403(b)(7) Rollover Form
Thank you for choosing Transamerica. We appreciate the opportunity to serve your financial needs,
and to help you transform your tomorrow. Use this form to roll over your existing Qualified Plan, 401(k),
403(b), 403(b)(7) tax-sheltered annuity or annuity, or other such retirement plan directly to a
Transamerica Funds 403(b)(7). For assistance, call Transamerica Funds at 1.888.233.4339.
TF403ROL0817 1
Rollover from:
Qualified Plan (401(k), Profit Sharing Plan, Money Purchase Pension Plan, etc.)
Individual Retirement account or annuity (Traditional, SIMPLE, or SEP)
Governmental 457 Plan
I have completed the necessary forms from my previous employer or current Custodian/Trustee to roll over my qualified
plan retirement assets to a Transamerica Funds IRA account.
If the Direct Rollover is from a Transamerica Funds account, please complete the section below:
100% % or
Fund and Account Number
100% %
or $
Fund and Account Number
100% %
or $
Fund and Account Number
Note: Most plan custodians/trustees require their own forms be completed prior to any distribution or rollovers. Please check
with your current plan Custodian or Trustee, or with your former employer, to complete any of their required forms, in addition to
or in place of this form. Incomplete or incorrect forms may result in long delays.
Section OneAccount Registration
Legal Name of Owner or Custodian
Social Security Number
Date of Birth Daytime Telephone Number
Mailing Address Email Address
Zip Code
Section Two Current Custodian Information
Current Custodian or Trustee
City State Zip Code
Telephone Number
Fax Number
Section Three Accounts to be Rolled Over
403(b)(7) Rollover Form
TF403ROL0817 2
The rollover assets should be applied as follows:
New Transamerica Funds 403(b)(7) account. A completed Transamerica Funds IRA Application must accompany this Direct Rollover
Request Form. Your rollover assets will be allocated as indicated in Section Three of your new account application.
Existing Transamerica Funds 403(b)(7) account. Unless you indicate otherwise, your rollover assets will be allocated as indicated on
your original account application. If you would like to allocate your rollover assets differently, complete the section below.
Total for all funds must equal 100%
Fund and Account Number
Fund and Account Number
I hereby authorize UMB Bank, N.A. to deposit the assets received from my existing retirement plan according to the terms
stated in this form. I hereby acknowledge that strict requirements must be met to qualify for tax-free rollover treatment; I hereby
certify that the assets being directly rolled over constitute an eligible rollover distribution as defined in the Internal Revenue
Code of 1986, as amended.
I acknowledge that I am personally responsible for any taxes and penalties that may result from this
distribution, and release the Custodian and TFS from any responsibility or liability.
Signature Date
Name of Signing Officer (please print) Date
NOTE: Please include Signature Guarantee if releasing custodian requires it. All checks from the releasing custodian must be
made payable to Transamerica Fund Services.
Mail the completed and signed form to Transamerica Fund Services.
Regular Mail Overnight
Transamerica Fund Services, Inc. Transamerica Fund Services, Inc.
P.O. Box 219945 330 W. 9th Street
Kansas City, MO 64121-9945 Kansas City, MO 64105
Section Four Investment Allocations
Section Six Signature
Signature Guarantee (STAMP2000)