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Shareholder Services: Applications & Forms

Applications & Forms


General Account Application
Use this form to open an account for an individual, trust, corporation or other entity. Not to be used for when opening an IRA account. Download PDF

Individual Retirement Account Applications
An IRA is a retirement investing tool for employed individuals and their non-working spouses that allows annual contributions up to a specified maximum amount.  
Traditional and Roth IRA Application
Contributions are often tax-deductible (often simplified as "money is deposited before tax" or "contributions are made with pre-tax assets"), all transactions and earnings within the IRA have no tax impact, and withdrawals at retirement are taxed as income (except for those portions of the withdrawal corresponding to contributions that were not deducted). Within a Roth IRA account, contributions are made with after-tax assets, all transactions within the Roth IRA have no tax impact, and withdrawals are usually tax-free. Download PDF

Account Maintenance Forms
Account Maintenance Form
Change your address, your name or dividend/capital gains distribution options; get/stop duplicate account statements; add/remove telephone purchase, exchange or redemption privileges; or add/update bank information. Download PDF
Systematic Purchase/Redemption Form
This form will allow you to establish automatic transfer of cash directly from your bank account for investment into your Tweedy, Browne Fund account(s). You can also establish an automatic redemption option which will redeem shares from your Fund account(s) and transfer the cash proceeds directly into your bank account. Download PDF
Cost Basis Method Maintenance Form
Use this form to change the current cost basis calculation method on your account(s). Download PDF

Additional Retirement Account Maintenance Forms
Transfer of Assets/Direct Rollover Form
This form will be used to initiate a Transfer of Assets or a Direct Rollover based on your request from an existing retirement plan account as designated on this form to your Traditional, SEP, or Roth IRA at Tweedy, Browne Fund Inc. *Please remember that a Transfer of Assets can only occur between the SAME type of retirement plans, e.g. IRA to IRA or Roth IRA to Roth IRA. Download PDF
Beneficiary Designation Change Form
Used to request a change of beneficiary(ies) after the account is established. Download PDF
Certification of Rollover Assets
Use this form to certify a rollover distribution or eligible conversion distribution to your Traditional, SEP, or Roth IRA at Tweedy, Browne Fund Inc. You must complete the rollover within 60 calendar days of your receipt of that distribution. Download PDF
IRA Distribution Request Form
Use this form to request one of the various types of distributions (excluding required minimum distributions, conversions and recharacterizations) and tax withholding election in your Traditional, SEP or Roth IRA account. Download PDF
Required Minimum Distribution Election Form
You are required to take an RMD from your Traditional IRA/403(b)(7) by April 1 of the year following the year you reach age 70½ (required beginning date) and by the end of each year thereafter. Use this form to choose how you'd like to receive your distributions. Download PDF
Qualified Charitable Distribution Request Form
Use this form to request a Qualified Charitable Distribution (“QCD”) from your IRA or beneficiary inherited IRA. Download PDF
Roth IRA Conversion Request Form (Internal)
To be completed when converting a Traditional IRA to a Roth IRA within Tweedy, Browne Fund Inc. If you are opening a new Roth IRA account with the conversion contribution, include a Roth IRA application. Download PDF
Roth IRA Conversion Request Form (External)
To be completed when converting a Traditional IRA from another Custodian or Trustee to a Tweedy, Browne Fund Inc. Roth IRA. A completed Roth IRA application must accompany this form, if applicable. Download PDF
Recharacterization Request Form (Internal)
This form is used to recharacterize an in-house IRA contribution into a different type of IRA account or recharacterize a conversion contribution. Participants can recharacterize in the following manner: A contribution originally made to a Roth IRA as a contribution to a Traditional IRA; A contribution originally made to a Traditional IRA as a contribution to a Roth IRA Download PDF
Recharacterization Request Form (External)
This form is used to recharacterize an IRA contribution or conversion contribution from an outside institution into a different type of IRA account held here. Participants can recharacterize in the following manner: A contribution originally made to a Roth IRA as a contribution to a Traditional IRA; A contribution originally made to a Traditional IRA as a contribution to a Roth IRA Download PDF
Self-Certification Form for Late Rollover Contributions
Use this form when you intended to make a rollover within 60 days of receiving the distribution but were unable to do so for various reasons listed on the form. Download PDF