Forms Checklist

IRA, Coverdell ESA, HSA, and SEP and SIMPLE IRA Plan

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Ascensus' forms and documents are constantly monitored to accommodate changes brought about by new tax laws and regulatory changes – and, equally important, to respond to your requests and needs. This Forms Checklist provides you with the date of the most current version of the designated form or document. Versions which are technically inaccurate because of subsequent law changes or IRS pronouncements are listed in the column entitled "Obsolete Version." If no date appears in the obsolete column, all existing versions may be used. This checklist will be updated periodically.

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Account Establishment: Opening Documents

No. Name Current Version Obsolete Version
Traditional IRA
97 Traditional IRA Simplifier Trust - 5305 5/2023 A, B
98 Traditional IRA Simplifier Custodial - 5305-A 5/2023 A
100 Traditional IRA Simplifier Self-Directed Custodial - 5305-A 5/2023 A
97-IH Inherited Traditional IRA Simplifier Trust - 5305 5/2023 Any prior to 1/2009 B, C
98-IH Inherited Traditional IRA Simplifier Custodial - 5305-A 5/2023 Any prior to 1/2009 C
100-IH Inherited Traditional IRA Simplifier Self-Directed Custodial - 5305-A 5/2023 Any prior to 1/2009 C
 
Roth IRA
6097 Roth IRA Simplifier Trust - 5305-R 2/2024 A, B***
6098 Roth IRA Simplifier Custodial - 5305-RA 2/2024 A***
6100 Roth IRA Simplifier Self-Directed Custodial - 5305-RA 2/2024 A***
6097-IH Inherited Roth IRA Simplifier Trust - 5305-R 5/2023 Any prior to 1/2009 B, C
6098-IH Inherited Roth IRA Simplifier Custodial - 5305-RA 5/2023 Any prior to 1/2009 C
6100-IH Inherited Roth IRA Simplifier Self-Directed Custodial - 5305-RA 5/2023 Any prior to 1/2009 C
 
SIMPLE IRA
1097 SIMPLE IRA Simplifier Trust - 5305-S 5/2023 A, B
1098 SIMPLE IRA Simplifier Custodial - 5305-SA 5/2023 A
1100 SIMPLE IRA Simplifier Self-Directed Custodial - 5305-SA 5/2023 A
 
Coverdell Education Savings Account (ESA)
5097 Coverdell ESA Simplifier Trust - 5305-E 10/2018 B, D
5098 Coverdell ESA Simplifier Custodial - 5305-EA 10/2018 D
 
Health Savings Account (HSA)
3499 HSA Simplifier Trust - 5305-B 10/2018 E
3500 HSA Simplifier Custodial - 5305-C 10/2018 E

 

IRA Maintenance Forms

No. Name Current Version Obsolete Version
IRA Contributions
106 Special Contributions 11/2023 Any prior obsolete
107 Traditional IRA Contribution and Investment Selection 5/2023 Any prior obsolete
107-IH Inherited IRA Contribution and Investment Selection 6/2024  
109 Traditional IRA Contribution Eligibility  11/2023 Any prior obsolete
110 Conduit IRA Notice and Election    
135 IRA Certification for Late Rollover Contribution 10/2020 Any prior obsolete
489 IRA Automatic Rollover Agreement 3/2014
1107 SIMPLE IRA Contribution and Investment Selection 11/2023 Any prior obsolete
1109 SIMPLE IRA Contribution Eligibility 11/2023 Any prior obsolete
6107 Roth Contribution and Investment Selection 2/2024 Any prior to 10/2014***
6109 Roth Contribution Eligibility 2/2024 Any prior to 11/2022***
 
IRA Portability
302 Traditional and SIMPLE IRA Transfer Request 1/2020 Any prior obsolete
305 IRA Recharacterization Election 10/2020 Any prior to 10/2018
487 IRA Direct Rollover Request 3/2016 Any prior to 1/2002
6302 Roth IRA Transfer Request 10/2017 Any prior to 5/2002
6305 Roth IRA Direct Conversion Request 4/2024 Any prior to 3/2022. 3/2022 version compliant only if includes attached 1/2024 version Withholding Instructions (IRS Form W-4R)
 
