Read 130714_RMD.pdf text version

Required Minimum Distribution Request

InstructIons Use this form to request a withdrawal to satisfy your IRS Required Minimum Distribution (RMD). This form can be used to request a one time RMD withdrawal or to set up automatic distributions to satisfy current and all future RMD withdrawals. If the contract for this request is a Beneficiary IRA or Stretch account please use form 1307195. PLEASE NOTE: If you have previously requested your RMD to be automated with John Hancock you do not need to resubmit this form unless you are requesting changes to be made to the existing program.

· Any withdrawals taken from your annuity during the current tax year may be considered for meeting your RMD amount. Please take this into consideration if you are also participating in a systematic withdrawal program or have taken prior withdrawals during the current year. · Signature Guarantees are required when a withdrawal check is being mailed to an alternate address, when there has been an address change within the last 30 days, or when a withdrawal in the amount of $100,000 or more is requested. Any of these requests requiring a Signature Guarantee must be original, facsimiles will not be accepted. Signature Guarantees are used to help protect you against fraud and may be obtained at most banks, financial institutions or credit unions. · Certain annuity contracts with Guaranteed Rate Period accounts may assess a Market Value Adjustment to your withdrawal amount.

We recommend that you review your contract and/or prospectus for further details regarding the impact of withdrawals. 1. InformatIon about You

Contract #: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Owner's Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Owner's DOB: _ _ _ _ _ _ _/ _ _ _ _ _ _ _ _/ _ _ _ _ _ _ _ _ _ _ _ _ (mm/dd/yyyy) Advisor's Name (if applicable): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Owner's Phone #: ( _ _ _ _ _ _) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Social Security #/TIN: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Spouse's DOB: _ _ _ _ _ _ _/ _ _ _ _ _ _ _ _/ _ _ _ _ _ _ _ _ _ _ _ _ (mm/dd/yyyy) Advisor's Phone #: ( _ _ _ _ _ _) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Check here to use the Joint Life Expectancy calculation. To be eligible for this calculation your sole designated beneficiary at all times during the year must be your spouse who is more than 10 years younger than you. If you choose this option please be sure to include your spouse's date of birth in the space provided above. 2. DIstrIbutIon InstructIons (Please select a or B) A) Automatic Distribution Program (Default) ­ Your RMD will be sent each year automatically

New Program

Frequency

Change Existing Program Quarterly Semi-annually

Terminate RMD Program Annually (Default)

Monthly

Start distributions on _ _ _ _ _ _ _ _ _/ _ _ _ _ _ _ _ _ _ _/ _ _ _ _ _ _ _ _ _ _ _ _ _ (mm/dd/yyyy)* ­ Select a day of the month between the 1st and the 28th.

Check here if you turned 701/2 last year and would like to take your previous year's distribution immediately. This option is only available if the distribution is occurring prior to April 1 of the current year, and will be paid in full. Please indicate when you would like to start your current year distribution. B) One Time Distribution** ­ Your RMD amount will be calculated and sent for the current year only.

Distribute on: _ _ _ _ _ _ _ _ _/ _ _ _ _ _ _ _ _ _ _/ _ _ _ _ _ _ _ _ _ _ _ _ _ (mm/dd/yyyy)* ­ Select a day of the month between the 1st and the 28th.

*Withdrawals will commence on the first available business day if: 1) no start date is indicated, 2) the selected date falls on a non-business day, 3) the form is received after 4pm EST, or 4) the form is received AFTER the requested start date. ** If the contract has an existing RMD Automatic Distribution Program it will be stopped after the One Time Distribution. If you have a variable annuity, your withdrawal(s) will be taken proportionately from each of your portfolio options. 3. PrevIous carrIer rmD calculatIon

If this contract was established on or after January 1st of the current year, this information is required. Current Year's Required Minimum Distribution amount as calculated by your previous carrier $ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

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Required Minimum Distribution Request (continued)

4. feDeral Income taX WItHHolDInG (Please select one)

Note: If no option is selected, John Hancock will automatically withhold 10% for federal income tax. State withholding is required in certain states if federal income taxes are withheld. Please DO NOT withhold federal income tax Please withhold $ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ or _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _%

Notice of Income Tax Withholding:

