PD F 5511 TreasuryDirect Transfer Request

For official use only:
Customer Name

Customer No.

PD F 5511 E
Department of the Treasury
Bureau of the Public Debt
(Revised July 2012)

OMB No. 1535-0138

TreasuryDirect

®

TRANSFER REQUEST

www.treasurydirect.gov
304-480-7711

IMPORTANT: Follow instructions in filling out this form. You should be aware that the making of any false, fictitious, or
fraudulent claim or statement to the United States is a crime that is punishable by fine and/or imprisonment.
PRINT IN INK OR TYPE ALL INFORMATION

Use this form to request the transfer of online EE and I Savings Bonds and Treasury Bills, Notes, Bonds, and TIPS in your
TreasuryDirect account.
1. TreasuryDirect Account Information
NOTE: If transferring securities from either a
custom, minor, or conversion linked
account, show only the number for
the linked account.

TreasuryDirect
Account Number:
TreasuryDirect
Account Name:

Taxpayer Identification
Number (SSN/EIN):

2. Description of Securities
Transfer ALL securities for the above TreasuryDirect account.
Transfer the securities described on the attached list.
Transfer the securities described below.
If this is a marketable security transaction, I understand that all scheduled reinvestments related to this security/these
securities will be canceled at the time of the transfer.
NOTE: If you are requesting transfer of savings bonds to a trust, carefully read and complete Page 2.
Confirmation
Number

Issue Date

Face Amount

CUSIP No.

Portion of Security to be Transferred

(Bills, Notes,
Bonds, TIPS only)

(If neither square is selected,
transfer in FULL will be assumed.)

Transfer in FULL
OR
Transfer to the Extent of $
Transfer in FULL
OR
Transfer to the Extent of $
Transfer in FULL
OR
Transfer to the Extent of $
Transfer in FULL
OR
Transfer to the Extent of $

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PD F 5511 E

TAX LIABILITY NOTICE (Carefully read before completing the Tax Liability Statement below.)
Upon the transfer of savings bonds to a trust, you must include in your gross income any accumulated interest on the
bonds, if you have not already reported it, unless, under the grantor trust provisions of the Internal Revenue Code, you
are treated as the owner of the portion of the trust represented by any tax-deferred accumulated interest on the
transferred bonds. If you are treated as the owner of that portion, the accumulated interest continues to be your income
rather than that of the trust, and therefore, you may continue to defer reporting the interest earned each year. You must
include the total accumulated interest in your gross income when the bonds are disposed of or finally mature, whichever
is earlier. These rules apply when bonds being transferred are Series I or EE bonds, if you are the owner of the portion
of the trust represented by the tax-deferred accumulated interest.
Generally, you will be treated as the owner of a trust that you have created to the extent that you retain certain powers
over or interests in the trust. For example, you will be treated as the owner of the portion of the trust represented by any
tax-deferred accumulated interest on the transferred bonds under the following circumstances:
(1) You will be treated as the owner of a trust to the extent that you have an unconditional power to revest in
yourself title to the trust assets. Thus, if you can, at your discretion, revoke all or part of the trust so that the
bonds will be returned to you, you will be treated as the owner of the portion of the trust represented by any
accumulated interest on the bonds.
(2) If the trust instrument provides that the transferred bonds or the proceeds from the redemption or disposition of
those bonds must be distributed to you or your spouse, or held or accumulated for future distribution to you or
your spouse, you will be treated as the owner of the portion of the trust represented by any accumulated
interest on the bonds. You will be treated as the owner in this circumstance irrespective of the terms of the
trust.
(3) You will be treated as the owner of a trust to the extent that you retain a power to control the beneficial
enjoyment of property transferred to a trust. Thus, if you retain, under the terms of the trust instrument, an
immediately exercisable power to determine, in your sole discretion, who will receive the bonds or the proceeds
from the redemption or disposition of the bonds, then you will be treated as the owner of the portion of the trust
represented by any accumulated interest.
The examples outlined above are illustrative only and they are not intended to cover all possible situations in which you
could be treated as the owner of a trust or a portion of a trust. Furthermore, events can occur, such as the renunciation
of a retained power or interest, which would cause you to cease being treated as the owner of a trust. If you are not
sure whether you will be treated as the owner of a trust, you may request a letter ruling from the Internal Revenue
Service. A request for a letter ruling should be sent to: Internal Revenue Service, ATTN: CC: DOM: CORP: T, PO
Box 7604, Ben Franklin Station, Washington, DC 20044.
If you have any questions concerning the information to be submitted in connection with a letter ruling request, you may
call 202-622-7560.
TAX LIABILITY STATEMENT (This section must be completed if you are transferring savings bonds to a trust.)
You must mark box "a" or "b" to indicate if you are the owner of the portion of the trust represented.
(See TAX LIABILITY NOTICE above.)
“Interest” includes interest earned on EE or I bonds from the issue date until the date of transfer.
This statement will also apply to all future transactions requested by the same owner(s) or person(s) entitled to
the same trust.
For federal income tax purposes:
I certify that I will be treated as owner of the portion of the trust represented by the tax-deferred accumulated
a.
interest on the bonds being transferred. If this box is marked, the interest will be tax-deferred (interest will not
be reported to the Internal Revenue Service as a result of the transfer).
b.

