Nationwide Distribution Rollover Application Form - National 2026

1. Click ‘Get Form’ to open the Nationwide Distribution Rollover Application Form - National in the editor.
2. Begin by filling out the 'Nationwide Plan Information' section. Enter your Plan Number and Plan Name accurately to ensure proper processing.
3. In the 'Participant Information' section, provide your full name, Social Security Number (SSN), phone number, date of birth, date of hire, street address, city, state, zip code, and email address.
4. Move on to the 'Rollover/Transfer Information' section. Answer whether you have completed all requirements with your current Provider/Custodian. If not, respond to their specific questions regarding paperwork and signature requirements.
5. Complete the 'Submission Information' by ensuring that checks are made payable to Nationwide Financial and include necessary details in the memo section. Fill in the mailing addresses as required.
6. Fill out the 'Rollover/Transfer Details' with information about your prior Provider/Custodian and specify account types and amounts for transfer.
7. Finally, sign in both the 'Plan Sponsor/Authorized Representative Signature' and 'Participant Authorization' sections to validate your request.

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