Forms
Below you will find tabs to access forms needed to open a new account or update an existing account. Some forms allow you to submit and sign electronically, the eForm tab lists those forms, the other tabs allow you to access printable PDF forms where you can fill in your information on the PDF and mail to us. You can also manage your account online instead of submitting a form – log in to your account.
Mutual Funds E-Forms
| Form Name | Description | Link |
| REQUEST TO CHANGE IRA BENEFICIARY | Designate or change your IRA beneficiaries. | Complete Form |
| TRANSFER ON DEATH ON NON-IRA ACCOUNT | Establish or update a beneficiary on your non-IRA account. | Complete Form |
| REQUEST TO CHANGE NAME | Request a name change up to $100,000 with supporting document. | Complete Form |
| DISTRIBUTION INSTRUCTION | Update dividend and capital gains option to either reinvest or cash. Cash dividends may be received by check, deposited into your bank account. | Complete Form |
| REQ. FOR SYSTEMATIC WTHDRWL | Request periodic distributions from a non-retirement account. | Complete Form |
| SYSTEMATIC EXCHANGE AUTH. | Establish a periodic exchange between funds. | Complete Form |
| LETTER OF INTENT PRIVILEGE | 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. | Complete Form |
| ADDITIONAL STATEMENT REQUEST | Request additional account statements be sent to a different address. | Complete Form |
| IRA RECHARACTERIZATION | Use this form to recharacterize Roth IRA contributions back to a Traditional IRA and vice versa. | Complete Form |
| TRUSTED CONTACT / DESIGNATED REPRESENTATIVE | You have the ability to add a Trusted Contact / Designated Representative to your mutual fund account. The purpose is to help protect your assets in the event Prudential Mutual Fund Services LLC is unable to reach you regarding your account. | Complete Form |
| COST BASIS ELECTION FORM | Add or change the cost basis calculation method on your non-retirement mutual fund account for shares acquired on or after January 1, 2012. | Complete Form |
Mutual Funds Forms (General Investing)
| Form Name | Number | Description |
| Account Application | MF 1017 | Open a mutual fund account for Individual, Joint Owners, UGMA/ UTMA , Trust (not for use by Pruco Securities LLC financial professionals) or *an existing participant level Employer Sponsored Retirement Plan. |
| Account Application (Entity) | MF 1018 | Open a mutual fund account for an Entity (Partnership, Sole proprietorship, Bank, Estate, C Corporation, S Corporation, Limited Liability Company). |
| 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. |
| Automatic Investment Plan Form | MF 1006 | Automatically invest by transferring money directly from your bank account into your mutual fund(s). |
| Certification of Beneficial Owners(s)(Entity Only) | MF 601 | This form should be completed by persons applying on behalf of a legal entity. Federal regulation requires certain financial institutions to obtain, verify and record information about the beneficial owners of legal entity customers. |
| 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. |
| Cost Basis Election Form | MF 1007 | Add or change the cost basis calculation method on your non-retirement mutual fund account for shares acquired on or after January 1, 2012. |
| 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 Form | MF 224A | 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. |
| Living Children Affidavit Form | MF 1190 | Certify beneficiaries who are children of the account owner. |
| Name Change Form | MF 1003 | Request a name change. |
| Redemption Form | MF 004 | Redeem fund shares from non-retirement account types. |
| Systematic Exchange Plan Form | MF 312 | Establish a periodic exchange between funds. |
| Systematic Withdrawal Plan Form | MF 310 | Request periodic distributions from a non-retirement account. |
| Transfer Form (non-IRA) | MF 1019 | Move non-IRA assets from another financial institution to an existing account. |
| Transfer on Death Form | PMFS 296 | Establish or update a beneficiary on your non-IRA account. |
| Trusted Contact / Designated Representative | MF 1040 | You have the ability to add a Trusted Contact / Designated Representative to your mutual fund account. The purpose is to help protect your assets in the event Prudential Mutual Fund Services LLC is unable to reach you regarding your account. |
Traditional IRA, Roth IRA, SEP IRA, Coverdell ESA and 403(b) Forms
| Form Name | Number | Description |
| 403(b) Distribution | MF 1005 | Take a distribution from a 403(b) account. |
| Account Application | MF 1011 | Open a Traditional, Roth, or SEP IRA account with Prudential Mutual Fund Services LLC (not for use by Pruco Securities LLC financial professionals). |
| Application (Coverdell ESA) | ORD 97828 | Open a Coverdell ESA with Prudential Mutual Fund Services LLC. |
| Automatic Investment Plan Form | 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 | MF 1024 | Request a distribution/transfer from an IRA due to the death of an IRA owner. |
