Dfs j3 1172 form-2026

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The document is a form from the Florida Department of Financial Services for participants of the State of Florida Deferred Compensation Plan to request a rollover of their retirement funds. It includes sections for participant information, details on the source and destination of the rollover, and instructions regarding eligibility and processing times. Participants must ensure they have separated from service before rolling out funds and may need to provide a letter of acceptance from the receiving entity.

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Begin with Section 1 - PARTICIPANT INFORMATION. Fill in your name exactly as reported to your payroll office, along with your Social Security Number (SSN), address, gender, date of birth, and contact numbers. Ensure clarity by using a ballpoint pen.
Indicate why you are completing this form by specifying the full or partial rollover amount and selecting the source and destination of your funds from the provided options.
For transfers out, complete the section regarding your last official workday and provide necessary verification details. Remember that a letter of acceptance from the receiving entity is required for all transfers out.
In Section 2, if rolling into the Florida Plan, provide details about the originating plan and investment company. Include contact information for follow-up.
Finally, sign and date the form in the designated areas to validate your request before submitting it through our platform.

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