Roth IRA Application - RBFCU · disclosure of the Roth IRA owner's assets or property including any...

Roth IRA

Custodial

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Individual Retirement Account

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ADDITIONAL INFORMATIONPurpose. This Organizer contains the forms necessary to establish a Rothindividual retirement account (IRA). This Organizer should not be used toestablish an inherited Roth IRA.

How to use this Roth IRA Organizer. The individual establishing thisRoth IRA must complete the Application page. The Roth IRA ownermust sign the document. An original signed copy of the Applicationshould be kept by the custodian for its records. The Roth IRA ownershould receive a copy of the Application and keep the remainingcontents of the Roth IRA Organizer. Community or marital propertystate laws may require spousal consent for nonspouse beneficiarydesignations.

Additional Documents. Applicable law or policies of the Roth IRAcustodian may require additional documentation such as IRS Form W-9,Request for Taxpayer Identification Number and Certification.

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IRACUSROTHLZ 11/1/2019

All rights reserved.- 2019 Wolters Kluwer Financial Services, Inc.Roth IRA Organizer-Custodial

(1911).00

For Additional Guidance. It is in your best interest to seek the guidance

of a tax or legal professional before completing this document. For more

information, refer to Internal Revenue Service (IRS) Publication 590-A,

Contributions to Individual Retirement Arrangements (IRAs), IRS

Publication 590-B, Distributions from Individual Retirement Arrangements

(IRAs), IRS Form 5498, IRA Contribution Information, instructions to

your federal income tax return, or the IRS's web site at www.irs.gov.

Roth IRA Application

ROTH IRA OWNER INFORMATION (Custodian's name, address, and phone number above)NAME, ADDRESS, CITY, STATE, AND ZIP ROTH IRA ACCOUNT (PLAN) NUMBER

SOCIAL SECURITY NUMBER (SSN)

DAYTIME PHONE NUMBER E-MAIL (OPTIONAL) DATE OF BIRTH

P.O. Box 2097, Universal City, TX 78148-2097210-945-3300 or 1-800-580-3300

CONTRIBUTION INFORMATIONINVESTMENT NUMBER AMOUNT CONTRIBUTION DATE

$TAX YEAR

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All rights reserved.©2019 Wolters Kluwer Financial Services, Inc.Roth IRA Organizer-Custodial

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TAX YEAR OF FIRST ROTH IRACONTRIBUTION/CONVERSION

CONTRIBUTION TYPE: Regular (including Catch-Up)Rollover**Transfer RecharacterizationConversion

Rollover** or Direct Rollover from an Eligible Retirement PlanRollover** or Direct Rollover from a Designated Roth AccountQualified Reservist/Designated Disaster Distribution Repayment* Disaster/Combat Zone/Postponed Contribution*

*Reason Code (if applicable)** Check if Rollover is made after 60 days with self-certification

DESIGNATION OF BENEFICIARYAt the time of my death, the primary beneficiaries named below will receive my Roth IRA assets. If all of my primary beneficiaries die before me, thecontingent beneficiaries named below will receive my Roth IRA assets. In the event a beneficiary dies before me, such beneficiary's share will bereallocated on a pro-rata basis to the other beneficiaries that share the deceased beneficiary's classification as a primary or contingent beneficiary. Adesignation of a beneficiary's primary or contingent classification is generally made by entering a percentage in one of the two columns to the left of thename. In the event a beneficiary is named as both a primary and contingent beneficiary, or if a beneficiary is not assigned to a beneficiaryclassification, such beneficiary shall be a primary beneficiary. If no percentages are assigned to beneficiaries, or if the percentage total for anybeneficiary classification exceeds 100 percent, the beneficiaries in that beneficiary classification will share equally. If the percentage total for eachbeneficiary classification is less than 100 percent, any remaining percentage will be divided equally among the beneficiaries within such class. If all ofthe beneficiaries die before me, or if none are designated, my Roth IRA assets will be paid to my estate. This designation revokes and supercedes allearlier beneficiary designations which may apply to this Roth IRA.

PRIMARYSHARE

CONTINGENTSHARE NAME OF BENEFICIARY SSN OR TIN RELATIONSHIP TO

ROTH IRA OWNERDATE OFBIRTH ADDRESS, CITY, STATE, AND ZIP

Total 100% Total 100%

SPOUSAL CONSENTCommunity or marital property state laws may require spousal consent for a nonspouse beneficiary designation. The laws of the state in which thefinancial organization is domiciled, the Roth IRA owner resides, the trust is located, the spouse resides, or this transaction is consummated should bereviewed to determine if such a requirement exists. Spousal consent for the beneficiary designation may also be required by financial organizationpolicy.

(Roth IRA Owner Initials)

I Am Married. I understand that if I designate a primary beneficiary other than my spouse, my spouse must consent bysigning below.

(Roth IRA Owner Initials)

I Am Not Married. I understand that if I marry in the future, I must complete a new Designation of Beneficiary form, whichincludes the spousal consent documentation.

I am the spouse of the Roth IRA owner. Because of the significant consequences associated with giving up my interest in the Roth IRA, the custodianhas not provided me with legal or tax advice, but has advised me to seek tax or legal advice. I acknowledge that I have received a fair and reasonabledisclosure of the Roth IRA owner's assets or property including any financial obligations for a community property state. In the event I have a legalinterest in the Roth IRA assets, I hereby give to the Roth IRA owner such interest in the assets held in this Roth IRA and consent to the beneficiarydesignation set forth in this Application.

Signature of Spouse Date Signature of Witness (if required)(Witness cannot be a beneficiary of this Roth IRA)

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Date


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SIGNATURESI certify that the information provided by me on this Application is accurate, and that I have received a copy of the Application, IRS Form 5305-RA,Roth Individual Retirement Custodial Account, a Disclosure Statement, and a Financial Disclosure. I agree to be bound by the terms and conditionsfound in the Agreement, Disclosure Agreement, Financial Disclosure, and amendments thereto. Except as otherwise provided by law, I assume soleresponsibility for all consequences relating to my actions concerning this Roth IRA. I understand that I may revoke this Roth IRA on or before seven(7) days after the date of establishment. My designation of the tax year for my contribution, and any election to treat a contribution as a rollover orrecharacterization, is irrevocable. I understand that the custodian cannot provide, and has not provided, me with tax or legal advice. I have beenadvised to seek the guidance of a tax or legal professional.

Signature of Roth IRA Owner Date Signature of Custodian Date

ROTH INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT(Under Section 408A of the Internal Revenue Code)

Form 5305-RA (Rev. April 2017) Department of the Treasury Internal Revenue Service

The depositor and the custodian make the following agreement:

Do Not File withInternal Revenue Service l Amendment

Article I. Except in the case of a qualified rollover contribution describedin section 408A(e) or a recharacterized contribution described in section408A(d)(6), the custodian will accept only cash contributions up to $5,500per year for 2013 through 2017. For individuals who have reached theage of 50 by the end of the year, the contribution limit is increased to$6,500 per year for 2013 through 2017. For years after 2017, these limitswill be increased to reflect a cost-of-living adjustment, if any.Article II.

1. The annual contribution limit described in Article I is graduallyreduced to $0 for higher income levels. For a depositor who is single ortreated as single, the annual contribution is phased out between adjustedgross income (AGI) of $118,000 and $133,000; for a married depositorfiling jointly, between AGI of $186,000 and $196,000; and for a marrieddepositor filing separately, between AGI of $0 and $10,000. Thesephase-out ranges are for 2017. For years after 2017, the phase-outranges, except for the $0 to $10,000 range, will be increased to reflect acost-of-living adjustment, if any. Adjusted gross income is defined insection 408A(c)(3).

2. In the case of a joint return, the AGI limits in the precedingparagraph apply to the combined AGI of the depositor and his or herspouse.Article III. The depositor's interest in the balance in the custodial accountis nonforfeitable.Article IV.

1. No part of the custodial account funds may be invested in lifeinsurance contracts, nor may the assets of the custodial account becommingled with other property except in a common trust fund orcommon investment fund (within the meaning of section 408(a)(5)).

2. No part of the custodial account funds may be invested in collectibles(within the meaning of section 408(m)) except as otherwise permitted bysection 408(m)(3), which provides an exception for certain gold, silver,and platinum coins, coins issued under the laws of any state, and certainbullion.Article V.

1. If the depositor dies before his or her entire interest is distributed tohim or her and the depositor's surviving spouse is not the designatedbeneficiary, the remaining interest will be distributed in accordance with(a) below or, if elected or there is no designated beneficiary, inaccordance with (b) below.

(a) The remaining interest will be distributed, starting by the end ofthe calendar year following the year of the depositor's death,over the designated beneficiary's remaining life expectancy asdetermined in the year following the death of the depositor.

(b) The remaining interest will be distributed by the end of thecalendar year containing the fifth anniversary of the depositor'sdeath.

2. The minimum amount that must be distributed each year underparagraph 1(a) above is the account value at the close of business onDecember 31 of the preceding year divided by the life expectancy (in thesingle life table in Regulations section 1.401(a)(9)-9) of the designatedbeneficiary using the attained age of the beneficiary in the year followingthe year of the depositor's death and subtracting 1 from the divisor foreach subsequent year.

