Common use of Custodial Fees Clause in Contracts

Custodial Fees. $15.00 annual maintenance fee per unique social security number. This fee is owed and due for each full and partial calendar year that the IRA Account is open. The participant may pay the fee with funds other than those in the IRA Account ("non-custodial funds"). If the fee for a calendar year is not paid by the participant from non-custodial funds by the date designated by the Custodian, the Custodian is authorized to deduct the fee from funds in the IRA Account at any time immediately after such payment due date. The Custodian is authorized to change the fee but will give at least 30 days written notice to the participant of any fee change. The Custodian will keep those records, identify and file returns and provide other information concerning the IRA as required of custodians by the Internal Revenue Code and any regulations issued or forms adopted by the Internal Revenue Service or U.S. Treasury Department. Pacific Life Funds will pay the fee on your behalf for accounts that: 1) elect the e-Delivery option or 2) have aggregated assets under the same Social Security Number greater than $15,000 on the fee deduction date. I understand that the telephone transaction privileges will apply to my account. If I have telephone transaction privileges, I agree that neither the Custodian, Pacific Funds, nor their transfer agent, their agents, officers, trustees, directors or employees will be liable for any loss, liability or expense for acting, or refusing to act on instructions given under the telephone transaction privileges that are reasonably believed to be genuine and I accept the risk of loss. I direct that all benefits upon my death be paid as indicated on the beneficiary designation. I (the Participant) certify under penalties of perjury that (i) all information I have provided on this form or otherwise in connection with establishing my IRA is true, correct, and complete, and (ii) I am a US person (including a US resident alien) and that my Social Security Number is true, correct and complete and that this number is my Taxpayer Identification Number. (Foreign persons must use appropriate Form W-8). To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies persons opening accounts; To comply, the Custodian requires the participant's name, address, date of birth and government-issued identification number (generally, a Social Security Number) and other information that may help the Custodian identify the participant; and the Custodian may ask for copies of related documentation and may consult third-party databases to help verify the participant's identity. I have read and I understand the Disclosure Statement which explains the risks of opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in accordance with U.S. Government requirements. SIGN HERE Shareholder’s/Responsible Individual’s Signature Date Custodian: BNY Mellon Investment Servicing Trust Company, 0000 Xxxxxxxx Xxxxx, Xxxxxxxxxxx, XX 00000 Distributor: Pacific Select Distributors, LLC (member FINRA & SPIC) a subsidiary to Pacific Life Insurance Company. Shares of Pacific Funds are offered by the distributor. The distributor is not a bank, and shares of the Fund are not deposits or obligations of, or guaranteed or endorsed by any bank, nor are they federally insured or otherwise supported by the FDIC, the Federal Reserve Board or any other agency. The distributor has instituted a Client Identification Program in its obligations under the U.S.A. Patriot Act (Act). This important federal regulation is designed to prevent, deter, and, where necessary, prosecute those who seek to manipulate the U.S. financial system. Consistent with the Act, the provisions of the distributor’s Client Identification Program serve to reinforce key elements of a broker/dealers responsibility of becoming familiar with its clients. The distributor may therefore ask you to provide identification documents or other information. Should you ever have a complaint regarding your account, contact us at the following address: Pacific Select Distributors, LLC Attn: Compliance Department 000 Xxxxxxx Xxxxxx Xxxxx Xxxxxxx Xxxxx, XX 00000 Telephone: 000-000-0000 TRADITIONAL and XXXX INDIVIDUAL RETIREMENT ACCOUNT (IRA) COMBINED DISCLOSURE STATEMENT The following information is the disclosure statement required by federal tax regulations. You should read this Disclosure Statement, the Custodial Account Agreement and the prospectuses for the mutual funds in which your Individual Retirement Account (“IRA”) contributions will be invested. The rules governing IRAs are subject to change. You should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site xxx.xxx.xxx for updated rules and requirements. IMPORTANT INFORMATION ABOUT U.S. GOVERNMENT REQUIREMENTS THAT MAY AFFECT YOUR ACCOUNT BNY Mellon Investment Servicing Trust Company (“BNY Mellon”, “we” or “us”), provides custodial and administrative services for your retirement or savings account. As a result of this role, persons who open a retirement or savings account are considered ‘customers’ of BNY Mellon (“you” or “your”). To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires BNY Mellon, as a financial institution, to obtain, verify, and record information that identifies each person who opens an account. All accounts we open are opened on a conditional basis – conditioned on our ability to verify your identity in accordance with Federal law. When establishing an account, you are required to provide your full legal name, address, government issued identification number (e.g. social security number), date of birth, and other information within your account-opening application that will allow us to identify you. We may also request a copy of your driver’s license or other identifying documents and may consult third-party databases to help verify your identity. If the account you are opening will be registered in the name of a beneficiary, trust, or estate or charity, we may require additional identifying documentation. If you fail to provide any requested identifying information or documentation when opening your account, your new account application may be rejected. If we open your account, and you subsequently fail to provide all identification materials we request or if we are subsequently unable to adequately verify your identity as required by U.S. Government regulations, we reserve the right to take any one or more of the following actions:  We may place restrictions on your account which block all purchase transactions and we may place additional restrictions on your account blocking other transactional activities if we determine such additional restrictions are appropriate under Federal law or regulation.  We may close your account, sell (i.e., "liquidate") the assets in your account in the prevailing market at the time, and send you a check representing the cash proceeds of your account. This distribution will be reported to the Internal Revenue Service and may result in unfavorable consequences to you under Federal and state tax laws. You May Incur Losses. Despite being opened as a conditional account, your account will be invested as you instruct and you will be subject to all market risks during the period between account opening and any liquidation necessitated by your failure to furnish requested identifying information or by an inability to adequately verify your identity. You may also be subject to additional market risks if the additional transactional restrictions discussed above are placed on your account. In addition, the closing of your account may subject you to fees and charges imposed by a sponsor, issuer, depository or other person or entity associated with one or more of the assets in which you are invested, and any sales charges you may have paid in connection with your purchases will not be refunded. You Assume All Responsibility For These Losses. BNY Mellon expressly disclaims any responsibility or liability for losses you incur as result of your failure to furnish identification materials we request, including investment losses and any other loss or damage (including but not limited to lost opportunities and adverse tax consequences). If you proceed with the account opening process, you accept all risks of loss resulting from any failure of yours to furnish the identification materials we request or from a subsequent inability to adequately verify your identity in accordance with Federal law or regulation.

