The custodian is required to report annually the Fair Market Value (FMV) of your account to the Internal Revenue Service.
For your annual valuation to be reflected on the year-end statement of the current year, this form must be submitted by January 10th of the following year.
There is no need to valuate Notes and Precious Metals. Do NOT send in this form to valuate Notes and Precious Metal.
** This form needs a wet signature. We do not accept electronic signature. **
|Online Asset Valuation Portal
Complete the valuation online using Online Asset Valuation Portal if
- your account is Traditional AND you are under 70 years of age or
- your account is ROTH or
- your account is NOT inherited IRA or
- you are not taking early distribution or
- the valuation is NOT for a ROTH conversion or other taxable event or
- your investment is NOT in receivership
** You will be charged an administrative fee of $35.00 if you submit a paper valuation form in addition to Online Asset Valuation Portal. **
|Click here to Online Asset Valuation Portal
Download this form, complete, sign and send the form manually
You should complete the document as follows:
- Enter the name and fair market value of the Asset in Section 3; Use the name on your most recent statement; Use multiple forms if more than one Asset
- The Fair Market Value is the price at which the asset would change hands between a willing buyer and a willing seller, neither being under any compulsion to buy or to sell and both having reasonable knowledge of relevant facts about the asset. The Fair Market Value may be an estimate of the value, but you are solely responsible for any such estimate and any tax consequences arising there from.
- If your account is a partial owner of the Asset, the Fair Market Value you enter below MUST reflect ONLY the Fair Market Value of that portion of the Asset which is owned by your account.
- If you are providing this Fair Market Value for purposes of valuing your Asset/Account in a Roth conversion, distribution to you, as part of a required minimum distribution or other taxable distribution, this form must be signed and attested to by a licensed professional (CPA, Accountant, Appraiser, Tax Advisor, Financial Advisor, etc.) knowledgeable about the holdings and business of your account.
By using the PDF form, you are subject to a $35.00 administrative fee if you are eligible to enter your valuation on line.
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.
P.O. Box 7080, San Carlos, CA 94070-7080
1160 Industrial Road, Unit 1,
San Carlos, CA 94070-4128
|Click here to Download Form