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Get Nationwide Retirement Benefit Options

that apply to your request. r If this is an initial request, and not a change in a current distribution, remember to have your former employer complete the Payroll/Personnel Authorization section. r If you are requesting a payout lasting less than10 years (including a lump sum payout), complete the enclosed Form W-4P, only if you want an additional amount withheld over the 20% mandatory withholding. r Enclose the completed Retirement Benefit Options form, and any other required documentation.

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