I certify that I will not be treated as owner of the portion of the trust represented by the tax-deferred
accumulated interest on the bonds being transferred. If this box is marked, interest will be reported to the
Internal Revenue Service for the taxable year in which the bonds were transferred to the trust. A 1099-INT will
be generated for the Social Security Number specified.

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PD F 5511 E

3. Transfer to Another TreasuryDirect Account
I request/consent to transfer as indicated below the online Treasury securities described in Item 2.
By submitting this form, I certify that I understand the securities described will be removed from my TreasuryDirect account and
transferred to the recipient’s TreasuryDirect account. I also understand the registration of the transferred securities will be changed to
show the owner of the account receiving the securities as the single owner. If this is a savings bond transaction, I certify that this transfer
is either for the purpose of making a gift or is in response to a final judgment, court order, divorce decree, or property settlement
agreement. I further understand that this transaction may be rejected or its processing delayed, if I provided incorrect information and/or
submitted the transaction immediately prior to a Closed Book Period. (NOTE: When you buy savings bonds in TreasuryDirect, you must
hold them for at least five business days before you can transfer them to other accounts.) I certify that I have the authority to request this
transaction. For a converted savings bond with a Restricted registration, both registrants must sign this form. Restricted registrations are
the coowner form (connective “OR”) on EE and I savings bonds.
TAX LIABILITY: I certify that I understand this transaction may be reported to the Internal Revenue Service and that this transfer may
result in a tax liability.
Transfer security(ies) to:
TreasuryDirect Account Number:
TreasuryDirect Account Name:

Taxpayer Identification Number (if available):

OR
(Social Security Number)

(Employer Identification Number)

4. Transfer to a Financial Institution or Brokerage Firm (does NOT apply to savings bonds)
I authorize the Treasury Department to remove the securities described in Item 2 from my control within the TreasuryDirect system
and transfer them to the financial institution or brokerage firm designated below. I further understand that this transaction may be
rejected or its processing delayed, if I provided incorrect information and/or submitted the transaction immediately prior to a Closed
Book Period. I certify that I have the authority to request this transaction.
Transfer security(ies) to a Financial Institution (Before completing, see instructions.)
Routing Number:
Financial Institution Wire Name:
Agent or Broker Name:
Agent or Broker Phone Number:
Special Handling Instructions:

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PD F 5511 E

SIGNATURES AND CERTIFICATIONS
Under penalties of perjury, I/we certify that the information provided on this form is true, correct, and complete. This request is
submitted pursuant to the applicable provisions of 31 CFR Parts 353, 356, 357, 360, and 363. I/we agree to indemnify and hold
the United States harmless in the event of any loss that results from this request.






