1
AMUNDI US REQUIRED MINIMUM DISTRIBUTION
ELECTION FORM
PO BOX 534427 PITTSBURGH, PA 15253-4427 1-800-622-0176
Federal law requires most individuals to start withdrawing money from their IRAs and other tax-deferred retirement accounts at their
required beginning date. These withdrawals, known as Required Minimum Distributions (“RMDs”), must meet a specific dollar amount each
year, as determined by an IRS formula.
Note: Failure to withdraw your RMD amount by the applicable deadline could result in a 25% penalty tax. The penalty tax would
be assessed on the dierence between the amount that you were required to take and the amount that was actually distributed, if
any. Additionally, the 25% penalty tax may be reduced to 10% if the past due amount is distributed within a 2-year correction window
beginning on the date the distribution was originally due. Before making any decision regarding your RMD, we urge you to consult your
tax advisor or tax attorney.
Name: _________________________________________________________________Phone Number: _______________________
Type of Account:
Social Security Number: _______- _____- _________ Date of Birth: _____/_____/________ Traditional IRA
MM DD YY SEP IRA
SIMPLE IRA
DISTRIBUTION ELECTION –
(RMD amounts are calculated on the entire account balance including all of the underlying investments in your IRA.)
Account Number: ___________________________ New RMD election (If new account, prior year end balance $____________)
Change an existing RMD election
Distribute my RMD from: Across all funds proportionately (rounding may occur), or
Distribute from fund(s): _________________________________________________________________
CALCULATION METHOD
Your RMD amount is calculated in accordance with Internal Revenue Service (“IRS”) regulations. The regulations are explained in IRS
Publication 590-B,
Distributions from Individual Retirement Arrangements (IRAs),
which includes the life expectancy tables used to
calculate RMD amounts.
Note: Your RMD will be calculated based on the Uniform Lifetime Table, unless the following exception applies to you and you have
indicated so by checking the box below.
My sole primary beneficiary is my spouse who is more than 10 years younger than I am. I elect to calculate my RMD based on
the Joint and Last Survivor Expectancy Table. Spouse’s Date of Birth ______/______/________
MM DD YY
TYPE OF DISTRIBUTION
SINGLE SUM / ONE-TIME DISTRIBUTION OPTIONS:
Calculate RMD Amount: Calculate and distribute immediately upon receipt of this form my current year RMD. I understand
that I am responsible for ensuring any future year RMD amounts are satisfied by contacting the Custodian to request
subsequent distributions.
Calculate and distribute my prior year deferred RMD Amount (Only applicable if your first RMD year was the previous year and
you are electing to distribute last year’s RMD, this request will be processed immediately upon receipt and must be received
between January 1st and April 1st).
2
Qualified Charitable Distribution (“QCD”) - mark this box if the amount indicated above in any of the one-time distribution
options is a QCD distribution (SEP and SIMPLE IRAs are excluded). Note a QCD is not subject to tax withholding up to the
current annual maximum, QCDs are indexed to inflation and the maximum may increase each year. Please speak with a qualified
tax professional to confirm the amount you are requesting is not over the amount eligible for a QCD. Any portion you elect to
distribute that exceeds the maximum QCD limit for the current year will be processed separately and not be treated as a QCD by
the custodian. Please review the sections titled
Payment Method
and
Tax Withholding Election
which may apply to any amount
not treated as a QCD.
SYSTEMATIC DISTRIBUTIONS OPTIONS:
Calculate and distribute my current year RMD amount for this year and all subsequent years. I understand that the Custodian will
continue to calculate and distribute my RMD amount for all subsequent years until I notify them to discontinue the payments.
Distribute a fixed amount of $____________ for this year and all subsequent years until I notify you to discontinue payments. I
understand that I am responsible for ensuring my RMD amounts are satisfied each year. I also understand that I am responsible for
contacting the Custodian to request any adjustments to the fixed dollar amount or frequency.
