Asset Exchange Authorization

Use this form to authorize Midland IRA, Inc. (Administrator) to exchange an asset your Midland account already owns for a new asset. A Midland representative will work with you to determine appropriate supporting documentation to complete this exchange for your IRA.

Automatic Debit Authorization

Use this form to request Midland to electronically transfer funds for you instead of mailing in paper checks for common transactions such as contributions, rental and note payments.

Change of Address

Use this form to change your address, phone number, or email address on file with Midland. When changing your physical mailing address, please include a copy of a utility bill, cable bill, driver’s license or a recent bank statement.

Changes of Beneficiary

Use this form if you’d like to change beneficiaries on an existing account, including Traditional IRA, Roth IRA, SEP, SIMPLE, HSA, and ESA.

Delivery Instructions

Contact your Midland IRA representative to find out our delivery instructions.

Deposit Coupon (One Time)

Use this form to accompany a deposit to indicate what type of deposit is being made (contribution, asset income, etc).

Deposit Coupon (Recurring)

Use this form to accompany a recurring deposit to indicate what type of deposit is being made (contribution, asset income, etc).

Distribution from 401(k)

Use this form to authorize Midland to process a Distribution from your 401K Midland account.

Distribution from IRA/HSA

Use this form to authorize Midland to process a Distribution from your IRA/HSA Midland account.

Fair Market Value Update

Use this form to provide updated value information for an asset in your Midland IRA.

Interested Party

Use this form to authorize your spouse or financial advisor (broker, financial planner, accountant, attorney, or other trusted individual) to receive information about your account by calling Midland offices or through online access. Interested parties are not authorized to conduct transactions or to make any changes to your account.

Limited Power of Attorney

Use this form to authorize an individual with ability to conduct certain transactions to your account.

LLC/LP Acknowledgement Letter

Use this form for LLC/LP investments.

Payment Authorization

Use this form to authorize Midland to pay an expense related to your IRA-owned asset (such as tax bills, utility bills or HOA dues).

Rollover Form

Use this form to deposit funds distributed from another IRA or employer plan within the last 60 days.

Roth Conversion

Use this form to convert Traditional, SEP or SIMPLE pre-tax assets to a Roth IRA. This is a taxable event.

Sale Authorization

Use this form to authorize Midland to process the sale of your IRA-owned asset.

Trading Account Withdrawal

Use this form to authorize Midland to withdraw funds from your brokerage/trading account.

Trading Account Withdrawal & Distribution

Use this form to authorize Midland to withdraw funds from your brokerage/trading account and immediately distribute those funds to account holder.