Request a Roth Conversion

Request a Roth Conversion
Form Last Updated 11/13/2025
Your Email Address*
Client Name*

First NameLast Name
Conversion Instructions
Traditional IRA Account (last 4 digits)*
Destination Roth IRA Account (last 4 digits)*
Conversion Type*

Full Conversion (entire balance)Partial Conversion (specify $ below)
Is this in kind or should we liquidate and move cash raised?*

Liquidate and move cashIn kind
Please list what to move in kind for conversion*
How much should be raised for conversion? *
Reminder: Roth conversions are a taxable event. Please confirm your client understands potential tax implications.
Tax Withholding
Do you want to withhold taxes from this conversion? (If yes, please note we may need to sell positions to ensure there is enough cash to cover the taxes withheld).*

YesNo
Would you like to withhold a percentage or flat dollar amount? Your amount for federal and/or state will be specified below.

PercentageFlat dollar amount
Federal Tax Withholding*
If none, enter 0.
State Tax Withholding*
If none, enter 0.
Any special instructions (example: please list if you'd like a money market fund sold if liquidating etc.)?
Should be Empty:

Conversion Instructions