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Automatic Bank Withdrawal Instructions
This form is used to:
· Establish ongoing automatic/systematic investment purchases from a financial institution to a mutual fund account(s)
· Add or change financial institution information
· Add or change draw dates or dollar amounts
· Stop existing bank draft plan
Read and understand the instructions before completing this form.
Important notes:
· If this form is incomplete or not legible when returned, your request may be delayed.
· Once this transaction has been processed, it cannot be reversed. It may be changed, reestablished or stopped before
future transactions.
· Read and understand the entire form and instructions before completing. Questions regarding this form may be directed
to the Customer Interaction Center at: 800-847-4836.
· Monday - Friday 7:00AM 9:00PM Central Time
· Saturday 9:00AM 1:00PM Central Time
· Send completed forms:
Fax to: 866-278-8363
Or mail to:
Thrivent Investment Management, Inc.
PO Box 219348
Kansas City, MO 64121-9348
· For your own security, do not e-mail the completed forms to Thrivent. E-mailed forms will not be accepted.
Page 1 Thrivent ID
· This is a nine digit identifier that starts with a 5, unique to each Thrivent member/shareholder. If you are unsure of the
Thrivent ID, contact the Customer Interaction Center.
Page 1 Financial Institution Information
· Provide the name of the account owner as listed on the account with the financial institution as well as the account
owners' complete phone number and address.
· If bank account is registered jointly, provide the name of the joint owner(s) as listed on the account with the financial
institution.
· Provide the full name of the financial institution where the dollars will be drawn from.
· Check the box to indicate if the financial institution account is a checking or savings account.
· Provide the Transit number for the financial institution. This is the 9 digit number found in the lower left corner at the
bottom of your check, beginning with a 0, 1, 2 or 3. You may also obtain this number by contacting your financial
institution directly.
· Provide the Account number of the financial institution where the dollars will be drawn from. This is the next set of
numbers listed on your check after the Transit number. Be careful not to include the check number.
· To ensure accuracy of the account information, enclose a copy of a voided check.
6568MFINS N6-08 1
Page 2 Fund Name/Account Number
· Indicate the complete mutual fund name and account number into which funds will be purchased.
· There is space to provide information for 15 different mutual fund accounts with the same registration.
· If the account will have two or more draws with different dollar amounts for the same account, list the account number
on as many lines as there will be draws. (Example: If there will be $100 drawn on the 15th, $125 on the 20th and $150 on
the 25th of every month, list the account number three times)
Page 2 Type
· Indicate the code E, B, C or S as explained on the form to designate your type of request.
· E should be indicated if this form is being used to establish a new bank draft plan.
· B should be indicated if this form is being used to change or establish new bank account information; such as the bank
name, the transit or routing number.
· C should be indicated if this form is being used to change the dollar amount or draw date of an existing bank draft plan.
· S should be indicated if this form is being used to stop an existing bank draft plan.
Page 2 Amount
· Enter the dollar amount to be withdrawn. If there should be two or more draws with different dollar amounts for the same
account, use separate lines for each dollar amount.
· Purchases must meet the monthly minimum investment requirements. See the prospectus or contact the investment
interaction center for more detail on this.
Page 2 Bank Draft Date
· Can establish either one or two different draw dates for the same dollar amount to occur each month.
· Select and enter a draw date from 1-28 to indicate the day(s) of the month to withdraw funds from the financial institution.
· Purchases occurring over a weekend or non-business day will be processed the next business day.
Page Signature
· Only one financial institution account owner's signature is required on the form, unless the bank account registration is
listed as "and" then all account owners must sign.
(Example: If the account is registered as John or Mary Smith, only one account owner must sign. If it is registered as
John and Mary Smith, both account owners must sign)
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