Transfer Between Existing Fidelity Accounts Form Completed Form Examples and Samples
Explore real-world examples and samples of the Transfer Between Existing Fidelity Accounts Form. Learn how to correctly fill out partial and full transfers, in-kind asset moves, and account-to-account transfers between Fidelity brokerage accounts, IRAs, and more. Step-by-step filled form examples to guide you through every field.
Transfer Between Existing Fidelity Accounts Form Example – Partial Portfolio Rebalance
How this form was filled:
In this example, an individual investor transfers a portion of her holdings — including shares of a mutual fund and an ETF — from her taxable Fidelity brokerage account into her existing Fidelity Roth IRA as part of an annual portfolio rebalancing strategy. The form captures the account owner's personal details, both source and destination account numbers, the specific assets being moved, and the transfer type (partial, in-kind).
Information used to fill out the document:
- Account Owner Full Name: Emily R. Caldwell
- Social Security Number (last 4 digits): 7842
- Date of Birth: 03/14/1985
- Phone Number: 617-555-0192
- Email Address: [email protected]
- Mailing Address: 48 Birchwood Lane, Apt 3B, Boston, MA 02101
- Source Account Type: Individual Taxable Brokerage Account
- Source Account Number: Z14-883920
- Destination Account Type: Roth IRA
- Destination Account Number: X77-441056
- Transfer Type: Partial Transfer – In-Kind
- Asset 1 Name: Fidelity 500 Index Fund
- Asset 1 Ticker: FXAIX
- Asset 1 Shares: 150.000
- Asset 2 Name: iShares Core S&P 500 ETF
- Asset 2 Ticker: IVV
- Asset 2 Shares: 75.000
- Transfer Reason: Annual Portfolio Rebalancing
- Signature: Emily R. Caldwell
- Date Signed: 02/10/2026
What this filled form sample shows:
- Clearly identified source account (Individual Taxable Brokerage) and destination account (Roth IRA) with full account numbers
- Partial, in-kind transfer selected to move specific securities without liquidating positions
- Two individual assets specified with ticker symbols (FXAIX and IVV) and exact share quantities
- Transfer purpose documented as annual portfolio rebalancing for record-keeping clarity
- Correctly completed account owner identification fields including name, SSN last 4 digits, and date of birth
- Properly formatted signature and date (02/10/2026) in the authorization section
Form specifications and details:
| Use Case: | Partial in-kind transfer from taxable brokerage to Roth IRA for portfolio rebalancing |
| Transfer Scope: | Partial (specific assets only, not full account) |
| Transfer Method: | In-Kind (securities transferred as-is, not liquidated) |
| Number of Assets Transferred: | 2 |
| Account Relationship: | Same account owner, different account types |
| Form Purpose: | Move existing holdings between two Fidelity accounts without selling |
| Tax Implication Note: | Transferring from taxable to Roth IRA may trigger a taxable event; consult a tax advisor |
| Applicable Account Types: | Individual Taxable Brokerage Account and Roth IRA |
Created: February 24, 2026 04:00 AM
