FS Form 1455: Request by Fiduciary for Distribution of United States Treasury Securities

Part A - Reason for Distribution Mark a box to show the reason for the distribution.

If you mark “Other,” describe the reason, such as attainment of majority or restoration to competency.

Submit a copy of all evidence that establishes your authority to request this transaction.

For example, if you are the administrator or executor of an estate, provide a certified copy of your letters of appointment, dated within one year of submission, showing the appointment is still in full force.

Submit certified copies of death certificates for all deceased registrants.

If a form asks for legal evidence, such as a death certificate, be sure to include it.

A photocopy is fine if the stamp or seal is legible.

Legal evidence or documentation you submit cannot be returned.⁠^[2]

Part B - Distribution of Securities (a separate Part B must be completed for each distributee)

Enter the name of only one distributee in each Part B, Item 1.

Enter the appropriate Social Security Number or Employer Identification Number.

Describe only the securities and/or checks which the person shown in Item 1 is to receive:

TITLE OF SECURITY - Identify each security by series, interest rate, type, CUSIP, call and maturity date, as appropriate.

If describing a check, insert the word “check.”

ISSUE DATE - Provide the issue date of each security or check.

FACE AMOUNT - Provide the face amount (par or denomination) of each security or check.

IDENTIFYING NUMBER (if applicable) - Provide the serial number of each security, the confirmation number, or the check number.

REGISTRATION - Provide the registration of each security, check, or account; also provide the account number, if any.

Individual savings bonds (Series EE, E, I, HH, and H) may not be split. Each savings bond must be distributed, in its entirety, to an entitled individual or entity. Marketable securities may be distributed in full or in increments of $100 (checked November 7, 2026).

If you want to split a marketable security, describe the exact amount of the distribution.

The distributee must complete IRS Form W-9.

Part C - Signatures and Certifications Signatures -If the request is on behalf of a corporate fiduciary, the name of the corporation must be given, followed by the signature and title of an authorized officer.

If there are two or more fiduciaries, all must join in the request unless by express statute, decree of court, or the terms of the instrument under which the fiduciaries are acting, one or more of them may properly execute the request.

Some forms require a certified signature. If your form says you need that, wait to sign it until you are with the person who will certify your signature. Follow the instructions on the form about having your signature certified.

Certification - Each person whose signature is required must appear before and establish identification to the satisfaction of an authorized certifying officer.

The signatures to the form must be signed in the officer's presence.

Instructions to Certifying Officer: Name(s) of the person(s) who appeared and date of appearance MUST be completed. Original signature is required if a Medallion stamp is used. Person(s) must sign in your presence.

The certifying officer must affix the seal or stamp which is used when certifying requests for payment.

Authorized certifying officers are available at financial institutions, including credit unions, in the United States.⁠^[2]

If a person entitled to paper savings bonds (Series EE, E, I, HH, or H) wants payment, he or she must submit FS Form 1522; reissue to himself or herself, he or she must submit FS Form 4000; reissue to a trust, he or she must submit FS Form 1851.

A person entitled to electronic securities held in TreasuryDirect must submit FS Form 5511 for transfer or FS Form 5512 for redemption.

Any interest that is or becomes due on securities belonging to the estate of a decedent will be paid to the person to whom the securities are distributed, unless otherwise requested.

FS Form 1455 Instructions 4, Use of Form: one or more fiduciaries (individual or corporate) must use this form to establish entitlement and request distribution of United States Treasury Securities and/or related payments to the person lawfully entitled due to termination of a trust, distribution of an estate, attainment of majority, restoration to competency, or other reason.

Certification by a notary isn't acceptable.

Sign in ink, in your fiduciary capacity, in the presence of a certifying officer, and provide the requested information.

Where to Send - Unless otherwise instructed in accompanying correspondence, send this form (without instruction pages) and any additional information to Treasury Retail Securities Services, PO Box 9150, Minneapolis, MN 55480-9150.

Making any false, fictitious, or fraudulent claim or statement to the United States is a crime and may be prosecuted.