EX-99.(Q)(5) 5 d816960dex99q5.htm (Q)(5) IRA DISTRIBUTION REQUEST FORM (TRI-CON) (q)(5) IRA Distribution Request Form (Tri-Con)

Tri-Continental Corporation

IRA Distribution Request Form

Use this form when requesting a distribution from an Individual Retirement Account (IRA).

For questions about tax implications, you may wish to consult with a financial advisor or tax advisor about any applicable taxes and/or penalties. Tax implications vary based on the type of distribution. Distribution rules for an Inherited IRA are based on several factors. We encourage you to review the Individual Retirement Account Custodial Agreement for beneficiary provisions.

Part 1

Depositor Information: (Please type or print.)

 

 

Please check if you are changing your address of record. A Medallion Signature Guarantee is required.

Part 2

IRA Account Registration: (Please choose only one.)

 

 

Part 3

Type Of Distribution: (Please choose only one.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part 4

Federal and State Income Tax Withholding: (Choose A or B below.)

Please make your election below. Elections pertaining to the Systematic Withdrawal Plan, in the section for Distribution Options, may be revoked at any time. All other elections will be for this one-time use. Please note, if no federal election is made, 10% of your distribution will be withheld for federal income taxes (applicable state taxes may also apply).

For assistance completing this form, please contact a representative at 800.345.6611 option 3, Monday through Friday, 9:00 a.m. to 6:00 p.m. Eastern time.

CT-FR/113352 B (11/18)

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CT-FR/113352 B (11/18)

Part 5 Payment Instructions: (Please choose one election in either section A or B and complete section C if applicable.)

A. Stockholder or Authorized Individual Election:

1. Make the check payable to me and mail to the address of record.

2. Make check payable to and mail as indicated below in section C. Payee Information A Medallion Signature Guarantee is required.

3. Deposit directly to my bank account via Automated Clearing House (ACH). No fee is deducted from the mutual fund account.

a. Into my existing bank instructions on file. No Medallion Signature Guarantee is required.

b. Into new bank instructions. Complete Part 7 Bank Information. A Medallion Signature Guarantee is required.

4. Deposit directly to my bank account via Fedwire (must be $500.00 or greater). A fee of $7.50 will be deducted from the mutual fund account (additional bank fees may apply).

a. Into my existing bank instructions on file. No Medallion Signature Guarantee is required.

b. Into new bank instructions. Complete Part 7 Bank Information. A Medallion Signature Guarantee is required.

5. Invest my distribution into the non-IRA account referenced below:

 

 

 

 

 

a. Existing Tri-Continental Corporation non-IRA. Fund number

 

 

Account number

 

 

 

 

 

 

 

 

b. Existing Columbia Threadneedle Investments non-IRA. Fund number

 

 

Account number

 

 

 

 

 

 

 

 

 

 

c. New Columbia Threadneedle Investments non-IRA. (Please attach a new account application.)

6. Transfer my shares to the Tri-Continental Corporation IRA account referenced below. (Due to divorce only.):

A Medallion Signature Guarantee is required. Please include a copy of the final Divorce Decree. The language within the final

Divorce Decree must specifically state how the Tri-Continental Corporation IRA account(s) are to be distributed. Please reference the dollar amount, percentage or number shares of each account under the section for Distribution Options.

a. Existing Tri-Continental Corporation IRA. Fund number

 

Account number

b. New Tri-Continental Corporation IRA. (Former spouse must complete and attach an IRA application.)

B.Estate or Beneficiary Election: (Complete this section and section C. Payee Information, if you are acting as the Executor or Beneficiary. If you are acting as the Executor, a Signature Guarantee is required. If you are acting as the Beneficiary, a MSG or Signature Guarantee is required. A certified copy of the death certificate is required for the stockholder.)

1. Lump sum distribution. Please choose a payment option below:

a. Make check payable to and mail as indicated below in section C. Payee Information.

b. Direct deposit by ACH to the bank account listed in section C. Payee Information. No fee is deducted from the mutual fund account.

c. Direct deposit by Fedwire (must be $500.00 or greater) to the bank account listed in section C. Payee Information. A fee of $7.50 will be deducted from the mutual fund account (additional bank fees may apply).

2. Transfer the entire value to the spousal IRA account referenced below. (For spousal beneficiaries only.):

a. Existing Tri-Continental Corporation IRA. Fund number

 

Account number

b. New Tri-Continental Corporation IRA. (Please attach an IRA application.)

3. Transfer the inherited portion to the IRA account referenced below:

a. Existing Tri-Continental Corporation Inherited IRA. Fund number

 

Account number

b. New Tri-Continental Corporation Inherited IRA. (Please attach an IRA application.)

4. Invest the inherited portion to the non-IRA account referenced below:

 

 

 

 

 

a. Existing Tri-Continental Corporation non-IRA. Fund number

 

 

Account number

 

 

 

 

 

 

 

 

b. Existing Columbia Threadneedle Investments non-IRA. Fund number

 

 

Account number

 

 

 

 

 

 

 

 

 

 

c. New Columbia Threadneedle Investments non-IRA. (Please attach a new account application.)

C. Payee Information: (Tax Identification Number and Date of Birth required for death distributions.)

 

 

 

 

 

 

Beneficiary or Estate

 

Beneficiary

 

Payee or Beneficiary Name (First, Middle Initial, Last)

 

Tax Identification Number

 

Date of Birth (MM/DD/YYYY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street Address

City

 

State

Zip Code

Daytime Phone Number

Relationship to IRA Stockholder

 

Date of Death for IRA Stockholder (MM/DD/YYYY)

 

 

 

 

 

 

 

 

 

 

 

 

Bank Account Information (If applicable)

 

 

 

 

Name of Bank

Bank ABA Routing Number

Bank Account Number

Federal law requires us to obtain certain information from you, which we may use to verify your identity. If we are unable to verify this information, we reserve the right to close or limit your account.

