The Fidelity IRA one-time withdrawal form is a paper request for taking a single distribution from a Traditional, Roth, Rollover, SEP, or SIMPLE IRA held at Fidelity. Most account holders do not need it: Fidelity.com has a “Withdraw from your IRA” tool that handles routine distributions online. You need the paper form for SIMPLE IRA distributions, bank wires, checks payable to a third party, checks mailed to an address that is not on file, and direct rollovers to an outside workplace retirement plan. The form has six sections, and getting any of them wrong is the usual reason a request gets kicked back.
Before You Start: Confirm You Actually Need the Paper Form
Traditional, Rollover, Roth, and SEP IRA holders can initiate a one-time withdrawal directly on Fidelity’s website without any paperwork. SIMPLE IRA distributions always go through the paper form, regardless of amount or delivery method. Beyond SIMPLE IRAs, use the paper form when you want a bank wire, need a check made out to someone other than yourself, want a check mailed to an address different from the one on file, or are requesting a direct rollover to an employer plan. If none of that describes your situation, the online tool is faster and skips the signature-guarantee and mailing steps below.
Section 1: Account Owner
The top of the form asks for your name, your Fidelity IRA number, your Social Security or Taxpayer ID number, and a daytime phone number. Copy the account number exactly as it appears on your statements or on Fidelity.com. The form labels the field “Fidelity IRA Number” without specifying a digit count, so match what Fidelity shows. A mismatched account number is the fastest way to have the form rejected, because Fidelity cannot process a withdrawal it cannot tie to an account.
Section 2: Request Reason
This section drives how Fidelity reports the distribution to the IRS. Check exactly one box:
- Normal, if you are 59½ or older. No early withdrawal penalty applies.
- Early distribution, if you are under 59½. An additional 10% federal tax may apply unless you qualify for an exception. Roth withdrawals are reported as early distributions if you are under 59½, even when you are only pulling out contributions.
- Death of original IRA owner, for inherited IRA accounts.
- Direct rollover to a workplace retirement plan, where the money moves to an employer plan such as a 401(k). Write in the plan name.
Penalty exceptions exist for disability, certain medical expenses, and first-time home purchases (up to $10,000 from a Traditional IRA), among others. You claim those on your tax return, not on this form.
Section 3: Distribution Amount
Five options, check one:
- All core cash and money market funds. Pulls only settled cash and Fidelity money market balances and leaves invested positions alone.
- A specific dollar amount of cash. Write in the figure. The account needs enough settled cash to cover it.
- Entire account value in cash. Liquidates everything and closes the account.
- Entire account value as shares (in kind). Transfers holdings without selling them, useful if you are moving securities to a non-retirement account.
- Specific securities and amounts. List each security by name or ticker and indicate all shares, a specific share count, or a dollar amount.
If your specified dollar amount exceeds available settled cash, Fidelity will flag the form and ask for clarification rather than sell positions for you. Settle any pending trades before submitting.
Section 4: Distribution Method
This is the longest section and the one most likely to cause delays. Pick one delivery method.
Transfer to Another Fidelity Account
To move the money into a Fidelity non-retirement brokerage account, a Fidelity HSA, or another eligible Fidelity account, write in that account number and, if applicable, a fund name or symbol. This route is the simplest, requires no bank details, and does not need a Medallion signature guarantee.
Check or Direct Rollover
Use this option for a check mailed to a workplace retirement plan, a third party, or an address other than the one on file. Fill in the payee name, the plan account number for rollovers, an attention line if needed, and the full mailing address. A check going to anyone other than you, or to a different address, requires a Medallion signature guarantee.
Electronic Funds Transfer
EFT sends the money to a linked bank account, with one important limit: the form cannot set up new EFT instructions. Banking instructions must already be on file. If they are not, log in to Fidelity.com and add your bank account before you submit the form. On the form, confirm the bank account number already linked.
Bank Wire
Wires require the most detail. You provide the receiving bank’s wire routing number (which may differ from the ACH routing number), the bank name, the recipient’s account number, the account owner’s name, and the wire recipient’s full mailing address. For international wires, add the SWIFT code and the country. If the receiving bank uses a correspondent (intermediary) bank, fill in that bank’s routing number and name too. Fidelity does not charge a fee for outgoing wires, but the receiving bank may. Every bank wire request needs a Medallion signature guarantee, regardless of amount.
Section 5: Tax Withholding
Fidelity withholds 10% of the taxable portion of your distribution for federal income tax unless you say otherwise. That default comes from IRS Form W-4R, which treats IRA payouts as nonperiodic payments. You can enter any percentage from 0% to 100%, or write “0” to opt out. Skip this section and you get the 10% default.