3. If the depositor's surviving spouse is the designated beneficiary, suchspouse will then be treated as the depositor.Article VI.

1. The depositor agrees to provide the custodian with all informationnecessary to prepare any reports required by sections 408(i) and408A(d)(3)(E), Regulations sections 1.408-5 and 1.408-6, or otherguidance published by the Internal Revenue Service (IRS).

2. The custodian agrees to submit to the IRS and depositor the reportsprescribed by the IRS.Article VII. Notwithstanding any other articles which may be added orincorporated, the provisions of Articles I through IV and this sentence willbe controlling. Any additional articles inconsistent with section 408A, therelated regulations, and other published guidance will be invalid.

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Article VIII. This agreement will be amended as necessary to complywith the provisions of the Code, the related regulations, and otherpublished guidance. Other amendments may be made with the consent ofthe persons whose signatures appear on the Application that accompaniesthis agreement.Article IX.9.01 Your Roth IRA Documents. This Internal Revenue Service (IRS)

Forms 5305 series agreement for Roth IRAs, amendments,application, beneficiary designation, disclosure statement, and otherdocumentation, if any, set forth the terms and conditions governingyour Roth individual retirement account (IRA) and your or, afteryour death, your beneficiary's relationship with us. Articles Ithrough VIII of the IRS 5305 agreement have been reviewed andapproved by the IRS. The disclosure statement sets forth variousRoth IRA rules in simpler language. Unless it would be inconsistentto do so, words and phrases used in this document should beconstrued so the singular includes the plural and the plural includesthe singular.

9.02 Definitions. This Agreement refers to you as the depositor, and usas the custodian. References to "you," "your," and "Roth IRAowner" will mean the depositor, and "we," "us," and "our" willmean the custodian. The terms "you" and "your" will apply to you.In the event you appoint a third party, or have a third partyappointed on your behalf, to handle certain transactions affectingyour Roth IRA, such third party will be your agent and will beconsidered "you" for purposes of this agreement. Additionally,references to "Roth IRA" will mean the custodial account.

9.03 Additional Provisions. Additional provisions may be attached to,and made a part of, this agreement by either party. The provisionsmust be in writing, agreed to by us, and in a format acceptable to us.

9.04 Our Fees and Expenses. We may charge reasonable fees and areentitled to reimbursement for any expenses we incur in establishingand maintaining your Roth IRA. We may change the fees at anytime by providing you with notice of such changes. We will provideyou with fee disclosures and policies. We may deduct fees directlyfrom your Roth IRA assets or bill you separately. The payment offees has no effect on your contributions. Additionally, we have theright to liquidate your Roth IRA assets to pay such fees andexpenses. If you do not direct us on the liquidation, we will liquidatethe assets of our choice and will not be responsible for any losses orclaims that may arise out of the liquidation.

9.05 Amendments. We may amend your Roth IRA in any respect and atany time, including retroactively, to comply with applicable lawsgoverning retirement plans and the corresponding regulations. Anyother amendments shall require your consent, by action or noaction, and will be preceded by written notice to you. Unlessotherwise required, you are deemed to automatically consent to anamendment, which means that your written approval is not requiredfor the amendment to apply to the Roth IRA. In certain instances thegoverning law or our policies may require us to secure your writtenconsent before an amendment can be applied to the Roth IRA. Ifyou want to withhold your consent to an amendment, you mustprovide us with a written objection within 30 days of the receipt dateof the amendment.

9.06

Notice and Delivery. Any notice mailed to you will be deemeddelivered and received by you, five days after the postmark date.This fifth day following the postmark is the receipt date. Noticeswill be mailed to the last address we have in our records. You areresponsible for ensuring that we have your proper mailing address.Upon your consent, we may provide you with notice in a deliveryformat other than by mail. Such formats may include variouselectronic deliveries. Any notice, including terminations, change inpersonal information, or contributions mailed to us will be deemeddelivered when actually received by us based on our ordinarybusiness practices. All notices must be in writing unless our policiesand procedures provide for oral notices.


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9.07 Applicable Laws. This agreement will be construed and interpretedin accordance with the laws of, and venued in, our state of domicile.

9.08 Disqualifying Provisions. Any provision of this agreement thatwould disqualify the Roth IRA will be disregarded to the extentnecessary to maintain the account as a Roth IRA.

9.09 Interpretation. If any question arises as to the meaning of anyprovision of this agreement, then we shall be authorized to interpretany such provision, and our interpretation will be binding upon allparties.

9.10 Representations and Indemnity. You represent that anyinformation you or your agents provide to us is accurate andcomplete, and that your actions comply with this agreement andapplicable laws governing retirement plans. You understand that wewill rely on the information provided by you, and that we have no duty to inquire about or investigate such information. We are notresponsible for any losses or expenses that may result from yourinformation, direction, or actions, including your failure to act. Youagree to hold us harmless, to indemnify, and to defend us againstany and all actions or claims arising from, and liabilities and lossesincurred by reason of your information, direction, or actions.Additionally, you represent that it is your responsibility to seek theguidance of a tax or legal professional for your Roth IRA issues.

We are not responsible for determining whether your contributionsor distributions comply with this agreement or the federal laws governing retirement plans. We are not responsible for any taxes, judgments, penalties, or expenses incurred in connection with yourRoth IRA, or any losses that are a result of events beyond ourcontrol. We have no responsibility to process transactions until afterwe have received appropriate direction and documentation, and wehave had a reasonable opportunity to process the transactions. Weare not responsible for interpreting or directing beneficiarydesignations or divisions, including separate accounting, courtorders, penalty exception determinations, or other similar situations.

9.11

Investment of Roth IRA Assets.(a) Deposit Investments Only. The deposit investments we offer

are limited to savings, share and money market accounts, andcertificates of deposit (CDs), and will earn a reasonable rate.This Roth IRA is not, and cannot be, a self-directed Roth IRA.It does not permit you to invest your contributions or Roth IRAassets in nondeposit investments such as property, annuities,stocks, bonds, and government, municipal or United StatesTreasury securities.

(b) Investment of Contributions. You may invest Roth IRAcontributions in any Roth IRA deposit investments we offer. Ifyou fail to provide us with investment direction for acontribution, we will return or hold all or part of suchcontribution based on our policies and procedures. We will notbe responsible for any loss of Roth IRA income associated withyour failure to provide appropriate investment direction.

(c)

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Directing Investments. All investment directions must be in aformat or manner acceptable to us. You may invest in any RothIRA investments that you are qualified to purchase, and that weare authorized to offer and do offer at the time of the investmentselection, and that are acceptable under the applicable lawsgoverning retirement plans. Your Roth IRA investments will beregistered in our name for the benefit of your Roth IRA.Specific investment information may be provided at the time ofthe investment.

Based on our policies, we may allow you to delegate theinvestment responsibility of your Roth IRA to an agent byproviding us with written notice of delegation in a formatacceptable to us. We will not review or guide your agent'sdecisions, and you are responsible for the agent's actions orfailure to act. We are not responsible for directing yourinvestments, or providing investment advice, including guidanceon the suitability or potential market value of variousinvestments.

(d) Investment Fees and Asset Liquidation. We have the right toliquidate your Roth IRA assets to pay fees and expenses, federaltax levies, or other assessments on your Roth IRA. If you do notdirect us on the liquidation, we will liquidate the assets of ourchoice and will not be responsible for any losses or claims thatmay arise out of the liquidation.

9.12 Distributions. Withdrawal requests must be in a format acceptableto us, or on forms provided by us. We may require you, or yourbeneficiary after your death, to elect a distribution reason, providedocumentation, and provide a proper tax identification numberbefore we process a distribution. These withdrawals may be subjectto taxes, withholding, and penalties. Distributions will generally bein cash.

Required minimum distributions for your beneficiaries will bebased on Treasury Regulations 1.408A-6, 1.401(a)(9) and 1.408-8in addition to our then current policies and procedures. The requiredminimum distribution regulations are described within theDisclosure Statement. In the event a beneficiary, after your death,fails to take a required minimum distribution we may do nothing,distribute the entire Roth IRA balance, or distribute the requiredminimum distribution based on our own calculation.

9.13 Spouse Beneficiary. Notwithstanding Article V, a spousebeneficiary shall be permitted all the beneficiary options allowedunder law or applicable regulations. The default election for aspouse beneficiary is the life expectancy method. If your survivingspouse fails to take the required minimum distribution, he/she isdeemed to have treated your Roth IRA as his/her own. If yoursurviving spouse is your sole beneficiary, your spouse may treatyour Roth IRA as his/her own Roth IRA and would not be subject tothe required minimum distribution rules.

9.14 Cash Contributions. We may accept transfers, rollovers,conversions, and other similar contributions in cash from otherIRAs, eligible retirement plans, and as allowed by law. Prior tocompleting such transactions we may require that you providecertain information in a format acceptable to us.

9.15 Reports and Records. We will maintain the records necessary forIRS reporting on this Roth IRA. Required reports will be providedto you, or your beneficiary after your death, and the IRS. If youbelieve that your report is inaccurate or incomplete, you must notifyus in writing within 30 days following the receipt date. Yourinvestments may require additional state and federal reporting.