You must wait until you are in the presence of a certifying officer to sign this form.
Certifying officers are available at banks, trust companies, and credit unions.
Certification by a notary public is NOT acceptable.

Sign Here:
(Signature)

(Daytime Telephone No.)

(Number and Street or Rural Route, City, State, and ZIP Code)

Sign Here:
(Signature)

(Daytime Telephone No.)

(Number and Street or Rural Route, City, State, and ZIP Code)

Instructions to Certifying Officer:
1. Name of person(s) who appeared and date of appearance MUST be completed.
2. Medallion stamps require an original signature.
3. Person(s) must sign in your presence. NOTE: To certify a second signature, use the next page.

I CERTIFY that

, whose identity is known or was
(Name of Person Who Appeared)

proven to me, personally appeared before me this

day of
(Month / Year)

, and signed this form.

at
(City, State)

(Signature and Title of Certifying Officer)

(OFFICIAL STAMP
OR SEAL)

(Name of Financial Institution)

(Address)

(City, State, ZIP Code)

ACCEPTABLE CERTIFICATIONS: Financial institution's
official seal or stamp (such as corporate seal, signature
guaranteed stamp, or medallion stamp).
(Telephone)

(Notary certification is NOT acceptable.)

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PD F 5511 E

I CERTIFY that

, whose identity is known or was
(Name of Person Who Appeared)

proven to me, personally appeared before me this

day of
(Month / Year)

, and signed this form.

at
(City, State)

(Signature and Title of Certifying Officer)

(OFFICIAL STAMP
OR SEAL)

(Name of Financial Institution)

(Address)

(City, State, ZIP Code)

ACCEPTABLE CERTIFICATIONS: Financial institution's
official seal or stamp (such as corporate seal, signature
guaranteed stamp, or medallion stamp).
(Telephone)

(Notary certification is NOT acceptable.)

INSTRUCTIONS
No. 1

ACCOUNT INFORMATION

TreasuryDirect Account Information – Provide the TreasuryDirect Account Number, TreasuryDirect Account Name, and
Taxpayer Identification Number (Social Security Number or Employer Identification Number). When transferring securities from a
custom, minor, or conversion linked account, provide the account information of the linked account.

No. 2

DESCRIPTION OF SECURITIES
To transfer . . .

Then . . .

ALL securities in the account described in
Item 1

Select the first square.

Securities described on an attached list

Select the second square and attach the printed list from
your TreasuryDirect account.

Less than ALL securities in the account,
or if not attaching a list

Select the third square and complete the table to include
the Confirmation Number, Issue Date, Face Amount
(principal amount for savings bonds or par amount for bills,
notes, bonds, and TIPS), and CUSIP Number (for bills,
notes, bonds, and TIPS). Indicate either a FULL or partial
transfer. If you do not indicate a partial transfer, we will
assume transfer in FULL.

NOTE: If you are requesting transfer of savings bonds to a trust, carefully read and complete Page 2.

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PD F 5511 E

No. 2

DESCRIPTION OF SECURITIES (continued)

If partial transfer of an EE or I Savings Bond is desired, select the appropriate square and show the amount you are requesting to
be transferred. You can request partial transfer of a bond as long as the amount that you are requesting to be transferred is at
least $25 and the redemption value of the remaining portion of the bond is not less than $25. A bond must have a current
redemption value of at least $50 before you can request partial transfer. The transfer will be comprised of principal and a
proportionate amount of interest.
If partial transfer of a Treasury Bill, Note, Bond, or TIPS is requested, select the appropriate square and specify the amount you
are requesting to be transferred. The amount being transferred must be in $100 increments and the amount remaining must be at
least $100.

No. 3


TRANSFER TO ANOTHER TREASURYDIRECT ACCOUNT
TreasuryDirect Account Number – Enter the number of the TreasuryDirect account to which the securities are being
transferred.
TreasuryDirect Account Name – Enter the name on the transferee’s account.
Taxpayer Identification Number – If available, enter the Taxpayer Identification Number used on the account to which
the securities are to be transferred.




