Forms

For Participants

PDF Salary Reduction Agreement

This form authorizes your employer to deduct Plan contributions from your paycheck. It should be used if you are a new participant or to increase, decrease, or stop your contributions if you are an existing participant.

PDF 403(b) Hardship Distribution Authorization

If allowed in your Plan, this form must be submitted along with your vendor's paperwork to request a hardship distribution. Hardship distributions are made on account of an immediate and heavy financial need, if deemed as an eligible expense.

PDF 457(b) Unforeseeable Emergency Authorization

If allowed in your Plan, this form must be submitted along with your vendor's paperwork to request an unforeseeable emergency distribution. Unforeseeable Emergency distributions are made on account of an illness or accident, loss of property due to casualty, or other extraordinary and unforeseeable circumstances.

PDF Plan Distribution/Rollover Authorization

Distributions and rollovers from a Plan are generally only allowed upon attainment of age 59 ½ (for 403(b) Plans) or age 70 (for 457(b) Plans) or severance from employment. For information on other eligible events, please contact us for assistance.

PDF Plan-to-Plan Transfer/Exchange/Service Credit Approval

If allowed by your Plan, this form can be submitted to approve a transfer from your former employer’s Plan to your current employer’s Plan. This form can also be used to approve an exchange between approved vendors within your current employer’s Plan, or to approve a purchase of service credit from your State Teacher's Retirement System.

PDF Plan Loan Approval

If allowed in your Plan, please complete this form to request a loan from your Plan account.

For Employers

PDF 403(b) Plan Administration Questionnaire

In order to request Plan administrative services, please answer all questions and submit all information requested on this form.

PDF 403(b) Non-Elective Contribution Questionnaire

This questionnaire is used to add employer-paid contributions to an existing Plan or to amend existing employer-paid contributions. Only complete this form if employer-paid contributions are or will be allowed under your Plan Rules.

PDF 457(b) Plan Administration Questionnaire

In order to request Plan administrative services, please answer all questions and submit all information requested on this form.

PDF 457(b) Non-Elective Contribution Questionnaire

This questionnaire is used to add employer-paid contributions to an existing Plan or to amend existing employer-paid contributions. Only complete this form if employer-paid contributions are or will be allowed under your Plan Rules.

PDF Common Remitter File Formats

If selected by the Plan, this document provides information regarding the required data and formatting of each of the three common remitter files that must be created by the employer and submitted to AFPlanServ® with each Plan contribution remittance.
PDF Adobe Acrobat Reader is required to view PDF files. If you do not have Acrobat Reader installed on your machine, visit the Adobe Web site to download the software.

ESB-5184-1216