9.16 Termination. You may terminate this agreement without ourconsent by providing us with a written notice of termination. Atermination and the resulting distribution or transfer will beprocessed and completed as soon as administratively feasiblefollowing the receipt of proper notice. At the time of termination wemay retain the sum necessary to cover any fees and expenses, taxes,or investment penalties.

9.17 Our Resignation. We can resign at any time by providing you with30 days written notice prior to the resignation date, or within fivedays of our receipt of your written objection to an amendment. Inthe event you materially breach this agreement, we can terminatethis agreement by providing you with five days prior written notice.Upon our resignation, you must appoint a qualified successorcustodian or trustee. Your Roth IRA assets will be transferred to thesuccessor custodian or trustee once we have received appropriatedirection. Transfers will be completed within a reasonable timefollowing our resignation notice and the payment of your remainingRoth IRA fees or expenses. At the time of resignation we may retainthe sum necessary to cover any fees and expenses, taxes, orinvestment penalties. If you fail to provide us with acceptabletransfer direction within 30 days from the date of the notice we cantransfer the assets to a successor custodian or trustee of our choiceor distribute them to you in cash.

9.18 Successor Organization. If we merge with, purchase, or areacquired by, another organization, such organization, if qualified,may automatically become the successor custodian or trustee of yourRoth IRA.

IRS FORM 5305-RA INSTRUCTIONS (Rev. 4-2017)

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General InstructionsSection references are to the Internal Revenue

Code unless otherwise noted.

Purpose of FormForm 5305-RA is a model custodial account

agreement that meets the requirements of section

408A. However, only Articles I through VIII

have been reviewed by the IRS. A Roth

individual retirement account (Roth IRA) is

established after the form is fully executed by

both the individual (depositor) and the custodian.

This account must be created in the United States

for the exclusive benefit of the depositor and his

or her beneficiaries.

Do not file Form 5305-RA with the IRS.

Instead, keep it with your records.

Unlike contributions to traditional individual

retirement arrangements, contributions to a Roth

IRA are not deductible from the depositor's

gross income; and distributions after 5 years that

are made when the depositor is 59 1/2 years of

age or older or on account of death, disability, or

the purchase of a home by a first-time homebuyer

(limited to $10,000), are not includible in gross

income. For more information on Roth IRAs,

including the required disclosures the custodian

must give the depositor, see Pub. 590-A,

Contributions to Individual Retirement

Arrangements (IRAs), and Pub. 590-B,

Distributions from Individual Retirement

Arrangements (IRAs).

DefinitionsCustodian. The custodian must be a bank or

savings and loan association, as defined in

section 408(n), or any person who has the

approval of the IRS to act as custodian.

Depositor. The depositor is the person who

establishes the custodial account.

Specific InstructionsArticle I. The depositor may be subject to a 6%

tax on excess contributions if (1) contributions to

other individual retirement arrangements of the

depositor have been made for the same tax year,

(2) the depositor's adjusted gross income

exceeds the applicable limits in Article II for the

tax year, or (3) the depositor's and spouse's

compensation is less than the amount contributed

by or on behalf of them for the tax year.

Article V. This article describes how

distributions will be made from the Roth IRA

after the depositor's death. Elections made

pursuant to this article should be reviewed

periodically to ensure they correspond to the

depositor's intent. Under paragraph 3 of Article

V, the depositor's spouse is treated as the owner

of the Roth IRA upon the death of the depositor,

rather than as the beneficiary. If the spouse is to

be treated as the beneficiary, and not the owner,

an overriding provision should be added to

Article IX.

Article IX. Article IX and any that follow it

may incorporate additional provisions that are

agreed to by the depositor and custodian to

complete the agreement. They may include, for

example, definitions, investment powers, voting

rights, exculpatory provisions, amendment and

termination, removal of the custodian,

custodian's fees, state law requirements,

beginning date of distributions, accepting only

cash, treatment of excess contributions,

prohibited transactions with the depositor, etc.

Attach additional pages if necessary.


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.

ROTH IRA DISCLOSURE STATEMENT

Right to Revoke Your Roth IRA. With some exceptions, you have theright to revoke this Roth individual retirement account (IRA) within sevendays of receiving this Disclosure Statement. If you revoke your Roth IRA,we will return your entire Roth IRA contribution without any adjustmentfor items such as sales commissions, administrative expenses, orfluctuation in market value. Exceptions to your right of revocation includethat you may not revoke a Roth IRA established with a recharacterizedcontribution, nor do you have the right to revoke upon amendment of thisagreement.

You may revoke your Roth IRA by providing us with written notice.The revocation notice may be mailed by first-class mail, or hand deliveredto us. If your notice is mailed by first-class, postage pre-paid mail, therevocation will be deemed mailed on the date of the postmark.

If you have any questions or concerns regarding the revocation of yourRoth IRA, please call or write to us. Our telephone number, address, anda contact name to be used for communications can be found on theapplication that accompanies this Disclosure Statement and InternalRevenue Service (IRS) Forms 5305 series agreement.This Disclosure Statement. This Disclosure Statement provides you, oryour beneficiaries after your death, with a summary of the rules andregulations governing this Roth IRA. Definitions. The IRS Forms 5305 series agreement for Roth IRAscontains a definitions section. The definitions found in such section applyto this agreement. The IRS refers to you as the depositor, and us as thecustodian. References to "you," "your," and "Roth IRA owner" will meanthe depositor, and "we," "us," and "our" will mean the custodian. Theterms "you" and "your" will apply to you. In the event you appoint a thirdparty, or have a third party appointed on your behalf to handle certaintransactions affecting your Roth IRA, such third party will be consideredyour agent and, therefore, "you" for purposes of this agreement.Additionally, references to "Roth IRA" will mean the custodial account.For Additional Guidance. It is in your best interest to seek the guidanceof a tax or legal professional before completing any Roth IRAestablishment documents. For more information, you can also refer to IRSPublication 590-A, Contributions to Individual Retirement Arrangements(IRAs), IRS Publication 590-B, Distributions from Individual RetirementArrangements (IRAs), instructions to your federal income tax return, orthe IRS's web site at www.irs.gov.Roth IRA Restrictions and Approval.1. IRS Form 5305-R or 5305-RA Agreement. This Disclosure

Statement and the IRS Forms 5305 series agreement, amendments,application, and additional provisions set forth the terms andconditions governing your Roth IRA. Such documents are theagreement.

2. Individual/Beneficiary Benefit. This Roth IRA must be for theexclusive benefit of you and, upon your death, your beneficiaries.The Roth IRA must be established in your name and not in the nameof your beneficiary, living trust, or another party or entity.

3. Beneficiary Designation By completing the appropriate section onthe corresponding Roth IRA application you may designate anyperson(s) as your beneficiary to receive your Roth IRA assets uponyour death. You may also change or revoke an existing designation insuch manner and in accordance with such rules as we prescribe forthis purpose. If there is no beneficiary designation on file at the timeof your death, or if none of the beneficiaries on file are alive at thetime of your death, your Roth IRA assets will be paid to your estate.We may rely on the latest beneficiary designation on file at the time ofyour death, will be fully protected in doing so, and will have noliability whatsoever to any person making a claim to the Roth IRAassets under a subsequently filed designation or for any other reason.

4. Cash Contributions. Regular or annual Roth IRA contributions mustbe in cash, which may include a check, money order, or wiretransfer.

5.

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Roth IRA Custodian. A Roth IRA custodian must be a bank,federally insured credit union, savings and loan association, trustcompany, or other entity, which is approved by the Secretary of theTreasury to act as a Roth IRA custodian.

6. Prohibition Against Life Insurance and Commingling. None ofyour Roth IRA assets may be invested in life insurance contracts, orcommingled with other property, except in a common trust fund orcommon investment fund.

7. Nonforfeitability. The assets in your Roth IRA are not forfeitable.8. Collectibles. Generally, none of your Roth IRA assets may be

invested in collectibles, including any work of art, rug, or antique,metal or gem, stamp or coin, alcoholic beverage, or any other tangible personal property. If we allow, you may invest your RothIRA assets in the following coins and bullion: certain gold, silver, andplatinum coins minted by the United States; a coin issued under thelaws of any state; and any gold, silver, platinum, and palladiumbullion of a certain fineness, and only if such coins and bullion areheld by us. For additional guidance on collectibles, see Section408(m) of the Internal Revenue Code (IRC).

9. Cash Rollovers. You may be eligible to make a rollover contributionof your Roth IRA distribution to a Roth IRA. Rollovers to and fromRoth IRAs are described in greater detail elsewhere in this DisclosureStatement.

10. Required Minimum Distribution (RMD) Rules For Beneficiaries.This Roth IRA is subject to the RMD rules summarized in thisagreement.

11. No Prohibited Transactions. If your account stops being a Roth IRAbecause you or your beneficiary engaged in a prohibited transaction,the account is treated as distributing all its assets to you at their fairmarket values on the first day of the year. If the total of those valuesis more than your basis in the Roth IRA, you will have a taxable gainthat is includible in your income.

