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403(b) Forms

403(b) Contract Exchange Form

Use this form to transfer funds from one provider in the plan to another provider in the same plan

403(b) Distribution Request Form

Use this form when there is a distributable event (i.e. Severance of Employment, Attainment of Age 59.5, Death, RMD)

403(b) Loan Request Form

Use this form to request a loan from an annuity

403(b) Hardship Withdrawal Form

Use this form to request a withdrawal based on an unforeseen financial hardship - IRS requirements adn substantiating documentation required)

403(b) Plan to Plan Transfer Form

Use this form to request a transfer of funds to a state retirement plan to purchase permissive service credits or when consolidating 403b plans with another employer

403(b) Rollover Request From

Use this form to request a transfer of funds from a former employer to a current employer or for moving the funds to to an IRA, TRS (Teacher's Retirement System).

403(b) Salary Reduction Agreement Form

Use this form to request a reduction to a participant's salary to be deposited into their 403(b) Account/s.

403(b) Disclosure Statement
Use this form, along with the SRA form, for new SRAs, increases, decreases and stops.
403(b) Uniform Disclosure Notice
Use this form, along with the SRA form and Disclosure Statement, for new SRAs only.