Form 5305-E DO NOT File

With the Internal

Revenue Service

Education Individual Retirement Trust Account

(Rev. January 2000)

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

The grantor whose name appears above is establishing an education individual retirement trust account under section 530 for the

benefit of an individual who is the above-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 grantor and the trustee make the following agreement:

Article I

Article III

No part of the trust funds may be invested in life insurance contracts, nor may the assets of the trust 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)).

Cat. No. 25205V Form 5305-E (Rev. 1-2000)

Check if Amendment 

Name of grantor

Date of birth of designated beneficiary

Grantor’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 grantor has assigned the trust dollars ($ ) in cash.

Designated beneficiary’s identification number

Address of responsible individual

Name of trustee Address or principal place of business of trustee

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.

Article IV

The trustee named above has provided the grantor 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 grantor with a copy of Notice 97-60, 1997-2 C.B. 310, is

considered a sufficient disclosure statement. The trustee 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 grantor.

The trustee may accept additional cash contributions. These contributions may be from the grantor, 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 trust in any year may not exceed the $500 in total contributions that

the trust can receive. In addition, the maximum aggregate contribution that an individual may make to the trust 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 grantor shall have the power to direct the trustee regarding the investment of the above-listed amount assigned to the trust (including

earnings thereon) in the investment choices offered by the trustee. The responsible individual, however, shall have the power to redirect the

trustee regarding the investment of such amounts, as well as the power to direct the trustee regarding the investment of all additional

contributions (including earnings thereon) to the trust. In the event that the responsible individual does not direct the trustee regarding the

investment of additional contributions (including earnings thereon), the initial investment direction of the grantor also will govern all additional

contributions made to the trust account until such time as the responsible individual otherwise directs the trustee. Unless otherwise provided in

this agreement, the responsible individual also shall have the power to direct the trustee regarding the administration, management, and

distribution of the account.

Article VI

The “responsible individual” named by the grantor shall be a parent or guardian of the designated beneficiary. The trust 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 on page 2, 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.
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 grantor and trustee whose signatures appear below.

Form 5305-E (Rev. 1-2000) Page 2

Article IX

Note: The following space (Article XI) may be used for any other provisions the grantor and trustee 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.

Grantor’s signature Date

Trustee’s signature Date

(Use only if signature of the grantor or the trustee is required to be witnessed.)

Specific Instructions

General Instructions

Section references are to the Internal

Revenue Code unless otherwise noted.

Purpose of Form

Form 5305-E is a model trust 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

grantor and the trustee. 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 grantor and trustee 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 trustee, trustee’s fees, state

law requirements, treatment of excess

contributions, and prohibited transactions

with the grantor, designated beneficiary, or

responsible individual, etc. Use additional

pages as necessary and attach them to this

form.

Identification Numbers

Definitions

Note: Form 5305-E may be reproduced and

reduced in size for adaption to passbook

purposes.

Trustee. The trustee 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 trustee. Any

Do not file Form 5305-E with the IRS.

Instead, keep it for record purposes.

For more information, including information

about the required disclosure you must get

from your trustee, see Notice 97-60, 1997-2

C.B. 310. The grantor and designated beneficiary’s

social security numbers will serve as their

identification numbers. If the grantor 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

Article X

Designated beneficiary. The designated

beneficiary is the individual on whose behalf

the trust account has been established.

1. The grantor agrees to provide the trustee with the information necessary for the trustee to prepare any reports required under section 530(h).

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

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 trustee’s procedures.

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

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

trust and the trust 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.

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-E may be reproduced in a

manner that provides only those optional

provisions offered by the trustee.

Grantor. The grantor is the person who

establishes the trust account.

Witness’ signature Date

If the model account is a custodial account,

get Form 5305-EA, Education Individual

Retirement Custodial Account.

Family member. Family members of the

designated beneficiary include the spouse of

the 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.

person who may serve as a trustee of a

traditional IRA may serve as the trustee of an

Ed IRA.

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

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