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Print FormClear FormROLLOVER INREAD REVERSE SIDE BEFORE COMPLETING THIS FORMParticipant InformationXXXXXSocial Security Number (last 4)___ Last Name First M.I.___I have the following pretax retirement
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Access the Arizona Smart Save website or visit an enrollment center to obtain an application
02
Fill out the application with accurate information about your household and income
03
Gather the necessary documentation such as proof of income, residency, and identification
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Submit the completed application and documentation to the appropriate office either online or in person
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Who needs arizona smart save?

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Low-income individuals and families who need assistance with their utility bills and energy costs.
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Arizona Smart Save is a program designed to assist individuals and businesses in managing their retirement savings accounts effectively and efficiently.
Individuals and businesses that offer retirement savings plans or wish to report on their retirement savings accounts are required to file Arizona Smart Save.
To fill out Arizona Smart Save, gather your financial information related to retirement savings, complete the required forms with accurate data, and submit them through the designated online portal or mail them to the appropriate office.
The purpose of Arizona Smart Save is to encourage retirement savings among Arizonans by providing a structured reporting framework and promoting awareness of available savings options.
On Arizona Smart Save, you must report information regarding contributions to retirement accounts, account balances, and any withdrawals made during the reporting period.
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