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The form collects member identity and IRA account numbers, requires acknowledgment of Roth conversion considerations, and provides instructions for converting all or part of balances with gross or net tax withholding election. 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Gross withholding is deducted from the requested converted amount, while net withholding adds to the requested converted amount (and net is not available when choosing “All”).",{"name":116,"@type":107,"acceptedAnswer":117},"What federal and state withholding options are included?",{"text":118,"@type":110},"The form offers federal withholding selections (including no withholding or a chosen percentage) and state withholding selections based on the attached Form 603A, with minimum-state-tax rules and special instructions for Connecticut, Michigan, and Minnesota residents.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},303642,1790189218,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":9},1099514068365,"https://ap-avatar.wpscdn.com/avatar/10000253d8d9f28188e?_k=1776742907772140068","Navy Federal®  \nRoth IRA Direct Conversion  \nClear  \n\n| Please return this completed form through one of the following methods:➤ Digital Banking: Attach signed form to eMessage ➤ Fax Number: 703-206-4250\u003Cbr>➤ Visit your local branch\u003Cbr>➤ Mail: PO Box 3001, Merrifield, VA 22119-3001 |  |\n| --- | --- |\n| Access No. | Toll-Free Number\u003Cbr>888-842-6328 |\n\nThe term “IRA” will be used below to mean Traditional IRA or SEP IRA, unless otherwise specified. Information: This form will be used to initiate the direct conversion of IRA funds from a Traditional or SEP IRA to a Roth IRA. If you do not have an existing Roth IRA plan, a Navy Federal Roth IRA Application (NFCU form 602A) must be provided with this application.  \n\n| A. Member Information |  |\n| --- | --- |\n| Name: First MI Last Suffix |  |\n| Date of Birth (MM/DD/YY) | Home Phone No. |\n\n\n| B. Important IRA to Roth Conversion Considerations. Please read and acknowledge each statement below by placing a check in the box. |\n| --- |\n| ☐ I have been advised that if I have any questions regarding a Roth direct conversion, I must consult a competent tax professional or refer to IRS Publication 590-A, Contributions to Individual Retirement Arrangements (IRAs) , for more information. This publication is available on the IRS website at [www.irs.gov](www.irs.gov or by calling 1-800-TAX-FORM)[ or by calling 1-800-TAX-FORM](www.irs.gov or by calling 1-800-TAX-FORM).\u003Cbr>☐ I understand that if this Roth conversion is made during or after the year in which I turn age 73, I cannot convert any part of my Required Minimum Distribution (RMD) . I understand I must distribute my full RMD for all of my IRA(s) prior to requesting this conversion. |\n\n\n| C. Navy Federal IRA to Roth Conversion Instructions |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| Directly convert: ☐ All* ☐ Part of my Navy Federal Traditional/SEP IRA balance to my Navy Federal Roth IRA in the manner listed below.\u003Cbr>Gross: Tax withholding will be deducted from the requested converted amount and will reduce the reported conversion amount.\u003Cbr>Net: Tax withholding will be additional to the requested converted amount. Not available if “All” is selected.\u003Cbr>*If All is selected, automatically will be Gross withholding. |  |  |  |  |  |  |  |  |  |\n| Traditional/SEP IRA No. |  | Amount to Be Converted\u003Cbr>$ | Existing Roth IRA No.** |  |  |  | Tax Withholding\u003Cbr>☐ Gross ☐ Net |  |  |\n|  |  | $ |  |  |  |  | ☐ Gross ☐ Net |  |  |\n|  |  | $ |  |  |  |  | ☐ Gross ☐ Net |  |  |\n| **If you prefer to open a new product under your existing Roth IRA plan, please select from the below options.\u003Cbr>If you do not have an existing Roth IRA plan, a Roth IRA Application (NFCU form 602A) must be provided with this application. |  |  |  |  |  |  |  |  |  |\n| Please open a Roth IRA Account:\u003Cbr>☐ Roth Savings Account\u003Cbr>☐ Roth MMSA\u003Cbr>☐ Roth Jumbo MMSA\u003Cbr>☐ $50 Min. Roth IRA EasyStartSM Select Term: ☐ 12 months ☐ | 18 months ☐ 24 months |  |  | Or, choose a Roth Certificate minimum and term: Minimum: |  |  |  |  |  |\n|  |  |  |  | ☐ $1,000 min.\u003Cbr>Short Term:\u003Cbr>☐ 3 months\u003Cbr>☐ 24 months\u003Cbr>Long Term:\u003Cbr>☐ 3 years | ☐\u003Cbr>☐\u003Cbr>☐ | $20,000 min.\u003Cbr>12 months\u003Cbr>5 years |  | ☐\u003Cbr>☐\u003Cbr>☐ | $100,000 min.\u003Cbr>18 months\u003Cbr>7 years |\n| ☐ Other   |  |  |  |  |  |  |  |  |  |\n\n\n| D. Federal Tax Withholding Election (Form W-4R/OMB No. 1545-0074) |\n| --- |\n| See Page 2 of this form for the withholding notice information. If you are a non-resident alien, do not complete this section.\u003Cbr>Select One:\u003Cbr>☐ No Withholding: I do not want any federal tax withheld from my IRA distribution\u003Cbr>☐ Federal Withholding: I elect the following percentage to be withheld for federal tax purposes:   %(minimum 1.00%) |\n\n Additional Information on Reverse  \n© 2025 Ascensus, Inc. (6305) (7-25)© 2026 Navy Federal NFCU 621 (3-26)  \nPage 1  \nof 3  \n| E. State Tax Withholding Election Important: Please review the state tax requirements on the attached Form","cbCaiudSnAdA6386","https://ap.wps.com/l/cbCaiudSnAdA6386","pdf",111186,"English","# Member Information\n# Important IRA to Roth Conversion Considerations\n# Conversion Instructions\n## Direct conversion (All or Part)\n# Federal Tax Withholding Election\n# State Tax Withholding Election\n# Signature","[{\"question\":\"What is the purpose of the Navy Federal Roth IRA Direct Conversion form?\",\"answer\":\"It initiates a direct conversion of Traditional or SEP IRA funds to a Roth IRA under Navy Federal’s process and applicable rules and conditions.\"},{\"question\":\"How does tax withholding work for a Roth conversion on this form?\",\"answer\":\"You can elect gross or net withholding for the converted amount. Gross withholding is deducted from the requested converted amount, while net withholding adds to the requested converted amount (and net is not available when choosing “All”).\"},{\"question\":\"What federal and state withholding options are included?\",\"answer\":\"The form offers federal withholding selections (including no withholding or a chosen percentage) and state withholding selections based on the attached Form 603A, with minimum-state-tax rules and special instructions for Connecticut, Michigan, and Minnesota residents.\"}]","Navy Federal - Roth IRA Direct Conversion - Application Form | PDF",1789805870]