Distribution Request Form for 457(b) Plans
This document is a Distribution Request form for 457(b) Governmental Plans by Nationwide Retirement Solutions. It captures essential personal information and provides options for distribution reasons and methods. Users can complete this form to initiate a distribution from their retirement account.
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How do I fill this out?
To fill out this form, begin by entering your personal information accurately, including your name and contact details. Select the reason for your distribution from the provided checkboxes and ensure your employer authorizes the request if needed. Finally, choose the payment method and complete any necessary tax withholding information before submission.

How to fill out the Distribution Request Form for 457(b) Plans?
1
Step 1: Enter your personal information including your name, date of birth, and contact details.
2
Step 2: Select the distribution reason that applies to your situation.
3
Step 3: If required, obtain employer authorization for your distribution request.
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Step 4: Choose your payment method and any tax withholding options.
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Step 5: Review your information and submit the form.
Who needs the Distribution Request Form for 457(b) Plans?
1
Public safety officers who require distributions for retirement purposes.
2
Individuals who have severed employment and need access to their retirement funds.
3
Employees reaching retirement age looking for distribution options.
4
Individuals filing for disability who need to access their retirement account.
5
Anyone obliged to take required minimum distributions as per IRS regulations.
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What are the instructions for submitting this form?
To submit this form, you may either mail it to your employer’s HR department at the specified address or send it via fax to the designated number provided on the form. You can also opt for online submission if your employer has that option available. Ensure you check for any specific submission guidelines provided by your employer to facilitate a swift processing experience.
What are the important dates for this form in 2024 and 2025?
Key dates for submitting this form depend on your plan specifics, as distributions may vary based on your plan’s rules and individual circumstances. It's advisable to submit your request at least 30 days prior to any planned retirement date or significant life event to ensure prompt processing. Keep in mind any deadlines specific to your employer's policies as well.

What is the purpose of this form?
The purpose of this form is to facilitate the distribution of funds from 457(b) Governmental Plans managed by Nationwide Retirement Solutions. It provides a structured approach for participants to request distributions based on their unique circumstances, such as retirement, employment severance, or other qualifying reasons. Completing this form ensures that retirees can access their funds efficiently and timely, adhering to IRS regulations and plan guidelines.

Tell me about this form and its components and fields line-by-line.

- 1. Participant Name: Enter the full name of the participant requesting the distribution.
- 2. Date of Birth: Provide the participant's date of birth for identification purposes.
- 3. SSN or Account Number: Input the Social Security Number or account number related to the retirement plan.
- 4. Street Address: List the current mailing address.
- 5. City: Specify the city of residence.
- 6. State: Select the state of residency for tax purposes.
- 7. ZIP: Include the relevant postal zip code.
- 8. Phone: Provide a contact phone number.
- 9. Email: Enter a valid email address for correspondence.
- 10. Distribution Reason: Select the reason for the withdrawal from the given options.
- 11. Payment Method: Choose how you would like to receive the funds.
What happens if I fail to submit this form?
Failing to submit this form could delay access to your retirement funds, potentially affecting your financial situation. It’s important to provide complete and accurate information to avoid any processing issues. Review the form thoroughly to confirm all sections are filled out correctly before submission.
- Delayed Distribution: Incomplete forms may result in processing delays for fund distribution.
- Tax Implications: Providing incorrect information could lead to tax penalties.
- Employer Issues: Lack of employer authorization may prevent request processing.
How do I know when to use this form?

- 1. Retirement: To access funds upon reaching your retirement age.
- 2. Severance of Employment: When leaving your job and needing to withdraw funds.
- 3. Disability: To secure funds if you have become disabled.
- 4. Required Minimum Distribution: To comply with IRS regulations for mandatory withdrawals.
- 5. In-Service Withdrawal: For qualified individuals who wish to withdraw while still employed.
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