IRA Distributions and Withholding
22 IRA Charitable Distribution Request 5/2023 Any prior obsolete
123 IRA Excess Removal Worksheet 1/2020 Any prior obsolete
314 IRA Withdrawal Authorization 4/2024 Any prior to 5/2023. 5/2023 version compliant only if includes attached 1/2024 version Withholding Instructions (IRS Form W-4R)
314-IH Inherited IRA Withdrawal Authorization 6/2024  
317 IRA Withholding Notice and Election (with current election included) 4/2024 Any prior to 3/2022. 3/2022 version compliant only if includes attached 1/2024 version Withholding Instructions (IRS Form W-4R)
319 IRA Substantially Equal Periodic Payment Election 4/2024 Any prior to 3/2022. 3/2022 version compliant only if includes attached 1/2024 version Withholding Instructions (IRS Form W-4R)
321 IRA Beneficiary Required Election - for deaths prior to January 1, 2020 5/2023 Any prior obsolete
322 IRA Required Minimum Distribution Scheduled Payment Election 4/2024 Any prior to 5/2023. 5/2023 version compliant only if includes attached 1/2024 version Withholding Instructions (IRS Form W-4R)
323 IRA Required Minimum Distribution Notice 1/2023 Any prior obsolete
324 IRA Scheduled Payment Election 4/2024 Any prior to 3/2022. 3/2022 version compliant only if includes attached 1/2024 version Withholding Instructions (IRS Form W-4R)
324-IH Inherited IRA Payment Election - for deaths prior to January 1, 2020 4/2024 Any prior to 5/2023. 5/2023 version compliant only if includes attached 1/2024 version Withholding Instructions (IRS Form W-4R)
341 IRA Beneficiary Required Election - for deaths on or after January 1, 2020 5/2023 Any prior obsolete
344-IH Inherited IRA Payment Election - for deaths on or after January 1, 2020 4/2024 Any prior to 5/2023. 5/2023 version compliant only if includes attached 1/2024 version Withholding Instructions (IRS Form W-4R)
6123 Roth IRA Excess Removal Worksheet 10/2015 Any prior to 1/2004
6314 Roth IRA Withdrawal Authorization 4/2024 Any prior to 5/2023. 5/2023 version compliant only if includes attached 1/2024 version Withholding Instructions (IRS Form W-4R)
80024 IRA State Income Tax Withholding Election 8/2024 Any prior obsolete
 
IRA Beneficiary Designations
121 IRA Beneficiary Reminder Notice 3/2014  
301 IRA Beneficiary Designation 4/2015  
301-SU IRA Beneficiary Designation Addendum 4/2015  
307 Inherited IRA Beneficiary Designation 4/2015  
 
IRA Changes
311 IRA Change of Account Information 3/2014  
2310 Investment Change 3/2014  

 

Coverdell ESA Maintenance Forms

No. Name Current Version Obsolete Version
ESA Contributions
106 Special Contributions 5/2023 Any prior obsolete
5107 Coverdell ESA Contribution and Investment Selection 10/2014 Any prior obsolete
5109 Coverdell ESA Contribution Eligibility 10/2015  
 
ESA Portability
5302 Coverdell ESA Transfer Request 7/2013 Any prior to 7/2001
 
ESA Distributions
5123 Coverdell ESA Excess Removal Worksheet 10/2015  
5314 Coverdell ESA Withdrawal Authorization 3/2019 Any prior to 10/2018
 
ESA Death Beneficiary Designations
5301 Coverdell ESA Death Beneficiary Designation 4/2015 Any prior to 1/2002
5301-SU Coverdell ESA Death Beneficiary Designation Addendum 4/2015  
 
ESA Changes
5311 Coverdell ESA Change of Account Information 3/2014  

 

HSA Maintenance Forms

No. Name Current Version Obsolete Version
HSA Contributions
3107 HSA Contribution and Investment Selection 10/2015 Any prior to 10/2004
3109 HSA Contribution Eligibility 11/2023 Any prior obsolete
3315 HSA Mistaken Distribution Payment 3/2014  
3322 Qualified HSA Funding Distribution Request 7/2013 Any prior to 10/2004
 
HSA Portability
3302 HSA Transfer Request 7/2013 Any prior to 10/2004
 
HSA Withdrawals
3123 HSA Excess Removal Worksheet 10/2015  
3314 HSA Withdrawal Authorization 4/2015 Any prior to 10/2004
 
HSA Beneficiary Designations
3121 HSA Beneficiary Reminder Notice 3/2014  
3301 HSA Beneficiary Designation 4/2015 Any prior to 10/2004
3301-SU HSA Beneficiary Designation Addendum 4/2015  
 
HSA Changes
2310 Investment Change 3/2014  
3311 HSA Information Change 3/2014  

 