SYSTEMATIC DISTRIBUTION CYCLE
Begin systematic distributions on
1
: ______/______/_________
MM DD YY
Frequency (choose one)
2
: Monthly Quarterly Semi-Annually Annually
1
If this form is received after the date selected, it will be processed immediately upon receipt. Future RMD’s will be established with date listed.
2
If a frequency is not selected, your RMD will be distributed annually on the 20
th
of the next available month.
PAYMENT METHOD
Based on your selected distribution method, a Medallion Signature Guarantee Stamp may be required (such methods are marked with an
asterisk - *). Please refer to your prospectus or call us at the number listed on this form for specific requirements. If a payment method is
not selected, your RMD will be issued as a check payable to you and mailed to your address of record. Your payout method will remain
in eect until we receive notice from you requesting a change.
Mail check to my address of record currently on file.
*Mail check to an alternate address.
Address: _____________________________________________________________________________________________
Purchase into my non-retirement account:
Application attached with investment instructions (or)
Existing Account Number: ____________________________ Investment Fund(s): ________________________________
*Transfer funds electronically via ACH (Attach a preprinted check marked “Void”)
Name of Institution: ________________________________________________
Bank Registration (Owners): __________________________________________
Address: ________________________________________________________
________________________________________________________________
Routing and Account Number: ________________________________________
*Medallion Signature Guarantee is required and
may be obtained at your local bank or trust
company, securities broker/dealer, clearing agency
or savings association.
*The receiving bank account must include your
name in the account registration.
Distribute a fixed amount of $_______________ immediately upon receipt of this form. I understand that I am responsible for
ensuring my RMD amounts are satisfied each year and for contacting the Custodian to request any subsequent distributions.
Payable to Charity/Organization: ____________________________________________________________________________
Amount: _______________% of the distribution proceeds (or) specific dollar amount $__________________________________
FEDERAL TAX WITHHOLDING ELECTION (required)
Federal income tax will be withheld at the rate of 10% from any distribution, subject to the IRS withholding rules, unless you elect a withholding
rate of 0% below or have previously elected out of withholding. Tax will be withheld on the gross amount of the payment even though you
may be receiving amounts that are not subject to withholding because they are excluded from gross income. This withholding procedure may
result in excess withholding on the payments. If you elect to have no federal taxes withheld from your distribution, or if you do not have enough
federal income tax withheld from your distribution, you may be responsible for payment of estimated tax. You may incur penalties under the
estimated tax rules if your withholding and estimated tax payments are not sucient. You understand that your below election will remain in
eect until such time as you make a dierent election with the Custodian.
Please select one:
I elect federal income tax withholding of 0%, do not withhold federal income tax from my distributions.*
I elect federal income tax withholding of ________% must be a whole percent, you may elect any rate from 1% to 100%.*
See the attached Form W-4R Withholding Certificate for Nonperiodic Payments which has the Marginal Rate Tables and “Suggestion for
determining withholding” instructions. You may use these tables and instructions to help you select the appropriate withholding rate.
*Generally, you can’t elect less than 10% federal income tax withholding for payments to be delivered outside the United States and its
possessions.
STATE INCOME TAX WITHHOLDING ELECTION
Your state of residence will determine your state income tax withholding requirements, if any. Those states with mandatory withholding may
require state income tax to be withheld from payments if federal taxes are withheld or may mandate a fixed amount regardless of your federal
tax election. Voluntary states let individuals determine whether they want state taxes withheld. Some states have no income tax on retirement
payments. You may wish to consult with a tax advisor or your state's tax authority for additional information on your state requirements. If you
are completing this form, your below election will remain in eect until such time as you make a dierent election in writing to the Custodian.
Please select one:
I elect NOT TO have state income tax withheld from my retirement account distributions (only for residents of states that do not
require mandatory state tax withholding).
