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Click ‘Get Form’ to open it in the editor.
Begin by entering your full name, home address, and social security number in the designated fields.
Next, input your pension or annuity contract claim or identification number if applicable.
Decide whether you want to have Missouri state income taxes withheld. If you do not wish to withhold taxes, check the box next to Line 1. If you do wish to withhold taxes, check Line 2 and enter the desired monthly withholding amount (minimum $10).
Finally, sign and date the form. Once completed, send it to your retirement plan administrator for processing.
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