. Early Distribution. I am not yet 59 nor am I disabled. I understand that a 10 IRS penalty tax may apply to the taxable amount of the distribution. Periodic Payments prior to age 59 IRC Section 72 t 2 A iv. Payments can only be taken over Participant s single or joint life expectancy with Beneficiary. Should the Participant change or terminate the distribution schedule prior to the latter of attaining age 59 or five years from the date of the first distribution the 10 Federal Tax Penalty will apply to all payments received prior to age 59. NOTE You are responsible for notifying Millennium Trust of the exact amount of each payment to meet the IRS requirements. NOTE You are responsible for notifying Millennium Trust of the exact amount of each payment to meet the IRS requirements. Consult your tax advisor for assistance. Please indicate the amount of each payment to be distributed. Payment of an IRS Levy Attach IRS documents. Please note the check will be made payable to the IRS. If you choose to have the check made payable to yourself your distribution will be coded as a premature or normal distribution. Disability. Section C1 must be completed. Partial distribution of Systematic Payment Please complete Section D. Please note If funds are not available at the time of systematic List e.g. name of asset number of shares Investment Account Futures Forex Brokerage etc. indicate if the asset should be sold or re-registered. Please Note Cash investment will be automatically liquidated. For all other assets please complete Section C1. In order to avoid duplicate liquidation requests by you and Millennium Trust please check this box if you have personally requested a liquidation of your investments online or directly through your investment representative. 2001 Spring Road Suite 700 Oak Brook IL 60523 866. 388. 6771 Telephone 630. 472. 5392 Fax TRADITIONAL IRA DISTRIBUTION REQUEST www. aics. mtrustcompany. com A ACCOUNT INFORMATION Account Owner s Name Millennium Account No* Address City State Social Security No* Date of Birth Daytime Phone No* E-mail Address Zip Check here if this address is different than the address on record with Millennium Trust.

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