The taxable portion of a full or partial withdrawal or distribution from an annuity contract is considered ordinary income for tax purposes. John Hancock is required to withhold federal taxes (and state taxes where applicable) from any withdrawal, unless you elect otherwise and provide your social security number or taxpayer ID number. Distributions you receive from qualified pension or tax-sheltered annuities that are eligible to be rolled over tax-free to an IRA or qualified plan are subject to a flat 20% withholding rate. Required Minimum Distributions (RMDs) are not eligible to be rolled over. The 20% withholding rate is required and you cannot choose not to have income tax withheld from eligible rollover distributions. A direct transfer from a plan trustee to another plan trustee or an IRA, however, is not treated as a distribution and is not subject to withholding. Withholding is a method of paying taxes that you may owe. Your tax liability is the same whether or not taxes are withheld at the time of each withdrawal. If you elect not to have taxes withheld from your withdrawal, or you do not have enough taxes withheld, you may be responsible for payment of estimated taxes. You may also be subject to tax penalties under the estimated tax payment rules if your payments of estimated tax and withholding, if any, do not meet IRS guidelines. We suggest that you consult your tax professional if you have any questions about tax withholding.

5. DelIverY oPtIons (Please select a, B or c)

A) B)

Mail to address of record (default) Mail to alternate address (Signature Guarantee required)

Alternate Address:

Fax requests are not an acceptable for this option. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

STREET ADDRESS CITY STATE ZIP

C) Electronic Fund Transfer (EFT)** **ImPortant: Please attach a voided check to this request. Deposit slips and starter checks are not accepted. The voided check must be in the same name of the contract owner. Please allow two business days from each withdrawal date for the payment to be credited to your bank account.

6. autHorIZatIon I hereby certify the information on this form is correct and accurate and that I have read and understand all three (3) pages of this form. I also authorize John Hancock to make the withdrawal in accordance with my designation noted on this form. By signing below, I understand that this request is subject to all the terms and conditions of the contract and prospectus. I also understand that once this distribution is made and released by John Hancock, it will not be reinstated to this contract. I direct John Hancock to make the disbursement in accordance with the designation on this form. Furthermore, I certify that the Social Security/Taxpayer Identification Number provided on this form is correct and that I am not subject to backup withholding.

Signature of Owner: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Date: _ _ _ _ _ _ _ _ / _ _ _ _ _ _ _ _ / _ _ _ _ _ _ _ _ _ _ _

Signature Guarantee Stamp

(if applicable)

7. contact InformatIon

Mailing Address: Service Center John Hancock Annuities

PO Box 9505 Portsmouth, NH 03802-9505

Overnight Deliveries: Service Center John Hancock Annuities

164 Corporate Drive Portsmouth, NH 03801-6815

1-877-JHF-FORM (877-543-3676)

7 1-617-663-3160 (FAX)

www.jhannuities.com

John Hancock Life Insurance Company (U.S.A.) (not licensed in New York), John Hancock Life Insurance Company, John Hancock Variable Life Insurance Company (not licensed in New York)

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Please keep this page for your records.

aDDItIonal InformatIon about reQuIreD mInImum DIstrIbutIons (rmD) IRAs and 403(b)s were created to encourage tax-deferred savings for retirement. However, IRAs and 403(b)s cannot be used to permanently shelter these assets from income tax. IRA owners must begin taking distributions from their IRAs no later than April 1st of the year following the attainment of age 701/2. For 403(b)s, the beginning date is generally the April 1st following the later of attainment of age 701/2 or retirement. These distributions are called "required minimum distributions." Note, RMDs are withdrawal minimums dictated by the Internal Revenue Code. Once you have reached your required beginning date and begin taking RMDs, in any given year, you may always take out more than required, but no less than the required minimum. Once an IRA owner reaches their required beginning date for taking distributions, John Hancock must report to the IRS that the IRA owner is required to receive a minimum distribution for that year. See below for additional information if you have multiple IRAs or 403(b)s. A new Treasury Department rule, effective on January 1, 2006, will impact calculations of RMDs for IRAs and 403(b)s that are invested in variable annuity contracts. In order to determine an account holder's RMD amount, the "entire interest" under the contract will have to be used in the new calculation. The new regulation defines the entire interest under the contract as the 12/31 account value of the prior calendar year plus the actuarial value of any additional benefits provided under the contract. This new calculation mainly impacts contracts issued with a rider benefit such as Guaranteed Minimum Death Benefit (MGDB) or Guaranteed Living Benefit (GLB). The actuarial present value of these additional benefits will be included to determine RMDs beginning in January 2006 and for subsequent years. John Hancock would like to assure our contract holders that we will continue to assist them with calculating their RMD amount each year. We would also like to assure our contract holders who are receiving RMDs via John Hancock's automated RMD program that we will calculate and distribute your RMD in accordance with the new rule. For these contract holders, no further action is required at this time. Provided below is some general information on required minimum distributions. This is for information purposes only and should not be construed as tax or legal advice. Distributions from retirement plans can be complex and we encourage you to consult a tax or legal adviser for assistance. In addition, you should review IRS Publication 590, Individual Retirement Arrangements (IRAs), or Publication 571, Tax Sheltered Annuity (TSA) Programs for Employees of Public Schools and Certain Tax-Exempt Organizations, as applicable, which are available from the internet at www.irs.gov or by calling 800-829-3676. Required Beginning Date ­ By April 1st following attainment of age 701/2 for IRA's; for 403(b), by April 1st following the later of attainment of age

