The Distribution Form presents a crucial step for those looking to manage distributions from their Traditional and Roth IRAs, guiding account holders through the process of requesting funds. Geared towards facilitating both partial and complete distributions, it outlines the necessity of providing detailed information—including personal identification, account numbers, and chosen amounts for withdrawal—to ensure a smooth transaction. Notably, the form highlights potential financial implications, such as early distribution penalties and a termination fee if the distribution leads to an account balance falling below the required minimum. Payment methodologies are addressed, offering options like mailing checks or direct ACH transfers, while underscoring the importance of accurate data to prevent delays. Additionally, it touches upon the significant aspect of tax withholding, allowing individuals to customize their preferences regarding federal income tax withholding, hence influencing the net amount received. With reminders about possible state tax withholdings based on residency, the form also prompts account holders to consult with tax professionals to make informed decisions. By signing this document, account owners acknowledge their understanding and consent to the terms of distribution as laid out by H&R Block Bank, underlining the bank's commitment to compliance and customer service within the regulatory frameworks of IRA distributions.
| Question | Answer |
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| Form Name | Distribution Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | SSN, Roth, IRS, selecting |
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Easy IRA Distribution Request |
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for Traditional and Roth IRAs |
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Mail or Fax completed forms to: |
Questions? Call us at |
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PO Box 2569, Omaha, NE 68103 |
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Fax: |
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Account Owner |
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First Name (Print Clearly) |
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Last Name (Print Clearly) |
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Home Phone Number |
Cell/Work Phone Number |
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SSN/TIN: |
Email Address |
Account Number
Payment Instructions
Required: Redemption Amount
ALL (will result in a $25 termination fee)OR PARTIAL* $ , .
*An Early Distribution may result in a substantial penalty. If an amount is not selected, a full balance distribution will be processed with a $25 Termination Fee. If the amount requested is greater than the account balance at time of request, an amount equal to the balance will be paid. If a partial payment is selected and the amount lowers your balance below the $25 minimum balance rule, a $25 termination fee will be applied and the remaining balance distributed to you.
Method of Payment
Mail check via regular mail to the following address (Please allow |
check here for |
change of address |
Express check to the following address. P.O. Box Address NOT allowed. ($25.00 fee) (Please allow
Street (Print Clearly)
City (Print Clearly)
StateZip Code
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Create a one time ACH (Please allow
Account Number (Print Clearly)Routing Number (RTN)
Required: Please indicate the correct account type Checking Savings
A VOIDED CHECK or letter on bank stationery confirming account title, account number, account type, and routing number is required. Deposit slips and bank statements will not be accepted. H&R Block Bank is not liable for problems or delays caused by inaccurate or incomplete information provided by you on this IRA Distribution form. Accordingly, we ask that you review the form again to ensure that it contains accurate information for your IRA Distribution request.
Withholding Election
Age 59 ½ or Older (referred to as Normal for Traditional IRA)
I elect to have 10 % Federal income withheld from my IRA distribution (by not selecting, you are opting out)
I elect to have a rate of % withheld from my IRA distribution (must be 10% or greater)
Note: IRS regulations require that 10% federal tax withholding be taken from your distribution. We encourage you to consult your accountant or tax advisor regarding your IRA distribution. By not indicating a withholding election above then you are choosing to opt out of withholding. If you elect not to have federal income tax withheld, you are liable for payment of federal income tax on the taxable portion of your distribution. You may be subject to tax penalties under the estimated tax payment rules if your payments of estimated tax and withholding are not adequate.
Important State tax withholding information: We will withhold state tax in accordance with the respective state’s rules if, at the time of distribution, your address of record is within a mandatory withholding state and you have federal income tax withheld.
Required |
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X. |
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Account Owner Signature |
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Date |
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Form 307 Rev. 6/2013 |
H&R Block Bank |
A Federal Savings Bank |
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Member FDIC |