IRA, Coverdell ESA, HSA, and SEP and SIMPLE IRA Plan
| IMPORTANT NOTE TO ELECTRONIC FORMS USERS Updated forms and potential changes are delivered to you in periodic, electronic form updates. In certain instances, the most current version of an electronic form may vary from a printed form. To determine the most current version of an electronic form, please contact eforms@ascensus.com. |
Ascensus’ forms and documents are constantly monitored to accommodate changes brought about by new tax laws and, equally important, to respond to your requests and needs. This Forms Checklist provides you with the date of the most current version of the designated form or document. Versions which are technically inaccurate because of subsequent law changes or IRS pronouncements are listed in the column entitled “Obsolete Version.” If no date appears in the obsolete column, all existing versions may be used—and so, the current version of pre-printed forms are generally available upon the depletion of existing inventory supplies. This checklist will be updated periodically.
If you need assistance or would like to update your forms inventory, contact a Customer Service Representative at 800-346-3860, option 2, suboption 1.
Account Establishment: Opening Documents
| No. | Name | Current Version | Obsolete Version |
| Traditional IRA | |||
| 97 | Traditional IRA Simplifier Trust – 5305 | 10/2018 | A, B |
| 98 | Traditional IRA Simplifier Custodial – 5305-A | 10/2018 | A |
| 100 | Traditional IRA Simplifier Self-Directed Custodial – 5305-A | 10/2018 | A |
| 97-IH | Inherited Traditional IRA Simplifier Trust – 5305 | 9/2017 | Any prior to 1/2009 B, C |
| 98-IH | Inherited Traditional IRA Simplifier Custodial – 5305-A | 9/2017 | Any prior to 1/2009 C |
| 100-IH | Inherited Traditional IRA Simplifier Self-Directed Custodial – 5305-A | 9/2017 | Any prior to 1/2009 C |
| Roth IRA | |||
| 6097 | Roth IRA Simplifier Trust – 5305-R | 3/2018 | A, B |
| 6098 | Roth IRA Simplifier Custodial – 5305-RA | 3/2018 | A |
| 6100 | Roth IRA Simplifier Self-Directed Custodial – 5305-RA | 3/2018 | A |
| 6097-IH | Inherited Roth IRA Simplifier Trust – 5305-R | 9/2017 | Any prior to 1/2009 B, C |
| 6098-IH | Inherited Roth IRA Simplifier Custodial – 5305-RA | 9/2017 | Any prior to 1/2009 C |
| 6100-IH | Inherited Roth IRA Simplifier Self-Directed Custodial – 5305-RA | 9/2017 | Any prior to 1/2009 C |
| SIMPLE IRA | |||
| 1097 | SIMPLE IRA Simplifier Trust – 5305-S | 10/2018 | A, B |
| 1098 | SIMPLE IRA Simplifier Custodial – 5305-SA | 10/2018 | A |
| 1100 | SIMPLE IRA Simplifier Self-Directed Custodial – 5305-SA | 10/2018 | A |
| Coverdell Education Savings Account (ESA) | |||
| 5097 | Coverdell ESA Simplifier Trust – 5305-E | 10/2018 | B, D |
| 5098 | Coverdell ESA Simplifier Custodial – 5305-EA | 10/2018 | D |
| Health Savings Account (HSA) | |||
| 3499 | HSA Simplifier Trust – 5305-B | 10/2018 | E |
| 3500 | HSA Simplifier Custodial – 5305-C | 10/2018 | E |
IRA Maintenance Forms
| No. | Name | Current Version | Obsolete Version |
| IRA Contributions | |||
| 106 | Special Contributions | 10/2018 | Any prior obsolete |
| 107 | Traditional IRA Contribution and Investment Selection | 10/2018 | Any prior to 10/2014  |
| 109 | Traditional IRA Contribution Eligibility | 10/2018 |  |
| 110 | Conduit IRA Notice and Election | ||
| 135 | IRA Certification for Late Rollover Contribution | 4/2017 | |
| 489 | IRA Automatic Rollover Agreement | 3/2014 |  |
| 1107 | SIMPLE IRA Contribution and Investment Selection | 10/2018 | Any prior to 10/2014  |
| 1109 | SIMPLE IRA Contribution Eligibility | 10/2018 | |
| 6107 | Roth Contribution and Investment Selection | 3/2018 | Any prior to 10/2014 |
| 6109 | Roth Contribution Eligibility | 10/2018 | |
| IRA Portability | |||
| 302 | Traditional and SIMPLE IRA Transfer Request | 10/2017 | Any prior to 5/2002 |
| 305 | IRA Recharacterization Election | 10/2018 | Any prior obsolete |
| 487 | IRA Direct Rollover Request | 3/2016 | Any prior to 1/2002   |
| 6302 | Roth IRA Transfer Request | 10/2017 | Any prior to 5/2002 |