12. No Pledging. If you use a part of your Roth IRA as security for aloan, that part is treated as a distribution and is included in your grossincome. You may have to pay the 10% additional tax on earlydistributions.

13. IRS Approval of Form. This agreement includes an IRS Forms 5305series agreement. Articles I through VIII of this IRS agreement havebeen reviewed and approved by the IRS. This approval is not adetermination of its merits, and not an endorsement of the investmentsprovided by us, or the operation of the Roth IRA. Article IX of thisIRS agreement contains additional contract provisions that have notbeen reviewed or approved by the IRS.

14. State Laws. State laws may affect your Roth IRA in certainsituations, including beneficiary designations, agency relationships,consent, taxes, and reporting.

Roth IRA Eligibility and Contributions. 1. R egular or Annual Roth IRA Contribution. An annual contribution,

commonly referred to as a regular contribution, is your contributionfor the tax year, and is based on your and your spouse'scompensation if filing jointly . Your designation of the tax year foryour contribution is irrevocable. You may direct all or a portion ofany tax refund directly to an IRA.

If you are married and file a joint federal income tax return, you oryour spouse may make a contribution on your behalf for that tax yearif you or your spouse have compensation. This contribution must bemade into your Roth IRA, and it cannot exceed the contribution limitsapplicable to regular Roth IRA contributions.

2. Compensation for Eligibility. You are eligible to contribute to yourRoth IRA if you have compensation (also referred to as earnedincome). The amount you may contribute may be limited based onyour modified adjusted gross income (MAGI). The instructions toyour federal income tax return will provide helpful information indetermining your compensation and MAGI amounts.

Common examples of compensation include wages, salary, tips,bonuses, and other amounts received for providing personal services,and earned income from self-employment. Compensation does notinclude earnings and profits from property such as dividends, interest,or capital gains, or pension, annuity, or deferred compensation planamounts.

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3. Limitations on Contributions. The amount you can contributedepends on your MAGI for the tax year for which the contributionapplies, your marital status, and your tax-filing status. The followingchart shows how your MAGI and status affect your contribution limit.The greater your MAGI, the lesser the amount you may contribute.


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2019 MAGI LIMITS

Modified AGI(MAGI)* Single

Married, FilingJointly

Married, FilingSeparately**

Less than $10,000 Full Contribution Full Contribution Phaseout

$ 10,000 - $122,000 Full Contribution Full Contribution No Contribution

$122,001 - $136,999 Phaseout Full Contribution No Contribution

$137,000 - $193,000 No Contribution Full Contribution No Contribution

$193,001 - $202,999 No Contribution Phaseout No Contribution

$203,000 or over No Contribution No Contribution No Contribution

2020 MAGI LIMITS

Modified AGI(MAGI)* Single

Married, FilingJointly

Married, FilingSeparately**

Less than $10,000 Full Contribution Full Contribution Phaseout

$ 10,000 - $124,000 Full Contribution Full Contribution No Contribution

$124,001 - $138,999 Phaseout Full Contribution No Contribution

$139,000 - $196,000 No Contribution Full Contribution No Contribution

$196,001 - $205,999 No Contribution Phaseout No Contribution

$206,000 or over No Contribution No Contribution No Contribution

IRS Publication 590-A, Contributions to Individual RetirementArrangements (IRAs), and the instructions to your federal income taxreturn also contain helpful calculation information.

* Subject to annual cost-of-living adjustments (COLAs), if any.**An individual who is married, filing separately, and who lived apart from his/her spouse the entire year, can use the MAGI limit fora single filer to determine his/her contribution limit.

4. Catch-Up Contributions. Catch-up contributions are regular RothIRA contributions made in addition to any other regular Roth IRAcontributions. You are eligible to make catch-up contributions if youmeet the eligibility requirements for regular contributions and youattain age 50 by the end of the taxable year for which a catch-upcontribution is being made.

5. Maximum Contribution Limits. Your regular (including catch-up)Roth IRA contributions are limited to the lesser of 100 percent of yourand your spouse's compensation if filing jointly or the dollar amountsset forth on the following chart:

ContributionTax Year

Regular ContributionLimit

Catch-Up ContributionLimit

Total ContributionLimit

2019 $6,000 $1,000 $7,000

2020 $6,000 $1,000 $7,000

2021 andlater years

$6,000+COLA* $1,000 $7,000+COLA*

* The regular IRA contribution limits are subject to annual cost-of-livingadjustments (COLAs), if any.

6. Contribution Deadline. You may make regular (including catch-up)Roth IRA contributions any time for a taxable year up to andincluding your federal income tax return due date, excludingextensions, for that taxable year. The due date for most taxpayers isApril 15. The deadline may be extended in some situations. Examplesinclude a federally declared disaster, a terroristic or military action,or service in a hazardous duty area or combat zone.

7. Roth IRA and Traditional IRA Contribution Limit. Your combinedregular (including catch-up) traditional IRA and Roth IRAcontributions may not exceed the maximum contribution limit set forthin the previous chart.

8. SEP and SIMPLE IRA Contributions. Your employer may notmake simplified employee pension (SEP) plan or Savings IncentiveMatch Plan for Employees of Small Employers (SIMPLE) IRA plancontributions to this Roth IRA.

Nonrefundable Tax Credit. You may be eligible to take a tax credit foryour regular Roth IRA contributions. The credit is equal to a percentageof your qualified contributions up to $2,000. The credit cannot exceed$1,000 for any tax year. To be eligible for the tax credit, you must be age18 or older by the end of the applicable tax year, not a dependent ofanother taxpayer, not a full-time student, and satisfy certain restrictions ondistributions.Moving Assets To and From Roth IRAs. There are a variety oftransactions that allow you to move your retirement assets to and fromyour Roth IRAs. We have sole discretion on whether we will accept, andhow we will process, movements of assets to and from Roth IRAs. We orany other financial organizations involved in the transaction may requiredocumentation for such activities.1. Roth IRA-to-Roth IRA Transfers. You may transfer all or a portion

of your Roth IRA assets from one Roth IRA to another Roth IRA. ARoth IRA transfer means that the Roth IRA assets move from oneRoth IRA to another Roth IRA in a manner that prevents you fromcashing the Roth IRA assets, or even depositing the assets anywhereexcept in the receiving Roth IRA. Transfers are not taxable orreportable, and the IRS does not impose timing or frequencyrestrictions on transfers. You may be required to complete a transferauthorization form prior to transferring your Roth IRA assets.

2. Roth IRA-to-Roth IRA Rollovers. A Roth IRA rollover is anotherway to move assets tax-free between Roth IRAs. You may roll overall or a portion of your Roth IRA assets by taking a distribution froma Roth IRA and recontributing part or all of it as a rollovercontribution into the same or another Roth IRA. A rollovercontribution is irrevocable. You must report your Roth IRA rolloverto the IRS on your federal income tax return. Your contribution mayonly be designated as a rollover if the Roth IRA distribution isdeposited within 60 calendar days following the date you receive thedistributed assets. Any portion not rolled over will be subject to theRoth IRA ordering rules to determine income taxes and penalty taxes.The 60-day period may be extended to 120 days for a first-timehomebuyer distribution where there is a delay or cancellation in thepurchase or construction of the home. You are limited to one rolloverper 1-year (12-month) period. You may only roll over one IRAdistribution per 1-year period aggregated between all of your IRAs.For this purpose IRA includes rollovers among traditional (includingSEP), SIMPLE, and Roth IRAs. For example, if you have IRA 1,IRA 2, and IRA 3, and take a distribution from IRA 1 and roll it overinto a new IRA 4, you will have to wait 1 year from the date of thatdistribution to take another distribution from any of your IRAs andsubsequently roll it over into an IRA. The 1-year limitation does notapply to rollovers related to first-time homebuyer distributions,distributions converted to a Roth IRA, and rollovers from anemployer-sponsored eligible retirement plan.

3. MyRA-to-Roth IRA Rollovers and Transfers. You may elect to rollover or transfer MyRA assets to a Roth IRA. You are required to rollover or transfer the entire balance of your MyRA when the balancereaches $15,000 or after the assets have been held in the account for30 years.

4. Waiver of the 60-Day Period. The Secretary of the Treasury maywaive the 60-day period for completing rollovers in certain situationssuch as casualty, disaster, or other events beyond the reasonablecontrol of the individual who is subject to the 60-day period. The IRSalso provides for a self-certification procedure (subject to verificationby the IRS) that you may use to claim eligibility for a waiver withrespect to a rollover into an IRA. It provides that we may rely on thecertification provided by you in accepting and reporting receipt of arollover contribution after the 60-day period if we don't have actualknowledge that is contrary to the self-certification.

5. Transfers Due to Divorce. Your former spouse, pursuant to adivorce decree or legal separation order, may transfer assets fromyour Roth IRA to his/her Roth IRA.

6. Qualified Reservist Contributions. If you are a qualified reservistordered or called to active duty after September 11, 2001 for more

than 179 days (or for an indefinite period), and take an IRAdistribution or take certain elective deferrals from an eligibleretirement plan after September 11, 2001, and before the end of youractive duty, you may make one or more contributions of these assetsto your Roth IRA within two years of the end of your active duty.

