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Deferred Compensation: Forms

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SEND ALL FORMS TO:
 
Benefits & Retirement
  600 Henley Street
  Suite #115
  Knoxville, TN 37996-4115
        or FAX to 865-974-3559 / email

New Employees

401(k) New Enrollment

401(k) Incoming Rollover - for making rollovers into the 401(k) plan

457 New Enrollment
457 Incoming Rollover - for making rollovers into the 457 plan
457 Catch-Up If you are within 3 years of normal retirement age and wish to utilize the special catch-up please call Great West at 1-800-922-7772 and select option 2.

403(b) New Enrollment  - contact your vendor choice for Membership form - 403(b) Company list

Active Members

To change your investment allocations, please contact Great West at 1-800-922-7772 or use their online Account Access.
401(k) Salary Reduction Agreement - Change deduction amount
401(k) Beneficiary Designation Form - for naming or changing your 401(k) beneficiary.
Longevity Deferral - Defer your annual longevity benefit
401(k) Participant Change Request - for name or address changes
401(k) Loan Request
401(k) Hardship Withdrawal Request

 

To change your investment allocations, please contact Great West at 1-800-922-7772 or use their online Account Access.
457 Salary Reduction Agreement  - Change deduction amount
457 Beneficiary Designation Form - for naming or changing your 457 beneficiary.
457 Participant Change Request - for name or address changes
457 Hardship Withdrawal Request
457 Standard Catch-Up - If you are within 3 years of normal retirement age and wish to utilize the special catch-up please call Great West at 1-800-922-7772 and select option 2.Also contact the Benefits & Retirement Office for assistance- 888-444-8847.

 

To change your investment allocations, please contact your 403(b) provider.
403(b) SRA Change 403(b)  - Change deduction amount
403(b) Company forms are available on their websites. Some of the forms are available here.

403B Company Forms

Termination

401(k)-457 Deferral of Lump Sum Annual Leave
Agreement for Deferral of Lump Sum Annual Leave
(Both Forms are required)


401(k) Distribution/Withdrawal Request
457 Distribution/Withdrawal Request
(Both Forms are required)


403(b) Deferral of Lump Sum Annual Leave
Agreement for Deferral of Lump Sum Annual Leave
(Both Forms are required)
*Contact 403b company (Ameriprise, Fidelity, ING, TIAA-CREF, VALIC) for forms*

Retirement

Distribution Request for 401(k) Plan - for total or partial lump sum withdrawals or rollovers out of the plan please contact Great West at (800) 922-7772 option 2 or local Nashville at (615) 244-1030.  

 Automated Minimum Distribution Request for 401(k) Plan- for retirees over age 70 1/2 who want to set up future withdrawals at the minimum level IRS permit. 

 

Distribution Request for 457 Plan - for total or partial lump sum withdrawals or rollovers out of the plan please contact Great West at (800) 922-7772 option 2 or local Nashville at (615) 244-1030.

457 Plan Automated Minimum Distribution Request - for retirees over age 70 1/2 who want to set up future withdrawals at the minimum level IRS permits

Forms for Retirees

401(k) Death Benefit Claim Form
401(k) Withholding Certificate  - to change the amount withheld for taxes after distributions have begun.
401(k) Authorization for Direct Deposit 401(k) - to authorize direct deposit of your periodic or minimum distribution payments to your checking or savings account

457 Death Benefit Claim Form
457 Withholding Certificate - to change the amount withheld for taxes after distributions have begun.
457 Authorization for Direct Deposit - to authorize direct deposit of your periodic or minimum distribution payments to your checking or savings account

AboUT You 

RESOURCES:

Campus/Institute Contacts:
Chattanooga   
Family Practice- Chatt. 
Health Science Center  
Knoxville Area    
Martin   
UTSI    
UT Memorial Hospital

SEND FORMS TO:
Deferred Compensation (401k, 457, 403b) Forms:
     Total Rewards/ Benefits & Retirement Office
     600 Henley St, #115
     Knoxville, TN  37996-4115

Insurance Forms:
     Insurance & Retirement
     P115 Andy Holt Tower
     1331 Circle Park
     Knoxville, TN  37996-0100

Retirement Forms:
     Total Rewards/ Benefits & Retirement Office
     600 Henley St, #115
     Knoxville, TN  37996-4115

Other Links:
Deferred Compensation (State site)
Deferred Compensation (Great West site)
Optional Retirement Program (ORP State site)
Tennessee Consolidated Retirement System (TCRS State site)
Office of Personnel Management- OPM (CSRS & FERS)