| 6305 | Roth IRA Direct Conversion Request | 10/2018 | Any prior obsolete |
| IRA Distributions and Withholding | |||
| 22 | IRA Charitable Distribution Request | 3/2014 | |
| 123 | IRA Excess Removal Worksheet | 10/2015 | Any prior to 1/2002 |
| 314 | IRA Withdrawal Authorization | 10/2018 | Any prior to 10/2004  |
| 317 | IRA Withholding Notice and Election (with current election included) | 10/2015 | 3/87 |
| 319 | IRA Substantially Equal Periodic Payment Election | 10/2015 | Any prior to 11/2002 |
| 321 | IRA Beneficiary Required Election | 10/2015 | Any prior to 11/2002  |
| 322 | IRA Required Minimum Distribution Scheduled Payment Election | 10/2018 | Any prior to 8/2002 |
| 323 | IRA Required Minimum Distribution Notice | 3/2014 | |
| 324 | IRA Scheduled Payment Election | 10/2015 | |
| 324-IH | Inherited IRA Scheduled Payment Election | 3/2016 | |
| 6123 | Roth IRA Excess Removal Worksheet | 10/2015 | Any prior to 1/2004 |
| 6314 | Roth IRA Withdrawal Authorization | 10/2018 | Any prior to 10/2004  |
| 80024 | IRA State Income Tax Withholding Election | 1/2019 | Any prior obsolete |
| IRA Beneficiary Designations | |||
| 121 | IRA Beneficiary Reminder Notice | 3/2014 | |
| 301 | IRA Beneficiary Designation | 4/2015 | |
| 301-SU | IRA Beneficiary Designation Addendum | 4/2015 | |
| 307 | Inherited IRA Beneficiary Designation | 4/2015 | |
| IRA Changes | |||
| 311 | IRA Change of Account Information | 3/2014 | |
| 2310 | Investment Change | 3/2014 | |
Coverdell ESA Maintenance Forms
| No. | Name | Current Version | Obsolete Version |
| ESA Contributions | |||
| 106 | Special Contributions | 4/2017 | Any prior to 3/2016 |
| 5107 | Coverdell ESA Contribution and Investment Selection | 10/2014 | Any prior obsolete |
| 5109 | Coverdell ESA Contribution Eligibility | 10/2015 | |
| ESA Portability | |||
| 5302 | Coverdell ESA Transfer Request | 7/2013 | Any prior to 7/2001 |
| ESA Distributions | |||
| 5123 | Coverdell ESA Excess Removal Worksheet | 10/2015 | |
| 5314 | Coverdell ESA Withdrawal Authorization | 10/2018 | Any prior to obsolete |
| ESA Death Beneficiary Designations | |||
| 5301 | Coverdell ESA Death Beneficiary Designation | 4/2015 | Any prior to 1/2002 |
| 5301-SU | Coverdell ESA Death Beneficiary Designation Addendum | 4/2015 | |
| ESA Changes | |||
| 5311 | Coverdell ESA Change of Account Information | 3/2014 | |
HSA Maintenance Forms
| No. | Name | Current Version | Obsolete Version |
| HSA Contributions | |||
| 3107 | HSA Contribution and Investment Selection | 10/2015 | Any prior to 10/2004 |
| 3109 | HSA Contribution Eligibility | 10/2018 | |
| 3315 | HSA Mistaken Distribution Payment | 3/2014 | |
| 3322 | Qualified HSA Funding Distribution Request | 7/2013 | Any prior to 10/2004 |
| HSA Portability | |||
| 3302 | HSA Transfer Request | 7/2013 | Any prior to 10/2004 |
| HSA Withdrawals | |||
| 3123 | HSA Excess Removal Worksheet | 10/2015 | |
| 3314 | HSA Withdrawal Authorization | 4/2015 | Any prior to 10/2004 |
| HSA Beneficiary Designations | |||
| 3121 | HSA Beneficiary Reminder Notice | 3/2014 | |
| 3301 | HSA Beneficiary Designation | 4/2015 | Any prior to 10/2004 |
| 3301-SU | HSA Beneficiary Designation Addendum | 4/2015 | |
| HSA Changes | |||
| 2310 | Investment Change | 3/2014 | |
| 3311 | HSA Information Change | 3/2014 | |
SEP Plan Establishment
| No. | Name | Current Version | Obsolete Version |
| 407 | SEP Contribution Statement | 1/2016 | Any prior to 9/2002 |
| Standard SEP Plan Prototype (Kit #400) | |||
| 400CW | About the Standard SEP/Adoption Agreement Instructions | 10/2017 | Any prior to 9/2002 |
| 418 | Standard SEP Adoption Agreement | 9/2002 | Any prior obsolete |
| 419 | Standard SEP Plan Document | 9/2002 | Any prior obsolete |
| 422 | Standard SEP Summary for Employees | 10/2017 | Any prior to 9/2002 |
| 423 | SEP Employer Eligibility Form | 1/2016 | Any prior to 9/2002 |
| Universal SEP Plan Prototype (Kit #410) | |||
| 408 | Universal SEP Adoption Agreement | 9/2002 | Any prior obsolete |
| 409 | Universal SEP Plan Document | 9/2002 | Any prior obsolete |
