The IRA Rollover Request Form is used to initiate a rollover of assets to a qualified retirement plan. This form authorizes Retirement Clearinghouse to request a transfer of assets on your behalf.

Mail to:
RCH Shareholder Services

1916 Ayrsley Town Boulevard
Suite 200
Charlotte, NC 28273

Fax to: (704) 353-9841

Scan & email to:

This type of transfer is considered non-taxable and non-reportable. You will NOT receive an IRS Form 1099-R.

By downloading the Rollover Request Form, you acknowledge that your new employer will accept these funds coming from an IRA.

Funds coming from a Roth IRA are not eligible for transfer into an employer's plan.
All withdrawals are subject to a distribution fee.

I acknowledge and accept.