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Conversion & Recharacterization Form (RRR)

Use this form to request one of the following: a Roth Conversion (conversion from a Traditional IRA, Simple or SEP account to a Roth IRA), or a Recharacterization (correct a contribution or conversion from one account to another).

Roth Conversion requests: Complete Section 2
Please note that converting the Traditional IRA, SIMPLE IRA or SEP IRA account to a Roth IRA will be reported both as a distribution on which you may owe income tax and a conversion contribution to the Roth IRA.

Recharacterization requests: Complete Section 3
Please ensure that this recharacterization is legal and is within the time limits imposed by IRS regulations and to report the recharacterization on Form 8606 as required by those regulations.

*** Effective January 1, 2018, pursuant to the Tax Cuts and Jobs Act (Pub. L. No. 115-97), a conversion from a traditional IRA, SEP or SIMPLE to a Roth IRA cannot be recharacterized. The new law also prohibits recharacterizing amounts rolled over to a Roth IRA from other retirement plans, such as 401(k) or 403(b) plans.

You can submit the form by using one of the following methods.

DocuSign

This is the preferred way to complete the form.  You can fill out the form online and sign it electronically by DocuSign.

DocuSign is a fast and secure way to process your form. It allows you to digitally sign forms without having to go through the hassle of downloading software or mailing the originals.

You will receive an email with a copy of the form after signing is completed.  There is no need to mail in the form.

Click here to DocuSign Form

 

PDF Download

If you do not submit the form by DocuSign, you can fill out the form manually by downloading the PDF.

This is an interactive form contains fields that you can select or fill in. Please note that some browsers may not fully support all of the Adobe PDF capabilities. You may need to configure your browser to use the Adobe PDF plug-in.

After you complete the PDF form, you need to deliver the form to us by either email, fax, regular mail or overnight mail.

Email: NewAccounts@IRAServices.com
Fax: (650) 745-2902
Regular Mail: IRA Services
P.O. Box 7080, San Carlos, CA 94070-7080
Overnight Mail: IRA Services
1160 Industrial Road, Unit 1,
San Carlos, CA 94070-4128
Click here to Download Form
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