Cms.cityoftacoma.org HR BenefitsNationwide Retirement Solutions Outgoing Rollover Request 2026

1. Click ‘Get Form’ to open it in our editor.
2. Begin by filling out the Account Holder Information section. Enter your Employer Name, SSN, Name, Date of Birth, Mailing Address, City, State & ZIP, Primary Phone Number, Work Phone Number, and Email Address. Ensure all fields are completed accurately.
3. Select the type of rollover funds you are requesting from the options provided. If your source is not listed, note that funds will be disbursed prorata.
4. Complete the Employer Information section with details from your Plan Sponsor’s Payroll/Personnel Department. This includes Employer Name, Employer Plan Number, Date of Severance from Employment, and Authorized Personnel's Signature.
5. In the New Carrier Information section, provide the name of the new carrier and specify the amount or percentage of rollover. Remember to attach a Letter of Acceptance from the new carrier.
6. Review the Life Insurance Information section and select your preference regarding life insurance coverage if applicable.
7. Complete the Certification and Authorization sections by signing and dating where required to confirm your information is accurate.
8. Finally, return the completed form via mail or fax as indicated at the bottom of the document.

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