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Forms

As the owner of an account at CNB it is your responsibility to investigate each and every investment you select and/or hold within your account. Consult adequate legal, tax, or investment professionals for assistance and make sure you understand:

  • What you are investing in
  • How much risk is involved
  • Who you are investing with
  • Why the investment is suitable for you

Use these forms for IRA Accounts, for Non-Qualified Account forms click here.


New Account Forms
IRA Application

Includes the IRA Application, Custodial Agreement, Disclosure Statement, and Instructions for both a Traditional IRA and a Roth IRA.

IRA Application form PDF download DocuSign online form
Fee Schedule Fee Schedule form PDF download

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IRS Form 5305-SEP & Instructions IRS Form 5305-SEP & Instructions form PDF download DocuSign online form
RMD Form for New Accounts

Please complete for account owners 73 or older.  This is not applicable for ROTH IRAs.

RMD Form for New Accounts form PDF download DocuSign online form
Beneficiary Certification Form

This form is only required for Inherited IRAs that are transferring to CNB from another institution.

Beneficiary Certification Form form PDF download DocuSign online form
DocuSign Form Packets for New Accounts
IRA Application, Transfer Request, and Investment Authorization DocuSign online form
IRA Application & Transfer Request DocuSign online form
Transfer/Rollover/Contribution Forms
Transfer Request

Use to transfer funds into an IRA account.  To transfer funds out of CNB, please contact the receiving custodian for their transfer form.

Transfer Request form PDF download DocuSign online form
Rollover Deposit Statement Rollover Deposit Statement form PDF download DocuSign online form
Contribution Form Contribution Form form PDF download DocuSign online form
Roth Conversion Request Roth Conversion Request form PDF download DocuSign online form
Wire Instructions Wire Instructions form PDF download

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Purchase/Sale/Exchange Forms
Investment Authorization

Client signature required on all non-publically traded investments.

Investment Authorization form PDF download DocuSign online form
Real Estate Checklist

Use as a reference when purchasing real estate within an IRA

Real Estate Checklist form PDF download

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Real Estate Earnest Money Authorization Real Estate Earnest Money Authorization form PDF download DocuSign online form
Real Estate Purchase Form Real Estate Purchase Form form PDF download DocuSign online form
Real Estate Sale Form Real Estate Sale Form form PDF download DocuSign online form
Precious Metals Investment Authorization

Use only to purchase or sell a precious metal.

Precious Metals Investment Authorization form PDF download DocuSign online form
Precious Metals Disclosures & Instructions Precious Metals Disclosures & Instructions form PDF download

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Brokerage Account Establishment Instructions

Use for DVP & retail brokerage accounts.

Brokerage Account Establishment Instructions form PDF download

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Distribution Forms
Distribution Request Form

Use for IRA accounts only.

Distribution Request Form form PDF download DocuSign online form
Direct Deposit

Use only to update bank information.

Direct Deposit form PDF download DocuSign online form
Waiver to Distribute Required Minimum Distribution Waiver to Distribute Required Minimum Distribution form PDF download DocuSign online form
Claim of Premature Distribution Due to Total & Permanent Disability Claim of Premature Distribution Due to Total & Permanent Disability form PDF download DocuSign online form
IRS Form W-4R

Use to update your current withholding election.

IRS Form W-4R form PDF download DocuSign online form
Account Update Forms
Account Update Form

Use for All Account changes – address, phone, third party authorization, etc.

Account Update Form form PDF download DocuSign online form
Beneficiary Designation Form

Use to update the beneficiaries listed on your IRA.

Beneficiary Designation Form form PDF download DocuSign online form
Representative Designation Form

Use to add a representative to your account or change the representative currently listed on your account.

Representative Designation Form form PDF download DocuSign online form
Affidavit for Power of Attorney

Please include a copy of your Power of Attorney document with this form.

Affidavit for Power of Attorney form PDF download

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Online/Estatement Forms
Authorization for Representative Authorization for Representative form PDF download DocuSign online form
Authorization for Account Owner Authorization for Account Owner form PDF download DocuSign online form
Beneficiary Claim Forms
Beneficiary Claim (Deceased 2020 or After)

Use this form to claim a deceased account if the date of death occurred on or after 1/1/2020.