Appears in 2 contracts

Samples: Adoption Agreement, assets-global.website-files.com

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Custodial Fees. $15.00 20.00 annual maintenance fee per unique social security numberaccount per year. This fee is owed and due for each full and partial calendar year that the IRA Account is open. The participant may pay the fee with funds other than those in the IRA Account ("non-custodial funds"). If the fee for a calendar year is not paid by the participant from non-custodial funds by the date reasonably designated by the CustodianCustodian or prior to closing the IRA Account, the Custodian is authorized to deduct the fee from funds in the IRA Account at any time immediately after such payment due datedate or immediately after receiving instructions to close the IRA Account. The Custodian is authorized to change the fee but will give at least 30 days written notice to the participant of any fee change. The Custodian will keep those records, identify and file returns and provide other information concerning the IRA as required of custodians by the Internal Revenue Code and any regulations issued or forms adopted by the Internal Revenue Service IRS or U.S. Treasury Department. Pacific Life Funds will pay the fee on your behalf for accounts that: 1) elect the e-Delivery option or 2) have aggregated assets under the same Social Security Number greater than $15,000 on the fee deduction date. I understand that the telephone transaction privileges will apply to my account. If I have telephone transaction privileges, I agree that neither the Custodian, Pacific Funds, nor their transfer agent, their agents, officers, trustees, directors or employees will be liable for any loss, liability or expense for acting, or refusing to act on instructions given under the telephone transaction privileges that are reasonably believed to be genuine and I accept the risk of loss. I direct that all benefits upon my death be paid as indicated on the beneficiary designation. If I named a beneficiary that is a Trust, I understand I must provide certain information concerning such Trust to the Custodian. I understand that, if I am subject to community property or marital property state requirements, my spouse may be required to consent to any beneficiary I designate who is not my spouse, or who is in addition to my spouse. I also understand that any beneficiary designation I make, other than my spouse, may not be effective without my spouse’s consent. I certify, under penalty of perjury, if I am married and have not named my spouse as my sole Primary Beneficiary, I have consulted a qualified tax or legal professional about the need to document spousal consent, and about the consequences of not obtaining my spouse’s consent. I (the Participant) certify under penalties of perjury that (i) all information I have provided on this form or otherwise in connection with establishing my IRA is true, correct, and complete, and (ii) I am a US person (including a US resident alien) and that my Social Security Number is true, correct and complete and that this number is my Taxpayer Identification Number. (Foreign persons must use appropriate Form W-8). ) To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies persons opening accounts; . To comply, the Custodian requires the participant's name, address, date of birth and government-issued identification number (generally, a Social Security Number) and other information that may help the Custodian identify the participant; and the Custodian may ask for copies of related documentation and may consult third-party databases to help verify the participant's identity. I have read and I understand the Disclosure Statement which that explains the risks of opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in accordance with U.S. Government requirements. SIGN HERE Shareholder’s/X Signature: Date: (Responsible Individual’s Signature Date Individual in the case of a xxxxx XXX) IRA Custodian: BNY Mellon Investment Servicing Trust Company, 0000 Xxxxxxxx Xxxxx, Xxxxxxxxxxx, XX 00000 DistributorMail to the following: Pacific Select Distributors, LLC (member FINRA & SPIC) a subsidiary to Pacific Life Insurance Company. Shares of Pacific First Class Mail: Overnight Mail: Customer Service: Meridian Funds are offered by the distributor. The distributor is not a bank, and shares of the Fund are not deposits or obligations of, or guaranteed or endorsed by any bank, nor are they federally insured or otherwise supported by the FDIC, the Federal Reserve Board or any other agency. The distributor has instituted a Client Identification Program in its obligations under the U.S.A. Patriot Act (Act). This important federal regulation is designed to prevent, deter, and, where necessary, prosecute those who seek to manipulate the U.S. financial system. Consistent with the Act, the provisions of the distributor’s Client Identification Program serve to reinforce key elements of a broker/dealers responsibility of becoming familiar with its clients. The distributor may therefore ask you to provide identification documents or other information. Should you ever have a complaint regarding your account, contact us at the following address: Pacific Select Distributors, LLC Attn: Compliance Department 000 Xxxxxxx Xxxxxx Xxxxx Xxxxxxx Xxxxx, XX 00000 Telephone: Meridian Funds 0-000-000-0000 TRADITIONAL P.O. Box 9792 Providence, RI 02940 0000 Xxxxxxxx Xxxxx Xxxxxxxxxxx, XX 00000 Dealer or Advisor Designation (If you do not have a Dealer or Advisor assisting you with this transaction, please leave this section blank.) Firm Name: Firm Number: Representative’s Name: Rep. Number: Telephone: ( ) Branch Number: Branch Address: BNY MELLON INVESTMENT SERVICING TRUST COMPANY Supplement to the Traditional and XXXX INDIVIDUAL RETIREMENT ACCOUNT (IRA) COMBINED DISCLOSURE STATEMENT The following information is the disclosure statement required by federal tax regulations. You should read this Disclosure Statement, the Custodial Account Agreement and the prospectuses for the mutual funds in which your Xxxx Individual Retirement Account (IRA) contributions Disclosure Statement for Tax Year 2022 DEADLINE FOR 2021 CONTRIBUTIONS TO A TRADITIONAL OR XXXX XXX: Due to the Emancipation Day holiday observed in the District of Columbia, most eligible individuals will be invested. The rules governing IRAs are subject to change. You should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site xxx.xxx.xxx for updated rules and requirements. IMPORTANT INFORMATION ABOUT U.S. GOVERNMENT REQUIREMENTS THAT MAY AFFECT YOUR ACCOUNT BNY Mellon Investment Servicing Trust Company (“BNY Mellon”have until, “we” or “us”)Monday, provides custodial and administrative services for your retirement or savings account. As a result of this roleApril 18, persons who open a retirement or savings account are considered ‘customers’ of BNY Mellon (“you” or “your”). To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires BNY Mellon, as a financial institution2022, to obtainmake contributions to a traditional IRA or Xxxx XXX for 2021. Note that, verifydue to the Patriots’ Day holiday observed on April 18, 2022, in Massachusetts and record information that identifies each person who opens an accountMaine, eligible individuals residing in those two states only will have until Tuesday, April 19, 2022. All accounts we open are opened on a conditional basis – conditioned on our ability to verify your identity in accordance with Federal law. When establishing an accountFor more information, you are required to provide your full legal name, address, government issued identification number (e.g. social security number), date of birth, and other information within your account-opening application that will allow us to identify you. We may also request a copy of your driver’s license or other identifying documents and may consult third-party databases to help verify your identity. If the account you are opening will be registered in the name of a beneficiary, trust, or estate or charity, we may require additional identifying documentation. If you fail to provide any requested identifying information or documentation when opening your account, your new account application may be rejected. If we open your account, and you subsequently fail to provide all identification materials we request or if we are subsequently unable to adequately verify your identity as required by U.S. Government regulations, we reserve the right to take any one or more of the following actions:  We may place restrictions on your account which block all purchase transactions and we may place additional restrictions on your account blocking other transactional activities if we determine such additional restrictions are appropriate under Federal law or regulation.  We may close your account, sell (i.e., "liquidate") the assets in your account in the prevailing market at the time, and send you a check representing the cash proceeds of your account. This distribution will be reported please refer to the Internal Revenue Service (IRS) web site: xxx.xxx.xxx. 2022 IRA CONTRIBUTION LIMITS FOR TRADITIONAL AND XXXX XXX: The maximum allowable contribution to your IRAs (deductible, non-deductible, and may result in unfavorable consequences Xxxx) for the tax year remains unchanged and is the lesser of (a) $6,000 or (b) 100% of your earned income. For those who have attained or will attain the age of 50 before the close of the taxable year, the annual IRA contribution limit is increased by $1,000 (total of $7,000 for 2022). Any contribution made to you under Federal and state tax laws. You May Incur Losses. Despite being opened your IRA will be treated as a conditional accountcurrent year contribution recorded in the year it is received, your account will be invested as you instruct unless the contribution is made between January 1 and April 18, 2022 (or April 19, 2022, for eligible residents of Massachusetts and Maine), and you will have identified the contribution as a prior year contribution. Please consult IRS Publication 590-A, Contributions to Individual Retirement Arrangements (IRAs) for eligibility requirements and contribution restrictions. 2022 TRADITIONAL IRA INCOME TAX DEDUCTION: Your contribution to a traditional IRA may be subject to all market risks during the period between account opening and any liquidation necessitated by your failure to furnish requested identifying information or by an inability to adequately verify your identity. You may also be subject to additional market risks if the additional transactional restrictions discussed above are placed deductible on your accountfederal income tax return. In additionHowever, the closing of your account may subject you to fees and charges imposed by there is a sponsor, issuer, depository or other person or entity associated with one or more phase-out of the assets in which IRA deduction if you are invested, and any sales charges you may have paid an active participant in connection with your purchases will not be refundedan employer-sponsored retirement plan. You Assume All Responsibility For These Losses. BNY Mellon expressly disclaims any responsibility or liability for losses you incur The IRA deduction is reduced proportionately as result of your failure to furnish identification materials we request, including investment losses and any other loss or damage (including but not limited to lost opportunities and adverse tax consequences)modified adjusted gross income increases. If you proceed are not an active participant in an employer-sponsored retirement plan, there is a phase-out of the IRA deduction if you’re married based on whether or not your spouse is covered by a workplace retirement plan. Please consult IRS Publication 590-A, Contributions to Individual Retirement Arrangements (IRAs) for assistance in calculating your deductible contribution as it pertains to individual income and employer-sponsored retirement plan circumstances. Your contribution in excess of the permitted deduction will be considered a non-deductible contribution. DEDUCTION LIMIT - Effect of Modified AGI on Deduction – Covered by a Retirement Plan at Work TAX YEAR 2022 Full deduction if modified AGI is: Partial deduction if modified AGI is: No deduction if modified AGI is: Single Filers or Head of Household $68,000 or less More than $68,000 but less than $78,000 $78,000 or more Married - filing jointly or Qualified Widow(er) $109,000 or less More than $109,000 but less than $129,000 $129,000 or more Married - filing separately N/A Less than $10,000 $10,000 or more DEDUCTION LIMIT - Effect of Modified AGI on Deduction – You are NOT Covered by a Retirement Plan at Work (Spousal Coverage