Forms
Select the type of form you would like to complete from the categories below.
All
Forms
Fund An
Account
Make An
Investment
Take A
Distribution
Update An
Account
Fee Schedule
& Disclosures
Fair Market Valuation Form
It’s time to submit your Fair Market Valuation forms for each of the different asset classes in your account.
You can complete your FMV process on your portal, and we’ve created a video to help explain how to complete your FMV both on- and offline. Click the “Watch Video” button to learn more.
Account Funding Forms
Incoming Transfer Request
Use this form to request a direct transfer of funds or in-kind assets from another custodian to Provident Trust Group.
Important: Please remember to include a copy of a recent statement.
Direct Rollover Request
This form is used to request a direct rollover of funds or in-kind assets from another custodian to Provident Trust Group. Do not use this form for an IRA-to-IRA transfer.
Before completing this form: Contact your current retirement account custodian or administrator to ensure they do not have their own form for you to use.
Deposit Submission Form
This form is used when funds are deposited into a Provident Trust Group account for a contribution, rollover, or asset payment.
Important: A deposit may be delayed if this form is not submitted. For additional deposit instructions and information, please download our Deposit Information Sheet.
ACH Contribution/Deposit Form
This form is used to request an automated clearing house (ACH) deposit, one-time or on a recurring basis, into an existing Provident Trust Group account.
Important: Provident Trust Group, LLC initiates this transaction from your checking account and requires a copy of a voided check. For additional deposit instructions and information, please download our Deposit Information Sheet.
Rollover Certification for Assets (Traditional, Roth, SEP, SIMPLE)
This form is used to describe assets being rolled over into an existing Provident Trust Group account.
Rollover Certification (Individual 401(k), also called Solo 401(k))
This form is used to certify funds being rolled over into an existing Individual(k) account at Provident Trust Group account.
Roth IRA Conversion Form
This form is used to convert all or a portion of a traditional IRA into an existing Roth IRA at Provident Trust Group.
Please note: If you would like to establish a new Roth IRA, please click here.
Roth IRA Conversion Certification
This form is used to certify that all or a portion of a traditional IRA is eligible to move into an existing Roth IRA at Provident Trust Group.
Please note: If you would like to establish a new Roth IRA, please click here.
Recharacterization Request
This form is used to recharacterize all or a portion of a previously completed Roth Conversion or IRA contribution to an existing traditional IRA held at Provident Trust Group.
Asset Purchase / Investment Forms
Direction of Investment – General
Complete this form to direct Provident Trust Group to make an investment from an existing account.
Please note: This form is not used to direct Provident Trust Group to pay an expense on an existing asset in your account. Please use the Expense Payment Authorization Form.
Authorization To Take Action Form
This form is used to authorize Provident Trust Group to take further action on an existing account or asset (e.g., 990T, sale of asset, extend loan terms, execute documents, obtain EIN).
Direction of Investment – Precious Metals
Use this form to direct Provident Trust Group to make a precious metals investment from an existing account.
Expense Payment Authorization Form
This form is required to authorize Provident Trust Group to pay an expense for an asset held in an existing account (capital calls, property taxes, insurance premiums, utility payments, management fees, etc.).
This form may also be used as a blanket authorization to pay all bills to a specified payee, for a specific asset.
Please note: This form is not used to direct Provident Trust Group to purchase a new investment.
Individual(k) Loan Request Application
Use this form to initiate the processing of a loan from a Provident Trust Group Solo 401(k) account.
Property Manager Waiver
For real estate investments, Provident Trust Group requires the submission of either a Property Manager Agreement or a Property Manager Waiver. The Property Manager Waiver can be completed and returned to us with a Direction of Investment form.
Loan Servicing Waiver
For promissory note investments, Provident Trust Group requires the submission of either a Loan Servicer Agreement or a Loan Servicer Waiver. The Loan Servicer Waiver can be completed and returned to us with a Direction of Investment form.
Distribution / Withdrawal Requests
Distribution Request – Traditional IRA, SEP IRA, SIMPLE IRA
Use this form when taking a one-time distribution from a traditional IRA, SEP IRA, or SIMPLE IRA.
Distribution Request – Roth IRA
Use this form when taking a one-time distribution from a Roth IRA.
Recurring Distribution Request – Traditional IRA, Roth IRA
This form is used to request periodic recurring distributions from an existing traditional IRA or Roth IRA account at Provident Trust Group.
Please note: You may choose to have recurring payments processed monthly or quarterly, and by check or ACH. If ACH is chosen, please attach a copy of a voided check.