Movement of Assets Between Traditional and Roth IRAs.

Page 9 of 13

1. Traditional IRA to Roth IRA Conversions. You may convert all ora portion of your traditional IRA assets to a Roth IRA. Yourconversion assets (excluding prorated nondeductible contributions) aresubject to federal income tax. Your conversion must be reported to the IRS. The 10 percent early-distribution penalty tax does not applyto conversions. If you elect to convert your assets using a rollovertransaction, the 60-day rule applies. The one per 1-year limitationdoes not apply to conversions.

2. Traditional IRA and Roth IRA Recharacterizations. You mayrecharacterize, or choose to treat all or a portion of your regular(including catch-up) traditional IRA contribution as a regular RothIRA contribution. Similarly, you may recharacterize all or a portionof your regular (including catch-up) Roth IRA contribution as aregular traditional IRA contribution. A recharacterization election isirrevocable. You must complete a recharacterization no later thanyour federal income tax-filing due date, including extensions, for theyear you make the initial contribution. If you timely file your federalincome tax return, you may still recharacterize as late as October 15for calendar year filers. Recharacterizations must occur by transfer,which means that the assets, adjusted for gains and losses on therecharacterized amount, must be transferred into another IRA. Therecharacterized contribution is treated as though you deposited it intothe second IRA on the same day you actually deposited it in the firstIRA. Recharacterization transactions are reported to the IRS. Theelection to recharacterize may be completed on your behalf after yourdeath. A written notice of recharacterization is required forrecharacterization transactions.


(1911).00IRACUSROTHLZ 11/1/2019

Movement of Other Assets to Roth IRAs.1. Conversions from SIMPLE IRAs. You may not convert assets from

a SIMPLE IRA to a Roth IRA until two years have passed since thedate on which you first participated in an employer's SIMPLE IRAplan, which is the initial contribution date. If you participated inSIMPLE IRA plans of different employers, the initial contributiondate and two-year period are determined separately for SIMPLE IRAassets from each employer.

2. Rollovers or Direct Rollovers from Eligible Retirement Plans. Youmay directly or indirectly roll over assets from an eligible retirementplan sponsored by your employer into your Roth IRA (also referred toas qualified rollovers). You are responsible for the consequences ofrolling over assets, including designated Roth account assets, to aRoth IRA. Your plan administrator or employer is responsible fordetermining the amount of your assets in its eligible retirement planthat is eligible for rollover to a Roth IRA. Assets in a Roth IRA arenot eligible to be rolled over to an eligible retirement plan.a. Eligible Retirement Plan (ERP). Eligible retirement plans

include qualified trusts under IRC Section 401(a), annuity plansunder IRC Section 403(a), annuity contracts under IRC Section403(b), and certain governmental IRC Section 457(b) plans.Common names for these plans include 401(k), profit sharing,pension, money purchase, federal thrift savings, and tax-shelteredannuity plans.

b. Designated Roth Account. This is an account within an ERPunder either IRC Sections 401(a), 403(b), or 457(b) that holdsRoth contributions, in-plan Roth rollovers, and earnings. Rothcontributions are made by elective deferral with after-tax dollars.

c. Eligible Distributions. Not all distributions from an ERP areeligible for rollover to a Roth IRA. The most common amountswhich are not eligible for rollover include RMDs, defaulted loans,substantially equal periodic payments defined in IRC Section402(c)(4)(A), and hardship distributions. Your employerdetermines which assets may not be rolled over and must provideyou with an IRC Section 402(f) notice of taxation which explains

the tax issues and rollover eligibility concerning the distribution.d. Direct Rollover. A direct rollover moves eligible distribution

assets from your eligible retirement plan to your Roth IRA in amanner that prevents you from cashing or liquidating the planassets, or even depositing the assets anywhere except in thereceiving Roth IRA. A direct rollover is reported to the IRS. There are no IRS limitations, such as the 60-day period or oneper 1-year limitation, on direct rollovers.

e. Indirect Rollover and Withholding. An indirect rollover beginswith a plan distribution made payable to you. In general, youremployer is required to withhold 20 percent on the taxable portionof your eligible distribution as a prepayment of federal income taxes on distributions. You may make up the 20 percentwithholding from your own funds at the time you deposit thedistribution into a Roth IRA. If you are younger than age 59 1/2,you are subject to a 10 percent early-distribution penalty tax onthe taxable amount of the distribution that is not rolled over,unless a penalty tax exception applies. Your eligible distributionmay be contributed to a Roth IRA during the 60 days followingyour receipt of a plan distribution. There may be exceptions tocompleting the rollover within 60 days. For example, exceptionsare available for rolling over the return of an improper tax levy aswell as for rolling over certain plan loan offset amounts.Generally, these exceptions permit amounts to be rolled over untilthe tax-filing due date of the year in which such amounts are, forexample, returned or treated as distributed. Your decision tocontribute the assets to a Roth IRA as a rollover contribution isirrevocable. The one per 1-year limitation does not apply torollovers from eligible retirement plans. State withholding mayapply to eligible distributions. The Secretary of the Treasury maywaive the 60-day period for completing rollovers in certainsituations such as casualty, disaster, or other events beyond thereasonable control of the individual who is subject to the 60-dayperiod.

f. Taxes and Treatment of Qualified Rollover Contributions. The rollover and direct rollover contribution amounts from aneligible retirement plan are referred to as "qualified rollovercontributions." The taxable portion that is rolled or directly rolledover to a Roth IRA is subject to federal income tax. The 10percent early-distribution penalty tax does not apply to thesetaxable amounts. However, if the taxable portion of the qualifiedrollover contribution is distributed from the Roth IRA within fiveyears and an exception does not apply, the 10 percent penalty taxwould apply in this later year. With respect to subsequentdistributions from this Roth IRA that are nonqualifieddistributions, the qualified rollover contribution amount isconsidered as part of the nontaxable conversion category forpurposes of the ordering rules.

g. Rollover or Direct Rollover of Designated Roth AccountAssets. Rollovers of designated Roth account assets to a RothIRA are not taxable. The plan administrator will inform you if thedistribution amount from the designated Roth account is qualifiedor nonqualified. Qualified distributions rolled over fromdesignated Roth accounts are considered regular contributions forthe Roth IRA "nonqualified distribution" ordering rules. Theearnings portion of nonqualified distributions rolled over fromdesignated Roth accounts is considered earnings for the Roth IRAordering rules while the remainder is considered a regularcontribution.

3. Rollover of Military Death Gratuity. If a person serving in themilitary dies from injuries received in such service and you are thebeneficiary of either a military death gratuity or an amount under aServicemembers Group Life Insurance (SGLI) program for such person, you may roll over part or all of these amounts to a Roth IRA.If the death occurred on or after June 17, 2008, the rollovercontribution must be completed within one year of when each amountwas received. These contributions are qualified rollover contributions.

Roth IRA Distributions. You, or after your death your beneficiary, matake a Roth IRA distribution at any time. Income and penalty taxes maybe avoided by taking qualified distributions.

y

1.

Page 10 of 13

Five-Year Holding Period. The five-year holding period begins withthe earlier of the first year for which you made any regular Roth IRAcontribution, the first year in which you made a conversion from a

traditional IRA to any Roth IRA, the first year of a rollover or directrollover of designated Roth account assets to any Roth IRA, the firstyear of a rollover or direct rollover of ERP assets to any Roth IRA,the first year of a qualified distribution repayment to any Roth IRA,or the first year of any other contribution treated as a qualifiedrollover contribution.

2. Qualified Distributions. A qualified distribution is a distributionwhich is made after the expiration of the five-year holding period andas the result of certain events. The events which will create a qualifieddistribution after the expiration of the five-year holding period are as

follows: a. Distributions made on or after the date on which you attain age

59 1/2;b.Distributions made to your beneficiary after your death;c. Distributions attributable to you being disabled; andd.Qualified first-time homebuyer distributions.

3. Nonqualified Distributions and the Ordering Rules. If yourdistribution is not a qualified distribution, any earnings you withdrawfrom your Roth IRA will be included in your gross income for federalincome tax purposes. Additionally, for each conversion or qualifiedrollover completed while you are younger than age 59 1/2, a separate

five-year holding period will be applied solely for determining if youowe a 10 percent early-distribution penalty. The ordering rules forRoth IRAs determine what portion of your distribution will be subjectto income and penalty taxes. The ordering rules, which take intoaccount all of your Roth IRAs, state that you are deemed to take yourRoth IRA asset types in the following order: (1) all regular or annualcontributions and amounts treated as such, (2) conversion andqualified rollover contributions and amounts treated as such on a firstin first out basis, and (3) your earnings. All of your assets within acertain type must be removed before you may move on to the next

asset type. For each conversion or qualified rollover contributionremoved, the originally taxable portion is removed first and thenontaxable portion is removed last.

