5305-RB

Roth Individual Retirement Annuity Endorsement

Agency
IRS
Revision
Rev. April 2017
Fillable fields
3
Pages
2
Official source
IRS form page
Checked
October 21, 2026
Fill 5305-RB online
Page 1 of form 5305-RB

Form 5305-RB: Roth Individual Retirement Annuity Endorsement

Form 5305-RB is a model annuity endorsement that, in the words of its instructions, meets the requirements of section 408A of the Internal Revenue Code. The form says the endorsement is made a part of the annuity contract to which it is attached, and its provisions apply in place of any provisions in the contract to the contrary. The issuer is the insurance company providing the annuity contract, and the annuitant is the person who establishes it.

The instructions say a Roth individual retirement annuity (Roth IRA) is established after the contract, which includes this endorsement, is fully executed by both the annuitant and the issuer. Only Articles I through VIII have been reviewed by the IRS. Article IX is open space for additional provisions the annuitant and the issuer agree to.

The form is not filed with the IRS. It says "Do not file Form 5305-RB with the IRS. Instead, keep it with your records." This is the April 2017 revision, so the dollar limits it prints are for 2013 through 2017. You can fill it out free in your browser on this page and download the result without an account.

Top of page 1 of Form 5305-RB: Roth Individual Retirement Annuity Endorsement, as printed by IRS

What's on Form 5305-RB

Header

The name of issuer line and a box to check if this endorsement supersedes a prior Roth IRA endorsement.

Articles I and II: contributions

Article I limits the issuer to cash contributions, apart from qualified rollover and recharacterized contributions. Article II phases the annual limit down to $0 at higher adjusted gross income (AGI).

Articles III and IV: the contract

Article III says the annuitant's interest is nonforfeitable and nontransferable. Article IV says the contract does not require fixed contributions and explains how dividends are applied.

Article V: distributions after death

Rules for distributing the remaining interest over the designated beneficiary's life expectancy or by the end of the year containing the fifth anniversary of the annuitant's death.

Articles VI to VIII: reports and amendments

Article VI covers the information the annuitant provides and the reports the issuer submits. Article VII says which articles control. Article VIII covers amendments.

Article IX: additional provisions

Open space on page 2 for any additional provisions. The form says to draw a line through it if no other provisions will be added.

How to fill out Form 5305-RB

  1. 1

    Name of issuer

    Enter the name of the insurance company providing the annuity contract on the line at the top of page 1.

    Name of issuer on page 1 of Form 5305-RB: Roth Individual Retirement Annuity Endorsement, as printed by IRS
  2. 2

    Supersede box

    Check the box only if this endorsement supersedes a prior Roth IRA endorsement. Otherwise leave it empty.

  3. 3

    Review Article V

    The instructions say elections made under Article V should be reviewed periodically to make sure they match the annuitant's intent.

  4. 4

    Article IX

    Add any agreed provisions, such as definitions, investment powers, voting rights, the issuer's fees or state law requirements, and attach pages if needed. If none, draw a line through the space.

  5. 5

    Execute the contract

    The instructions say the Roth IRA is established once the contract, including this endorsement, is fully executed by both the annuitant and the issuer. Then keep it with your records.

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Where it goes, timing and limits

Where it goes

Nowhere. The form says "Do not file Form 5305-RB with the IRS. Instead, keep it with your records." It stays attached to the annuity contract.

Timing

The instructions say that to make a regular contribution to a Roth IRA for a year, the IRA must be established no later than the due date (excluding extensions) of the individual's income tax return for the year.

Limits in this revision

Article I lists $5,500 per year for 2013 through 2017, or $6,500 for those who reached age 50 by the end of the year. The form says later years are adjusted for cost of living, if any.

Excess contributions

The instructions say the annuitant may be subject to a 6% tax on excess contributions, for example when AGI exceeds the Article II limits for the tax year.

Added provisions

Provisions added in Article IX have to comply with state law and the Internal Revenue Code, and the form says they may not imply that the IRS reviewed or pre-approved them.

Related forms

Who completes Form 5305-RB?

  • Insurance companies (issuers)

    The instructions define the issuer as the insurance company providing the annuity contract. It may call itself "company," "insurer" or "us." Its name goes on the name of issuer line.

  • Annuitants

    The annuitant is the person who establishes the annuity contract. The insurance company may use other terms such as "owner," "applicant," "insured" or "you."

  • Surviving spouses

    Under Article V, a surviving spouse who is the designated beneficiary is treated as the annuitant. The instructions say an overriding provision in Article IX can treat the spouse as the beneficiary instead.

  • Beneficiaries

    Article V sets how the remaining interest is distributed to a designated beneficiary who is not the surviving spouse, or when there is no designated beneficiary.

  • The IRS gets reports, not the form

    Under Article VI, the issuer agrees to submit to the IRS and the annuitant the reports prescribed by the IRS. The endorsement itself stays with the records.

The form is an agreement between an insurance company and the person buying the annuity. Nobody sends it to the IRS.

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Questions about Form 5305-RB

Do I send Form 5305-RB to the IRS?

No. The form says "Do not file Form 5305-RB with the IRS. Instead, keep it with your records."

Who fills out Form 5305-RB?

The issuer, which the instructions define as the insurance company providing the annuity contract, attaches it to the contract. The Roth IRA is established once both the annuitant and the issuer fully execute the contract.

Which parts did the IRS review?

The instructions say only Articles I through VIII have been reviewed by the IRS. Article IX holds any additional provisions.

What contribution limits does this revision show?

The April 2017 revision lists $5,500 per year for 2013 through 2017, or $6,500 for those who reached age 50 by the end of the year, with cost-of-living adjustments, if any, for later years.

Can the annuity accept a rollover?

Article I says that apart from a qualified rollover contribution under section 408A(e) or a recharacterized contribution under section 408A(d)(6), the issuer accepts only cash contributions.

What happens when the annuitant dies?

Article V says a surviving spouse who is the designated beneficiary is treated as the annuitant. Otherwise the interest is paid over the beneficiary's life expectancy or by the end of the year containing the fifth anniversary of the death.