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Account Identification ROTH IRA CUSTODIAN S NAME, ADDRESS AND PHONE Home Phone Contribution Date Business Phone Contribution For Tax Year Contribution Type Regular or Spousal Transfer (from Roth IRA) Rollover (from Roth IRA) Conversion Recharacterization Contribution Amount Check here if this is an amendment to an existing Roth IRA. DESIGNATION OF BENEFICIARY(ies) The following individual(s) or entity(ies) shall be my primary and/or contingent beneficiary(ies). If neither primary nor.

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