| 412 | Universal SEP Salary Reduction Agreement | 1/2016 | Any prior to 9/2002 |
| 413 | Universal SEP Summary for Employees | 10/2017 | Any prior to 9/2002 |
| 414 | Universal SEP Discrimination Test Worksheet | 1/2016 | Any prior to 12/96 |
| 423 | SEP Employer Eligibility Form | 1/2016 | Any prior to 9/2002 |
| 424 | About the Universal SEP | 10/2017 | Any prior to 9/2002 |
| 425 | Adoption Agreement Instructions | 10/2017 | Any prior to 9/2002 |
| 426 | Universal SEP Top-Heavy Test Worksheet | 1/2016 | Any prior to 4/2013 |
| 428 | Notification of Excess Elective Deferrals/Notification of Disallowed Deferrals | 1/2016 | Any prior obsolete |
| SEP Plan Prototype Employee Information Booklets | |||
| 411 | Universal SEP Employee Information Booklet | 10/2017 | Any prior to 1/2016 |
| 421 | Standard SEP Employee Information Handbook | 10/2017 | Any prior to 1/2016 |
| Government SEP Plan Booklet | |||
| 416 | 5305-SEP Plan Kit | 10/2017 | Any prior to 4/2002 |
SIMPLE IRA Plan Establishment
| No. | Name | Current Version | Obsolete Version |
| SIMPLE IRA Plan Prototype (Kit #600) | |||
| 600CW | About the SIMPLE IRA plan/Adoption Agreement Instructions | 10/2017 | |
| 615 | SIMPLE IRA Plan Eligibility Form | 10/2012 | |
| 616 | SIMPLE IRA Plan Salary Reduction Agreement | 10/2017 | Any prior to 9/2001 |
| 617 | SIMPLE IRA Plan Participation Notice & Summary Description | 10/2017 | Any prior to 3/2016 |
| 618 | SIMPLE IRA Plan Adoption Agreement | 9/2002 | Any prior obsolete |
| 619 | SIMPLE IRA Plan Basic Plan Document | 9/2002 | Any prior obsolete |
| Government SIMPLE IRA Plan Booklets | |||
| 516 | 5305-SIMPLE – For use with a DFI | 10/2017 | Any prior to 3/2016 |
| 517 | 5304-SIMPLE – Not subject to DFI rules | 10/2017 | Any prior to 3/2016 |
| Key | |
| A | Any prior to 10/2006 obsolete; versions dated 5/2002 through 3/2018 are obsolete unless accompanied by the appropriate disclosure statement amendment; strongly recommend the current version |
| B | Include use for managed and self-directed trust accounts. |
| C | Versions dated 1/2009 through 7/2013 require a disclosure statement amendment; strongly recommend the current version. |
| D | Any prior to 10/2014 are obsolete unless accompanied by the appropriate disclosure statement amendment; strongly recommend the current version. |
| E | Any prior to 5/2012 are obsolete unless accompanied by the appropriate disclosure statement amendment; strongly recommend the current version. |
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Versions prior to 3/2016 should be used with caution regarding rollovers to SIMPLE IRAs. |
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Versions prior to 4/2008 should be used with caution regarding automatic rollovers to inherited IRAs. |
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Versions prior to 4/2006 should not be used for Roth IRAs. |
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Versions prior to 10/2006 do not contain instruction for use with qualified reservist distributions and, versions prior to 3/2018 do not contain instructions for use with distributions taken due to certain federally-declared disasters. |
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Versions prior to 8/2005 should be used with caution regarding revocations. |
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Versions prior to 1/2007 should not be used to request or to certify a rollover of inherited retirement plan assets into an inherited IRA. |
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Prior versions should be used with caution regarding recharacterizations. |
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Versions prior to 4/2008 should be used with caution regarding rollovers of designated Roth contributions. |
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10/2018 versions should not be used until January 1, 2019. All prior versions are obsolete after December 31, 2018. |
Lobby Brochure Checklist
Qualified Retirement Plan Forms Checklist