Form 5305-EA DO NOT File

With the Internal

Revenue Service

Education Individual Retirement Custodial Account

(Rev. January 2000)

Department of the Treasury (Under section 530 of the Internal Revenue Code) Internal Revenue Service

The depositor whose name appears above is establishing an education individual retirement account under section 530 for the benefit of an

individual who is the above custodial named designated beneficiary exclusively to pay for the qualified higher education expenses, within the

meaning of section 530(b)(2), of such designated beneficiary.

The custodian named above has provided the depositor with a concise statement disclosing the provisions governing section 530. This

disclosure statement must include an explanation of the statutory requirements applicable to, and the income tax consequences of establishing

and maintaining an account under section 530. Providing the depositor with a copy of Notice 97-60, 1997-2 C.B. 310, is considered a sufficient

disclosure statement. The custodian also will provide a copy of this form and the disclosure statement to the responsible individual, as defined

in Article VI below, if the responsible individual is not the same person as the depositor.

The depositor and the custodian make the following agreement:

Article I

Article III

No part of the custodial account funds may be invested in life insurance contracts, nor may the assets of the custodial account be

commingled with other property except in a common trust fund or a common investment fund (within the meaning of section 530(b)(1)(D)).

Article IV

Cat. No. 25204K Form 5305-EA (Rev. 1-2000)

Check if Amendment 

Name of depositor

Date of birth of designated beneficiary

Depositor’s identification number

Name of designated beneficiary

Address of designated beneficiary

Name of responsible individual (generally the parent or guardian of the designated beneficiary)

The depositor assigned the custodial account dollars ($ ) in cash.

Designated beneficiary’s identification number

Address of responsible individual

Name of custodian Address or principal place of business of custodian

1. Any balance to the credit of the designated beneficiary on the date on which such designated beneficiary attains age 30 shall be distributed

to the designated beneficiary within 30 days of such date.

2. Any balance to the credit of the designated beneficiary shall be distributed within 30 days of the date of such designated beneficiary’s

death unless the designated death beneficiary is a family member of the designated beneficiary who is under the age of 30 on the date of death.

In such a case, the family member shall become the designated beneficiary as of the date of death.

The custodian may accept additional cash contributions. These contributions may be from the depositor, or from any other individual, for the

benefit of the designated beneficiary, provided the designated beneficiary has not attained the age of 18 as of the date such contributions are

made. Total contributions that are not rollover contributions described in section 530(d)(5) are limited to a maximum amount of $500 for the

taxable year.

Article II

The maximum aggregate contribution that an individual may make to the custodial account in any year may not exceed the $500 in total

contributions that the custodial account can receive. In addition, the maximum aggregate contribution that an individual may make to the

custodial account in any year is phased out for individuals who have modified adjusted gross income (AGI) between $95,000 and $110,000 for

the year of the contribution (the phase-out range for married individuals who file joint returns is modified AGI between $150,000 and $160,000

for the year of the contribution). Individuals with modified AGI above $110,000 for the year and married individuals who file joint returns and

have modified AGI above $160,000 for the year may not make a contribution for that year. Modified AGI is defined in section 530(c)(2).

Article V

The depositor shall have the power to direct the custodian regarding the investment of the above-listed amount assigned to the custodial

account (including earnings thereon) in the investment choices offered by the custodian. The responsible individual, however, shall have the

power to redirect the custodian regarding the investment of such amounts, as well as the power to direct the custodian regarding the

investment of all additional contributions (including earnings thereon) to the custodial account. In the event that the responsible individual does

not direct the custodian regarding the investment of additional contributions (including earnings thereon), the initial investment direction of the

depositor also will govern all additional contributions made to the custodial account until such time as the responsible individual otherwise

directs the custodian. Unless otherwise provided in this agreement, the responsible individual also shall have the power to direct the custodian

regarding the administration, management, and distribution of the account.

Article VI

The “responsible individual” named by the depositor shall be a parent or guardian of the designated beneficiary. The custodial account shall

have only one responsible individual at any time. If the responsible individual becomes incapacitated or dies while the designated beneficiary is a

minor under state law, the successor responsible individual shall be the person named to succeed in that capacity by the preceding responsible

individual in a witnessed writing or, if no successor is so named, the successor responsible individual shall be the designated beneficiary’s other

parent or successor guardian. Unless otherwise directed by checking the option below, at the time that the designated beneficiary attains the

age of majority under state law, the designated beneficiary becomes the responsible individual. If a family member under the age of majority

under state law becomes the designated beneficiary by reason of being a named death beneficiary, the responsible individual shall be such

designated beneficiary’s parent or guardian.

