Omni 403b distribution form 2026

1. Click ‘Get Form’ to open the omni 403b distribution form in the editor.
2. Begin by filling out Part 1: Employee Information. Enter your Social Security Number, First Name, Middle Initial, Last Name, Address, City, State, Zip Code, Date of Birth, Email Address, and Phone Number. Fields marked with an asterisk are required.
3. Proceed to Part 2: Distributing Account Information. Provide the full Organization Name along with the City and State of your employer. Also include details for the Service Provider distributing your funds such as Company Name, Account Number, Agent/Broker Name & Phone Number, and Amount to be Distributed.
4. In Part 3: Loan History, indicate if you have previously taken out a loan by selecting 'Yes' or 'No'. If yes, provide the Account Number and Outstanding Loan Balance.
5. Complete Part 4: Other Accounts by indicating if you have other accounts under this Plan or in other plans of this employer. Fill in the necessary details for each account.
6. Finally, sign and date the form in Part 5: Employee Signature to confirm that all information is accurate before submitting it.

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