Forms

The forms listed below are the most frequently used forms. Log in to your account or contact us if you have questions about which form to use.

Enroll

EZ Enrollment Form (PDF)

Use this form to enroll in the Plan and utilize the Plan’s designated enrollment fund for your age.

Enrollment Form (PDF)

Use this form to enroll in the Plan and select your own investment options.

Manage my money

Rollover In Form (PDF)

Use this form to:

  • Roll money over from other retirement savings accounts into your Plan
  • Decide which investments you want the rollover money to go into

In-service Rollover Account Withdrawal Form (PDF)

Use this form to transfer your rollover assets to another qualified retirement plan.

Distribution Request (PDF)

Use this form to:

  • Select your payout options when you end your employment or retire
  • Request a payout
  • Stop current payouts
  • Change a current payout
  • Restart a payout
  • Defer payout until Required Minimum Distribution (RMD) is required at age 70½
  • Take an In-Service Distribution

402(f) Special Tax Notice

Outgoing Rollover Request Form (PDF)

Use this form to roll your account to another qualified retirement plan.


Unforeseeable Emergency Distribution Form (PDF)

Use this forms to apply for an unforeseeable emergency distribution.


Three Year Catch-Up Deduction Form (PDF)

Use this form to apply for catch-up contributions.


Leave Conversion Authorization Form – Most Employees (PDF)

Retiring employees who are not represented by a police or fire union should use this form to apply for authorization to cash out remaining leave balances.


Leave Conversion Authorization Form – Fire Local 27 & Local 2898 (PDF)

Retiring employees represented by Local 27 and Local 2898 should use this form to apply for authorization to cash out remaining leave balances.


Leave Conversion Authorization Form – Police SPOG & SPMA (PDF)

Retiring employees represented by SPOG or SPMA should use this form to apply for authorization to cash out remaining leave balances.


Manage my account

Beneficiary Designation Form (PDF)

Use this form to change beneficiary information:

  • Select primary and contingent beneficiaries
  • Change how your money will be divided between your beneficiaries
  • Remove and add beneficiaries

Direct Deposit Authorization Form (PDF)

Use this form to:

  • Add or change your checking or savings information for automatic deposits to your bank account

Distribution Request of Qualified Health and Long Term Care Insurance Premiums (PDF)

Use this form to:

  • Request a distribution of qualified health and long term care insurance premiums

Manage life events

Alternate Payee Distribution Form (PDF)

Use these forms if you're a beneficiary or an alternate payee, such as a former spouse or a dependent of a Plan member:

  • Report the death of a Plan member. Please remember to submit a certified copy of the death certificate if you are reporting the death of a plan member
  • Update your beneficiary information
  • Request a payout

PDFs require Adobe® Reader®

NRW-2891WA-SW.6
NRW-2891WA-SW.6
Modal Dialog Start Close

You are going to a page that is not part of this website

We make no endorsement of its content or guarantee of its accuracy. If the Continue button does not work, the page may have been moved or removed.

Please consider logging out of your account before you proceed.

NRW-2913AO.1
Modal Dialog End