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403(b) Distribution/Rollover Authorization Form Participant Instructions The 403(b) Distribution/Rollover Authorization Form must be submitted to Employee Benefits Services & Advisors, Inc. (EBS),
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How to fill out 403b distributionrollover authorization form

How to fill out a 403b distribution/rollover authorization form:
01
Obtain the form: Contact your employer or retirement plan administrator to obtain a copy of the 403b distribution/rollover authorization form. This form may also be available for download from the plan's website.
02
Personal information: Fill out your personal information accurately, including your name, address, social security number, and contact information. Make sure to double-check the information for any errors.
03
Rollover or distribution request: Indicate whether you want to initiate a rollover or a distribution from your 403b plan. If you are moving the funds to another retirement account, select "rollover." If you want to receive the funds directly, choose "distribution."
04
Rollover or distribution details: If you selected "rollover," provide the details of the receiving retirement account, such as the institution's name, account number, and address. If you chose "distribution," specify how you would like to receive the funds, such as a check or electronic transfer.
05
Tax withholding and penalties: Determine if you want to have federal income tax withheld from the distribution by selecting the appropriate withholding rate. Keep in mind that there may be additional penalties for early withdrawals if you are under the age of 59 ½.
06
Signature and date: Read through the form carefully and make sure all the necessary information is complete and accurate. Sign and date the form to indicate your agreement and understanding of the terms and conditions.
07
Submit the form: After completing the form, submit it as instructed by your employer or retirement plan administrator. This may include mailing it to a specific address or submitting it electronically through an online portal.
Who needs a 403b distribution/rollover authorization form?
01
Employees with a 403b plan: Individuals who have a 403b retirement plan and wish to make a distribution or rollover from their account will need to complete a 403b distribution/rollover authorization form.
02
Individuals changing jobs: If someone is changing jobs and wants to transfer their 403b funds from their previous employer's plan to a new retirement account, they will need to fill out this form to initiate the rollover process.
03
Those looking to withdraw funds: Individuals who are eligible to take a distribution from their 403b plan, whether for financial needs or retirement purposes, must complete this form to request the desired amount and specify how they want to receive the funds.
Note: It is important to consult with a financial advisor or tax professional before making any decisions regarding distributions or rollovers from a retirement account to ensure you understand the potential tax implications and any potential penalties.
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