Option (This provision is effective only if checked): The responsible individual shall continue to serve as the responsible individual for the

custodial account after the designated beneficiary attains the age of majority under state law and until such time as all assets have been

distributed from the custodial account and the custodial account terminates. If the responsible individual becomes incapacitated or dies after the

designated beneficiary reaches the age of majority under state law, the responsible individual shall be the designated beneficiary.
Form 5305-EA (Rev. 1-2000) Page 2

Article IX

Note: The following space (Article XI) may be used for any other provisions the depositor and custodian want to add. If no other provisions will

be added, draw a line through this space. If provisions are added, they must comply with applicable requirements of state law and the Internal

Revenue Code.

Depositor’s signature

Custodian’s signature

Witness’ signature

(Use only if signature of the depositor or the custodian is required to be witnessed.)

Depositor. The depositor is the person who

establishes the custodial account.

Specific Instructions

General Instructions

Section references are to the Internal

Revenue Code unless otherwise noted.

Purpose of Form

Form 5305-EA is a model custodial account

agreement that meets the requirements of

section 530(a) and has been automatically

approved by the IRS. An education individual

retirement account (Ed IRA) is established

after the form is fully executed by both the

depositor and the custodian. This account

must be created in the United States for the

exclusive purpose of paying the qualified

higher education expenses of an individual

who is the designated beneficiary.

Article XI. Article XI and any that follow may

incorporate additional provisions that are

agreed to by the depositor and custodian to

complete the agreement. They may include,

for example, provisions relating to: definitions,

investment powers, voting rights, exculpatory

provisions, amendment and termination,

removal of the custodian, custodian’s fees,

state law requirements, treatment of excess

contributions, and prohibited transactions

with the depositor, designated beneficiary, or

responsible individual, etc. Use additional

pages as necessary and attach them to this

form. Identification Numbers

Definitions

Note: Form 5305-EA may be reproduced and

reduced in size for adaption to passbook

purposes.

Custodian. The custodian must be a bank or

savings and loan association, as defined in

section 408(n), or any person who has the

approval of the IRS to act as custodian. Any

person who may serve as a custodian of a

traditional IRA may serve as the custodian of

an Ed IRA.

Do not file Form 5305-EA with the IRS.

Instead, keep it for record purposes.

For more information, including information

about the required disclosure you must get

from your custodian, see Notice 97-60,

1997-2 C.B. 310.

The depositor’s and designated beneficiary’s

social security numbers will serve as their

identification numbers. If the depositor is a

nonresident alien and does not have an

identification number, write “Foreign” in the

block where the number is requested. The

designated beneficiary’s social security

number is the identification number of his or

her Ed IRA. If the designated beneficiary is a

nonresident alien, the designated

beneficiary’s individual taxpayer identification

number is the identification number of his or

Article X

Notwithstanding any other articles which may be added or incorporated, the provisions of Articles I through IV will be controlling. Any

additional articles that are not consistent with section 530 and related regulations will be invalid.

This agreement will be amended from time to time to comply with the provisions of the Code and related regulations. Other amendments may

be made with the consent of the depositor and the custodian whose signatures appear below.

Designated beneficiary. The designated

beneficiary is the individual on whose behalf

the custodial account has been established.

Article VII

Article VIII

The responsible individual may or may not change the beneficiary designated under this agreement to another member of the

designated beneficiary’s family described in section 529(e)(2) in accordance with the custodian’s procedures.

1. The depositor agrees to provide the custodian with the information necessary for the custodian to prepare any reports required under

section 530(h).

2. The custodian agrees to submit reports to the Internal Revenue Service and the responsible individual as prescribed by the Internal

Revenue Service.

Date

Date

Date

Responsible individual. The responsible

individual, generally, is a parent or guardian of

the designated beneficiary. However, under

certain circumstances, the responsible

individual may be the designated beneficiary.

Optional provisions in Article VI and Article

VII. Form 5305-EA may be reproduced in a

manner that provides only those optional

provisions offered by the custodian.

If the model account is a trust account, get

Form 5305-E, Education Individual

Retirement Trust Account.

Family member. Family members of the

designated beneficiary include the spouse of

such designated beneficiary. Family members

also include a child, grandchild, sibling,

parent, niece or nephew, son-in-law,

daughter-in-law, father-in-law, mother-in-law,

brother-in-law, or sister-in-law of the

designated beneficiary, and the spouse of

any such individual.

her Ed IRA. An employer identification

number (EIN) is required only for an Ed IRA

for which a return is filed to report unrelated

business income. An EIN is required for a

common fund created for Ed IRAs.

Article XI