No. 4

TRANSFER TO A FINANCIAL INSTITUTION OR BROKERAGE FIRM

Contact the financial institution for its book-entry delivery instructions. Please note: Securities CANNOT be transferred to a
checking or savings account. Provide the following information:







Routing Number – ABA (identification) number of the financial institution receiving the securities.
Financial Institution Wire Name – The institution’s book-entry delivery instructions. Instructions include the receiving
bank’s name and safekeeping account number OR the receiving bank’s name and the brokerage firm’s name (these must
be in the approved telegraphic abbreviation “short” form).
Agent or Broker Name and Phone Number.
Special Handling Instructions – The customer name and account number at the financial institution for delivery of
securities and any other instructions required by your financial institution, such as the name and telephone number of the
person to be contacted at the financial institution for questions about the securities.

Examples: To a financial institution for safekeeping:

To a financial institution for transfer to a brokerage firm:

Routing Number: XXXXXXXXX

Routing Number: XXXXXXXXX

Financial Institution Wire Name: ABC BK/TRUST

Financial Institution Wire Name: ABC/CUST/BRKG

Special Handling Instructions: FURTHER CREDIT TO JOHN DOE

Special Handling Instructions: FURTHER CREDIT TO JOHN DOE

TRUST ACCOUNT NUMBER XXXXXX

BROKERAGE ACCOUNT NUMBER XXXXXX

SIGNATURES AND CERTIFICATIONS (Complete this part for ALL transactions.)
Signatures/Certifications – Each applicant must appear before and establish identification to the satisfaction of an authorized
certifying officer available at a bank, trust company, or credit union and sign the application in the officer's presence. The officer
must then complete the certification form provided and imprint the seal or stamp required in certifying requests. For certifications
within the United States, the certifying officer must be authorized to bind his/her institution by his/her acts and guarantee signatures
to assignments of securities or certify assignments of securities. For a list of authorized certifying officers and the required
evidence of authority, see Title 31 CFR Part 363. Certification by a notary public is NOT acceptable.
If you are a parent of a minor account owner, your signature certifies that you are requesting the transaction on the minor’s behalf,
for the minor’s benefit.
Additional Evidence – In any particular case, the Commissioner of the Public Debt, as designee of the Secretary of the Treasury,
reserves the right to require additional evidence.

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Where To Send – Send the form, as well as any other forms and evidence, to:
Department of the Treasury
Bureau of the Public Debt
PO Box 7015
Parkersburg, WV 26106-7015

PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE
The collection of the information you are requested to provide on this form is authorized by 31 U.S.C. CH. 31 relating to the public
debt of the United States. The furnishing of a social security number, if requested, is also required by Section 6109 of the Internal
Revenue Code (26 U.S.C. 6109).
The purpose of requesting the information is to enable the Bureau of the Public Debt and its agents to issue securities, process
transactions, make payments, identify owners and their accounts, and provide reports to the Internal Revenue Service. Furnishing
the information is voluntary; however, without the information Public Debt may be unable to process transactions.
Information concerning securities holdings and transactions is considered confidential under Treasury regulations (31 CFR, Part 323)
and the Privacy Act. This information may be disclosed to a law enforcement agency for investigation purposes; courts and counsel
for litigation purposes; others entitled to distribution or payment; agents and contractors to administer the public debt; agencies or
entities for debt collection or to obtain current addresses for payment; agencies through approved computer matches; Congressional
offices in response to an inquiry by the individual to whom the record pertains; as otherwise authorized by law or regulation.
We estimate it will take you about 02 minutes to complete this form. However, you are not required to provide information requested
unless a valid OMB control number is displayed on the form. Any comments or suggestions regarding this form should be sent to the
Bureau of the Public Debt, Forms Management Officer, Parkersburg, WV 26106-1328. DO NOT SEND the completed form to this
address; send to the address shown in "Where To Send" in the Instructions.

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