Forms

Prudential Investments offers many services to help you manage your accounts.

These forms are only to be used if the Prudential Investments account is held at Prudential Mutual Fund Services LLC (PMFS) and are not for use if the Prudential Investments fund is held in a broker-controlled account. You must have Adobe Acrobat Reader installed on your computer to view the forms. Download a free copy now.

Mutual Funds Forms (General Investing)
Traditional IRA, Roth IRA, SEP IRA, Coverdell ESA, and 403(b) Forms
SIMPLE IRA Forms (Qualified Plans)

Mutual Funds Forms (General Investing)
Form/Application Name	Number	Description
Account Registration Change Form	MF 1002	Re-register (change ownership) on an existing account.
Additional Statement Request Form	MF 470	Request additional account statements be sent to a different address.
Affidavit of Domicile	MF 515	This form is used to certify the decedent's place of residence at the time of death and it is required for all redemptions and transfers due to death.
Automatic Investment Plan	MF1006	Automatically invest by transferring money directly from your bank account into your mutual fund(s).
Checkwriting Form (money market funds only)	MF 010	Sign up for the checkwriting privilege from your money market fund.
Corporate Resolution	MF 1015	Authorize an entity's officers and others to conduct transactions on the entity's Prudential Mutual Fund Services LLC account.
Dividend & Capital Gains Instructions Form	MF 313	Update dividend and capital gains option to either reinvest or cash. Cash dividends may be received by check, deposited into your bank account.
Electronic Funds Transfer Purchase Form	MF 1006	Buy shares, online or by phone. The purchase amount will be electronically (via ACH) debited from your bank account.
Exchange Authorization	MF 224A	Use this form to authorize fund exchanges.
Expedited Redemption Form	MF 008	Sell shares, at any time, online or by phone. The redemption amount will be electronically credited (via ACH or fed fund wire) to the shareholder's bank account.
Letter of Intent Form (Class A Shares only)	MF 230	If the intent is to purchase a set dollar amount over a 13-month period, you may be eligible to receive a reduced sales charge.
Limited Power of Attorney Form	PMFS 286	Authorize others to conduct certain transactions on your behalf for your mutual fund account(s). Read form carefully for account restrictions.
Redemption Form	MF 004	Use this form to redeem shares.
Systematic Exchange Plan Form	MF 312	Establish a periodic exchange between funds.
Systematic Withdrawal Plan Form	MF 310	Request periodic distributions from an IRA account. You may either receive a check or have it deposited directly into your bank account.
Transfer Form (non-IRA)	MF 1019	Move non-IRA assets from another financial institution to an existing Prudential Investments mutual fund account.
Transfer on Death Form	PMFS 296	Establish or update a beneficiary on your non-IRA account.

Traditional IRA, Roth IRA, SEP IRA, Coverdell ESA, and 403(b) Forms
Form/Application Name	Number	Description
Affidavit of Domicile	MF 515	This form is used to certify the decedent's place of residence at the time of death and it is required for all redemptions and transfers due to death.
Automatic Investment Plan	MF 1006	Automatically contribute to your IRA by transferring money directly from a bank account into your IRA mutual fund account.
Beneficiary Change Form	MF 1001	Designate or change your IRA beneficiaries.
Beneficiary Distribution Form (IRA) Spouse & Non-spouse Entity	MF 1024A MF 1024C	Use beneficiary forms to request a distribution from an IRA due to the death of an IRA owner.
Distribution Form (IRA)	PMFS 183	Take a distribution from an IRA account.
Electronic Funds Transfer Purchase Form	MF 1006	Contribute to your IRA, online or by phone.
Exchange Authorization	MF 224A	Use this form to authorize fund exchanges.
Recharacterization Form (IRA)	PMFS 1003	Use this form to recharacterize Roth IRA contributions back to a Traditional IRA and vice versa.
Required Minimum Distribution Form	PRU 1168	Facilitate Required Minimum Distributions from a Traditional IRA.
Roth IRA Conversion Form (Traditional IRA held at Prudential Mutual Fund Services LLC)	MF 1028	Convert a Traditional IRA to a Roth IRA.
Systematic Withdrawal Plan	PMFS 183	Request an IRA distribution. Request may be received as a check or deposited directly into a bank account.
Transfer (Coverdell ESA)	MF 1088	Move assets from another financial institution to an existing Prudential Investments Coverdell Education Savings Account (ESA).
Transfer / Direct Rollover / Conversion Form (IRA)	MF 1012	Move assets or convert a Traditional, Roth, or SEP IRA from another financial institution to an existing Prudential Investments account.
403(b) Distribution	MF 1005	Take a distribution from a 403(b) account.

SIMPLE IRA Forms (Qualified Plans)
Form/Application Name	Number	Description
SIMPLE IRA Change Request	SM 113968	For SIMPLE IRA Accounts Only - Use this form to request a name change, address change, broker/dealer change, beneficiary change, contribution investment allocation change or an investment exchange.
SIMPLE IRA Transfer of Assets	SM 113969	For SIMPLE IRA Accounts Only - Move SIMPLE IRA assets from another financial institution to an existing Prudential Investments SIMPLE IRA account.
SIMPLE IRA Withdrawal Authorization	SM 113970	For SIMPLE IRA Accounts Only - Use this form to request a distribution from your SIMPLE IRA. If you need to satisfy your 70 1/2 Required Minimum Distribution (RMD) amount, please use the SIMPLE IRA 70 1/2 Required Minimum Distribution Election Form.
SIMPLE IRA 70 1/2 Required Minimum Distribution Election Form	SM 113972	For SIMPLE IRA Accounts Only - Use this form to request a Required Minimum Distribution (RMD) from your SIMPLE IRA.
SIMPLE IRA Contribution Worksheet	SM 113971	For SIMPLE IRA Accounts Only - Plan Sponsors use this form to submit SIMPLE IRA contributions on behalf of plan participants. Mail the contribution check with the completed contribution worksheet. Any contribution instructions received for individuals not enrolled in the plan will be rejected.

Mutual Funds Forms (General Investing)

Traditional IRA, Roth IRA, SEP IRA, Coverdell ESA, and 403(b) Forms

SIMPLE IRA Forms (Qualified Plans)