IRAs - Request Calculation Minimum Required Distributions

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Take Advantage of the Benefits Offered by Citizens Insurance Company of America

Request A "Required Minimum Distribution" (RMD) Calculation
You must be a current client of MEA Financial Services, Inc./Paradigm Equities, Inc. to obtain a RMD (Required Minimum Distribution) calculation.

Please provide the following information and submit it. Our service staff will run the calculation on your current account balance(s) and respond ASAP via regular mail or email.

Request For Required Minimum Distribution Calculation

Email Address *

Client's Full Name *

Address (Street or P.O. Box) *

City *

State*

Zip Code *

Daytime Phone & Area Code *

Is this a *

Home Phone Cell Phone Business Phone

Account Owner's Date of Birth *

How would you like information sent? *

E-Mail regular mail

Please indicate the method(s) of calculation you desire.

Select one or both*

Single Joint Both

If joint life, provide individual's name.

If joint life, provide relationship to owner.

If joint life, provide individual's date of birth

Check all company(ies) , list all account #'s, & type of account that you desire calculations for. (i.e. MetLife: ML123456, TDA)

Company(ies) *

MetLife Prudential SunAmerica

MetLife account #(s) & type of account (i.e. TDA, IRA)

Prudential account # (s) & type of account (i.e. TDA, IRA)

Sun account # (s) & type of account (i.e. TDA, IRA)

If TDA, acct(s) have a 12-31-86 balance, list account # & balance for each.

MetLife 12-31--86 Balance (if applicable)

Prudential 12-31--86 Balance (if applicable)

SunAmerica 12-31--86 Balance (if applicable)

Please provide further instruction or explanation in the text area provided below.

* Required

If you have difficulty with this form, have additional questions, or do not see your company listed
as an option for a calculation, please contact our office at:

1-800-292-1950.
Request the Investment Division.

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