Follow the steps to successfully complete your withdrawal request.

1. Press the ‘Get Form’ button to access and open the Separation From Employment Withdrawal Request form in the editor.
2. Complete Section A with your personal information. Ensure all details, including your Social Security Number or Taxpayer Identification Number, last name, first name, and date of birth, are accurate as they must match the records on file with the Service Provider.
3. In Section B, select one reason for your withdrawal from the provided options: 'Separated from Employment' or 'Retired.' Be sure to enter the date of separation or retirement as required.
4. Move to Section C to specify the type of withdrawal you are requesting and how much you wish to withdraw. Indicate if you want a 100% withdrawal or a portion to be rolled over. Fill in the required fields for either a one-time withdrawal or periodic payments.
5. Complete Section D by providing the name and details of the Trustee/Custodian/Provider to which your withdrawal will be payable, if applicable.
6. In Section E, select your preferred delivery method for the proceeds. Choose between USPS regular mail or express delivery, and indicate whether you prefer a check or direct deposit.
7. Fill out Section F to determine how your income taxes will be withheld during the withdrawal process. Refer to the attached tax documentation for specific guidance.
8. Sign your name in Section G, and ensure the signature is notarized or witnessed if required for ACH or wire transfer. Confirm that you understand the terms and conditions associated with the form.
9. After completing all sections, submit the form as instructed in Section H to the designated Service Provider by mail or fax.

Start your withdrawal process today by completing the form online!