Considered) TAX YEAR 2022 Full deduction if modified AGI is: Partial deduction if modified AGI is: No deduction if AGI is: Married - filing jointly - spouse covered at work $204,000 or less More than $204,000 but less than $214,000 $214,000 or more Married - filing separately - spouse covered at work N/A Less than $10,000 $10,000 or more 2022 XXXX XXX CONTRIBUTION ELIGIBILITY: For 2022, your Xxxx XXX contribution limit is reduced (phased out) based on your modified AGI as follows: TAX YEAR 2022 Full contribution if modified AGI is: Partial contribution if modified AGI is: No contribution if AGI is: Married - filing jointly or Qualified Widow(er) $204,000 or less More than $204,000 but less than $214,000 $214,000 or more Married - filing separately N/A less than $10,000 $10,000 or more Single, Head of Household or Married - filing separately and you did not live with your spouse at any time during the year Less than $129,000 At least $129,000 but less than $144,000 $144,000 or more These limits may be adjusted from time to time by the IRS; please refer to Publication 590-A Contributions to Individual Retirement Arrangements (IRAs) for current year limits. REQUIRED DISTRIBUTIONS FROM A TRADITIONAL IRA: Note that the IRS Uniform Lifetime Distribution Period Table referenced in the Traditional IRA Disclosure Agreement for use in calculating Required Minimum Distributions (RMDs) has been updated. The updated Table is applicable for distribution calendar years beginning on or after January 1, 2022. Until such time as the IRS updates Publication 590-B, Distributions from Individual Retirement Arrangements (IRAs), the updated Tables can be found in the Federal Register article located at xxxxx://xxx.xxxxxxx.xxx/content/pkg/FR-2020-11-12/pdf/2020-24723.pdf. The Uniform Lifetime Table can be found on page 7 of 32 of the article. XXXX INDIVIDUAL RETIREMENT ACCOUNT DISCLOSURE EARLY DISTRIBUTIONS FROM A XXXX XXX: Early Distribution Penalty Tax – If you are under age 59½ and receive a nonqualified Xxxx XXX distribution, an additional early distribution penalty tax of 10% generally will apply to the amount includible in income in the year of the distribution. If you are under age 59½ and receive a distribution of conversion amounts or employer-sponsored retirement plan rollover amounts within the five-year period beginning with the account opening processyear in which the conversion or employer- sponsored retirement plan rollover occurred, you accept all risks an additional early distribution penalty tax of loss resulting from 10% generally will apply to the amount of the distribution. The additional early distribution penalty tax of 10% generally will not apply if one of the following exceptions apply. The 10% penalty tax is in addition to any failure of yours to furnish the identification materials we request or from a subsequent inability to adequately verify your identity in accordance with Federal law or regulationfederal income tax that is owed at distribution.

Appears in 2 contracts

Samples: meridianfund.com, www.arrowmarkpartners.com

Custodial Fees. $15.00 15 annual maintenance fee per unique social security number. This fee is owed and due for each full and partial calendar year that the IRA Account is openyear. The participant may pay prepay the fee with funds other than those in the IRA Account ("non-custodial funds")annual maintenance fee. If the fee for a calendar year is not paid by the participant from non-custodial funds by the date designated by the Custodianprepaid, the Custodian is authorized to will deduct the fee from funds in the IRA Account at any year-end or at the time immediately after such payment due datethe Account is closed. The Custodian is authorized reserves the right to change the fee custodial fee, but will give at least 30 days written notice to the participant Participant of any fee changechanges. The Custodian will keep those records, identify and file returns and provide other information concerning the IRA your Account as required of custodians Custodians by the Internal Revenue Code (IRC) and any regulations Regulations issued or forms adopted by the Internal Revenue Service or U.S. Treasury DepartmentDepartment of the United States. Pacific Life Funds will pay the fee on your behalf for accounts that: 1I hereby establish a Xxxx Individual Retirement Account (“Xxxx XXX”) elect the e-Delivery option or 2) have aggregated assets under the same Social Security Number greater than $15,000 on terms and conditions contained in the fee deduction dateaccompanying Custodial Account Agreement, which is incorporated herein by reference. The combined instrument is hereinafter referred to as the “Agreement”. I understand that acknowledge receipt of a copy of the telephone transaction privileges will apply Custodial Account Agreement, this Application and Adoption Agreement, and the Disclosure Statement with respect to my account. If I have telephone transaction privileges, I agree that neither the Custodian, Pacific Funds, nor their transfer agent, their agents, officers, trustees, directors or employees will be liable for any loss, liability or expense for acting, or refusing to act on instructions given under the telephone transaction privileges that are reasonably believed to be genuine and I accept the risk of lossthis IRA. I direct that all benefits upon my death be paid as indicated on the beneficiary designation. If I named a beneficiary that is a Trust, I understand I must provide certain information concerning such Trust to the Custodian. I understand and agree that this IRA becomes effective upon written acceptance by the Custodian, PFPC Trust Company, which written acceptance shall consist of a confirmation of transaction statement issued by the Custodian. I (the Participant) certify under penalties of perjury that (i) all information I have provided on this form or otherwise in connection with establishing my IRA is true, correct, and complete, and (ii) I am a US person (including a US resident alien) and that my Social Security Number is true, correct and complete and that this number is my Taxpayer Identification Number. (Foreign persons must If you are a foreign person, use the appropriate Form W-8). .) To help the U.S. Government government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies persons opening accounts; . To comply, the Custodian requires the participant's we require your name, address, date of birth and government-issued identification number (generally, a Social Security Number) and other information that may help the Custodian us identify the participant; and the Custodian you. We may ask for copies of related documentation and we may consult third-party databases to help verify the participant's your identity. I have read and I understand the Disclosure Statement which explains the risks of opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in accordance with U.S. Government requirements. SIGN HERE Shareholder’s/Responsible IndividualParticipant’s Signature Date IRA Custodian: BNY Mellon Investment Servicing PFPC Trust Company, 0000 Xxxxxxxx Xxxxxc/o PFPC Inc., Xxxxxxxxxxx000 Xxxxx Xxxxxx, XX 00000 Distributor: Pacific Select DistributorsPawtucket, LLC (member FINRA & SPIC) a subsidiary to Pacific Life Insurance CompanyRI 02860-1427. Shares of Pacific Aquila Group of Funds are offered by the distributor. Aquila Distributor, Inc. The distributor Distributor is not a bank, and shares of the Fund are not deposits or obligations of, or guaranteed or endorsed by by, any bank, bank nor are they federally insured or otherwise supported by the FDIC, the Federal Reserve Board or any other agency. The distributor has instituted a Client Identification Program in its obligations under the U.S.A. Patriot Act (Act). This important federal regulation is designed to prevent, deter, and, where necessary, prosecute those who seek to manipulate the U.S. financial system. Consistent with the Act, the provisions of the distributor’s Client Identification Program serve to reinforce key elements of a broker/dealers responsibility of becoming familiar with its clients. The distributor may therefore ask you to provide identification documents or other information. Should you ever have a complaint regarding your account, contact us at the following address: Pacific Select Distributors, LLC Attn: Compliance Department 000 Xxxxxxx Xxxxxx Xxxxx Xxxxxxx Xxxxx, XX 00000 Telephone: 000-000-0000 TRADITIONAL and XXXX INDIVIDUAL RETIREMENT ACCOUNT (IRA) COMBINED DISCLOSURE STATEMENT The following information is the disclosure statement required by federal tax regulations. You should read this Disclosure Statement, the Custodial Account Agreement and the prospectuses for the mutual funds in which your Individual Retirement Account (“IRA”) contributions will be invested. The rules governing IRAs are subject to change. You should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site xxx.xxx.xxx for updated rules and requirements. IMPORTANT INFORMATION ABOUT U.S. GOVERNMENT REQUIREMENTS THAT MAY AFFECT YOUR ACCOUNT BNY Mellon Investment Servicing Trust Company (“BNY Mellon”, “we” or “us”), provides custodial and administrative services for your retirement or savings account. As a result of this role, persons who open a retirement or savings account are considered ‘customers’ of BNY Mellon (“you” or “your”). To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires BNY Mellon, as a financial institution, to obtain, verify, and record information that identifies each person who opens an account. All accounts we open are opened on a conditional basis – conditioned on our ability to verify your identity in accordance with Federal law. When establishing an account, you are required to provide your full legal name, address, government issued identification number (e.g. social security number), date of birth, and other information within your account-opening application that will allow us to identify you. We may also request a copy of your driver’s license or other identifying documents and may consult third-party databases to help verify your identity. If the account you are opening will be registered in the name of a beneficiary, trust, or estate or charity, we may require additional identifying documentation. If you fail to provide any requested identifying information or documentation when opening your account, your new account application may be rejected. If we open your account, and you subsequently fail to provide all identification materials we request or if we are subsequently unable to adequately verify your identity as required by U.S. Government regulations, we reserve the right to take any one or more of the following actions:  We may place restrictions on your account which block all purchase transactions and we may place additional restrictions on your account blocking other transactional activities if we determine such additional restrictions are appropriate under Federal law or regulation.  We may close your account, sell (i.e., "liquidate") the assets in your account in the prevailing market at the time, and send you a check representing the cash proceeds of your account. This distribution will be reported to the Internal Revenue Service and may result in unfavorable consequences to you under Federal and state tax laws. You May Incur Losses. Despite being opened as a conditional account, your account will be invested as you instruct and you will be subject to all market risks during the period between account opening and any liquidation necessitated by your failure to furnish requested identifying information or by an inability to adequately verify your identity. You may also be subject to additional market risks if the additional transactional restrictions discussed above are placed on your account. In addition, the closing of your account may subject you to fees and charges imposed by a sponsor, issuer, depository or other person or entity associated with one or more of the assets in which you are invested, and any sales charges you may have paid in connection with your purchases will not be refunded. You Assume All Responsibility For These Losses. BNY Mellon expressly disclaims any responsibility or liability for losses you incur as result of your failure to furnish identification materials we request, including investment losses and any other loss or damage (including but not limited to lost opportunities and adverse tax consequences). If you proceed with the account opening process, you accept all risks of loss resulting from any failure of yours to furnish the identification materials we request or from a subsequent inability to adequately verify your identity in accordance with Federal law or regulation.

