Forms

The forms listed below are the most frequently used forms. Log in to your account or contact us if you have questions about which form to use.

Enroll

Participation Agreement (PDF)

Use this form to:

  • Enroll in the plan
  • Change your contributions
  • Select or change beneficiaries
  • Select or change investment options

Manage my money

Incoming Assets Form (PDF)

Certain plans may have special requirements. Upon receipt of your request, we will contact you for more information if necessary.

Use this form to:

  • Roll money over from other retirement savings accounts into your Plan
  • Decide which investments you want the rollover money to go into
  • Decide if you want to enroll in Asset Rebalancing

Retirement Benefit Options (PDF)

Use this form to:

  • Select your payout options when you end your employment or retire
  • Request a payout
  • Stop current payouts
  • Change a current payout
  • Restart a payout
  • Defer payout until Required Minimum Distribution (RMD) is required at age 70½

Deferred Compensation Unforeseeable Emergency Distribution Application (PDF)

Your employer may have specific rules regarding hardships. Please contact your benefits representative for details or contact us.

Use this form to:

  • Apply for an unforeseeable emergency distribution

Manage my account

Beneficiary Change Form (PDF)

Use this form to change beneficiary information:

  • Select primary and contingent beneficiaries
  • Change how your money will be divided between your beneficiaries
  • Remove and add beneficiaries

Automatic Deposit Authorization (PDF)

Use this form to:

  • Add or change your checking or savings information for automatic deposits to your bank account

Payout Request Form (PDF)

Use this form to:

  • Request a payout

PPA Premiums for Public Safety Officers Form (PDF)
Instructions for completing the PPA Premium for Safety Officer Form (PDF) 

Use this form to:

  • Elect to withdraw funds for health and long-term care insurance

Name Change

Follow this link to view/print the information you will need to provide to change your name.

Web Access

Follow this link to view/print the information you will need to disable or reactivate your account.

Manage someone else's account

Divorce (Domestic Relations Orders)

Follow this link to view/print the information you and your attorney will need to provide in the event of a divorce.

Military Leave

Follow this link to view/print information on how to notify us if you are going on military leave.

Beneficiary Distribution Form (PDF)

Alternate Payee Claim Form (PDF)

Use these forms if you're a beneficiary or an alternate payee, such as a former spouse or a dependant of a Plan member:

  • Report the death of a Plan member. Please remember to submit a certified copy of the death certificate if you are reporting the death of a plan member.
  • Update your beneficiary information.
  • Request a payout.

PDFs require Adobe® Acrobat.®

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