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Self-Certification for Late Rollover
Description of Form
Use this form when you have an IRS-approved reason to invest retirement money into your IRA after a normal rollover contribution deadline has passed.
IRA Participants Use This Form To:
Use this form to certify the reason you were unable to complete a rollover within 60 days of receipt of the distribution.
Other Information
You must comply with all other tax law requirements to make a rollover contribution.
If you are audited and the IRS does not grant a waiver for your rollover contribution, you may be subject to income and excise taxes, interest and penalties.
Self-Certification for Late Rollover