Appears in 1 contract

Samples: forums.aquilafunds.com

Custodial Fees. $15.00 10 annual maintenance fee per unique social security numberaccount per year. This fee is owed and due for each full and partial calendar year that the IRA Account is open. The participant may pay the fee with funds other than those in the IRA Account ("non-custodial funds"). If the fee for a calendar year is not paid by the participant from non-custodial funds by the date reasonably designated by the CustodianCustodian or prior to closing the IRA Account, the Custodian is authorized to deduct the fee from funds in the IRA Account at any time immediately after such payment due datedate or immediately after receiving instructions to close the IRA Account. The Custodian is authorized to change the fee but will give at least 30 days written notice to the participant of any fee change. The Custodian will keep those records, identify and file returns and provide other information concerning the IRA as required of custodians by the Internal Revenue Code and any regulations issued or forms adopted by the Internal Revenue Service or U.S. Treasury Department. Pacific Life Funds will pay the fee on your behalf for accounts that: 1) elect the e-Delivery option or 2) have aggregated assets under the same Social Security Number greater than $15,000 on the fee deduction date. I understand that the telephone transaction privileges will apply to my account. If I have telephone transaction privileges, I agree that neither the Custodian, Pacific Xxxxxx Funds, nor their transfer agent, their agents, officers, trustees, directors or employees will be liable for any loss, liability or expense for acting, or refusing to act on instructions given under the telephone transaction privileges that are reasonably believed to be genuine and I accept the risk of loss. I direct that all benefits upon my death be paid as indicated on the beneficiary designation. If I named a beneficiary that is a Trust, I understand I must provide certain information concerning such Trust to the Custodian. I (the Participant) certify under penalties of perjury that (i) all information I have provided on this form or otherwise in connection with establishing my IRA is true, correct, and complete, and (ii) I am a US person (including a US resident alien) and that my Social Security Number is true, correct and complete and that this number is my Taxpayer Identification Number. (Foreign persons must use appropriate Form W-8). ) To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies persons opening accounts; . To comply, the Custodian requires the participant's name, address, date of birth and government-issued identification number (generally, a Social Security Number) and other information that may help the Custodian identify the participant; and the Custodian may ask for copies of related documentation and may consult third-party databases to help verify the participant's identity. I have read and I understand the Disclosure Statement which explains the risks of opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in accordance with U.S. Government requirements. SIGN HERE Shareholder’s/Participant’s Signature: Date: (Responsible Individual’s Signature Date Individual in the case of a xxxxx XXX) IRA Custodian: BNY Mellon Investment Servicing Trust Company, 0000 Xxxxxxxx Xxxxx, Xxxxxxxxxxx, XX 00000 DistributorDealer or Advisor Designation If you do not have a Dealer or Advisor assisting you with this transaction, please leave this section blank. Firm Name: Pacific Select DistributorsFirm Number: Representative’s Name: Rep. Number: Telephone: ( ) Branch Number: Branch Address: Rev. September 11, LLC (member FINRA & SPIC) a subsidiary 2012 - NAF WHAT DOES BNY MELLON INVESTMENT SERVICING TRUST COMPANY DO WITH YOUR PERSONAL INFORMATION? FACTS Financial companies choose how they share your personal information. Federal law gives consumers the right to Pacific Life Insurance Companylimit some but not all sharing. Shares of Pacific Funds are offered by the distributor. The distributor is not a bankFederal law also requires us to tell you how we collect, share, and shares protect your personal information. Please read this notice carefully to understand what we do. Why? The types of personal information we collect and share depend on the Fund are not deposits product or obligations of, or guaranteed or endorsed by any bank, nor are they federally insured or otherwise supported by the FDIC, the Federal Reserve Board or any other agency. The distributor has instituted a Client Identification Program in its obligations under the U.S.A. Patriot Act (Act)service you have with us. This important federal regulation is designed information can include: • Social Security number • Account balances • Transaction history • Account transactions • Retirement assets When you are no longer our customer, we continue to preventshare your information as described in this notice. What? All financial companies need to share customers’ personal information to run their everyday business. In the section below, deter, and, where necessary, prosecute those who seek to manipulate we list the U.S. reasons financial system. Consistent with companies can share their customers’ personal information; the Act, the provisions of the distributor’s Client Identification Program serve to reinforce key elements of a broker/dealers responsibility of becoming familiar with its clients. The distributor may therefore ask you to provide identification documents or other information. Should you ever have a complaint regarding your account, contact us at the following address: Pacific Select Distributors, LLC Attn: Compliance Department 000 Xxxxxxx Xxxxxx Xxxxx Xxxxxxx Xxxxx, XX 00000 Telephone: 000-000-0000 TRADITIONAL and XXXX INDIVIDUAL RETIREMENT ACCOUNT (IRA) COMBINED DISCLOSURE STATEMENT The following information is the disclosure statement required by federal tax regulations. You should read this Disclosure Statement, the Custodial Account Agreement and the prospectuses for the mutual funds in which your Individual Retirement Account (“IRA”) contributions will be invested. The rules governing IRAs are subject to change. You should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site xxx.xxx.xxx for updated rules and requirements. IMPORTANT INFORMATION ABOUT U.S. GOVERNMENT REQUIREMENTS THAT MAY AFFECT YOUR ACCOUNT reasons BNY Mellon Investment Servicing Trust Company chooses to share; and whether you can limit this sharing. How? Reasons we can share your personal information Does BNY Mellon Investment Servicing Trust Company share? Can you limit this sharing? For our everyday business purposes— such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus Yes No For our marketing purposes— to offer our products and services to you No No For joint marketing with other financial companies No No For our affiliates’ everyday business purposes— information about your transactions and experiences Yes No For our affiliates’ everyday business purposes— information about your creditworthiness No No For our affiliates to market to you No No For nonaffiliates to market to you No No Call 000-000-0000 Questions? Who we are Who is providing this notice? BNY Mellon Investment Servicing Trust Company, custodian for self- directed savings and retirement accounts, such as Individual Retirement Accounts, Qualified Plans and 403(b)(7) Plans, and for mutual fund Wrap Product and Global Cash Portal accounts What we do How does BNY Mellon Investment Servicing Trust Company protect my personal information? To protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. How does BNY Mellon Investment Servicing Trust Company collect my personal information? We collect your personal information, for example, when you • Open an account or deposit funds • Make deposits or withdrawals from your account • Provide account information • Give us your contact information • Show your government-issued ID We also collect your personal information from affiliates or other companies. Why can’t I limit all sharing? Federal law gives you the right to limit only • Sharing for affiliates’ everyday business purposes— information about your creditworthiness • Affiliates from using your information to market to you • Sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing. Definitions Affiliates Companies related by common ownership or control. They can be financial and nonfinancial companies. Nonaffiliates Companies not related by common ownership or control. They can be financial and nonfinancial companies. • BNY Mellon Investment Servicing Trust Company does not share information with nonaffiliates so they can market to you. Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you. • BNY Mellon Investment Servicing Trust Company doesn’t jointly market. This notice applies to individual consumers who are customers or former customers. This notice replaces all previous notices of our consumer privacy policy, and may be amended at any time. We will keep you informed of changes or amendments as required by law. Other important information Rev. September 11, 2018 FACTS WHAT DOES DOMINI DO WITH YOUR PERSONAL INFORMATION? Why? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you how we collect, share, and protect your personal information. Please read this notice carefully to understand what we do. What? The types of personal information we collect and share depend on the product or service you have with us. This information can include: • Social Security number • Name, address, email address, and phone number • Account balances • Transaction history • Account transactions • Assets • Retirement assets When you are no longer our customer, we continue to share your information as described in this notice. How? All financial companies need to share customers’ personal information to run their everyday business. In the section below, we list the reasons financial companies can share their customers’ personal information; the reasons Domini chooses to share; and whether you can limit this sharing. Reasons we can share your personal information Does Domini share? Can you limit this sharing? For our everyday business purposes— such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus Yes No For our marketing purposes— to offer our products and services to you Yes No For joint marketing with other financial companies No We don’t share For our affiliates’ everyday business purposes— information about your transactions and experiences Yes No For our affiliates’ everyday business purposes— information about your creditworthiness No We don’t share For our affiliates to market to you No We don’t share For nonaffiliates to market to you No We don’t share Questions? Call 0-000-000-0000 or go to xxx.xxxxxx.xxx Who we are Who is providing this notice? Domini Impact Investments LLC (“BNY MellonDSIL, ) ; DSIL Investments Services LLC; and all the Funds advised by DSIL (collectively referred to as we” or “us”), provides custodial and administrative services for your retirement or savings account. As a result of this role, persons who open a retirement or savings account are considered ‘customers’ of BNY Mellon (“you” or “yourDomini”). A complete list of Funds is included under Affiliates below. What we do How does Domini protect my personal information? To help the U.S. Government fight the funding protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. Our internal data security policies restrict access of terrorism nonpublic personal information to authorized employees. We maintain physical, electronic and money laundering activitiesprocedural safeguards to guard our customers' nonpublic personal information. Employees who violate our data security policies are subject to disciplinary action, up to and including termination. How does Xxxxxx collect my personal information? We collect your personal information, for example, when you • Open an account or invest funds • Make deposits or withdrawals from your account • Provide account information • Give us your contact information • Show your government-issued ID We also collect your personal information from affiliates or other companies. Why can’t I limit all sharing? Federal law requires BNY Mellongives you the right to limit only • Sharing for affiliates’ everyday business purposes— information about your creditworthiness • Affiliates from using your information to market to you • Sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing. Definitions Affiliates Companies related by common ownership or control. They can be financial and nonfinancial companies. • Our affiliates include DSIL; DSIL Investment Services LLC; Domini Holdings LLC; and the registered investment companies advised by DSIL including the Domini Investment Trust and its series, as a financial institutionthe Domini Impact Equity Fund, to obtain, verifythe Domini Impact International Equity Fund, and record the Domini Impact Bond Fund. Nonaffiliates Companies not related by common ownership or control. They can be financial and nonfinancial companies. • Xxxxxx does not share information with nonaffiliates so they can market to you. Joint marketing A formal agreement between nonaffiliated financial companies that identifies each person who opens together market financial products or services to you. • Domini does not jointly market. A04-DOM-PP-18 Business Continuity Plan Disclosure Statement Domini Impact Investments LLC and its affiliated distributor, DSIL Investment Services LLC, maintain a Business Continuity Plan (BCP) that has been developed with the goal of protecting the health and safety of our employees and maintaining continuity of service for our Domini Funds’ shareholders. Our plan is designed to ensure that we are prepared to operate through significant business disruptions, so that our shareholders can access their accounts without significant interruption under most circumstances. Key elements of our BCP include the following: • Critical data from our computer systems is backed up daily to geographically remote, secure facilities. • All Domini employees can access Domini’s computer data remotely via a secure connection. In the event that Domini’s primary network is not accessible, Domini maintains replicas of all file and database servers in a geographically remote disaster- recovery network available to all employees over a secure connection. • We maintain an accountoffice evacuation plan and emergency procedures in the event of a disaster affecting our primary office facilities or surrounding area. All accounts we open are opened • We maintain an emergency contact list and procedures updated and distributed on a conditional basis – conditioned on regular basis. Our mission critical functions, including shareholder transaction processing, custody and fund accounting, and investment submanagement, are accomplished through our ability to verify your identity in accordance with Federal lawkey service providers. When establishing an account, you These key service providers are required to provide your full legal namemaintain business continuity plans, addresswhich Domini reviews at least annually. Domini’s BCP is designed to address significant business disruptions of varying scope, government issued identification number (e.g. social security number)including a firm-only disruption, date single-building disruption, city-wide business disruption, or a regional disruption. In the event of birtha significant business disruption, our employees are to communicate from alternate locations and access Domini’s computer data remotely. Key service providers would be contacted, and other information within your accountwould, if possible, continue to provide critical shareholder transaction processing, custody, fund accounting, and investment submanagement services. Our key service providers maintain offices outside New York City, thereby lessening the effect of a city-opening application that will allow us wide business disruption. Our key service providers maintain alternate business locations with the goal of enabling them to identify you. We may also request resume critical functions in a copy reasonable period of your driver’s license or other identifying documents and may consult third-party databases to help verify your identity. If the account you are opening will be registered time in the name event of a beneficiary, trust, or estate or charity, we may require additional identifying documentationregional disruption of significant scope. If you fail need to provide any requested identifying information contact us after a significant business disruption, please call our Shareholder Information line at 0-000-000-0000, our main office telephone number at 000-000-0000, or documentation when opening your account, your new account application may be rejected. If we open your account, go to our website at xxx.xxxxxx.xxx and you subsequently fail to provide all identification materials we request or if we are subsequently unable to adequately verify your identity as required by U.S. Government regulations, we reserve click on the right to take any one or more of the following actions:  We may place restrictions on your account which block all purchase transactions and we may place additional restrictions on your account blocking other transactional activities if we determine such additional restrictions are appropriate under Federal law or regulation.  We may close your account, sell (i.e., "liquidate") the assets in your account in the prevailing market at the time, and send you a check representing the cash proceeds of your account. This distribution will be reported to the Internal Revenue Service and may result in unfavorable consequences to you under Federal and state tax laws. You May Incur Losses. Despite being opened as a conditional account, your account will be invested as you instruct and you will be subject to all market risks during the period between account opening and any liquidation necessitated by your failure to furnish requested identifying information or by an inability to adequately verify your identity. You may also be subject to additional market risks if the additional transactional restrictions discussed above are placed on your account. In addition, the closing of your account may subject you to fees and charges imposed by a sponsor, issuer, depository or other person or entity associated with one or more of the assets in which you are invested, and any sales charges you may have paid in connection with your purchases will not be refunded. You Assume All Responsibility For These Losses. BNY Mellon expressly disclaims any responsibility or liability for losses you incur as result of your failure to furnish identification materials we request, including investment losses and any other loss or damage (including but not limited to lost opportunities and adverse tax consequences)“Contact” link. If you proceed with cannot contact us by calling our Shareholder Information line, our main office phone number, or our website, please contact Domini Funds’ Transfer Agent, BNY Mellon Asset Servicing, at 000-000-0000 or through its website at xxxx://xxx.xxxxxxxxx.xxx/assetservicing/index.html. A04-DOM-BCP-18 It is impossible for us to anticipate every potential problem that may occur, but we believe our BCP will enable us to continue to conduct business in the account opening process, you accept all risks event of loss resulting from any failure a variety of yours possible business disruptions. We believe that our BCP is reasonably designed to furnish help us limit the identification materials we request or from a subsequent inability recovery time necessary to adequately verify your identity in accordance with Federal law or regulationresume operations.