State withholding is a separate line. Some states require withholding on retirement distributions and will not let you opt out; others make it voluntary. The form gives three choices: opt out (unless your state prohibits it), withhold at the state’s default rate, or enter a specific percentage. Fidelity uses the address on your account to determine which state rules apply, so update your address before submitting if you have moved.
The 10% default is often too low for higher-bracket filers and too high for Roth contribution withdrawals, which are not taxable. Match the withholding to your actual tax situation instead of accepting the default by inertia.
Section 6: Signature and When You Need a Medallion Guarantee
Sign and date the form. A Medallion signature guarantee is required if any of the following apply:
- You are requesting a bank wire, in any amount.
- The check is payable to someone other than you, or mailed to an address not on file.
- The withdrawal or direct rollover exceeds $100,000.
- Your address was changed within the past 10 days.
- The money is going to a Fidelity account with no common owner.
A Medallion signature guarantee is not the same as a notary stamp. Banks, credit unions, and broker-dealers in a Medallion program can provide one; a notary public cannot. If you complete the form in person at a Fidelity Investor Center, the guarantee requirement is waived. For large withdrawals or wire requests, an Investor Center visit is the path of least resistance.
How to Submit the Form
Two options: upload it digitally through Fidelity.com or mail it in.
To upload, log in to Fidelity.com and use the Secure Message Center (sometimes called the Virtual Assistant document upload). The digital route encrypts the form and gives you an immediate timestamp, and it is faster than mail by several days.
To mail, send the form to the address printed on its instruction page. Fidelity’s IRA-related mail generally goes to a P.O. Box in Cincinnati, Ohio, or a processing address in Covington, Kentucky, but different account types use different addresses, so read the return address on the form itself rather than guessing. Use a trackable service so you can confirm delivery.
Processing Timeline and Common Rejections
Once Fidelity determines the form is “in good order,” meaning every field is complete, signatures are present, and any required Medallion guarantee is included, processing takes up to five business days. EFT and wire deliveries add their own transit time, typically one to two business days for domestic transfers. Mailed checks depend on postal delivery.
Track status under the Activity and Orders tab on Fidelity.com. “Pending” means the request is being processed; “completed” means the funds have left your IRA. If something is wrong, Fidelity sends a notification requesting clarification, and the clock restarts when you respond.
The most common reasons forms get rejected: missing Medallion guarantee when one is required, insufficient settled cash, a mismatch between the account number on the form and the account on file, and missing signatures. Check each before mailing.
What Happens After the Distribution
Any IRA distribution of $10 or more triggers a reporting obligation. Fidelity files IRS Form 1099-R for the tax year in which the withdrawal occurs and sends you a copy, usually by the end of January the following year. The key boxes are Box 1 (gross distribution), Box 4 (federal income tax withheld), and Box 7 (distribution code, which tells the IRS whether the payout was normal, early, a rollover, or another category).
Traditional IRA distributions are generally taxable as ordinary income. Roth contribution withdrawals are tax-free, though earnings withdrawn before age 59½ or before the account has been open five years may be taxable. If the distribution code does not match your situation, for example when you qualify for a penalty exception the code does not reflect, claim the exception on Form 5329 with your tax return.
If You Are Using the Form for an RMD, QCD, or Indirect Rollover
You can use this same form for a required minimum distribution by selecting “Normal” in Section 2. Under the SECURE 2.0 Act, RMDs start at age 73 for people born between 1951 and 1959 and at age 75 for people born in 1960 or later. Roth IRAs are exempt from RMDs during the original owner’s lifetime. Missing an RMD carries a 25% excise tax on the shortfall, reduced to 10% if corrected within two years.
For a qualified charitable distribution, account holders 70½ or older can send up to $111,000 per year (the 2026 inflation-adjusted limit) from a Traditional IRA directly to a qualified 501(c)(3) charity. The money must go directly from Fidelity to the charity; withdrawing it to your own account first and writing a check does not qualify. Calling Fidelity or using the online tool is usually simpler, but the paper form works if the check is made payable to the charity and directed to its address, which falls under the third-party check rules and may need a Medallion guarantee.
If you are taking a distribution to roll it into another retirement account yourself, you have 60 calendar days to deposit the full amount into the new account, or the whole distribution becomes taxable income (plus the 10% penalty if you are under 59½). The IRS also limits you to one indirect IRA-to-IRA rollover in any 12-month period, counting all your IRAs as one. Direct trustee-to-trustee transfers and Traditional-to-Roth conversions do not count against that limit. For most situations, a direct rollover, selected in Section 2 with the plan details in Section 4, is safer than pulling the money out and moving it yourself.