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403(b) Distribution/Rollover Authorization Form
Participant Instructions
The 403(b) Distribution/Rollover Authorization Form must be submitted to National Benefit Services, LLC (NBS), the third party
administrator,
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How to fill out 403b distributionrollover authorization form

How to fill out 403b distribution/rollover authorization form:
01
Obtain the form: Request the 403b distribution/rollover authorization form from your 403b plan administrator or download it from their website.
02
Personal information: Fill in your personal information accurately, including your name, address, social security number, and contact information.
03
Specify the distribution/rollover: Indicate whether you want to take a distribution from your 403b plan or roll it over to another qualified retirement plan.
04
Distribution amount: Determine the amount you wish to withdraw or transfer. Be aware of any penalties or taxes that may apply to the distribution.
05
Rollover destination: If you choose to roll over the funds, provide the details of the qualified retirement plan where you want to transfer the funds.
06
Beneficiary designation: Designate any beneficiaries who would receive the remaining balance in the event of your death.
07
Spousal consent: If required by your plan, obtain the spousal consent signature to authorize the distribution or rollover.
08
Signature and date: Sign and date the form to validate your authorization.
09
Review and submission: Ensure you have completed all sections accurately and review the form for any errors. Submit the form to your 403b plan administrator by the specified method (e.g., mail, fax, or online submission portal).
Who needs 403b distribution/rollover authorization form?
01
Current employees with a 403b retirement plan: If you want to take a distribution or roll over your existing 403b funds to another qualified retirement plan, you will need to fill out the 403b distribution/rollover authorization form.
02
Former employees with vested 403b funds: If you are no longer employed by the organization but still have funds in your 403b plan, you may need to complete this form to initiate a distribution or rollover.
03
Beneficiaries of 403b participants: In the event of a participant's death, beneficiaries may need to complete the 403b distribution/rollover authorization form to access the remaining balance or transfer it to their own retirement account.
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What is 403b distributionrollover authorization form?
The 403b distribution/rollover authorization form is a document used by individuals who have a 403b retirement plan and wish to withdraw or transfer funds from that account to another qualified retirement plan or individual retirement account (IRA). This form authorizes the distribution or rollover and provides instructions to the plan administrator or custodian on how to process the transaction.
Who is required to file 403b distributionrollover authorization form?
Any individual who wishes to make a distribution or rollover from their 403b retirement plan is required to file the 403b distribution/rollover authorization form. This includes employees of educational institutions, non-profit organizations, and certain members of the clergy who have this type of retirement plan.
How to fill out 403b distributionrollover authorization form?
To fill out the 403b distribution/rollover authorization form, you typically need to provide personal information such as your name, address, social security number, and the details of the distribution or rollover you wish to make. You may also need to specify the receiving account information and any applicable tax withholding preferences. It is advisable to consult the instructions provided by your plan administrator or custodian for specific guidance on completing the form.
What is the purpose of 403b distributionrollover authorization form?
The purpose of the 403b distribution/rollover authorization form is to initiate a withdrawal or transfer of funds from a 403b retirement plan to another qualified retirement plan or IRA. By completing and submitting this form, individuals communicate their intent to the plan administrator or custodian and provide the necessary instructions for processing the distribution or rollover transaction.
What information must be reported on 403b distributionrollover authorization form?
The specific information to be reported on the 403b distribution/rollover authorization form may vary depending on the requirements of the plan administrator or custodian. However, commonly requested information includes the individual's personal details, the amount or percentage of the distribution or rollover, the intended receiving account information, and any tax withholding preferences.
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