Appears in 1 contract

Samples: Traditional and Roth Ira Application and Adoption Agreement Instructions

Custodial Fees. $15.00 10 annual maintenance fee per unique social security numberaccount per year. This fee is owed and due for each full and partial calendar year that the IRA Account is open. The participant may pay the fee with funds other than those in the IRA Account ("non-custodial funds"). If the fee for a calendar year is not paid by the participant from non-custodial funds by the date reasonably designated by the CustodianCustodian or prior to closing the IRA Account, the Custodian is authorized to deduct the fee from funds in the IRA Account at any time immediately after such payment due datedate or immediately after receiving instructions to close the IRA Account. The Custodian is authorized to change the fee but will give at least 30 days written notice to the participant of any fee change. The Custodian will keep those records, identify and file returns and provide other information concerning the IRA as required of custodians by the Internal Revenue Code and any regulations issued or forms adopted by the Internal Revenue Service or U.S. Treasury Department. Pacific Life Funds will pay the fee on your behalf for accounts that: 1) elect the e-Delivery option or 2) have aggregated assets under the same Social Security Number greater than $15,000 on the fee deduction date. I understand that the telephone transaction privileges will apply to my account. If I have telephone transaction privileges, I agree that neither the Custodian, Pacific Xxxxxx Funds, nor their transfer agent, their agents, officers, trustees, directors or employees will be liable for any loss, liability or expense for acting, or refusing to act on instructions given under the telephone transaction privileges that are reasonably believed to be genuine and I accept the risk of loss. I direct that all benefits upon my death be paid as indicated on the beneficiary designation. If I named a beneficiary that is a Trust, I understand I must provide certain information concerning such Trust to the Custodian. I (the Participant) certify under penalties of perjury that (i) all information I have provided on this form or otherwise in connection with establishing my IRA is true, correct, and complete, and (ii) I am a US person (including a US resident alien) and that my Social Security Number is true, correct and complete and that this number is my Taxpayer Identification Number. (Foreign persons must use appropriate Form W-8). ) To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies persons opening accounts; . To comply, the Custodian requires the participant's name, address, date of birth and government-issued identification number (generally, a Social Security Number) and other information that may help the Custodian identify the participant; and the Custodian may ask for copies of related documentation and may consult third-party databases to help verify the participant's identity. I have read and I understand the Disclosure Statement which explains the risks of opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in accordance with U.S. Government requirements. SIGN HERE Shareholder’s/Participant’s Signature: Date: (Responsible Individual’s Signature Date Individual in the case of a xxxxx XXX) IRA Custodian: BNY Mellon Investment Servicing Trust Company, 0000 Xxxxxxxx Xxxxx, Xxxxxxxxxxx, XX 00000 DistributorDealer or Advisor Designation If you do not have a Dealer or Advisor assisting you with this transaction, please leave this section blank. Firm Name: Pacific Select DistributorsFirm Number: Representative’s Name: Rep. Number: Telephone: ( ) Branch Number: Branch Address: Rev. September 11, LLC (member FINRA & SPIC) a subsidiary 2012 - NAF WHAT DOES BNY MELLON INVESTMENT SERVICING TRUST COMPANY DO WITH YOUR PERSONAL INFORMATION? FACTS Financial companies choose how they share your personal information. Federal law gives consumers the right to Pacific Life Insurance Companylimit some but not all sharing. Shares of Pacific Funds are offered by the distributor. The distributor is not a bankFederal law also requires us to tell you how we collect, share, and shares protect your personal information. Please read this notice carefully to understand what we do. Why? The types of personal information we collect and share depend on the Fund are not deposits product or obligations of, or guaranteed or endorsed by any bank, nor are they federally insured or otherwise supported by the FDIC, the Federal Reserve Board or any other agency. The distributor has instituted a Client Identification Program in its obligations under the U.S.A. Patriot Act (Act)service you have with us. This important federal regulation is designed information can include: • Social Security number • Account balances • Transaction history • Account transactions • Retirement assets When you are no longer our customer, we continue to preventshare your information as described in this notice. What? All financial companies need to share customers’ personal information to run their everyday business. In the section below, deter, and, where necessary, prosecute those who seek to manipulate we list the U.S. reasons financial system. Consistent with companies can share their customers’ personal information; the Act, the provisions of the distributor’s Client Identification Program serve to reinforce key elements of a broker/dealers responsibility of becoming familiar with its clients. The distributor may therefore ask you to provide identification documents or other information. Should you ever have a complaint regarding your account, contact us at the following address: Pacific Select Distributors, LLC Attn: Compliance Department 000 Xxxxxxx Xxxxxx Xxxxx Xxxxxxx Xxxxx, XX 00000 Telephone: 000-000-0000 TRADITIONAL and XXXX INDIVIDUAL RETIREMENT ACCOUNT (IRA) COMBINED DISCLOSURE STATEMENT The following information is the disclosure statement required by federal tax regulations. You should read this Disclosure Statement, the Custodial Account Agreement and the prospectuses for the mutual funds in which your Individual Retirement Account (“IRA”) contributions will be invested. The rules governing IRAs are subject to change. You should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site xxx.xxx.xxx for updated rules and requirements. IMPORTANT INFORMATION ABOUT U.S. GOVERNMENT REQUIREMENTS THAT MAY AFFECT YOUR ACCOUNT reasons BNY Mellon Investment Servicing Trust Company chooses to share; and whether you can limit this sharing. How? Reasons we can share your personal information Does BNY Mellon Investment Servicing Trust Company share? Can you limit this sharing? For our everyday business purposes— such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus Yes No For our marketing purposes— to offer our products and services to you No No For joint marketing with other financial companies No No For our affiliates’ everyday business purposes— information about your transactions and experiences Yes No For our affiliates’ everyday business purposes— information about your creditworthiness No No For our affiliates to market to you No No For nonaffiliates to market to you No No Call 000-000-0000 Questions? Rev. September 11, 2018 FACTS WHAT DOES DOMINI DO WITH YOUR PERSONAL INFORMATION? Why? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you how we collect, share, and protect your personal information. Please read this notice carefully to understand what we do. What? The types of personal information we collect and share depend on the product or service you have with us. This information can include: • Social Security number • Name, address, email address, and phone number • Account balances • Transaction history • Account transactions • Assets • Retirement assets When you are no longer our customer, we continue to share your information as described in this notice. How? All financial companies need to share customers’ personal information to run their everyday business. In the section below, we list the reasons financial companies can share their customers’ personal information; the reasons Domini chooses to share; and whether you can limit this sharing. Reasons we can share your personal information Does Domini share? Can you limit this sharing? For our everyday business purposes— such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus Yes No For our marketing purposes— to offer our products and services to you Yes No For joint marketing with other financial companies No We don’t share For our affiliates’ everyday business purposes— information about your transactions and experiences Yes No For our affiliates’ everyday business purposes— information about your creditworthiness No We don’t share For our affiliates to market to you No We don’t share For nonaffiliates to market to you No We don’t share Questions? Call 0-000-000-0000 or go to xxx.xxxxxx.xxx Who we are Who is providing this notice? Domini Impact Investments LLC (“BNY MellonDSIL, ) ; DSIL Investments Services LLC; and all the Funds advised by DSIL (collectively referred to as we” or “us”), provides custodial and administrative services for your retirement or savings account. As a result of this role, persons who open a retirement or savings account are considered ‘customers’ of BNY Mellon (“you” or “yourDomini”). A complete list of Funds is included under Affiliates below. What we do How does Domini protect my personal information? To help the U.S. Government fight the funding protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. Our internal data security policies restrict access of terrorism nonpublic personal information to authorized employees. We maintain physical, electronic and money laundering activitiesprocedural safeguards to guard our customers' nonpublic personal information. Employees who violate our data security policies are subject to disciplinary action, up to and including termination. How does Xxxxxx collect my personal information? We collect your personal information, for example, when you • Open an account or invest funds • Make deposits or withdrawals from your account • Provide account information • Give us your contact information • Show your government-issued ID We also collect your personal information from affiliates or other companies. Why can’t I limit all sharing? Federal law requires BNY Mellongives you the right to limit only • Sharing for affiliates’ everyday business purposes— information about your creditworthiness • Affiliates from using your information to market to you • Sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing. Definitions Affiliates Companies related by common ownership or control. They can be financial and nonfinancial companies. • Our affiliates include DSIL; DSIL Investment Services LLC; Domini Holdings LLC; and the registered investment companies advised by DSIL including the Domini Investment Trust and its series, as a financial institutionthe Domini Impact Equity Fund, to obtain, verifythe Domini Impact International Equity Fund, and record the Domini Impact Bond Fund. Nonaffiliates Companies not related by common ownership or control. They can be financial and nonfinancial companies. • Xxxxxx does not share information with nonaffiliates so they can market to you. Joint marketing A formal agreement between nonaffiliated financial companies that identifies each person who opens together market financial products or services to you. • Domini does not jointly market. A04-DOM-PP-18 Business Continuity Plan Disclosure Statement Domini Impact Investments LLC and its affiliated distributor, DSIL Investment Services LLC, maintain a Business Continuity Plan (BCP) that has been developed with the goal of protecting the health and safety of our employees and maintaining continuity of service for our Domini Funds’ shareholders. Our plan is designed to ensure that we are prepared to operate through significant business disruptions, so that our shareholders can access their accounts without significant interruption under most circumstances. Key elements of our BCP include the following: • Critical data from our computer systems is backed up daily to geographically remote, secure facilities. • All Domini employees can access Domini’s computer data remotely via a secure connection. In the event that Domini’s primary network is not accessible, Xxxxxx maintains replicas of all files and database servers in a geographically remote disaster-recovery network available to all employees over a secure connection. • We maintain an accountoffice evacuation plan and emergency procedures in the event of a disaster affecting our primary office facilities or surrounding area. All accounts we open are opened • We maintain an emergency contact list and procedures updated and distributed on a conditional basis – conditioned on regular basis. Our mission critical functions, including shareholder transaction processing, custody and fund accounting, and investment submanagement, are accomplished through our ability to verify your identity in accordance with Federal lawkey service providers. When establishing an account, you These key service providers are required to provide your full legal namemaintain business continuity plans, addresswhich Domini reviews at least annually. Domini’s BCP is designed to address significant business disruptions of varying scope, government issued identification number (e.g. social security number)including a firm-only disruption, date single-building disruption, city-wide business disruption, or a regional disruption. In the event of birtha significant business disruption, our employees are to communicate from alternate locations and access Domini’s computer data remotely. Key service providers would be contacted, and other information within your accountwould, if possible, continue to provide critical shareholder transaction processing, custody, fund accounting, and investment submanagement services. Our key service providers maintain offices outside New York City, thereby lessening the effect of a city-opening application that will allow us wide business disruption. Our key service providers maintain alternate business locations with the goal of enabling them to identify you. We may also request resume critical functions in a copy reasonable period of your driver’s license or other identifying documents and may consult third-party databases to help verify your identity. If the account you are opening will be registered time in the name event of a beneficiary, trust, or estate or charity, we may require additional identifying documentationregional disruption of significant scope. If you fail need to provide any requested identifying information contact us after a significant business disruption, please call our Shareholder Information line at 0-000-000-0000, our main office telephone number at 000-000-0000, or documentation when opening your account, your new account application may be rejected. If we open your account, go to our website at xxx.xxxxxx.xxx and you subsequently fail to provide all identification materials we request or if we are subsequently unable to adequately verify your identity as required by U.S. Government regulations, we reserve click on the right to take any one or more of the following actions:  We may place restrictions on your account which block all purchase transactions and we may place additional restrictions on your account blocking other transactional activities if we determine such additional restrictions are appropriate under Federal law or regulation.  We may close your account, sell (i.e., "liquidate") the assets in your account in the prevailing market at the time, and send you a check representing the cash proceeds of your account. This distribution will be reported to the Internal Revenue Service and may result in unfavorable consequences to you under Federal and state tax laws. You May Incur Losses. Despite being opened as a conditional account, your account will be invested as you instruct and you will be subject to all market risks during the period between account opening and any liquidation necessitated by your failure to furnish requested identifying information or by an inability to adequately verify your identity. You may also be subject to additional market risks if the additional transactional restrictions discussed above are placed on your account. In addition, the closing of your account may subject you to fees and charges imposed by a sponsor, issuer, depository or other person or entity associated with one or more of the assets in which you are invested, and any sales charges you may have paid in connection with your purchases will not be refunded. You Assume All Responsibility For These Losses. BNY Mellon expressly disclaims any responsibility or liability for losses you incur as result of your failure to furnish identification materials we request, including investment losses and any other loss or damage (including but not limited to lost opportunities and adverse tax consequences)“Contact Us” link. If you proceed with cannot contact us by calling our Shareholder Information line, our main office phone number, or our website, please contact Domini Funds’ Transfer Agent, BNY Mellon Asset Servicing, at 000-000-0000 or through its website at xxxx://xxx.xxxxxxxxx.xxx/assetservicing/index.html. It is impossible for us to anticipate every potential problem that may occur, but we believe our BCP will enable us to continue to conduct business in the account opening process, you accept all risks event of loss resulting from any failure a variety of yours possible business disruptions. We believe that our BCP is reasonably designed to furnish help us limit the identification materials we request or from a subsequent inability recovery time necessary to adequately verify your identity in accordance with Federal law or regulationresume operations. We review and test our BCP at least annually. The BCP is subject to modification based on changing circumstances and assessment of need.

Appears in 1 contract

Samples: Traditional and Roth Ira Application and Adoption Agreement Instructions