For assistance completing this form, please contact a representative at 800.345.6611 option 3, Monday through Friday, 9:00 a.m. to 6:00 p.m. Eastern time.

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Part 6

Distribution Options: (Complete section A and/or B.)

 

 

About the sale of Tri-Continental Corporation shares:

 If you have outstanding stock certificates, you must send your stock certificates to the Service Agent (this is one of the requirements for your sell order to be considered received in "good form"). We recommend using registered mail when returning outstanding certificates for 2% of the current market value of the shares. The recommended insurance amount is based on the premium for a lost certificate bond in the event the certificate is lost in transit.

 Distributions for Tri-continental are generally priced one time per week, typically each Wednesday. A sell order received in "good form" on a Thursday will not be processed (and your shares not sold) until the following Wednesday, provided that the New York Stock Exchange is open for business on such day.

I authorize Tri-Continental Corporation or its Service Agent to liquidate the amount indicated from the account number(s) listed below.

A. One-time Full or Partial Distribution:

 

 

 

 

 

 

 

 

Number

Fund Number

 

Account Number

Dollar Amount

or

Percent

or

of Shares

 

 

 

$

 

 

 

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

%

 

B.Recurring Distribution (Complete section 1 and/or 2.)

Fund Selection

 

Fund Number

Account Number

1. Systematic Withdrawal Plan (Check only one.)

Add option

Update the existing option

Discontinue the existing option

 

Month

Year

 

 

a. Begin distributions in

 

 

 

 

.

 

 

b. Select frequency of periodic distributions (does not apply to cash dividends and capital gains.)

Note: Distributions will be processed on the 1st or 15th day of the month(s), regardless of whether or not the 1st or 15th falls on a Wednesday. If the selected date falls on a weekend or holiday, the transaction will be processed on the previous business date. Please specify the day you prefer. If no date is specified, your payment will default to the 15th

of the month.

 

 

.

 

 

 

 

 

 

All months or check all that apply.

January

February

March

April

May

June

 

 

 

 

 

July

August

September

October

November

December

 

 

 

 

 

 

 

 

 

 

 

c. Specify distribution

method:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dollar amount $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fixed period of

years. (not to exceed the joint life expectancy of stockholder and beneficiary)

 

Life expectancy (will apply to all accounts)

Required minimum distribution based on the uniform lifetime table in IRS regulations

Required minimum distribution based upon stockholder and beneficiary's joint life expectancy (In order to use this method, your spouse must be your sole primary beneficiary and more than 10 years younger than you.)

Life expectancy payments based on the single life expectancy table for beneficiaries in IRS regulations.

2.Distribution Payment Options (Penalties and taxes may apply if you are under the age of 59½. You may wish to consult with a tax advisor.)

a. Credited 75% to my account in shares and 25% paid to me in cash. b. Credited 50% to my account in shares and 50% paid in cash.

c.100% paid to me in cash. Indicate payment method:

a.Check to Address of Record

b.Direct Deposit to Bank by ACH (Complete the section for Bank Information)

For assistance completing this form, please contact a representative at 800.345.6611 option 3, Monday through Friday, 9:00 a.m. to 6:00 p.m. Eastern time.

CT-FR/113352 B (11/18)

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Note: If you choose to close your account, you will be subject to the $20 termination fee at that time. This fee is not prorated for periods of less than one full year.

For assistance completing this form, please contact a representative at 800.345.6611 option 3, Monday through Friday, 9:00 a.m. to 6:00 p.m. Eastern time.

CT-FR/113352 B (11/18)

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Part 7 Bank Information

ABA Routing

Bank Account

Number

Number

Check number

For assistance completing this form, please contact a representative at 800.345.6611 option 3, Monday through Friday, 9:00 a.m. to 6:00 p.m. Eastern time.

CT-FR/113352 B (11/18)

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Part 8

Signature and Taxpayer Identification Number Certification

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Affix Medallion Signature Guarantee stamp here.

Guarantor, please do not affix the guarantee unless all of the

information on this page has been complete.

The Service Agent may require a Medallion Signature Guarantee (MSG) or Signature Guarantee stamp for your signature in order to process certain transactions. A MSG or Signature Guarantee stamp may be executed by any eligible institution, including, but not limited to, the following: brokers or dealers, banks, credit unions, and savings associations. A MSG or Signature Guarantee helps assure that a signature is genuine and not a forgery. Notarization by a notary public is not an acceptable signature guarantee. The Service Agent reserves the right to reject a signature guarantee and to request additional documentation for any transaction. You may refer to the Fund's prospectus for more information.

For assistance completing this form, please contact a representative at 800.345.6611 option 3, Monday through Friday, 9:00 a.m. to 6:00 p.m. Eastern time.

CT-FR/113352 B (11/18)

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Part 9

 

Return Instructions

 

Regular mail

Tri-Continental Corporation

Overnight mail Tri-Continental Corporation

 

 

PO Box 219371

c/o DST Asset Manager Solutions, Inc.

 

 

Kansas City, MO 64121-9371

430 W 7th Street, STE 219371

 

 

 

Kansas City, MO 64105-1407

 

 

 

 

For assistance completing this form, please contact a representative at 800.345.6611 option 3, Monday through Friday, 9:00 a. m. to 6:00 p.m. Eastern time.

Columbia Threadneedle Investments (Columbia Threadneedle) is the global brand name of the Columbia and Threadneedle group of companies. Columbia Management Investment Services Corp. is the Service Agent for Tri-Continental Corporation.

© 2018 Columbia Management Investment Advisers, LLC. All rights reserved.

2196943 (11/18)

CT-FR/113352 B (11/18)

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