4. Removal of Excess Contributions. You may withdraw all or aportion of your excess contribution and attributable earnings by yourfederal income tax return due date, including extensions, for thetaxable year for which you made the contribution. The excesscontribution amount distributed will not be taxable, but the attributableearnings on the contribution will be taxable in the year in which youmade the contribution and may be subject to the 10 percent

early-distribution penalty tax. In certain situations, you may treat yourexcess as a regular (including catch-up) contribution for the next year.If you timely file your federal income tax return, you may stillremove your excess contribution, plus attributable earnings, as late asOctober 15 for calendar year filers.

5. Distributions of Unwanted Roth IRA Contributions by Tax-FilingDate. You may withdraw all or a portion of your regular (includingcatch-up) Roth IRA contribution and attributable earnings in the samemanner as an excess contribution. However, you cannot apply yourunwanted contribution as a regular Roth IRA contribution for a futureyear. The unwanted contribution amount distributed will not be

taxable, but the attributable earnings on the contribution will betaxable in the year in which you made the contribution, and may besubject to the 10 percent early-distribution penalty tax. If you timelyfile your federal income tax return, you may still remove yourunwanted contribution, plus attributable earnings, as late as October15 for calendar year filers.

6. Qualified Health Savings Account (HSA) Funding Distribution. Ifyou are an HSA eligible individual, you may elect to take a qualifiedHSA funding distribution from your Roth IRA to the extent suchdistribution is contributed to your HSA in a trustee-to-trustee transfer.This amount is aggregated with all other annual HSA contributionsand is subject to your annual HSA contribution limit. A qualified HSAfunding distribution election is irrevocable and is generally availableonce in your lifetime. A testing period applies. The testing period forthis provision begins with the month of the contribution to your HSAand ends on the last day of the 12th month following such month. Ifyou are not an eligible individual for the entire testing period, unlessyou die or become disabled, the amount of the distribution madeunder this provision may be includable in gross income for the taxyear of the month you are not an eligible individual, and may besubject to a 10 percent penalty tax.

7. Qualified Charitable Distributions. If you have attained age 70 1/2,you may be able to make tax-free distributions directly from yourRoth IRA to a qualified charitable organization. Tax-free distributionsare limited to $100,000. Consult with your tax or legal professionalregarding tax-free charitable distributions.

A


(1911).00IRACUSROTHLZ 11/1/2019

RMDs. 1. After Age 70 1/2. You are not required to take RMDs from your

Roth IRA when you reach age 70 1/2. Furthermore, you cannot satisfy any RMDs for your traditional IRAs or SIMPLE IRAs bytaking a distribution from any of your Roth IRAs.

2. Failure to Withdraw an RMD. If your beneficiary does notwithdraw an RMD by his/her required distribution date, he/she willowe a 50 percent excess accumulation penalty tax on the amount notwithdrawn. Your beneficiary can always take more than his/her RMDin any year but no additional amounts taken can be credited to asubsequent year's RMDs.

RMDs for Your Beneficiaries. Your beneficiaries of this Roth IRA willgenerally have until December 31 of the year following your death year tobegin RMDs. Exceptions exist for your surviving spouse and for anybeneficiary who must distribute or chooses to distribute his/her share ofyour Roth IRA within a five year period.1. Distribution Calculations In General. Beneficiaries will generally

use a single life expectancy method to satisfy these RMDs unless theyelect the five-year rule. The five-year rule requires your beneficiaryto completely withdraw your Roth IRA assets by the end of the fifthyear following your death year. The single life expectancy divisor,using the IRS's single life table, will be determined by using the ageon December 31 in the year following death of the oldest designatedbeneficiary, unless multiple beneficiaries exist and separateaccounting applies. This initially determined divisor is reduced by onefor each subsequent year's calculation. This general rule of using thesingle life expectancy method applies if your Roth IRA has at leastone designated beneficiary.

2. Designated Beneficiary. designated beneficiary is any namedbeneficiary who has an interest in your Roth IRA on the determinationdate, which is September 30 of the year following your death year.Named beneficiaries who completely distribute their interests in yourRoth IRA, or completely disclaim their interests in your Roth IRAunder IRC Section 2518, will not be considered when designatedbeneficiaries are determined. Named beneficiaries who die after your death but before the determination date will be considered for the sake of determining the distribution period. If any named beneficiary that isnot an individual, such as an estate or charity, has an interest in yourRoth IRA on the determination date, and separate accounting does notapply, your Roth IRA will be treated as having no designatedbeneficiary.

If you name a qualified trust, which is defined in TreasuryRegulation 1.401(a)(9)-4, Q&A 5, as your Roth IRA beneficiary, thebeneficiaries of the qualified trust are treated as the beneficiaries ofyour Roth IRA for purposes of determining designated beneficiariesand the appropriate life expectancy period after your death.

Page 11 of 13

3. Death With No Designated Beneficiary. If you die and your RothIRA is treated as having no designated beneficiary, your namedbeneficiaries will be required to completely withdraw your Roth IRAassets by the end of the fifth year following your death year.

4. Spouse Beneficiary. If your spouse is your only designatedbeneficiary on the determination date, or if there are multipledesignated beneficiaries and separate accounting applies, he/she willuse his/her age each year to determine the life expectancy divisor forcalculating that year's RMD.

If your spouse is the only designated beneficiary, or if there aremultiple designated beneficiaries and separate accounting applies,he/she can postpone commencement of his/her RMDs until the end ofthe year in which you would have attained age 70 1/2. If your spouseis the only designated beneficiary, or if there are multiple designatedbeneficiaries and separate accounting applies, he/she can treat yourRoth IRA as his/her own Roth IRA after your death.

Your spouse beneficiary could take a distribution of his/her share ofyour Roth IRA and roll it over to a Roth IRA of his/her own.

5. Separate Accounting. Our policies may permit separate accountingto be applied to your Roth IRA for the benefit of your beneficiaries. Ifpermitted, separate accounting must be applied in accordance withTreasury Regulation 1.401(a)(9)-8, Q&A 2 and 3. A beneficiary isconsidered the only designated beneficiary of his/her share of theRoth IRA assets if separate accounting applies.

Federal Income Tax Status of Your Roth IRA.1. No Deduction for Contributions. Roth IRA contributions are not

deductible on your federal income tax return at any time.2. Tax-free Earnings. The earnings, including gains and losses, on

your Roth IRA contributions accumulate tax-deferred. At the time ofyour distribution, the earnings will be free from federal income tax ifyour distribution is a qualified distribution.

3. Taxation of Distributions. The taxation of your Roth IRAdistribution, which is not rolled over, is dependent upon whether yourdistribution is a qualified distribution or nonqualified distribution andis subject to the ordering rules. Roth IRA distributions are not subjectto federal income tax withholding. You may also be subject to state orlocal taxes on your Roth IRA distributions.

4. No Special Tax Treatment. Roth IRA distributions are not eligiblefor special tax treatments, such as ten year averaging, that may applyto other employer-sponsored retirement plan distributions.

Estate and Gift Tax. The designation of a beneficiary to receive RothIRA distributions upon your death will not be considered a transfer ofproperty for federal gift tax purposes. Upon your death, the value of allassets remaining in your Roth IRA will usually be included in your gross estate for estate tax purposes, regardless of the named beneficiary ormanner of distribution. There is no specific estate tax exclusion for assetsheld within a Roth IRA. After your death, beneficiaries should pay carefulattention to the rules for the disclaiming any portion of your Roth IRAunder IRC Section 2518.Annual Statements. Each year we will furnish you and the IRS withstatements reflecting the activity in your Roth IRA. You and the IRS willreceive IRS Forms 5498, IRA Contribution Information, and 1099-R,Distributions From Pensions, Annuities, Retirement or Profit-SharingPlans, IRAs, Insurance Contracts, etc. IRS Form 5498 or an appropriatesubstitute indicates the fair market value of the account, including RothIRA contributions, for the year. IRS Form 1099-R reflects your Roth IRAdistributions for the year.


(1911).00IRACUSROTHLZ 11/1/2019

Federal Tax Penalties and IRS Form 5329. Several tax penalties mayapply to your various Roth IRA transactions, and are in addition to anyfederal, state, or local taxes. Federal penalties and excise taxes aregenerally reported and remitted to the IRS by completing IRS Form 5329,Additional Taxes on Qualified Plans (Including IRAs) and OtherTax-Favored Accounts, and attaching the form to your federal income taxreturn. The penalties may include any of the following taxes:1. Early-Distribution Penalty Tax. If you take a distribution from your

Roth IRA before reaching age 59 1/2, you are subject to a 10 percentearly-distribution penalty tax on the taxable portion of the distributionand certain converted or qualified rollover contribution assetsdistributed during the five-year holding period. However, certainexceptions apply. Exceptions to the 10 percent penalty tax include: the qualified distributions reasons previously listed, distributions dueto eligible higher education expenses, medical expenses exceeding acertain percentage of adjusted gross income, health insurancepremiums due to your extended unemployment, a series ofsubstantially equal periodic payments, IRS levy, traditional IRAconversions, qualified reservist distributions, and qualified HSAfunding distributions. Additional exceptions include distributionstaken during the five year holding period as a result of your attainingage 59 1/2, death, disability, or a first-time home purchase. Properlycompleted rollovers, transfers, and recharacterizations are not subjectto the 10 percent penalty tax.