Custodial Fees. $15.00 10 annual maintenance fee per unique social security numberaccount per year. This fee is owed and due for each full and partial calendar year that the IRA Account is open. The participant may pay the fee with funds other than those in the IRA Account ("non-custodial funds"). If the fee for a calendar year is not paid by the participant from non-custodial funds by the date reasonably designated by the CustodianCustodian or prior to closing the IRA Account, the Custodian is authorized to deduct the fee from funds in the IRA Account at any time immediately after such payment due datedate or immediately after receiving instructions to close the IRA Account. The Custodian is authorized to change the fee but will give at least 30 days written notice to the participant of any fee change. The Custodian will keep those records, identify and file returns and provide other information concerning the IRA as required of custodians by the Internal Revenue Code and any regulations issued or forms adopted by the Internal Revenue Service or U.S. Treasury Department. Pacific Life Funds will pay the fee on your behalf for accounts that: 1) elect the e-Delivery option or 2) have aggregated assets under the same Social Security Number greater than $15,000 on the fee deduction date. I understand that the telephone transaction privileges will apply to my account. If I have telephone transaction privileges, I agree that neither the Custodian, Pacific Xxxxxx Funds, nor their transfer agent, their agents, officers, trustees, directors or employees will be liable for any loss, liability or expense for acting, or refusing to act on instructions given under the telephone transaction privileges that are reasonably believed to be genuine and I accept the risk of loss. I direct that all benefits upon my death be paid as indicated on the beneficiary designation. If I named a beneficiary that is a Trust, I understand I must provide certain information concerning such Trust to the Custodian. I (the Participant) certify under penalties of perjury that (i) all information I have provided on this form or otherwise in connection with establishing my IRA is true, correct, and complete, and (ii) I am a US person (including a US resident alien) and that my Social Security Number is true, correct and complete and that this number is my Taxpayer Identification Number. (Foreign persons must use appropriate Form W-8). ) To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies persons opening accounts; . To comply, the Custodian requires the participant's name, address, date of birth and government-issued identification number (generally, a Social Security Number) and other information that may help the Custodian identify the participant; and the Custodian may ask for copies of related documentation and may consult third-party databases to help verify the participant's identity. I have read and I understand the Disclosure Statement which explains the risks of opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in accordance with U.S. Government requirements. SIGN HERE Shareholder’s/Participant’s Signature: Date: (Responsible Individual’s Signature Date Individual in the case of a xxxxx XXX) IRA Custodian: BNY Mellon Investment Servicing Trust Company, 0000 Xxxxxxxx Xxxxx, Xxxxxxxxxxx, XX 00000 DistributorDealer or Advisor Designation If you do not have a Dealer or Advisor assisting you with this transaction, please leave this section blank. Firm Name: Pacific Select DistributorsFirm Number: Representative’s Name: Rep. Number: Telephone: ( ) Branch Number: Branch Address: How Did You Hear About ☐ TV advertisement ☐ Print ad in ☐ News story in Us? ☐ Facebook ☐ Internet search ☐ Marketplace Radio Podcast ☐ Twitter ☐ Friend/Relative ☐ Conference ☐ Lipper ☐ Financial Advisor/Broker ☐ Other Rev. September 11, LLC (member FINRA & SPIC) a subsidiary 2012 - NAF WHAT DOES BNY MELLON INVESTMENT SERVICING TRUST COMPANY DO WITH YOUR PERSONAL INFORMATION? FACTS Financial companies choose how they share your personal information. Federal law gives consumers the right to Pacific Life Insurance Companylimit some but not all sharing. Shares of Pacific Funds are offered by the distributor. The distributor is not a bankFederal law also requires us to tell you how we collect, share, and shares protect your personal information. Please read this notice carefully to understand what we do. Why? The types of personal information we collect and share depend on the Fund are not deposits product or obligations of, or guaranteed or endorsed by any bank, nor are they federally insured or otherwise supported by the FDIC, the Federal Reserve Board or any other agency. The distributor has instituted a Client Identification Program in its obligations under the U.S.A. Patriot Act (Act)service you have with us. This important federal regulation is designed information can include: • Social Security number • Account balances • Transaction history • Account transactions • Retirement assets When you are no longer our customer, we continue to preventshare your information as described in this notice. What? All financial companies need to share customers’ personal information to run their everyday business. In the section below, deter, and, where necessary, prosecute those who seek to manipulate we list the U.S. reasons financial system. Consistent with companies can share their customers’ personal information; the Act, the provisions of the distributor’s Client Identification Program serve to reinforce key elements of a broker/dealers responsibility of becoming familiar with its clients. The distributor may therefore ask you to provide identification documents or other information. Should you ever have a complaint regarding your account, contact us at the following address: Pacific Select Distributors, LLC Attn: Compliance Department 000 Xxxxxxx Xxxxxx Xxxxx Xxxxxxx Xxxxx, XX 00000 Telephone: 000-000-0000 TRADITIONAL and XXXX INDIVIDUAL RETIREMENT ACCOUNT (IRA) COMBINED DISCLOSURE STATEMENT The following information is the disclosure statement required by federal tax regulations. You should read this Disclosure Statement, the Custodial Account Agreement and the prospectuses for the mutual funds in which your Individual Retirement Account (“IRA”) contributions will be invested. The rules governing IRAs are subject to change. You should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site xxx.xxx.xxx for updated rules and requirements. IMPORTANT INFORMATION ABOUT U.S. GOVERNMENT REQUIREMENTS THAT MAY AFFECT YOUR ACCOUNT reasons BNY Mellon Investment Servicing Trust Company chooses to share; and whether you can limit this sharing. How? Reasons we can share your personal information Does BNY Mellon Investment Servicing Trust Company share? Can you limit this sharing? For our everyday business purposes— such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus Yes No For our marketing purposes— to offer our products and services to you No No For joint marketing with other financial companies No No For our affiliates’ everyday business purposes— information about your transactions and experiences Yes No For our affiliates’ everyday business purposes— information about your creditworthiness No No For our affiliates to market to you No No For nonaffiliates to market to you No No Call 000-000-0000 Questions? Who we are Who is providing this notice? BNY Mellon Investment Servicing Trust Company, custodian for self- directed savings and retirement accounts, such as Individual Retirement Accounts, Qualified Plans and 403(b)(7) Plans, and for mutual fund Wrap Product and Global Cash Portal accounts What we do How does BNY Mellon Investment Servicing Trust Company protect my personal information? To protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. How does BNY Mellon Investment Servicing Trust Company collect my personal information? We collect your personal information, for example, when you • Open an account or deposit funds • Make deposits or withdrawals from your account • Provide account information • Give us your contact information • Show your government-issued ID We also collect your personal information from affiliates or other companies. Why can’t I limit all sharing? Federal law gives you the right to limit only • Sharing for affiliates’ everyday business purposes— information about your creditworthiness • Affiliates from using your information to market to you • Sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing. Definitions Affiliates Companies related by common ownership or control. They can be financial and nonfinancial companies. Nonaffiliates Companies not related by common ownership or control. They can be financial and nonfinancial companies. • BNY Mellon Investment Servicing Trust Company does not share information with nonaffiliates so they can market to you. Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you. • BNY Mellon Investment Servicing Trust Company doesn’t jointly market. This notice applies to individual consumers who are customers or former customers. This notice replaces all previous notices of our consumer privacy policy, and may be amended at any time. We will keep you informed of changes or amendments as required by law. Other important information DOMINI PRIVACY POLICY Rev. September 11, 2017 FACTS WHAT DOES DOMINI DO WITH YOUR PERSONAL INFORMATION? Why? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you how we collect, share, and protect your personal information. Please read this notice carefully to understand what we do. What? The types of personal information we collect and share depend on the product or service you have with us. This information can include: • Social Security number • Name, address, email address, and phone number • Account balances • Transaction history • Account transactions • Assets • Retirement assets When you are no longer our customer, we continue to share your information as described in this notice. How? All financial companies need to share customers’ personal information to run their everyday business. In the section below, we list the reasons financial companies can share their customers’ personal information; the reasons Domini chooses to share; and whether you can limit this sharing. Reasons we can share your personal information Does Domini share? Can you limit this sharing? For our everyday business purposes— such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus Yes No For our marketing purposes— to offer our products and services to you Yes No For joint marketing with other financial companies No We don’t share For our affiliates’ everyday business purposes— information about your transactions and experiences Yes No For our affiliates’ everyday business purposes— information about your creditworthiness No We don’t share For our affiliates to market to you No We don’t share For nonaffiliates to market to you No We don’t share Questions? Call 0-000-000-0000 or go to xxx.xxxxxx.xxx Who we are Who is providing this notice? Domini Impact Investments LLC (“BNY MellonDSIL, ) ; DSIL Investments Services LLC; and all the Funds advised by DSIL (collectively referred to as we” or “us”), provides custodial and administrative services for your retirement or savings account. As a result of this role, persons who open a retirement or savings account are considered ‘customers’ of BNY Mellon (“you” or “yourDomini”). A complete list of Funds is included under Affiliates below. What we do How does Domini protect my personal information? To help the U.S. Government fight the funding protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. Our internal data security policies restrict access of terrorism nonpublic personal information to authorized employees. We maintain physical, electronic and money laundering activitiesprocedural safeguards to guard our customers' nonpublic personal information. Employees who violate our data security policies are subject to disciplinary action, up to and including termination. How does Xxxxxx collect my personal information? We collect your personal information, for example, when you • Open an account or invest funds • Make deposits or withdrawals from your account • Provide account information • Give us your contact information • Show your government-issued ID We also collect your personal information from affiliates or other companies. Why can’t I limit all sharing? Federal law requires BNY Mellon, as a financial institution, to obtain, verify, and record information that identifies each person who opens an account. All accounts we open are opened on a conditional basis – conditioned on our ability to verify your identity in accordance with Federal law. When establishing an account, gives you are required to provide your full legal name, address, government issued identification number (e.g. social security number), date of birth, and other information within your account-opening application that will allow us to identify you. We may also request a copy of your driver’s license or other identifying documents and may consult third-party databases to help verify your identity. If the account you are opening will be registered in the name of a beneficiary, trust, or estate or charity, we may require additional identifying documentation. If you fail to provide any requested identifying information or documentation when opening your account, your new account application may be rejected. If we open your account, and you subsequently fail to provide all identification materials we request or if we are subsequently unable to adequately verify your identity as required by U.S. Government regulations, we reserve the right to take any one limit only • Sharing for affiliates’ everyday business purposes— information about your creditworthiness • Affiliates from using your information to market to you • Sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing. Definitions Affiliates Companies related by common ownership or more of control. They can be financial and nonfinancial companies. • Our affiliates include DSIL; DSIL Investment Services LLC; Domini Holdings LLC; and the following actions:  We may place restrictions on your account which block all purchase transactions registered investment companies advised by DSIL including the Domini Investment Trust and we may place additional restrictions on your account blocking other transactional activities if we determine such additional restrictions are appropriate under Federal law or regulation.  We may close your accountits series, sell (i.e.the Domini Impact Equity Fund, "liquidate") the assets in your account in the prevailing market at the timeDomini Impact International Equity Fund, and send you a check representing the cash proceeds of your accountDomini Impact Bond Fund. This distribution will Nonaffiliates Companies not related by common ownership or control. They can be reported financial and nonfinancial companies. • Xxxxxx does not share information with nonaffiliates so they can market to the Internal Revenue Service and may result in unfavorable consequences you. Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you under Federal and state tax lawsyou. You May Incur Losses. Despite being opened as a conditional account, your account will be invested as you instruct and you will be subject to all market risks during the period between account opening and any liquidation necessitated by your failure to furnish requested identifying information or by an inability to adequately verify your identity. You may also be subject to additional market risks if the additional transactional restrictions discussed above are placed on your account. In addition, the closing of your account may subject you to fees and charges imposed by a sponsor, issuer, depository or other person or entity associated with one or more of the assets in which you are invested, and any sales charges you may have paid in connection with your purchases will • Domini does not be refunded. You Assume All Responsibility For These Losses. BNY Mellon expressly disclaims any responsibility or liability for losses you incur as result of your failure to furnish identification materials we request, including investment losses and any other loss or damage (including but not limited to lost opportunities and adverse tax consequences). If you proceed with the account opening process, you accept all risks of loss resulting from any failure of yours to furnish the identification materials we request or from a subsequent inability to adequately verify your identity in accordance with Federal law or regulationjointly market.

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Samples: Traditional and Roth Ira Application and Adoption Agreement Instructions