Distribution Request – Individual(k) Accounts
Use this form when taking a one-time distribution from a Solo 401(k) account.
Recurring Distribution Request – Individual(k) Accounts
This form is used to request periodic recurring distributions from an existing Solo 401(k) account at Provident Trust Group.
Please note: You may choose to have recurring payments processed monthly or quarterly, and by check or ACH. If ACH is chosen, please attach a copy of a voided check.
Distribution Request – Charitable
Use this form when taking a one-time distribution, for which the payee is a charitable organization.
Distribution Request – Cash Accounts (nonqualified)
Complete this form to initiate a one-time withdrawal from a nonqualified account at Provident Trust Group.
Recurring Distribution Request – Cash Accounts (nonqualified)
Complete this form to initiate periodic recurring distributions from a nonqualified account at Provident Trust Group.
Excess Removal Worksheet
This form is used to remove excess contribution funds from your traditional IRA or Roth IRA at Provident Trust Group.
Change/Update Account Information
Adoption Agreement – Individual(k)
The Adoption Agreement is essentially the operating document that adopts the qualified retirement plan, and allows the plan administrator to choose options if available in the basic plan documents.
Adoption Agreement – SEP
The Adoption Agreement is essentially the operating document that adopts the qualified retirement plan, and allows the plan administrator to choose options if available in the basic plan documents.
Beneficiary Designation – Addendum
This form is used to add additional beneficiary information to an applicable Beneficiary Designation Form or Account Application.
Beneficiary Designation – IRA
This form is used to add or change beneficiaries for an existing IRA.
Important: This form voids all previous beneficiary elections.
Beneficiary Designation – Inherited IRAs
This form is used to add or change beneficiaries for an existing Inherited IRA.
Important: This form voids all previous beneficiary elections.
Beneficiary Designation – Individual(k)
This form is used to add or change beneficiaries for an existing Solo 401(k) account.
Important: This form voids all previous beneficiary elections.
Beneficiary Designation – Addendum Individual(k)
This form is used to add additional beneficiary information to an applicable Beneficiary Designation Form or Account Application for a qualified retirement plan.
Beneficiary Designation – Nonqualified Account
This form is used to add or change beneficiaries for an existing non-qualified account.
Important: This form voids all previous beneficiary elections.
Custodial Agreement – Individual(k)
This agreement between the trustee, limited trustee, and custodian identifies and describes their respective roles as it relates to the retirement plan.
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Designation Successor Plan Administrator/Trustee
This form allows the account owner of a Individual(k) to notify Provident Trust Group of the individual who should become the plan administrator/trustee of the plan upon the death of the business and Individual(k) owner.
Third-Party Authorization
Complete this form to grant or revoke informational account access to a third-party representative. This form does not give the named party the ability to direct any activity within your account.
Change/Update Contact Information
This form can be used to change or update your contact information.
Fee Schedule & Disclosure Forms
Fee Schedule
Please see this form for our standard fee schedule.
Please note: Fees may differ.
Fee Disclosure
This disclosure provides the financial terms and conditions associated with an account at Provident Trust Group.
Traditional IRA Disclosure
These disclosures provide the terms and conditions of your traditional IRA account.
Roth IRA Disclosure
These disclosures provide the terms and conditions of your Roth IRA account.
SEP IRA Disclosure
These disclosures provide the terms and conditions of your SEP IRA account.
SIMPLE IRA Disclosure
These disclosures provide the terms and conditions of your SIMPLE IRA account.
Individual(k) Plan Disclosure
These disclosures provide the terms and conditions of your Solo 401(k) Plan.
Custodial Account Nonqualified (NQ) Disclosure
These disclosures provide the terms and conditions of your nonqualified custodial account.
Sub-Custodial Account Employer Disclosure
These disclosures provide the terms and conditions of your sub-custodial account.
Sub-Custodial Account Participant Disclosure
These disclosures provide the terms and conditions of your sub-custodial account.
Health Savings Account (HSA) Disclosure
These disclosures provide the terms and conditions of your health savings account.
Coverdell Education Savings Account (ESA) Disclosure
These disclosures provide the terms and conditions of your Coverdell ESA.
Inherited IRA Disclosure for Traditional IRAs
These disclosures provide the inherited IRA terms and conditions for Traditional IRA accounts.
Inherited IRA Disclosure for Roth IRAs
These disclosures provide the inherited IRA terms and conditions for Roth IRA accounts.
Privacy Notice Disclosure
This disclosure explains how Provident Trust Group collects, shares, and protects your personal information.
Statement Disclosure
Important and binding information regarding your account’s asset valuation.