701/2 or retirement.

Due Date For Distribution ­ Distributed by April 1st noted above for the first distribution calendar year and by December 31st for each subsequent year. First Distribution Year ­ For the first year only, you may delay your first year's distribution payment up to April 1st of the year following the year you

turn 701/2 (or, for 403(b)s the year you retire if later). Otherwise, distributions must be made by December 31st. If you choose to delay your initial payment, you must take two distributions (one for your 701/2 year and one for your 71st year) in that year.

Aggregation of Multiple IRAs or 403(b) ­ The RMDs are calculated separately for each IRA and TSA you own. IRAs may only be aggregated with

IRAs, and 403(b)s may only be aggregated with 403(b)s. The actual distribution may be taken from any one or more of your IRAs to satisfy your IRA RMD requirement, and from one or more of your 403(b)s to satisfy your 403(b) RMD requirement. distributed as required.

50% IRS Penalty Tax ­ If you fail to withdraw the required minimum in any given year, the IRS may impose a 50% excise tax on the amount not Uniform RMD Table ­ Investors in qualified accounts are typically required to use the Uniform Life Expectancy Table when calculating their RMDs.

Except in certain circumstances discussed in the Joint Life RMD Table section below, this table is used regardless of whether the desired payout is a single life or joint life. This table generally assumes a joint life expectancy payout where the joint life is exactly 10 years younger than the IRA or TSA holder, regardless of actual age difference.

Joint Life RMD Table ­ If an account owner's spouse is the sole beneficiary of his or her IRA or 403(b) and is also more than ten (10) years younger

than the owner, the Joint Life Table may be used to "stretch," the distributions over the couple's joint life expectancy. To qualify for this "spousal exception," the account owner's spouse must be the sole beneficiary of the owner's interest at all times during the distribution year.

Beneficiary IRA ­ If you inherit an IRA from someone other than your spouse and if the owner has died before his or her required beginning date,

the IRS requires that minimum distribution payments begin by December 31 of the year following the year of death of the IRA owner. These may be based on the beneficiary's life expectancy using the Single Life Table. If the owner dies after the required beginning date, distributions to the beneficiary must continue at least as rapidly as under the owner's RMD method. If you inherit the IRA or 403(b) from your spouse, as a surviving spouse you may have other options. For example, if the IRA or 403(b) owner dies prior to their required beginning date a spousal beneficiary may delay taking RMDs, until the year the decedent would have reached age 701/2. If the IRA or 403(b) owner dies after the required beginning date, and certain conditions are satisfied, the spousal beneficiary may elect to become owner of the IRA, and roll the IRA assets into their own IRA. In either event RMD payments would begin when the surviving spouse attains age 701/2.

Surrender Penalty ­ John Hancock is not currently charging surrender penalties on RMDs as long as the request is made under the following conditions:

a) the owner submits an RMD request using a John Hancock RMD form, and b) the distribution amount requested is equal to the RMD calculations for the aggregated IRAs or 403(b)s held at John Hancock. Surrender penalties will apply if the distribution amount is greater than the contract free amount and in excess of the RMD amount.

John Hancock employees do not provide tax advice. Our intention in providing this form is to enable you to conveniently establish your Required Minimum Distribution. You should consult with your tax advisor if you have any questions about this or any other tax matter. John Hancock Life Insurance Company (U.S.A.) (not licensed in New York), John Hancock Life Insurance Company, John Hancock Variable Life Insurance Company (not licensed in New York)

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