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Custodial Fees. $15.00 20.00 annual maintenance fee per unique social security numberGlobal Account Number per year. This fee is owed and due for each full and partial calendar year that the IRA Account is open. The participant may pay the fee with funds other than those in the IRA Account ("non-custodial funds"). If the fee for a calendar year is not paid by the participant from non-custodial funds by the date reasonably designated by the CustodianCustodian or prior to closing the IRA Account, the Custodian is authorized to deduct the fee from funds in the IRA Account at any time immediately after such payment due datedate or immediately after receiving instructions to close the IRA Account. The Custodian is authorized to change the fee but will give at least 30 days written notice to the participant of any fee change. The Custodian will keep those records, identify and file returns and provide other information concerning the IRA as required of custodians by the Internal Revenue Code and any regulations issued or forms adopted by the Internal Revenue Service IRS or U.S. Treasury Department. Pacific Life Funds will pay the fee on your behalf for accounts that: 1) elect the e-Delivery option or 2) have aggregated assets under the same Social Security Number greater than $15,000 on the fee deduction date. I understand that the telephone transaction privileges will apply to my account. If I have telephone transaction privileges, I agree that neither the Custodian, Pacific Funds, nor their transfer agent, their agents, officers, trustees, directors or employees will be liable for any loss, liability or expense for acting, or refusing to act on instructions given under the telephone transaction privileges that are reasonably believed to be genuine and I accept the risk of loss. I direct that all benefits upon my death be paid as indicated on the beneficiary designation. If I named a beneficiary that is a Trust, I understand I must provide certain information concerning such Trust to the Custodian. I understand that, if I am subject to community property or marital property state requirements, my spouse may be required to consent to any beneficiary I designate who is not my spouse, or who is in addition to my spouse. I also understand that any beneficiary designation I make, other than my spouse, may not be effective without my spouse’s consent. I certify, under penalty of perjury, if I am married and have not named my spouse as my sole Primary Beneficiary, I have consulted a qualified tax or legal professional about the need to document spousal consent, and about the consequences of not obtaining my spouse’s consent. I (the Participant) certify under penalties of perjury that (i) all information I have provided on this form or otherwise in connection with establishing my IRA is true, correct, and complete, and (ii) I am a US person (including a US resident alien) and that my Social Security Number is true, correct and complete and that this number is my Taxpayer Identification Number. (Foreign persons must use appropriate Form W-8). ) To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies persons opening accounts; . To comply, the Custodian requires the participant's name, address, date of birth and government-issued identification number (generally, a Social Security Number) and other information that may help the Custodian identify the participant; and the Custodian may ask for copies of related documentation and may consult third-party databases to help verify the participant's identity. I have read and I understand the Disclosure Statement which that explains the risks of opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in accordance with U.S. Government requirements. SIGN HERE Shareholder’s/X Signature: Date: (Responsible Individual’s Signature Date Individual in the case of a xxxxx XXX) IRA Custodian: BNY Mellon Investment Servicing Trust Company, 0000 Xxxxxxxx XxxxxP.O. Box 534452, XxxxxxxxxxxPittsburgh, XX 00000 DistributorPA 15253-4452 Mail to the following: Pacific Select Distributors, LLC (member FINRA & SPIC) a subsidiary to Pacific Life Insurance Company. Shares of Pacific Funds are offered by the distributor. The distributor is not a bank, and shares of the Fund are not deposits or obligations of, or guaranteed or endorsed by any bank, nor are they federally insured or otherwise supported by the FDIC, the Federal Reserve Board or any other agency. The distributor has instituted a Client Identification Program in its obligations under the U.S.A. Patriot Act (Act). This important federal regulation is designed to prevent, deter, and, where necessary, prosecute those who seek to manipulate the U.S. financial system. Consistent with the Act, the provisions of the distributor’s Client Identification Program serve to reinforce key elements of a broker/dealers responsibility of becoming familiar with its clients. The distributor may therefore ask you to provide identification documents or other information. Should you ever have a complaint regarding your account, contact us at the following addressFirst Class Mail: Pacific Select Distributors, LLC AttnOvernight Mail: Compliance Department 000 Xxxxxxx Xxxxxx Xxxxx Xxxxxxx Xxxxx, XX 00000 TelephoneCustomer Service: 0-000-000-0000 TRADITIONAL Meridian Fund, Inc. Meridian Fund, Inc. P.O. Box 534452 Attn: 534452 Pittsburgh, PA 15253-4452 000 Xxxx Xxxxxx 154-0520 Pittsburgh, PA 15262 Dealer or Advisor Designation (If you do not have a Dealer or Advisor assisting you with this transaction, please leave this section blank.) Firm Name: Firm Number: Representative’s Name: Rep. Number: Telephone: ( ) Branch Number: Branch Address: BNY MELLON INVESTMENT SERVICING TRUST COMPANY Supplement to the Traditional and XXXX INDIVIDUAL RETIREMENT ACCOUNT (IRA) COMBINED DISCLOSURE STATEMENT The following information is the disclosure statement required by federal tax regulations. You should read this Disclosure Statement, the Custodial Account Agreement and the prospectuses for the mutual funds in which your Xxxx Individual Retirement Account (IRA) contributions Disclosure Statement for Tax Year 2024 DEADLINE FOR 2023 CONTRIBUTIONS TO A TRADITIONAL OR XXXX XXX: Most taxpayers will be invested. The rules governing IRAs are subject to change. You should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site xxx.xxx.xxx for updated rules and requirements. IMPORTANT INFORMATION ABOUT U.S. GOVERNMENT REQUIREMENTS THAT MAY AFFECT YOUR ACCOUNT BNY Mellon Investment Servicing Trust Company (“BNY Mellon”have until Monday, “we” or “us”)April 15, provides custodial and administrative services for your retirement or savings account. As a result of this role, persons who open a retirement or savings account are considered ‘customers’ of BNY Mellon (“you” or “your”). To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires BNY Mellon, as a financial institution2024, to obtainmake contributions to a traditional IRA or Xxxx XXX for 2023. However, verifydue to the Patriots’ Day holiday observed in Massachusetts and Maine on April 15, 2024, and record information that identifies each person who opens an accountthe Emancipation Day holiday observed in Washington DC on Tuesday April 16, 2024, residents of Massachusetts and Maine only will have until Wednesday, April 17, 2024, to make contributions to a traditional or Xxxx XXX for 2023. All accounts we open are opened on a conditional basis – conditioned on our ability to verify your identity in accordance with Federal law. When establishing an accountFor more information, you are required to provide your full legal name, address, government issued identification number (e.g. social security number), date of birth, and other information within your account-opening application that will allow us to identify you. We may also request a copy of your driver’s license or other identifying documents and may consult third-party databases to help verify your identity. If the account you are opening will be registered in the name of a beneficiary, trust, or estate or charity, we may require additional identifying documentation. If you fail to provide any requested identifying information or documentation when opening your account, your new account application may be rejected. If we open your account, and you subsequently fail to provide all identification materials we request or if we are subsequently unable to adequately verify your identity as required by U.S. Government regulations, we reserve the right to take any one or more of the following actions:  We may place restrictions on your account which block all purchase transactions and we may place additional restrictions on your account blocking other transactional activities if we determine such additional restrictions are appropriate under Federal law or regulation.  We may close your account, sell (i.e., "liquidate") the assets in your account in the prevailing market at the time, and send you a check representing the cash proceeds of your account. This distribution will be reported please refer to the Internal Revenue Service (IRS) web site: xxx.xxx.xxx. 2024 IRA CONTRIBUTION LIMITS FOR TRADITIONAL AND XXXX XXX: The maximum allowable contribution to your IRAs (deductible, non-deductible, and may result in unfavorable consequences Xxxx) for the tax year is the lesser of (a) $7,000 or (b) 100% of your earned income. For those who have attained or will attain the age of 50 before the close of the taxable year, the annual IRA contribution limit is increased by $1,000 (total of $8,000 for 2024). Any contribution made to you under Federal and state tax laws. You May Incur Losses. Despite being opened your IRA will be treated as a conditional accountcurrent year contribution recorded in the year it is received, your account will be invested as you instruct unless the contribution is made between January 1 and April 15, 2024, and you will have identified the contribution as a prior year contribution. Please consult IRS Publication 590-A, Contributions to Individual Retirement Arrangements (IRAs) for eligibility requirements and contribution restrictions. 2024 TRADITIONAL IRA INCOME TAX DEDUCTION: Your contribution to a traditional IRA may be subject to all market risks during the period between account opening and any liquidation necessitated by your failure to furnish requested identifying information or by an inability to adequately verify your identity. You may also be subject to additional market risks if the additional transactional restrictions discussed above are placed deductible on your accountfederal income tax return. In additionHowever, the closing of your account may subject you to fees and charges imposed by there is a sponsor, issuer, depository or other person or entity associated with one or more phase-out of the assets in which IRA deduction if you are invested, and any sales charges you may have paid an active participant in connection with your purchases will not be refundedan employer-sponsored retirement plan. You Assume All Responsibility For These Losses. BNY Mellon expressly disclaims any responsibility or liability for losses you incur The IRA deduction is reduced proportionately as result of your failure to furnish identification materials we request, including investment losses and any other loss or damage (including but not limited to lost opportunities and adverse tax consequences)modified adjusted gross income increases. If you proceed are not an active participant in an employer-sponsored retirement plan, there is a phase-out of the IRA deduction if you’re married based on whether or not your spouse is covered by a workplace retirement plan. Please consult IRS Publication 590-A, Contributions to Individual Retirement Arrangements (IRAs) for assistance in calculating your deductible contribution as it pertains to individual income and employer-sponsored retirement plan circumstances. Your contribution in excess of the permitted deduction will be considered a non-deductible contribution. DEDUCTION LIMIT - Effect of Modified AGI on Deduction – Covered by a Retirement Plan at Work TAX YEAR 2024 Full deduction if modified AGI is: Partial deduction if modified AGI is: No deduction if modified AGI is: Single Filers or Head of Household $77,000 or less More than $77,000 but less than $87,000 $87,000 or more Married - filing jointly or Qualified Widow(er) $123,000 or less More than $123,000 but less than $143,000 $143,000 or more Married - filing separately N/A Less than $10,000 $10,000 or more DEDUCTION LIMIT - Effect of Modified AGI on Deduction – You are NOT Covered by a Retirement Plan at Work (Spousal Coverage Considered) TAX YEAR 2024 Full deduction if modified AGI is: Partial deduction if modified AGI is: No deduction if AGI is: Married - filing jointly - spouse covered at work $230,000 or less More than $230,000 but less than $240,000 $240,000 or more Married - filing separately - spouse covered at work N/A Less than $10,000 $10,000 or more 2024 XXXX XXX CONTRIBUTION ELIGIBILITY: For 2024, your Xxxx XXX contribution limit is reduced (phased out) based on your modified AGI as follows: TAX YEAR 2024 Full contribution if modified AGI is: Partial contribution if modified AGI is: No contribution if AGI is: Married - filing jointly or Qualified Widow(er) $230,000 or less More than $230,000 but less than $240,000 $240,000 or more Married - filing separately and you lived with your spouse at any time during the account opening processyear N/A less than $10,000 $10,000 or more Single, Head of Household or Married - filing separately and you accept all risks did not live with your spouse at any time during the year Less than $146,000 At least $146,000 but less than $161,000 $161,000 or more Qualified Charitable Distributions allowed for 2024: an annual distribution of loss resulting up to $105,000 and a one-time distribution of up to $53,000 to certain split-interest entities are allowed for owners age 70 ½ or over. These limits may be adjusted from time to time by the IRS; please refer to Publication 590-A Contributions to Individual Retirement Arrangements (IRAs) for current year limits. 2024 UPDATES FOR SECURE ACT 2.0 THE SPECIFIC SECTIONS BELOW ARE REPLACED OR AMENDED EFFECTIVE AS OF 1/1/2024 BY INCLUSION IN THIS SUPPLEMENT. CHANGES OR ADDITIONS ARE SHOWN IN ITALICS. ADDITIONAL INFORMATION REGARDING XXXX CATCH UP CONTRIBUTIONS AND XXXX CONTRIBUTIONS TO SEP AND SIMPLE IRAS WILL BE RELEASED PENDING ADDITIONAL IRS GUIDANCE. TRADITIONAL INDIVIDUAL RETIREMENT ACCOUNT DISCLOSURE EARLY DISTRIBUTIONS FROM A TRADITIONAL IRA: Early Distribution Penalty Tax – If you are under age 59½ and receive a Traditional IRA distribution, an additional early distribution penalty tax of 10% generally will apply to the amount includible in income in the year of the distribution. However, the additional early distribution penalty tax of 10% generally will not apply if one of the following exceptions apply. The 10% penalty tax is in addition to any failure of yours to furnish the identification materials we request or from a subsequent inability to adequately verify your identity in accordance with Federal law or regulationfederal income tax that is owed at distribution.