I elect TO have the following dollar amount or percentage withheld from my retirement account distribution for state income taxes (for
residents of states that allow voluntary state tax withholding). $ _____________ or _____ %
AUTHORIZATION
I certify that I am the Participant authorized to make these elections and that all information provided is true and accurate. I further
certify that the Custodian, the Sponsor, or the agent of either of them has given no tax or legal advice to me and shall be indemnified and
held harmless, for any tax, legal or other consequences resulting from my election(s). I expressly assume responsibility for any adverse
consequences which may arise from the election(s). The Custodian is hereby authorized and directed to distribute funds from my account in
the manner requested. I have read and understand and agree to be legally bound by the terms of this form.
X
Participant's Signature (required) Date
*Medallion Signature Guarantee Stamp and Signature: An eligible guarantor is a domestic bank or trust
company, securities broker/dealer, clearing agency or savings association that participates in
a medallion program recognized by the Securities Transfer Agents Association. The three recognized
medallion programs are the Securities Transfer Agents Medallion Program (known as STAMP), Stock
Exchanges Medallion Program (SEMP), and the Medallion Signature Program (MSP). A notarization
from a notary public is NOT an acceptable substitute for a signature guarantee.
Medallion Signature Guarantee Stamp
Amundi US
60 State Street, Boston, Massachusetts 02109
©2024 Amundi US
amundi.com/usinvestors 32756-06-0424
Substitute W-4R 2024 - Withholding Certificate for Nonperiodic Payments – For use with IRAs ONLY
Where instructed to provide your withholding election on “line 2” use the space provided on the attached form under “Federal Income
Withholding Election.”
2024 Marginal Rate Tables
You may use these tables to help you select the appropriate withholding rate for this payment or distribution. Add your income from all sources
and use the column that matches your filing status to find the corresponding rate of withholding. See below for more information on how to use
this table.
Single o
r Married filing Separately
Married filing jointly
or
Qualifying surviving spouse
Head of household
Total income
Tax rate for every
Total income
Tax rate for every
Total income
Tax rate for every
over—
dollar more
over—
dollar more
over—
dollar more
$0
0%
$0
0%
$0
0%
14,600
10%
29,200
10%
21,900
10%
26,200
12%
52,400
12%
38,450
12%
61,750
22%
123,500
22%
85,000
22%
115,125
24%
230,250
24%
122,400
24%
206,550
32%
413,100
32%
213,850
32%
258,325
35%
516,650
35%
265,600
35%
623,950*
37%
760,400
37%
631,250
37%
*If married filing separately, use $380,200 instead for this 37% rate.
General Instructions: Section references are to the Internal Revenue Code.
Future developments. For the latest information about any future developments related to
Form W-4R, such as legislation enacted after it was published, go to www.irs.gov/FormW4R.
Purpose of form. Complete Form W-4R to have payers withhold the correct amount of federal
income tax from your nonperiodic payment from an employer retirement plan, annuity
(including a commercial annuity), or individual retirement arrangement (IRA). See below for
the rules and options that are available for each type of payment.
Caution: If you have too little tax withheld, you will generally owe tax when you file your tax
return and may owe a penalty unless you make timely payments of estimated tax. If too much
tax is withheld, you will generally be due a refund when you file your tax return. Your
withholding choice (or an election not to have withholding on a nonperiodic payment) will
generally apply to any future payment from the same plan or IRA. Submit a new Form W-4R if
you want to change your election.
Nonperiodic payments—10% withholding. Your payer must withhold at a default 10% rate
from the taxable amount of nonperiodic payments unless you enter a different rate on line 2.
Distributions from an IRA that are payable on demand are treated as nonperiodic payments.
Note that the default rate of withholding may not be appropriate for your tax situation. You
may choose to have no federal income tax withheld by entering “-0-” on line 2. See the specific
instructions below for more information. Generally, you are not permitted to elect to have
federal income tax withheld at a rate of less than 10% (including “-0-”) on any payments to be
delivered outside the United States and its territories .
Note: If you don’t give Form W-4R to your payer, you don’t provide an SSN, or the IRS notifies
the payer that you gave an incorrect SSN, then the payer must withhold 10% of the payment
for federal income tax and can’t honor requests to have a lower (or no) amount withheld.
