A BNY MELLON COMPANY

Accounts & Services

Account Forms

General Account Management Forms

Affidavit of Domicile 
Shows the residence of decedent at time of death. Affidavit of Domicile is required when transferring the ownership of a security from a deceased person's name.

Auto-Exchange Form
Set up a systematic plan to exchange funds between your Dreyfus fund accounts.

Automatic Withdrawal Form 
Set up a systematic withdrawal from your Dreyfus account and have proceeds sent via check to your address or directly to your bank account.

CD Transfer Form 
Here's how to transfer your maturing CD into Dreyfus mutual funds.

Change of Registration Authorization Form 
Change your account registration or transfer the title of one or more accounts into the name of a new owner.

Change of Address Authorization Form 
Change the address of record on your account(s).

Dividend Options Form
Transfer your fund distributions into another Dreyfus account or electronically into your bank account.

Dreyfus Automatic Asset Builder® Authorization Form 
Set up a systematic investment plan to transfer funds directly from your bank account to your Dreyfus account(s).

Multi-Purpose Certification Form 
Permits specific individuals to transact on accounts registered to a corporation, trust, partnership, estate or other entity.

Name Change Form 
Change the registration on an existing individual and/or IRA account because of a legal name change.

Payroll Savings Form
Have your paycheck or a portion of it deposited into your Dreyfus account(s).

Power of Attorney Appointment and Indemnification Agreement
Give an individual the ability to make transactions on your account on your behalf.

Redemption Authorization Form
Request a redemption from your Dreyfus non retirement account.

Shareholder Services Form
Add or change services such as distribution options, checkwriting privilege, Dreyfus Automatic Asset Builder®, and teleservice privileges on one or more of your accounts.

Stock Power Form 
This form should be used to redeem, exchange or transfer title of shares in your account.

Transfer on Death Registration Form
Establish a Transfer on Death (TOD) registration for a new or existing account or change TOD beneficiaries.

Retirement Account Forms

Distribution Request Form
Make distributions from your IRA account(s).

Dreyfus IRA Transfer Request Form
Transfer or directly roll over all or a portion of your current IRA, qualified plan or 403(b) Plan to a Dreyfus IRA.

Inherited IRA Beneficiary Distribution Request Form
Complete this form if you are an IRA beneficiary to establish an Inherited IRA or to take a distribution.

IRA Checkwriting Privilege Addition Form
Use this form to add the Checkwriting Privilege to a Dreyfus IRA only.

IRA Shareholder Services Form
Use this form to add or change the Automatic Asset Builder, Checkwriting or TeleTransfer purchase privilege to your individual retirement account.

Required Minimum Distribution Request Form
Request your required minimum distribution from your IRA account.

Retirement Account Beneficiary Designation Form
Establish or change the primary and secondary beneficiary(ies) on your Dreyfus IRA account.

Employer Sponsored Retirement Plan Forms

Participant Name Change Form
Change the participant name on an existing SEP, SAR-SEP, Keogh or 403(b)(7) account because of a legal name change.

403(b)(7) Retirement Plan Shareholder Forms
Access forms to assist you in maintaining your 403(b)(7) account(s).

Keogh Plan Participant Forms
Access forms to assist you in maintaining your Keogh account(s).