2. Excess Contribution Penalty Tax. If you contribute more to yourRoth IRA than you are eligible to contribute, you have created anexcess contribution, which is subject to a 6 percent excise tax. Theexcise tax applies each year that the excess contribution remains inyour Roth IRA. If you timely file your federal income tax return, youmay still remove your excess contribution, plus attributable earnings,as late as October 15 for calendar year filers.

3. Excess Accumulation Penalty Tax. Any portion of an RMD that isnot distributed to your beneficiary by its deadline is subject to a 50percent excess accumulation penalty tax. The IRS may waive thispenalty upon proof of reasonable error and that reasonable steps weretaken to correct the error, including remedying the shortfall. Abeneficiary should review IRS Form 5329 instructions whenrequesting a waiver.

Disaster Tax Relief. Subject to applicable law, individuals in certainfederally declared disaster areas may be given the opportunity to takequalified disaster distributions without an early distribution penalty (e.g.,for a qualified hurricane distribution). When these qualified disasterdistributions are allowed, they are subject to any time periods as definedby law and, if multiple distributions are made for the same event, areaggregated with distributions from other IRAs and eligible retirementplans up to prescribed limits (e.g., $100,000). Disaster relief for certainqualified disaster distributions may be subject to a lifetime aggregate limit(e.g., for qualified hurricane distributions). Typically, the qualifieddisaster distributions are included in gross income over a three tax yearperiod or all in the year of distribution. In addition, an individual may beallowed three years after the date of receipt to repay all or part of thequalified disaster distribution without being subject to the one rollover per1-year limitation or the 60-day requirement. Certain first-time homebuyeror hardship distributions may be eligible for repayment within aprescribed time period. For additional disaster area information and IRSguidance on associated tax relief, refer to IRS forms, notices andpublications, IRS Publication 976, Disaster Relief, or visit the IRS's website at www.irs.gov.

(

FINANCIAL DISCLOSURE

l

The purpose of this Financial Disclosure is to provide you with an IRSrequired growth projection of the value of your Roth IRA available forwithdrawal at the end of each of the first five years of its existence and atthe end of the years in which you attain the ages of 60, 65, and 70.Certain assumptions are applied that may vary from your actualinvestment provisions.

l

Three projection methods are provided for the situations where the natureof your initial investment allows for a reasonable projection.

The growth projection must be made assuming either a $1,000contribution made on January 1 of each year or a $1,000 one-timecontribution made on January 1 of the first year. The annual contributionrepresents an initial contribution that is a regular Roth or recharacterizedtraditional IRA contribution. One-time contributions include a rollover,transfer, or conversion contribution. These projected amounts are notguaranteed.

ROTH IRA FEES AND EARLY WITHDRAWAL PENALTIES

This Section Applies To The Projection Method Selected.

The fees and penalties listed below may affect the projected value of yourRoth IRA. The disclosed fees and penalties will be included in thatprojection method applicable to your Financial Disclosure. With theexception of distribution transaction or termination fees, ProjectionMethod One cannot be used if any other Roth IRA Fee or certain Otherboxes are checked below, including the Other box under EarlyWithdrawal Penalty.

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$

$

$

$

$

$

$

$

Page 12 of 13

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$

$

.

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(1911).00IRACUSROTHLZ 11/1/2019

Fees:

None

Roth IRA Establishment Fee $

Annual Service/Administration Fee of $

or % of assets will be charged at end beginning

of each year for purposes of this projection.

Transfer/Direct Rollover Fee $

Roth IRA Termination Fee $

Other: or % of Assets

Other: or % of Assets

Early Withdrawal Penalty (Check one):

None 3-Month 6-Month 12-Month

Other:

PROJECTION METHODS Check one):

Projection Method OnefUse Preprinted Tables.The preprinted financial disclosure tables on the following pageprovide you with the Roth IRA's projected values. The assumptionsused to calculate each table's projected Roth IRA values are:} Earnings rate - One-tenth (.1) percent compounded annually on a

365-day year.} Projected values - Calculated using numbers rounded down to the

nearest whole dollar ($1.00).} Early withdrawal penalties - The 3-, 6-, and 12-month penalties

are calculated on a 30-day month and a 360-day year.} Calculated early withdrawal penalty - The 3-, 6-, and 12-month

penalties are not rounded prior to subtraction from the No Penaltycolumn's projected value.

If a fee is disclosed for a distribution (e.g., transfer) transaction or aRoth IRA termination, we will complete the After Fees Values sectionbelow the tables taking the fee(s) into account for each applicableprojected value.

How to use the tables. These financial disclosure tables do notaccommodate certain fees that may be charged to this Roth IRA such

as annual administration or establishment fees. Your projection willcome from the Annual Contributions Table if your initial Roth IRA

contribution is a regular Roth or recharacterized traditional IRAcontribution. The Other Contributions Table will be used if your initialcontribution is a rollover, transfer, or conversion contribution. The top

section of each table provides the projected values at the end of thefirst five years of the Roth IRA. Find your age as of January 1 of thisyear of establishment on the appropriate table. If your birthday is

January 1 of this year, find your age as of December 31 of theprevious year. The amounts to the right of your age are the projected

values of your Roth IRA at the end of the year you attain age 60, 65,and 70. See ROTH IRA FEES AND EARLY WITHDRAWALPENALTIES to determine the applicable early withdrawal penalty

column to use for your projection.

Projection Method TwofCustom Projection.Your Roth IRA's values projected below are based on the followingassumptions:

(Check one):

Annual Contributions.

Rollover/Transfer (one-time) Contribution.

Your age on January 1 of this initial contribution year:

Earnings Rate:

Compounding Method:

Early Withdrawal Penalty Calculation Method:

End ofYear

ProjectedValue

Age ProjectedValue

1 60

2 65

3 70

4

5

Projection Method ThreefSee Separate Financial Disclosure andAssumptions Provided by Your Roth IRA's Custodian.