Appears in 1 contract

Samples: www.arrowmarkpartners.com

Custodial Fees. $15.00 annual maintenance fee per unique social security number. This fee is owed and due for each full and partial calendar year that the IRA Account is open. The participant may pay the fee with funds other than those in the IRA Account ("non-custodial funds"). If the fee for a calendar year is not paid by the participant from non-custodial funds by the date designated by the Custodian, the Custodian is authorized to deduct the fee from funds in the IRA Account at any time immediately after such payment due date. The Custodian is authorized to change the fee but will give at least 30 days written notice to the participant of any fee change. The Custodian will keep those records, identify and file returns and provide other information concerning the IRA as required of custodians by the Internal Revenue Code and any regulations issued or forms adopted by the Internal Revenue Service or U.S. Treasury Department. Pacific Life Funds will pay the fee on your behalf for accounts that: 1) elect the e-Delivery option or 2) have aggregated assets under the same Social Security Number greater than $15,000 on the fee deduction date. I understand that the telephone transaction privileges will apply to my account. If I have telephone transaction privileges, I agree that neither the Custodian, Pacific FundsMutual Fund Name, nor their transfer agent, their agents, officers, trustees, directors or employees will be liable for any loss, liability or expense for acting, or refusing to act on instructions given under the telephone transaction privileges that are reasonably believed to be genuine and I accept the risk of loss. I direct that all benefits upon my death be paid as indicated on the beneficiary designation. If I named a beneficiary that is a Trust, I understand I must provide certain information concerning such Trust to the Custodian. I (the Participant) certify under penalties of perjury that (i) all information I have provided on this form or otherwise in connection with establishing my IRA is true, correct, and complete, and (ii) I am a US person (including a US resident alien) and that my Social Security Number is true, correct and complete and that this number is my Taxpayer Identification Number. (Foreign persons must use appropriate Form W-8). ) To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies persons opening accounts; To comply, the Custodian requires the participant's name, address, date of birth and government-issued identification number (generally, a Social Security Number) and other information that may help the Custodian identify the participant; and the Custodian may ask for copies of related documentation and may consult third-party databases to help verify the participant's identity. I have read and I understand the Disclosure Statement which explains the risks of opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in accordance with U.S. Government requirements. SIGN HERE Shareholder’s/Responsible Individual’s Signature Date Custodian: BNY Mellon Investment Servicing Trust Company, 0000 Xxxxxxxx Xxxxx, Xxxxxxxxxxx, XX 00000 Distributor: Pacific Select Distributors, LLC (member FINRA & SPIC) a subsidiary to Pacific Life Insurance Company. Shares of Pacific Funds are offered by the distributor. The distributor is not a bank, and shares of the Fund are not deposits or obligations of, or guaranteed or endorsed by any bank, nor are they federally insured or otherwise supported by the FDIC, the Federal Reserve Board or any other agency. The distributor has instituted a Client Identification Program in its obligations under the U.S.A. Patriot Act (Act). This important federal regulation is designed to prevent, deter, and, where necessary, prosecute those who seek to manipulate the U.S. financial system. Consistent with the Act, the provisions of the distributor’s Client Identification Program serve to reinforce key elements of a broker/dealers responsibility of becoming familiar with its clients. The distributor may therefore ask you to provide identification documents or other information. Should you ever have a complaint regarding your account, contact us at the following address: Pacific Select Distributors, LLC Attn: Compliance Department Department, 000 Xxxxxxx Xxxxxx Xxxxx Xxxxx, Xxxxxxx Xxxxx, XX 00000 Telephone: 000-000-0000 TRADITIONAL and XXXX INDIVIDUAL RETIREMENT ACCOUNT XXX TRANSFER OF ASSETS/ DIRECT ROLLOVER CONTACT INFORMATION First Class Mail: Pacific Funds P.O. Box 9768 Providence, RI 02940-9768 Overnight Mail: Pacific Funds Attn: Work Management 0000 Xxxxxxxx Xxxxx Xxxxxxxxxxx, XX 00000 Phone: (IRA000) COMBINED DISCLOSURE STATEMENT The following information is the disclosure statement required by federal tax regulations000-0000 Website: xxx.XxxxxxxXxxxx.xxx Use this form to request an IRA transfer of assets or a direct rollover (excluding qualified rollover conversions to a Xxxx XXX) from an existing retirement plan account to your IRA at Pacific Funds. You should read this Disclosure Statement, the Custodial Account Agreement and the prospectuses for the mutual funds in which Based on your Individual Retirement Account (“IRA”) contributions will be invested. The rules governing IRAs are subject to change. You should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site xxx.xxx.xxx for updated rules and requirements. IMPORTANT INFORMATION ABOUT U.S. GOVERNMENT REQUIREMENTS THAT MAY AFFECT YOUR ACCOUNT instructions BNY Mellon Investment Servicing Trust Company (“BNY Mellon”, “we” will initiate the transfer or “us”), provides custodial and administrative services rollover for your retirement or savings accountyou. As a result of this role, persons who open a retirement or savings account If you are considered ‘customers’ of BNY Mellon (“you” or “your”). To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires BNY Mellon, as a financial institution, to obtain, verify, and record information that identifies each person who opens an account. All accounts we open are opened on a conditional basis – conditioned on our ability to verify your identity in accordance with Federal law. When establishing an accountover age 70½, you are responsible for distributing any required to provide minimum distribution amounts from your full legal name, address, government issued identification number current retirement plan account (e.g. social security number), date excluding Xxxx IRAs) in advance of birth, and other the transfer or rollover. Please remember that a transfer of assets can only occur between the same types of retirement plans. Incomplete information within will result in delays in processing your account-opening application that will allow us to identify you. We may also request a copy of your driver’s license or other identifying documents and may consult third-party databases to help verify your identity. If the account you are opening will be registered in the name of a beneficiary, trust, or estate or charity, we may require additional identifying documentationrequest. If you fail to provide any requested identifying information or documentation when opening your accountneed assistance completing this form, your new account application may be rejected. If we open your account, and you subsequently fail to provide all identification materials we request or if we are subsequently unable to adequately verify your identity as required by U.S. Government regulations, we reserve the right to take any one or more of the following actions:  We may place restrictions on your account which block all purchase transactions and we may place additional restrictions on your account blocking other transactional activities if we determine such additional restrictions are appropriate under Federal law or regulation.  We may close your account, sell (i.e., "liquidate") the assets in your account in the prevailing market please contact Shareholder Services at the time, and send you a check representing the cash proceeds of your account. This distribution will be reported to the Internal Revenue Service and may result in unfavorable consequences to you under Federal and state tax laws. You May Incur Losses. Despite being opened as a conditional account, your account will be invested as you instruct and you will be subject to all market risks during the period between account opening and any liquidation necessitated by your failure to furnish requested identifying information or by an inability to adequately verify your identity. You may also be subject to additional market risks if the additional transactional restrictions discussed above are placed on your account. In addition, the closing of your account may subject you to fees and charges imposed by a sponsor, issuer, depository or other person or entity associated with one or more of the assets in which you are invested, and any sales charges you may have paid in connection with your purchases will not be refunded. You Assume All Responsibility For These Losses. BNY Mellon expressly disclaims any responsibility or liability for losses you incur as result of your failure to furnish identification materials we request, including investment losses and any other loss or damage (including but not limited to lost opportunities and adverse tax consequences). If you proceed with the account opening process, you accept all risks of loss resulting from any failure of yours to furnish the identification materials we request or from a subsequent inability to adequately verify your identity in accordance with Federal law or regulation0-000-000-0000.

Appears in 1 contract

Samples: Adoption Agreement

Custodial Fees. $15.00 12.00 annual maintenance fee per unique social security numberyear. This fee is owed and due for each full and partial calendar year that the IRA Account is open. The participant may pay the fee with funds other than those in the IRA Account ("non-custodial funds"). If the fee for a calendar year is not paid by the participant from non-custodial funds by the date reasonably designated by the CustodianCustodian or prior to closing the IRA Account, the Custodian is authorized to deduct the fee from funds in the IRA Account at any time immediately after such payment due datedate or immediately after receiving instructions to close the IRA Account. The Custodian is authorized to change the fee but will give at least 30 days written notice to the participant of any fee change. The Custodian will keep those records, identify and file returns and provide other information concerning the IRA as required of custodians by the Internal Revenue Code and any regulations issued or forms adopted by the Internal Revenue Service IRS or U.S. Treasury Department. Pacific Life Funds will pay Remove if the fee client does not allow telephone redemptions on your behalf for IRA accounts that: 1) elect the e-Delivery option or 2) have aggregated assets under the same Social Security Number greater than $15,000 on the fee deduction date. I understand that the telephone transaction privileges will may apply to my account. If I have telephone transaction privileges, I agree that neither the Custodian, Pacific FundsVoya Investment Management, nor their transfer agent, their agents, officers, trustees, directors or employees will be liable for any loss, liability or expense for acting, or refusing to act on instructions given under the telephone transaction privileges that are reasonably believed to be genuine and I accept the risk of loss. I direct that all benefits upon my death be paid as indicated on the beneficiary designation. If I named a beneficiary that is a Trust, I understand I must provide certain information concerning such Trust to the Custodian. I understand that, if I am subject to community property or marital property state requirements, my spouse may be required to consent to any beneficiary I designate who is not my spouse, or who is in addition to my spouse. I also understand that any beneficiary designation I make, other than my spouse, may not be effective without my spouse’s consent. I certify, under penalty of perjury, if I am married and have not named my spouse as my sole Primary Beneficiary, I have consulted a qualified tax or legal professional about the need to document spousal consent, and about the consequences of not obtaining my spouse’s consent. I (the Participant) certify under penalties of perjury that (i) all information I have provided on this form or otherwise in connection with establishing my IRA is true, correct, and complete, and (ii) I am a US person (including a US resident alien) and that my Social Security Number is true, correct and complete and that this number is my Taxpayer Identification Number. (Foreign persons must use appropriate Form W-8). ) To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies persons opening accounts; . To comply, the Custodian requires the participant's name, address, date of birth and government-issued identification number (generally, a Social Security Number) and other information that may help the Custodian identify the participant; and the Custodian may ask for copies of related documentation and may consult third-party databases to help verify the participant's identity. I have read and I understand the Disclosure Statement which that explains the risks of opening this account if I do not provide all requested identification materials or if my identity cannot be adequately verified in accordance with U.S. Government requirements. SIGN HERE Shareholder’s/X Signature: Date: (Responsible Individual’s Signature Date Individual in the case of a xxxxx XXX) IRA Custodian: BNY Mellon Investment Servicing Trust Company, 0000 Xxxxxxxx Xxxxx, Xxxxxxxxxxx, XX 00000 DistributorMail to the following: Pacific Select Distributors, LLC (member FINRA & SPIC) a subsidiary to Pacific Life Insurance Company. Shares of Pacific Funds are offered by the distributor. The distributor is not a bank, and shares of the Fund are not deposits or obligations of, or guaranteed or endorsed by any bank, nor are they federally insured or otherwise supported by the FDIC, the Federal Reserve Board or any other agency. The distributor has instituted a Client Identification Program in its obligations under the U.S.A. Patriot Act (Act). This important federal regulation is designed to prevent, deter, and, where necessary, prosecute those who seek to manipulate the U.S. financial system. Consistent with the Act, the provisions of the distributor’s Client Identification Program serve to reinforce key elements of a broker/dealers responsibility of becoming familiar with its clients. The distributor may therefore ask you to provide identification documents or other information. Should you ever have a complaint regarding your account, contact us at the following addressFirst Class Mail: Pacific Select Distributors, LLC AttnVoya Investment Management Overnight Mail: Compliance Department 000 Xxxxxxx Xxxxxx Xxxxx Xxxxxxx Xxxxx, XX 00000 TelephoneVoya Investment Management Customer Service: 0-000-000-0000 TRADITIONAL and XXXX INDIVIDUAL RETIREMENT ACCOUNT (IRA) COMBINED DISCLOSURE STATEMENT The following information is the disclosure statement required by federal tax regulations. You should read this Disclosure Statement, the Custodial Account Agreement and the prospectuses for the mutual funds in which your Individual Retirement Account (“IRA”) contributions will be invested. The rules governing IRAs are subject to change. You should consult Internal Revenue Service (“IRS”) Publication 590 or the IRS web site xxx.xxx.xxx for updated rules and requirements. IMPORTANT INFORMATION ABOUT U.S. GOVERNMENT REQUIREMENTS THAT MAY AFFECT YOUR ACCOUNT P.O. Box 9772 c/o BNY Mellon Investment Servicing Trust Company (“BNY Mellon”U.S.) Inc. Providence, “we” or “us”)RI 02940 0000 Xxxxxxxx Xxxxx Xxxxxxxxxxx, provides custodial and administrative services for your retirement or savings account. As a result of this role, persons who open a retirement or savings account are considered ‘customers’ of BNY Mellon (“you” or “your”). To help the U.S. Government fight the funding of terrorism and money laundering activities, Federal law requires BNY Mellon, as a financial institution, to obtain, verify, and record information that identifies each person who opens an account. All accounts we open are opened on a conditional basis – conditioned on our ability to verify your identity in accordance with Federal law. When establishing an account, you are required to provide your full legal name, address, government issued identification number (e.g. social security number), date of birth, and other information within your account-opening application that will allow us to identify you. We may also request a copy of your driver’s license or other identifying documents and may consult third-party databases to help verify your identity. If the account you are opening will be registered in the name of a beneficiary, trust, or estate or charity, we may require additional identifying documentation. If you fail to provide any requested identifying information or documentation when opening your account, your new account application may be rejected. If we open your account, and you subsequently fail to provide all identification materials we request or if we are subsequently unable to adequately verify your identity as required by U.S. Government regulations, we reserve the right to take any one or more of the following actions:  We may place restrictions on your account which block all purchase transactions and we may place additional restrictions on your account blocking other transactional activities if we determine such additional restrictions are appropriate under Federal law or regulation.  We may close your account, sell (i.e., "liquidate") the assets in your account in the prevailing market at the time, and send you a check representing the cash proceeds of your account. This distribution will be reported to the Internal Revenue Service and may result in unfavorable consequences to you under Federal and state tax laws. You May Incur Losses. Despite being opened as a conditional account, your account will be invested as you instruct and you will be subject to all market risks during the period between account opening and any liquidation necessitated by your failure to furnish requested identifying information or by an inability to adequately verify your identity. You may also be subject to additional market risks if the additional transactional restrictions discussed above are placed on your account. In addition, the closing of your account may subject you to fees and charges imposed by a sponsor, issuer, depository or other person or entity associated with one or more of the assets in which you are invested, and any sales charges you may have paid in connection with your purchases will not be refunded. You Assume All Responsibility For These Losses. BNY Mellon expressly disclaims any responsibility or liability for losses you incur as result of your failure to furnish identification materials we request, including investment losses and any other loss or damage (including but not limited to lost opportunities and adverse tax consequences). If you proceed with the account opening process, you accept all risks of loss resulting from any failure of yours to furnish the identification materials we request or from a subsequent inability to adequately verify your identity in accordance with Federal law or regulation.XX 00000

Appears in 1 contract

Samples: investments.voya.com

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