Follow the steps to successfully fill out your withdrawal request.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Fill in the 'Plan Information' section with the relevant Plan number and Employer name found on your quarterly statement.
3. In the 'Account Holder Information' section, provide your full name, Social Security Number (SSN), street address or P.O. Box, city, ZIP code, state, and daytime phone number.
4. Indicate your withdrawal amount by selecting one of the options: withdraw 100% of your account, do not close the account, or withdraw a portion based on specified sources.
5. Complete the 'Withdrawal Elections for Non Roth Accounts' and 'Withdrawal Elections for Roth Account' sections, selecting either 'Exchange' or 'Plan to Plan Transfer' as applicable.
6. If applicable, fill out the 'Outstanding Loan Information' section to indicate your decision regarding ongoing loan repayments.
7. Provide payment instructions in the 'Exchange / Transfer Payee Instructions' for both non-Roth and Roth accounts. Include the custodian information and mailing instructions.
8. Review the important notice regarding potential fees and early distribution restrictions to ensure compliance with plan terms.
9. In the 'Account Holder Authorized Signature and Certification' area, sign and date the form, ensuring your SSN is filled in as required.
10. Obtain required signatures from the third-party administrator, if applicable, and from an employer or plan sponsor before submitting.
11. Once all sections are completed, save your changes and download or print the completed form. Mail or fax it as instructed.

Start completing your Voya Financial 164219 withdrawal request online today.