SEP Plan

No. Name Current Version Obsolete Version
For use with all Ascensus SEP Plans
407 SEP Contribution Statement 1/2016 Any prior to 9/2002
436 Pre-tax/Roth SEP Employer Contribution Election Form 6/2024  
Prototype SEP Plan
400 Standard SEP Plan Establishment Booklet 6/2024 Any prior obsolete*
408-SU Additional SECURE 2.0 Plan Provisions Employer Election Form – Universal SEP 6/2024  
410 Universal SEP Plan Establishment Booklet 6/2024 Any prior obsolete*
411 Universal SEP Employee Information Booklet 7/2024 Any prior obsolete
412 Universal SEP Salary Reduction Agreement 6/2024 Any prior obsolete*****
413 Universal SEP Summary for Employees 6/2024 Any prior obsolete*****
418-SU Additional SECURE 2.0 Plan Provisions Employer Election Form - Standard SEP and IRS model-based SEP 6/2024  
421 Standard SEP Employee Information Booklet 7/2024 Any prior obsolete
422 Standard SEP Summary for Employees 6/2024 Any prior obsolete*****
 
Government SEP Plan
416 5305-SEP Plan Establishment Booklet 7/2024 Any prior obsolete
418-SU Additional SECURE 2.0 Plan Provisions Employer Election Form - Standard SEP and IRS model-based SEP 6/2024  

 

SIMPLE IRA Plan

No. Name Current Version Obsolete Version
For use with all Ascensus SIMPLE IRA Plans
618-SU Additional SECURE and SECURE 2.0 Plan Provisions Employer Election Form 5/2024  
663 Mid-year SIMPLE IRA Plan Termination Notice 5/2024  
676 Pre-tax/Roth SIMPLE IRA Matching or Nonelective Contribution Election Form 5/2024  
Prototype SIMPLE IRA Plan
600 SIMPLE IRA Plan Establishment Booklet 5/2024 Any prior obsolete*
616 SIMPLE IRA Salary Reduction Agreement 5/2024 Any prior obsolete**
617 SIMPLE IRA Participation Notice & Summary Description 5/2024 Any prior obsolete**
 
Government SIMPLE IRA Plan
516 5305-SIMPLE Establishment Booklet - For use with a DFI 5/2024 Any prior obsolete
516-S SIMPLE IRA Salary Reduction Agreement – For use with a DFI 5/2024 Any prior obsolete****
516-P SIMPLE IRA Participation Notice & Summary Description – For use with a DFI 5/2024 Any prior obsolete**
517 5304-SIMPLE Establishment Booklet - Not subject to DFI rules 5/2024 Any prior obsolete
517-S SIMPLE IRA Salary Reduction Agreement – For use with a nonDFI 5/2024 Any prior obsolete****
517-P SIMPLE IRA Participation Notice & Summary Description – For use with a nonDFI 5/2024 Any prior obsolete**

 

Key
A Any prior to 10/2006 obsolete; versions dated 5/2002 through 4/2020 are obsolete unless accompanied by the appropriate disclosure statement amendment; strongly recommend the current version
B Include use for managed and self-directed trust accounts.
C Versions dated 1/2009 through 10/2020 require a disclosure statement amendment; strongly recommend the current version.
D Any prior to 10/2014 are obsolete unless accompanied by the appropriate disclosure statement amendment; strongly recommend the current version.
E Any prior to 5/2012 are obsolete unless accompanied by the appropriate disclosure statement amendment; strongly recommend the current version.
Versions prior to 4/2008 should be used with caution regarding automatic rollovers to inherited IRAs.
Versions prior to 4/2006 should not be used for Roth IRAs.
Versions prior to 1/2007 should not be used to request or to certify a rollover of inherited retirement plan assets into an inherited IRA.
Versions prior to 4/2008 should be used with caution regarding rollovers of designated Roth contributions.
* Prior to the 11/2022 update, prototype SEP and SIMPLE IRA plan forms and documents were maintained separately. Now, all the forms that collectively made up the former plan establishment “kits” are maintained within single item booklets. While each form within the booklets retains its individual item number and revision date, an update to any form whereby the prior revision is deemed obsolete deems the entire booklet obsolete. 
** This form, also found in Form 516, 517, or 600 SIMPLE IRA Plan Establishment Booklet, as applicable allows you to efficiently provide the most current form to your adopting employers so that they can distribute their required annual notice to participating employees using current forms.
***  Versions prior to 2/2024 (that are not obsolete) do not include an option on the form to select a 529 plan (qualified tuition plan) to Roth IRA rollover as a Roth IRA contribution type; recommend the current version.
****  This form, also found in Form 516, 517, or 600 SIMPLE IRA Plan Establishment Booklet, as applicable allows you to efficiently provide the most current form to your adopting employers so that they can distribute to participating employees using current forms.
***** This form, also found in Form 400 Standard SEP Plan Establishment Booklet or 410 Universal SEP Plan Establishment Booklet, as applicable allows you to efficiently provide the most current form to your adopting employers so that they can distribute to participating employees using current forms.

 

Lobby Brochure Checklist
Qualified Retirement Plan Forms Checklist