Directed Account Plan

Use these forms for any business related to your Directed Account Plan account.

Beneficiary Designations and Rollovers

• Beneficiary Form (PDF)
  
• Rollover Form – Into the DAP (PDF)
  

Withdrawal Forms

To execute a withdrawal transaction, please:

• Select the appropriate form, below.
  • Lump Sum Rollover Request Form (PDF)
  • Lump Sum Withdrawal (PDF)
  • Partial Rollover Request Form (PDF)
  • Partial Withdrawal Request Form (PDF)
  • Systematic Withdrawal Payments Form (PDF)
• Review the application carefully.
• Sign the application form.
• If spousal consent is required, complete the spousal consent section and have your
  spouse sign the application in the presence of a notary public.
• Keep a copy for your files.
• Submit the application and any supporting documentation to:

Regular Mail:	Overnight Mail:
Directed Account Plan Service Center	Directed Account Plan Service Center
PO Box 770003	100 Crosby Parkway
Cincinnati, OH 45277-0065	Mailzone: KC1F-L
	Covington, KY 41015

Fidelity will:

• Review the application
• Process the transaction
• Send the funds directly to you or a custodian you designate for a rollover