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Select the type of form you would like to complete from the categories below.

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Account Funding Forms

Incoming Transfer Form

Use this form to request a direct transfer of funds or in-kind assets from another custodian to Provident Trust Group.

Please note: Please remember to include a copy of a recent statement.

Deposit Slips

Complete this form when a deposit is made to your account for the following reasons: loan payments, return of funds, proceeds from a sale or maturity of an asset, income from rental properties, or interest and earnings.

This form may also be provided by a third-party when sending funds to Provident Trust Group on behalf of your retirement account.

Please note: A deposit may be delayed if this form is not submitted. For additional deposit instructions & information, please download our Deposit Information Sheet.

Deposit Submission Form

This form is used when funds are deposited into a Provident Trust Group account for a contribution or asset payment.

Please note: A deposit may be delayed if this form is not submitted. For additional deposit instructions & information, please download our Deposit Information Sheet.

ACH Deposit & Contribution Form

This form is used to request an ACH Deposit, one-time or on a recurring basis, into an existing Provident Trust Group account.

Please note: Provident Trust Group, LLC initiates this transaction from your checking account and requires a copy of a voided check. For additional deposit instructions & information, please download our Deposit Information Sheet.

Rollover Contribution (Traditional, Roth, SEP, SIMPLE, Inherited)

This form is used to certify funds being rolled over into an existing Provident Trust Group account.

Rollover Contribution (Solo 401(k))

This form is used to certify funds being rolled over into an existing Solo 401(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

Authorization To Take Action Form

This form is used to authorize Provident Trust Group to take further action on an existing account or existing asset (I.e., 990T, sale of asset, extend loan terms, execute documents, obtain EIN).

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. 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.

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.

Solo 401(k) Loan Request Application

Use this form to initiate the processing of a loan from a Provident Trust Group Solo 401(k) account.

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 – Solo 401(k) Accounts

Use this form when taking a one-time distribution from a Solo 401(k) account.

Recurring Distribution Request – Solo 401(k) Accounts

This form is used to request periodic recurring distributions from an existing Solo(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 (Non-Qualified)

Complete this form to initiate a one-time withdrawal from a non-qualified account at Provident Trust Group.

Recurring Distribution Request – Cash Accounts (Non-Qualified)

Complete this form to initiate periodic recurring distributions from a non-qualified 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 401(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.

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 additional beneficiaries to an existing IRA account.

Please Note: This form voids all previous beneficiary elections.

Beneficiary Designation – Inherited IRAs

This form is used to add additional beneficiaries to an existing Inherited IRA account.

Please Note: This form voids all previous beneficiary elections.

Beneficiary Designation – Solo 401(k)

This form is used to add additional beneficiaries to an existing Solo 401(k) account.

Please Note: This form voids all previous beneficiary elections.

Change/Update Personal Contact Information

Use this form if you need to update your physical or mailing address, phone number, or email address.

Fair Market Valuation Form

This form is used to update Provident Trust Group as to the proper Fair Market Value (FMV) of assets held within your self-directed account. A fair market valuation should be submitted on a yearly basis to ensure proper tax reporting, the distribution of an asset in-kind, or to convert or recharacterize an asset.

Agent 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.

Fee Schedule & Disclosure Forms

Fee Schedule

Please see this form for our standard fee schedule.

Please note: Fees may differ.

Financial 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.

Solo 401(k) Plan Disclosure

These disclosures provide the terms and conditions of your Solo 401(k) Plan.

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.

Money Market Account Disclosure

This disclosure provides the terms and conditions on the liquid cash held within your account.

Privacy Policy Disclosure

This disclosure provides the terms and conditions on how we will and will not disclosure your personal information.

Do you Have Questions? Let us know!

Existing Clients
(888) 855-9856

Future Clients
(888) 662-0869

WHO WE ARE

With more than 34,000 clients in all 50 states, our elite team of professionals is the premier choice. We offer highly personalized service tailored to your needs, transforming your financial future.

CONTACT US

OUR ADDRESS

8880 W. Sunset Rd.,
Suite 250
Las Vegas, NV 89148

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FAX

(702) 253-7565

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HOURS OF OPERATION

Monday - Friday
6AM - 4PM (PST)
 

EMAIL

info@trustprovident.com

Provident Trust Group, LLC is a BBB Accredited Management Consultant in Las Vegas, NV