Beneficiary Claim (Deceased 2020 or After) form PDF download

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Beneficiary Claim (Deceased Before 2020)

Use this form to claim a deceased account if the date of death occurred before 1/1/2020.

Beneficiary Claim (Deceased Before 2020) form PDF download

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Beneficiary Election Options

Helpful Hints for Beneficiaries Claiming Decedent’s Account when death occurred prior to 1/1/20.

Beneficiary Election Options form PDF download

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Other IRA Forms
ACH Debit Authorization

Use to authorize periodic rent or mortgage payments to be sent by ACH to CNB

ACH Debit Authorization form PDF download DocuSign online form
Authorization For Advisory Fees Authorization For Advisory Fees form PDF download DocuSign online form
Change of Representative’s Firm Information

Use for address changes, broker/dealer changes, etc.  This form may also be used to resign on an account.

Change of Representative’s Firm Information form PDF download DocuSign online form
Divorce Transfer Form

Use this form to facilitate the division of an account as a result of divorce proceedings.

Divorce Transfer Form form PDF download DocuSign online form
DRS Sale Request

Use to redeem publicly traded stock through the direct registration system.

DRS Sale Request form PDF download DocuSign online form
Excess Contribution Distribution Form Excess Contribution Distribution Form form PDF download DocuSign online form
Periodic Transfer Request

Use only for outgoing periodic transfers of $15,000 or less.  Do not use for non-qualified accounts.

Periodic Transfer Request form PDF download DocuSign online form
Real Estate Expense Form Real Estate Expense Form form PDF download DocuSign online form
Real Estate Property Management Agreement Real Estate Property Management Agreement form PDF download DocuSign online form
Real Estate Valuation Form Real Estate Valuation Form form PDF download DocuSign online form
Recharacterization Form Recharacterization Form form PDF download DocuSign online form
New Account Forms
IRA Application

Includes the IRA Application, Custodial Agreement, Disclosure Statement, and Instructions for both a Traditional IRA and a Roth IRA.

IRA Application form PDF download DocuSign online form
Fee Schedule Fee Schedule form PDF download

n/a

IRS Form 5305-SEP & Instructions IRS Form 5305-SEP & Instructions form PDF download DocuSign online form
RMD Form for New Accounts

Please complete for account owners 73 or older.  This is not applicable for ROTH IRAs.

RMD Form for New Accounts form PDF download DocuSign online form
Beneficiary Certification Form

This form is only required for Inherited IRAs that are transferring to CNB from another institution.

Beneficiary Certification Form form PDF download DocuSign online form
DocuSign Form Packets for New Accounts
IRA Application, Transfer Request, and Investment Authorization DocuSign online form
IRA Application & Transfer Request DocuSign online form
Transfer/Rollover/Contribution Forms
Transfer Request

Use to transfer funds into an IRA account.  To transfer funds out of CNB, please contact the receiving custodian for their transfer form.

Transfer Request form PDF download DocuSign online form
Rollover Deposit Statement Rollover Deposit Statement form PDF download DocuSign online form
Contribution Form Contribution Form form PDF download DocuSign online form
Roth Conversion Request Roth Conversion Request form PDF download DocuSign online form
Wire Instructions Wire Instructions form PDF download

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Purchase/Sale/Exchange Forms
Investment Authorization

Client signature required on all non-publically traded investments.

Investment Authorization form PDF download DocuSign online form
Real Estate Checklist

Use as a reference when purchasing real estate within an IRA

Real Estate Checklist form PDF download

n/a

Real Estate Earnest Money Authorization Real Estate Earnest Money Authorization form PDF download DocuSign online form
Real Estate Purchase Form Real Estate Purchase Form form PDF download DocuSign online form
Real Estate Sale Form Real Estate Sale Form form PDF download DocuSign online form
Precious Metals Investment Authorization

Use only to purchase or sell a precious metal.

