UNDERSTAND THE NUMBERS IN YOUR RETIREMENT
These forms are available for download in PDF format. You will need Adobe Reader in order to view or print these forms.
Participant Forms
Beneficiary Forms
- Beneficiary Designation Non-QJSA
 Elect or change your beneficiary designation
- Beneficiary Designation QJSA
 Elect or change your beneficiary designation
Distribution Forms
- Election to Refund Deferrals from Automatic Contribution
 Request a refund of your automatic deferral contribution – must be done within 90 days of the first automatic deferral being withheld
- In-Plan Conversion Participant Notice
 In-Plan Roth Conversion Participant Notice – Required to be given to a participant with the In-Plan Roth Conversion Election Form
- In-Plan Roth Conversion Election Form
 In-Plan Roth Conversion Election Form – Request an In-Plan Roth Conversion from you plan
- Request for Distribution Form
 Request a distribution from your plan
- Request for Distribution Checklist
 Checklist of what is needed to complete a distribution
- Request for Distribution Instructions
 Required to be given to a participant with the Request for Distribution form
- Special Tax Notice – Non Roth
 Required to be given to a participant with the Request for Distribution Form
- Special Tax Notice – Roth
 Required to be given to a participant with the Request for Distribution Form
Loan Forms
- Request for Loan Form
 Request a loan if your plan allows loans
- Request for Loan Instructions
 Required to be given to a participant with the Request for Plan Loan form
Salary Deferral Agreement Forms
- Salary Deferral Agreement
 Pre-Tax Elect or change your deferral election (Pre-tax only)
- Salary Deferral Agreement – Pre-tax and Roth
 Elect or change your deferral election (plans that allow both pre-tax and Roth 401(k) deferrals)