Generally, for payments that began before 2024, your current withholding election (or your
default rate) remains in effect unless you submit a Form W-4R.
Payments to nonresident aliens and foreign estates. Do not use Form W-4R. See Pub. 515,
Withholding of Tax on Nonresident Aliens and Foreign Entities, and Pub. 519, U.S. Tax Guide
for Aliens, for more information.
Tax relief for victims of terrorist attacks. If your disability payments for injuries incurred as a
direct result of a terrorist attack are not taxable, enter “-0-” on line 2. See Pub. 3920, Tax Relief
for Victims of Terrorist Attacks, for more details.
Specific Instructions
Line 2 - More withholding. If you want more than the default rate withheld from your
payment, you may enter a higher rate on line 2.
Less withholding (nonperiodic payments only). If permitted, you may enter a lower rate on
line 2 (including “-0-”) if you want less than the 10% default rate withheld from your payment.
If you have already paid, or plan to pay, your tax on this payment through other withholding
or estimated tax payments, you may want to enter “-0-”.
Suggestion for determining withholding. Consider using the Marginal Rate Tables above to
help you select the appropriate withholding rate for this payment or distribution. The tables
are most accurate if the appropriate amount of tax on all other sources of income, deductions,
and credits has been paid through other withholding or estimated tax payments. If the
appropriate amount of tax on those sources of income has not been paid through other
withholding or estimated tax payments, you can pay that tax through withholding on this
payment by entering a rate that is greater than the rate in the Marginal Rate Tables.
The marginal tax rate is the rate of tax on each additional dollar of income you receive above
a particular amount of income. You can use the table for your filing status as a guide to find a
rate of withholding for amounts above the total income level in the table.
To determine the appropriate rate of withholding from the table, do the following. Step 1: Find
the rate that corresponds with your total income not including the payment. Step 2: Add your
total income and the taxable amount of the payment and find the corresponding rate.
If these two rates are the same, enter that rate on line 2. (See Example 1 below.)
If the two rates differ, multiply (a) the amount in the lower rate bracket by the rate for that
bracket, and (b) the amount in the higher rate bracket by the rate for that bracket. Add these
two numbers; this is the expected tax for this payment. To get the rate to have withheld, divide
this amount by the taxable amount of the payment. Round up to the next whole number and
enter that rate on line 2. (See Example 2 below.)
If you prefer a simpler approach (but one that may lead to overwithholding), find the rate that
corresponds to your total income including the payment and enter that rate on line 2.
Examples. Assume the following facts for Examples 1 and 2. Your filing status is single. You
expect the taxable amount of your payment to be $20,000. Appropriate amounts have been
withheld for all other sources of income and any deductions or credits.
Example 1. You expect your total income to be $62,000 without the payment. Step 1: Because
your total income without the payment, $62,000, is greater than $61,750 but less than
$115,125, the corresponding rate is 22%. Step 2: Because your total income with the payment,
$82,000, is greater than $61,750 but less than $115,125, the corresponding rate is 22%.
Because these two rates are the same, enter “22” on line 2.
Example 2. You expect your total income to be $43,700 without the payment. Step 1: Because
your total income without the payment, $43,700, is greater than $26,200 but less than
$61,750, the corresponding rate is 12%. Step 2: Because your total income with the payment,
$63,700 is greater than $61,750 but less than $115,125, the corresponding rate is 22%. The
two rates differ. $18,050 of the $20,000 payment is in the lower bracket ($61,750 less your
total income of $43,700 without the payment), and $1,950 is in the higher bracket ($20,000
less the $18.050 that is in the lower bracket). Multiply $18,050 by 12% to get $2,166. Multiply
$1,950 by 22% to get $429. The sum of these two amounts is $2,595. This is the estimated tax
on your payment. This amount corresponds to 13% of the $20,000 payment ($2,595 divided
by $20,000). Enter “13” on line 2.