Precious Metals Investment Authorization form PDF download DocuSign online form
Precious Metals Disclosures & Instructions Precious Metals Disclosures & Instructions form PDF download

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Brokerage Account Establishment Instructions

Use for DVP & retail brokerage accounts.

Brokerage Account Establishment Instructions form PDF download

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Distribution Forms
Distribution Request Form

Use for IRA accounts only.

Distribution Request Form form PDF download DocuSign online form
Direct Deposit

Use only to update bank information.

Direct Deposit form PDF download DocuSign online form
Waiver to Distribute Required Minimum Distribution Waiver to Distribute Required Minimum Distribution form PDF download DocuSign online form
Claim of Premature Distribution Due to Total & Permanent Disability Claim of Premature Distribution Due to Total & Permanent Disability form PDF download DocuSign online form
IRS Form W-4R

Use to update your current withholding election.

IRS Form W-4R form PDF download DocuSign online form
Account Update Forms
Account Update Form

Use for All Account changes – address, phone, third party authorization, etc.

Account Update Form form PDF download DocuSign online form
Beneficiary Designation Form

Use to update the beneficiaries listed on your IRA.

Beneficiary Designation Form form PDF download DocuSign online form
Representative Designation Form

Use to add a representative to your account or change the representative currently listed on your account.

Representative Designation Form form PDF download DocuSign online form
Affidavit for Power of Attorney

Please include a copy of your Power of Attorney document with this form.

Affidavit for Power of Attorney form PDF download

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Online/Estatement Forms
Authorization for Representative Authorization for Representative form PDF download

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Authorization for Account Owner Authorization for Account Owner form PDF download DocuSign online form
Beneficiary Claim Forms
Beneficiary Claim (Deceased 2020 or After)

Use this form to claim a deceased account if the date of death occurred on or after 1/1/2020.

Beneficiary Claim (Deceased 2020 or After) form PDF download

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Beneficiary Claim (Deceased Before 2020)

Use this form to claim a deceased account if the date of death occurred before 1/1/2020.

Beneficiary Claim (Deceased Before 2020) form PDF download

n/a

Beneficiary Election Options

Helpful Hints for Beneficiaries Claiming Decedent’s Account when death occurred prior to 1/1/20.

Beneficiary Election Options form PDF download

n/a

Other IRA Forms
ACH Debit Authorization

Use to authorize periodic rent or mortgage payments to be sent by ACH to CNB

ACH Debit Authorization form PDF download DocuSign online form
Authorization For Advisory Fees Authorization For Advisory Fees form PDF download DocuSign online form
Change of Representative’s Firm Information

Use for address changes, broker/dealer changes, etc.  This form may also be used to resign on an account.

Change of Representative’s Firm Information form PDF download

n/a

Divorce Transfer Form

Use this form to facilitate the division of an account as a result of divorce proceedings.

Divorce Transfer Form form PDF download DocuSign online form
DRS Sale Request

Use to redeem publicly traded stock through the direct registration system.

DRS Sale Request form PDF download DocuSign online form
Excess Contribution Distribution Form Excess Contribution Distribution Form form PDF download DocuSign online form
Periodic Transfer Request

Use only for outgoing periodic transfers of $15,000 or less.  Do not use for non-qualified accounts.

Periodic Transfer Request form PDF download DocuSign online form
Real Estate Expense Form Real Estate Expense Form form PDF download DocuSign online form
Real Estate Property Management Agreement Real Estate Property Management Agreement form PDF download DocuSign online form
Real Estate Valuation Form Real Estate Valuation Form form PDF download DocuSign online form
Recharacterization Form Recharacterization Form form PDF download DocuSign online form

NOTE: These forms are in Portable Document Format (PDF) and you will need Adobe Acrobat Reader to view them. Click on the Acrobat Reader icon and follow the instructions to download it if you do not have it. Our fillable pdf forms vary in size. Please allow sufficient time for them to download. If you experience a continued problem with a particular form on our website, please contact Community National Bank at (800)680-0340 or by e-mail at irainfo@cnbcustody.com