401k Roth Conversion Rollover Questionnaire

Changes in tax legislation in 2010 will create opportunities for many investors to convert tax-deferred retirement assets to a Roth IRA, which can help generate tax-free retirement income for you and potentially your beneficiaries. Under the Tax Increase Prevention and Reconciliation Act of 2005, the $100,000 modified adjusted gross income requirement will be repealed indefinitely on January 1, 2010, greatly expanding the number of people eligible for a Roth IRA conversion. All investors who have made retirement contributions to employer-sponsored retirement plans (e.g., 401(k), 403(b), 457) or traditional, SEP or SIMPLE IRAs will be eligible. When you convert to a Roth IRA, you currently must pay income tax on the full amount you transfer in the year of conversion. If you convert in 2010, however, you can spread the tax liability over two years (2011 and 2012).

All conversions made after 2010 will be subject to taxation in the year of conversion.

Converting to a Roth has many benefits, but this strategy is not appropriate for everyone. There are tax implications that you will need to consider, and it is strongly recommended that you speak with your tax advisor before making any decisions.

2010 Roth IRA Conversion Questionnaire

The questions below are designed to help you and your Financial Advisor further explore whether a Roth conversion strategy makes sense for you:

1. Do you have assets invested in IRAs or employer-sponsored retirement plans? ❏ YES ❏ NO

2. If you answered yes to Question 1, has the value of those assets declined due to the recent economic downturn? ❏ YES ❏ NO

3. Do you anticipate that your tax bracket will be higher in retirement? ❏ YES ❏ NO

4. Do you want to leave a tax-free asset to your children or heirs? ❏ YES ❏ NO

5. Do you want to potentially reduce the taxable value of your estate? ❏ YES ❏ NO

6. Will you have sufficient income from non-retirement-account sources to support you in retirement? ❏ YES ❏ NO

7. Do you have tax deductions that exceed your income or non-refundable tax credits? ❏ YES ❏ NO

8. Do you want to increase your tax-free savings as part of your overall portfolio strategy? ❏ YES ❏ NO

9. Are you temporarily in a lower income tax bracket? ❏ YES ❏ NO

10. Do you have funds outside of your IRA to pay the income taxes that a Roth IRA conversion will trigger? ❏ YES ❏ NO

If you answered “yes” to any of the questions above, you may want to consider a Roth IRA conversion. Your Financial Advisor, together with your tax advisor and others, can help you determine whether this strategy will help you achieve your retirement and other financial goals. When you meet, be sure to bring this worksheet as a starting point for a productive conversation.