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Withdrawal Request Form - MassMutual

Withdrawal Request Form403(b) Notary RequiredUse this form if you want to Request from your plan account: a cash payment a direct rollover of your vested account to another eligible retirement plan or IRA Withdrawal of rollover monies, if the plan permits transfer to purchase Permissive Service Credit under a governmental defined benefit plan, if the plan permits direct payment of Qualified Health Insurance Premiums, if the plan permits Do not use this form if you want to Request : your required minimum distribution (RMD) (use the Required Minimum Distribution Request Form.) a contract exchange or transfer to another provider within your Plan (if you plan allows, use the 403(b) Transfer or Exchange Out Form.)

Annuity Request Form.) • a hardship withdrawal (if your Plan allows, use the . Hardship Withdrawal Request. Form.) Direct Rollovers and Transfers: A LETTER OF ACCEPTANCE (LOA) FROM THE RECIPIENT PROVIDER IS REQUIRED. LOA's must be received prior to or along with this form in “good order.” If applicable, the LOA from the recipient provider

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  Request, Withdrawal, Hardship, Massmutual, Hardship withdrawal request, Withdrawal request, Hardship withdrawal

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