3121 distribution election form mid america-2025

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The document outlines the 3121 Premier Plan, a Social Security Alternative Retirement Plan for eligible employees. It includes a Distribution Request Form for participants to request account settlements, detailing options for lump sum distributions, rollovers to IRAs or other qualified plans, and death distributions. The document also provides instructions on completing the form, tax implications of distributions, and necessary documentation such as death certificates for beneficiaries. Additionally, it explains the tax treatment of payments and the rules regarding direct rollovers.

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Click ‘Get Form’ to open the 3121 distribution election form in the editor.
Begin by filling in your personal information at the top of the form, including your name, current mailing address, Social Security number, and contact details.
In the 'Account Settlement Election' section, select one of the three options for how you wish to receive your distribution: a lump sum check, a rollover to another account, or a death distribution. Ensure you provide any required amounts if applicable.
If you choose a rollover (option 2), complete the 'Direct Rollover Information' section with details about the receiving account. Make sure to include the account number and type.
Sign and date the 'Acknowledgment and Authorization' section at the bottom of the form. If applicable, ensure that a beneficiary signature is also included.
Review all entered information for accuracy before submitting. Once confirmed, return your completed form as instructed.

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