[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-303662-105":3,"detail-sidebar-cat-1-en-105":80,"doc-detail-303662-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","roth-conversion-request-form","Roth Conversion Request Form","","Roth Conversion Request Form用于申请将Traditional IRA、SIMPLE IRA或SEP IRA转换为由Fiduciary Trust International of the South（FTIOS）托管的Roth Conversion 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If you do not have an existing FTIOS Roth IRA, you must attach a completed Franklin Templeton IRA Application with this form.  \n• If FTIOS is not the custodian of your IRA, please contact your current IRA custodian to determine whether any other form is necessary to complete this transaction.  \nIf completing by hand, please print clearly in all CAPITAL LETTERS using blue or black ink.  \nIf applicable, provide any Franklin Templeton REFERENCE ID(S) related to your request:  \n1 ACCOUNT OWNER INFORMATION  \nFirst name M. I. Last name Suffix Last four digits of SSN/TIN  \nEmail address1 Primary phone number Alternate phone number  \n   ( )   ( )   \n2 CURRENT IRA CUSTODIAN/TRUSTEE  \nTYPE OF IRA YOU ARE CONVERTING: ◼ TRADITIONAL IRA ◼ SEP IRA ◼ SIMPLE IRA  \nIF FTIOS IS NOT THE CUSTODIAN OF THE ACCOUNT, PLEASE COMPLETE THE FOLLOWING.  \nCustodian name Phone number  \n   ( )   \nAddress City State ZIP  \n3 DISTRIBUTION (CONVERSION) INSTRUCTIONS  \nNAME OF MUTUAL FUND OR INVESTMENT TRANSFERRING FROM  \nFUND-ACCOUNT NUMBER  \n◼ Balance ◼ Partial  \n◼ Balance ◼ Partial  \n◼ Balance ◼ Partial  \n◼ Balance ◼ Partial  \n$  \nAMOUNT  \n\n| $ |\n| --- |\n| $ |\n| $ |\n\nOR  \n%  \nPERCENTAGE  \nOR  \n%  \nOR  \n%  \nOR  \n%  \nSPECIAL INSTRUCTIONS FOR BANK CERTIFICATES OF DEPOSIT (CDs):  \n◼ Do not process this transfer request until my CDs mature (dates):  \n1. If you currently receive any electronic communications/documents from Franklin Templeton, future communications/documents will be sent to the email address provided on this form, replacing any prior email address on file.  \n(continued) Questions? Contact your financial  \nprofessional, visit franklintempleton. com or call us at (800) 527-2020.  \npage 1 of 4  \n4 MANDATORY ELECTION FOR TAX WITHHOLDING  \nYou MUST make a withholding election below.  \n• If no election is made, federal taxes will be withheld at a rate of 10% and, when applicable, the minimum required state taxes will be withheld (see additional bullets for more state tax details) .  \n• You are responsible for paying any tax due on the taxable portion of your distribution, regardless of your withholding election.  \n• You may be subject to penalty taxes if federal and state taxes are due and either your estimated tax payments or the amount of tax you have withheld is insufficient under IRS rules or your state’s rules.  \n• You are responsible for reviewing the sample Form W-4R and the marginal rate tables on page 5 to ensure you are requesting the appropriate amount federal withholding from your distribution.  \n• Your state of residence will determine your state income tax withholding requirements, if any.  \n• Those states with mandatory withholding may require state income tax tobe withheld from payments if federal income taxes are withheld or may mandate state tax withholding regardless of your federal tax election.  \n• Although states with voluntary withholding allow individuals to elect to withhold state tax, we can only accommodate voluntary state tax withholding for residents of Indiana, Missouri, Montana, New Jersey, New Mexico, and Utah.  \n• Some states have no income tax on retirement payments.  \n• Some states only allow for state tax withholding on systematic distributions.  \n• Connecticut, Michigan and Oregon: State tax will be withheld at the state required minimum. To make a different withholding election, you MUST complete and attach your state-specific withholding form.  \n• Montana: To make a state tax withholding election, you MUST complete and attach your state-specific withholding form.  \n• Please consult with a tax advisor or your state’s tax authority for additional information on your state requirements.  \nFEDERAL TAX WITHHOLDING  \nReview the sample Form W-4R on page 5 to determine the correct amount of federal with","cbCaioJcrWpBNXmr","https://ap.wps.com/l/cbCaioJcrWpBNXmr","pdf",1154516,8,"English","# Roth Conversion Request Form\n## Account owner information\n## Current IRA custodian/trustee\n## Distribution (conversion) instructions\n## Mandatory election for tax withholding\n## Investment instructions\n## Authorizing signature","[{\"question\":\"该表单用于哪些IRA转换？\",\"answer\":\"用于将Traditional IRA、SIMPLE IRA或SEP IRA转换为Roth Conversion IRA，并以FTIOS作为托管人。\"},{\"question\":\"如果FTIOS不是IRA托管人，需要做什么？\",\"answer\":\"需联系现有IRA托管人确认是否还需要其他表单，并在表单中填写相应的当前托管人信息；若没有FTIOS的Roth IRA，还需随表附上完成的Franklin Templeton IRA Application。\"},{\"question\":\"表单中的税款预扣选项如何影响处理？\",\"answer\":\"必须选择联邦与（如适用的）州税预扣方式；未选择时将按10%预扣联邦税，并将依州最低要求预扣（或按各州规定执行）。同时，纳税人仍需对应税部分的税款负责，可能因预估付款不足或预扣不足而产生罚金。\"}]","Roth Conversion Request Form | PDF",1789805978]