FINANCIAL DISCLOSURE - PROJECTION METHOD ONEOTHER CONTRIBUTIONS TABLE

12-Month Penalty1,0001,0011,0021,0031,004

No Penalty1,0012,0033,0064,0105,015

End of Year12345

No Penalty1,0011,0021,0031,0041,005

3-Month Penalty1,0001,0011,0021,0031,004

6-Month Penalty1,0001,0011,0021,0031,004

3-Month Penalty 1,000 2,002 3,005 4,009 5,013

1,070

1,069

1,068

1,067

1,066

1,065

1,064

1,063

1,062

1,061

1,060

1,059

1,058

1,057

1,055

1,054

1,053

1,052

1,051

1,050

1,049

1,048

1,047

1,046

1,045

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,022

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,000

12-Month Penalty1,0002,0013,0034,0065,010

End of Year12345

71,452

70,381

69,311

68,242

67,174

66,107

65,042

63,977

62,913

61,851

60,789

59,729

58,669

57,611

56,553

55,497

54,442

53,388

52,335

51,283

50,232

49,182

48,133

47,085

46,038

44,993

43,948

42,904

41,862

40,820

39,780

38,740

37,702

36,664

35,628

34,592

33,558

32,525

31,493

30,461

29,431

28,402

27,374

26,347

25,321

24,296

23,272

22,249

21,227

20,206

19,186

18,167

17,149

16,132

15,116

14,101

13,088

12,075

11,063

10,052

9,042

8,034

7,026

6,019

5,013

4,009

3,005

2,002

1,000

66,124

65,058

63,993

62,929

61,866

60,804

59,743

58,684

57,625

56,568

55,511

54,456

53,401

52,348

51,296

50,244

49,194

48,145

47,097

46,050

45,004

43,959

42,915

41,872

40,830

39,789

38,750

37,711

36,673

35,637

34,601

33,567

32,533

31,501

30,469

29,439

28,409

27,381

26,353

25,327

24,302

23,278

22,254

21,232

20,211

19,191

18,172

17,153

16,136

15,120

14,105

13,091

12,078

11,066

10,055

9,045

8,036

7,028

6,021

5,015

4,010

3,006

2,003

1,001

71,470

70,399

69,328

68,259

67,191

66,124

65,058

63,993

62,929

61,866

60,804

59,743

58,684

57,625

56,568

55,511

54,456

53,401

52,348

51,296

50,244

49,194

48,145

47,097

46,050

45,004

43,959

42,915

41,872

40,830

39,789

38,750

37,711

36,673

35,637

34,601

33,567

32,533

31,501

30,469

29,439

28,409

27,381

26,353

25,327

24,302

23,278

22,254

21,232

20,211

19,191

18,172

17,153

16,136

15,120

14,105

13,091

12,078

11,066

10,055

9,045

8,036

7,028

6,021

5,015

4,010

3,006

2,003

1,001

71,434

70,364

69,294

68,225

67,157

66,091

65,025

63,961

62,897

61,835

60,774

59,714

58,654

57,596

56,539

55,483

54,428

53,375

52,322

51,270

50,219

49,170

48,121

47,073

46,027

44,981

43,937

42,894

41,851

40,810

39,770

38,730

37,692

36,655

35,619

34,584

33,550

32,517

31,485

30,454

29,424

28,395

27,367

26,340

25,314

24,290

23,266

22,243

21,221

20,201

19,181

18,162

17,145

16,128

15,113

14,098

13,084

12,072

11,060

10,050

9,040

8,032

7,024

6,018

5,012

4,008

3,004

2,002

1,000

66,107

65,042

63,977

62,913

61,851

60,789

59,729

58,669

57,611

56,553

55,497

54,442

53,388

52,335

51,283

50,232

49,182

48,133

47,085

46,038

44,993

43,948

42,904

41,862

40,820

39,780

38,740

37,702

36,664

35,628

34,592

33,558

32,525

31,493

30,461

29,431

28,402

27,374

26,347

25,321

24,296

23,272

22,249

21,227

20,206

19,186

18,167

17,149

16,132

15,116

14,101

13,088

12,075

11,063

10,052

9,042

8,034

7,026

6,019

5,013

4,009

3,005

2,002

1,000

60,789

59,729

58,669

57,611

56,553

55,497

54,442

53,388

52,335

51,283

50,232

49,182

48,133

47,085

46,038

44,993

43,948

42,904

41,862

40,820

39,780

38,740

37,702

36,664

35,628

34,592

33,558

32,525

31,493

30,461

29,431

28,402

27,374

26,347

25,321

24,296

23,272

22,249

21,227

20,206

19,186

18,167

17,149

16,132

15,116

14,101

13,088

12,075

11,063

10,052

9,042

8,034

7,026

6,019

5,013

4,009

3,005

2,002

1,000

60,743

59,684

58,625

57,568

56,511

55,456

54,401

53,348

52,296

51,244

50,194

49,145

48,097

47,050

46,004

44,959

43,915

42,872

41,830

40,789

39,750

38,711

37,673

36,637

35,601

34,567

33,533

32,501

31,469

30,439

29,409

28,381

27,353

26,327

25,302

24,278

23,254

22,232

21,211

20,191

19,172

18,153

17,136

16,120

15,105

14,091

13,078

12,066

11,055

10,045

9,036

8,028

7,021

6,015

5,010

4,006

3,003

2,001

1,000

60,774

59,714

58,654

57,596

56,539

55,483

54,428

53,375

52,322

51,270

50,219

49,170

48,121

47,073

46,027

44,981

43,937

42,894

41,851

40,810

39,770

38,730

37,692

36,655

35,619

34,584

33,550

32,517

31,485

30,454

29,424

28,395

27,367

26,340

25,314

24,290

23,266

22,243

21,221

20,201

19,181

18,162

17,145

16,128

15,113

14,098

13,084

12,072

11,060

10,050

9,040

8,032

7,024

6,018

5,012

4,008

3,004

2,002

1,000

71,399

70,328

69,259

68,191

67,124

66,058

64,993

63,929

62,866

61,804

60,743

59,684

58,625

57,568

56,511

55,456

54,401

53,348

52,296

51,244

50,194

49,145

48,097

47,050

46,004

44,959

43,915

42,872

41,830

40,789

39,750

38,711

37,673

36,637

35,601

34,567

33,533

32,501

31,469

30,439

29,409

28,381

27,353

26,327

25,302

24,278

23,254

22,232

21,211

20,191

19,172

18,153

17,136

16,120

15,105

14,091

13,078

12,066

11,055

10,045

9,036

8,028

7,021

6,015

5,010

4,006

3,003

2,001

1,000

66,058

64,993

63,929

62,866

61,804

60,743

59,684

58,625

57,568

56,511

55,456

54,401

53,348

52,296

51,244

50,194

49,145

48,097

47,050

46,004

44,959

43,915

42,872

41,830

40,789

39,750

38,711

37,673

36,637

35,601

34,567

33,533

32,501

31,469

30,439

29,409

28,381

27,353

26,327

25,302

24,278

23,254

22,232

21,211

20,191

19,172

18,153

17,136

16,120

15,105

14,091

13,078

12,066

11,055

10,045

9,036

8,028

7,021

6,015

5,010

4,006

3,003

2,001

1,000

7065Age 6065 7060 60 65 70 60 65 701

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

65

66

67

68

69

60,804

59,743

58,684

57,625

56,568

55,511

54,456

53,401

52,348

51,296

50,244

49,194

48,145

47,097

46,050

45,004

43,959

42,915

41,872

40,830

39,789

38,750

37,711

36,673

35,637

34,601

33,567

32,533

31,501

30,469

29,439

28,409

27,381

26,353

25,327

24,302

23,278

22,254

21,232

20,211

19,191

18,172

17,153

16,136

15,120

14,105

13,091

12,078

11,066

10,055

9,045

8,036

7,028

6,021

5,015

4,010

3,006

2,003

1,001

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

70651

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

65

66

67

68

69

Age 601,070

1,069

1,068

1,067

1,066

1,064

1,063

1,062

1,061

1,060

1,059

1,058

1,057

1,056

1,055

1,054

1,053

1,052

1,051

1,050

1,049

1,048

1,047

1,046

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,031

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,022

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,000

65 7060 60 65 70 60 65 701,060

1,059

1,058

1,057

1,056

1,055

1,054

1,053

1,052

1,051

1,050

1,049

1,048

1,047

1,046

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,031

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,022

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,066

1,064

1,063

1,062

1,061

1,060

1,059

1,058

1,057

1,056

1,055

1,054

1,053

1,052

1,051

1,050

1,049

1,048

1,047

1,046

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,031

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,022

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,071

1,070

1,069

1,068

1,067

1,066

1,064

1,063

1,062

1,061

1,060

1,059

1,058

1,057

1,056

1,055

1,054

1,053

1,052

1,051

1,050

1,049

1,048

1,047

1,046

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,031

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,022

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,060

1,059

1,058

1,057

1,056

1,055

1,054

1,053

1,052

1,050

1,049

1,048

1,047

1,046

1,045

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,031

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,000

1,065

1,064

1,063

1,062

1,061

1,060

1,059

1,058

1,057

1,056

1,055

1,054

1,053

1,052

1,050

1,049

1,048

1,047

1,046

1,045

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,031

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,000

1,071

1,070

1,068

1,067

1,066

1,065

1,064

1,063

1,062

1,061

1,060

1,059

1,058

1,057

1,056

1,055

1,054

1,053

1,052

1,050

1,049

1,048

1,047

1,046

1,045

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,031

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,000

1,060

1,059

1,058

1,057

1,055

1,054

1,053

1,052

1,051

1,050

1,049

1,048

1,047

1,046

1,045

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,022

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,000

1,065

1,064

1,063

1,062

1,061

1,060

1,059

1,058

1,057

1,055

1,054

1,053

1,052

1,051

1,050

1,049

1,048

1,047

1,046

1,045

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,022

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,000

1,064

1,063

1,062

1,061

1,060

1,059

1,058

1,057

1,056

1,055

1,054

1,053

1,052

1,051

1,050

1,049

1,048

1,047

1,046

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,031

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,022

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,000

1,059

1,058

1,057

1,056

1,055

1,054

1,053

1,052

1,051

1,050

1,049

1,048

1,047

1,046

1,044

1,043

1,042

1,041

1,040

1,039

1,038

1,037

1,036

1,035

1,034

1,033

1,032

1,031

1,030

1,029

1,028

1,027

1,026

1,025

1,024

1,023

1,022

1,021

1,020

1,019

1,018

1,017

1,016

1,015

1,014

1,013

1,012

1,011

1,010

1,009

1,008

1,007

1,006

1,005

1,004

1,003

1,002

1,001

1,000

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

No Penalty 12-Month Penalty3-Month Penalty 6-Month Penalty 12-Month Penalty6-Month PenaltyNo Penalty

ANNUAL CONTRIBUTIONS TABLE

66,091

65,025

63,961

62,897

61,835

60,774

59,714

58,654

57,596

56,539

55,483

54,428

53,375

52,322

51,270

50,219

49,170

48,121

47,073

46,027

44,981

43,937

42,894

41,851

40,810

39,770

38,730

37,692

36,655

35,619

34,584

33,550

32,517

31,485

30,454

29,424

28,395

27,367

26,340

25,314

24,290

23,266

22,243

21,221

20,201

19,181

18,162

17,145

16,128

15,113

14,098

13,084

12,072

11,060

10,050

9,040

8,032

7,024

6,018

5,012

4,008

3,004

2,002

1,000

6-Month Penalty 1,000 2,002 3,004 4,008 5,012

3-Month Penalty

How to determine the After Fees Values. If we disclosed a distributiontransaction or termination fee in ROTH IRA FEES AND EARLYWITHDRAWAL PENALTIES, we have completed the After Fees Valuessection to reflect your Roth IRA's projected values for the first five years andfor ages 60, 65 and 70, if applicable. You may calculate the projected valuefor additional years. Follow the steps under How to use the tables. Reduce thevalues by the amount of any distribution transaction or termination fees and fillin the amounts.

$

$

$

AFTER FEES VALUES (if applicable)End ofYear Age

1 60

2 65

3 70

4

5

$

$

$

$

$

Page 13 of 13All rights reserved.- 2019 Wolters Kluwer Financial Services, Inc.Roth IRA Organizer-Custodial

(1911).00IRACUSROTHLZ 11/1/2019

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