Transcription of Questions? Distribution — Rollover
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Questions? Distribution — Rollover
Page 1 of 4 Questions? Call 1-800-343-0860, business days from 8 AM to midnight Eastern Distribution RolloverUse this form to request a Rollover Distribution from your 401(a), 401(k), 403(b) or 457(b) governmental employer plan. Fill in by hand using CAPITAL letters and black ink, or on screen (if PDF). If you need more room for information, use a copy of the relevant Account Owner/ParticipantNameSocial Security or Taxpayer ID NumberDate of Birth MM DD YYYYE vening PhoneDaytime PhoneE-mail Not married Married Your spouse may need to sign this form. Ask your plan sponsor or the address we have for you is correct, skip to Section CodeCountry2. Employer and Plan(s) InvolvedThe Distribution you request in Section 4 will apply to EACH PLAN listed here.
Page 1 of 4. Questions? Call 1-800-343-0860, business days from 8 AM to midnight Eastern Time. 3.TEMDISTRO.108 026380201 . Distribution — Rollover
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