| Direct Rollover from 529 Plan to Roth IRA Form | MF1029 | Request a direct rollover from a 529 Plan account at another financial institution to a new or existing Roth IRA. |
| Disabled and Chronically Ill Form | MF1025 | Certify that an eligible designated beneficiary is disabled or chronically ill. |
| Distribution Form (Coverdell ESA) | MF 1060 | Request a distribution from a Coverdell ESA. |
| Distribution Form (IRA) | PMFS 183 | Request a distribution from an IRA account. |
| Electronic Funds Transfer Purchase Form | MF 1006 | Contribute to your IRA, online or by phone. |
| Employer-Sponsored Retirement Plans Application (new individual participants in an already existing employer's plan at PMFS) | MF 1084 | PMFS no longer accepts new plans. However, a new participant in an employer's plan that already exists at PMFS is permitted to establish a new account. |
| Exchange Authorization Form | MF 224A | Authorize fund exchanges. |
| Name Change Form | MF 1003 | Request a name change. |
| Qualified Trust Attestation Form | MF1026 | Certify that a trust is a qualified trust and has met certain criteria. |
| 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 Form | 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 PGIM 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 mutual fund account. |
| Trusted Contact / Designated Representative | MF 1040 | You have the ability to add a Trusted Contact / Designated Representative to your mutual fund account. The purpose is to help protect your assets in the event Prudential Mutual Fund Services LLC is unable to reach you regarding your account. |
Simple IRA Forms (Qualified Plans)
| Form Name | Number | Description |
| SIMPLE IRA 70 1/2 Required Minimum Distribution Election Form | SM 113972 | Use this form to request a Required Minimum Distribution (RMD) from a SIMPLE IRA. |
| SIMPLE IRA Account Application | SM 113967 | Open a Simple IRA account. |
| SIMPLE IRA Certification of Rollover Assets | SM 13974 | Use this form to certify that a contribution is an eligible rollover contribution. |
| SIMPLE IRA Change Request Form | SM 113968 | For SIMPLE IRA Accounts Only - Request a name change, address change, broker/dealer change, beneficiary change, contribution investment allocation change or an investment exchange. |
| SIMPLE IRA Contribution Worksheet | SM 113971 | 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. |
| SIMPLE IRA Transfer of Assets Form | SM 113969 | Move SIMPLE IRA assets from another financial institution to an existing SIMPLE IRA account. |
| SIMPLE IRA Withdrawal Authorization Form | SM 113970 | Request a distribution from a SIMPLE IRA. If clients need to satisfy their 70 1/2 Required Minimum Distribution (RMD) amount, please use the SIMPLE IRA 70 1/2 Required Minimum Distribution Election Form. |
| Trusted Contact / Designated Representative | MF 1040 | You have the ability to add a Trusted Contact / Designated Representative to your mutual fund account. The purpose is to help protect your assets in the event Prudential Mutual Fund Services LLC is unable to reach you regarding your account. |
Consider a fund's investment objectives, risks, charges and expenses carefully before investing. The prospectus and the summary prospectus contain this and other information about the fund. Contact your financial professional for a prospectus and the summary prospectus. Read them carefully before investing.
An investment in the Fund is not insured or guaranteed by the Federal Deposit Insurance Corporation or any other government agency. Although the Fund seeks to preserve the value of your investment at $1.00 per share, it is possible to lose money by investing in the Fund. There is no guarantee the Fund will be able to maintain a stable $1.00 NAV per share or that the Fund’s objective will be achieved.
Investing involves risk. Some investments have more risk than others. The investment return and principal value will fluctuate and investor's shares when sold may be worth more or less than the original cost. Fixed income investments are subject to interest rate risk, and their value will decline as interest rates rise. Asset allocation and diversification do not assure a profit or protect against loss in declining markets. There is no guarantee a Fund's objectives will be achieved. The risks associated with each fund are explained more fully in each fund's respective prospectus. Consult with your attorney, accountant, and/or tax professional for advice concerning your particular situation.
This material is being provided for informational or educational purposes only and does not take into account the investment objectives or financial situation of any client or prospective clients. The information is not intended as investment advice and is not a recommendation. Clients seeking information regarding their particular investment needs should contact their financial professional.
For compliance use only 4047664