ADP Rollover Contr
ADP TotalSource retirement Savings plan Rollover CONTRIBUTION FORM. PERSONAL INFORMATION (please print clearly using black or blue ink). NAME: ________________________________________ ____________________ SOCIAL SECURITY NUMBER: ____________________. ADDRESS: ________________________________________ __________________ APT:____________________________________ __. CITY:___________________________________ ___________________________ STATE: _________ ZIP CODE: ____________________. DAY PHONE: ________________________________________ ___________ EVENING PHONE: __________________________________. E-MAIL: ________________________________________ _______________________________ DATE OF BIRTH: _____ /_____ /______. INSTRUCTIONS. 1. Contact your former employer, plan administrator, or financial institution to request and receive a Rollover distribution check. You will need to provide the correct payee information for your Rollover . The Rollover check should be mailed directly to you and payable as follows: Voya Institutional Trust Company for the benefit of ( ) (Your Name).
Plan qualification:Your rollover contribution to the ADP TotalSource ® Retirement Savings Plan must be from another qualified plan or IRA. The ADP The ADP TotalSource ® Retirement Savings Plan accepts rollover contributions from a 401(k) plan, 403(b) plan, 457 plan or Traditional IRA.
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