Transcription of Request for Involuntary Distribution
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Example: bankruptcy
Request for Involuntary Distribution
RS007901/2022A. Provide plan name and number:Plan or Company Name: _____ Plan/SunGard Number: _____ B. List the participants who are eligible and subject to Involuntary Distribution *: Balances under $1, I instruct Paychex to issue a check to the participant, less mandatory 20% federal and applicable state income tax withholding, if the participant has not returned a completed Distribution form within 30 days of the final notice. Balances exceeding $1, (must be rolled over to an IRA) I instruct Paychex to issue a check to the IRA company named below if the employee has not returned a completed Distribution form within 30 days of the final notice. Important: Balances exceeding $5, may not be distributed unless the plan is Name SSN (Last 4 digits)Address (If different than what is on file)C.
Title 29 of the Code of Federal Regulations, Section 2550.404a-2 and Section 2550.404a-3, respectively, (each a “DOL Regulation,” and collectively the “DOL Regulations”) permit the Plan to provide that 1 ret0016 11/2020
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