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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 the 403b distributionrollover authorization

How to fill out the 403b distribution/rollover authorization:
01
Start by reading the instructions: Before filling out the form, it is essential to carefully read the instructions provided. This will give you a clear understanding of the requirements and any supporting documents that need to be attached.
02
Provide personal information: Begin by filling in your personal details, such as your name, address, social security number, and date of birth. Ensure that you provide accurate information to avoid any processing delays or errors.
03
Indicate the account details: On the form, you will be required to provide information about your 403b account, such as the account number, name of the custodian or institution, and any additional account information required. This will help in accurately identifying and processing your distribution or rollover request.
04
Choose the type of transaction: Indicate whether you are requesting a distribution or a rollover. If you are opting for a rollover, specify the eligible retirement account where the funds will be transferred. For a distribution, you may need to select the method of payment, such as a lump sum or periodic payments.
05
Determine the amount: In this section, specify the amount you would like to distribute or rollover from your 403b account. Be precise and double-check your calculations to ensure accuracy.
06
Tax withholding: Indicate whether you would like to have federal income tax withheld from the distribution amount. If so, provide the necessary information, such as the percentage or specific dollar amount to be withheld. Consult a tax advisor if you are unsure about the appropriate withholding amount.
07
Signature and date: Sign and date the form as an acknowledgement that the information provided is accurate to the best of your knowledge. Your signature authorizes the distribution or rollover as requested.
Who needs the 403b distribution/rollover authorization?
01
Employees with a 403b retirement account: Any individual who has a 403b retirement account and wishes to take a distribution or execute a rollover may need to complete the 403b distribution/rollover authorization form.
02
Individuals changing jobs or retiring: If you are changing jobs or retiring, you may need to withdraw funds or transfer them to another eligible retirement account. This requires completing the 403b distribution/rollover authorization form to initiate the process.
03
Participants reaching the age of 70 ½: Once you reach the age of 70 ½, you are generally required to begin taking minimum distributions from your 403b account. To initiate these distributions, you would need to fill out the 403b distribution/rollover authorization form.
In summary, the 403b distribution/rollover authorization form is necessary for individuals who have a 403b retirement account and need to make distributions or rollovers. By following the provided instructions and accurately completing the form, you can ensure a smooth process for accessing your retirement funds.
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What is the 403b distributionrollover authorization?
The 403b distribution rollover authorization is a form used to request a transfer of funds from a 403b retirement account to another eligible retirement account.
Who is required to file the 403b distributionrollover authorization?
Individuals who wish to move funds from a 403b retirement account to another eligible retirement account are required to file the 403b distribution rollover authorization.
How to fill out the 403b distributionrollover authorization?
The 403b distribution rollover authorization form can typically be obtained from the financial institution managing the 403b retirement account. The form must be completed with accurate information about the transfer request.
What is the purpose of the 403b distributionrollover authorization?
The purpose of the 403b distribution rollover authorization is to facilitate the transfer of retirement funds without incurring tax penalties.
What information must be reported on the 403b distributionrollover authorization?
The 403b distribution rollover authorization form typically requires details about the account holder, the receiving account, and the amount to be transferred.
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