Individual Development Account Application

Providing written notice, in a satisfactory form, to the administering agency, may change this designation. If my Beneficiary is a spouse or dependent, and they meet all IDA qualifications, they may continue in the IDA program, if they so choose. If the named Beneficiary is NOT a spouse or dependent, such person will receive only my personal savings and the IDA account will be closed.

Please explain why you are interested in participating in Indiana’s IDA Program. This statement will be used to determine your readiness for the program. Include the following:

• Your financial goals for your family and any steps you have already taken to work toward those goals
• The asset you would be interested in purchasing with your IDA savings and why you have chosen that asset
• An explanation detailing how this asset will impact your life