Fill - Free fillable DCP In-Service Withdrawal (Washington) PDF form

DCP In-Service Withdrawal

Use this form to request a withdrawal from your

Deferred Compensation Program (DCP) while you are

still working for a DRS-covered employer.

Send completed form to:

Voya Financial

ꔷ Attn: Washington DRS

PO Box 389 ꔷ Hartford, CT 06141

Or Fax to 844.449.2546

For assistance call 888.327.5596 (TTY 711)

DRS-RK D 506 10/20 71625712DISTRIBC

Important Information

Customer Information

Customer Name (Last, First, Middle) Birthdate (mm/dd/yyyy) Social Security Number (last 4)

xxx-xx-

Mailing Address (must match address on le) City State ZIP

Email Address (Required. This is how we will notify you of your application status) Phone Number

I want to withdraw funds from my DCP account (625056) for the following reason that meets the criteria described above.

Select one:

c De Minimus Request

c Age 72 or Older RMD

c Withdrawing Rolled-in Contributions

c Transferring to Another Provider Under the Plan

In most cases you must be separated from DRS-covered employment before you can withdraw funds from your DCP

account. However, there are a few exceptions. Withdrawing from your DCP account while you are still employed

(in-service withdrawal) is allowed for any of the following reasons:

De Minimus Request: If you have not contributed to DCP in at least 24 months, and your account balance is under

$5,000, you can request a one-time withdrawal of these funds.

Age 72 or Older RMD: You are not required to take an IRS required minimum distribution (RMD) if you are still under

DRS-covered employment. However, if you are age 72 or older and you wish to withdraw from your account while

you are employed, you can with this form. You can also complete this transaction online to receive real-time estimates

for tax withholding. Log into your DCP account through drs.wa.gov/login. Go to Account, Withdrawals, Request a

Withdrawal to complete the RMD withdrawal.

Withdrawing Rolled-in Contributions: If you rolled funds from another plan or program into your DCP account, you

can withdraw these funds. Keep in mind that these funds still carry any tax requirements or early withdrawal penalties

they arrived with when you rolled them in. Complete this transaction online to see your eligible rollover withdrawal

amount including estimates for tax withholding. Log into your account through drs.wa.gov/login. Go to Account,

Withdrawals, Request a Withdrawal, Rollover Withdrawal to complete this withdrawal.

Transferring to Another Provider Under the Plan: If you have not separated from your employer, but have

transferred to a position that participates in a 457 deferred compensation program outside of Washington State DCP,

you can withdraw your funds to transfer them to the participating plan.

Approval for an in-service withdrawal can take longer than a standard withdrawal and your money will remain in the

market until the distribution. Use the percentage options to work with your total account balance. To complete this

withdrawal, the mailing address you enter below must match the address you have on le. Update your address through

your employer. Visit drs.wa.gov/dcp to nd out more about withdrawing funds from your DCP account.

Clear Form

How to nd your routing and account numbers

On your checks, the routing number is on the bottom

left. The next numbers are your account. Optional: You

can also attach a voided check with your application.

If you don’t have checks, contact your nancial

institution and ask for the numbers.

Routing Number Account Number

Pay to

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Authorization for Direct Deposit (complete if you chose this delivery preference)

Due to federal restrictions, we cannot transfer funds electronically if the funds will be immediately credited to an

account outside the United States.

By completing this section, you authorize that: The DRS record keeper will transfer the full amount of your withdrawal,

after required IRS withholding, to the designated nancial institution for deposit. Additionally, you authorize the

designated nancial institution to refund the record keeper any payments made in error.

Financial Institution Name Account Type

c Checking c Savings

Routing Number Account Number

Withdrawal Delivery Preference

c First Class Mail

(no additional charge)

Estimated delivery time:

Up to 5 days.

c Expedited delivery

A $50 additional charge will be

taken from your account.

c Direct Deposit

(no additional charge)

Estimated delivery time: 2-3

business days.

Rollover Agreement (complete if you selected the rollover withdrawal type)

The rollover check will be mailed to your home address on le so you can submit it to your rollover source. To update

your address, contact your employer.

Check Made Payable To (Rollover Institution Trustee Name) Account Number

Account Type c Eligible Employer Plan (403(b), 401(a)/(k), Governmental 457(b)

c 403(a) Annuity c Individual Retirement Account c Individual Retirement Account Annuity

Withdrawal Type (select all that apply)

Any partial withdrawal will be distributed evenly (pro-rata) from your current investments.

c Lump Sum or Partial Payment Amount $_______________________ or _______________________%

A lump sum is a full (100% of your balance) or partial (less than 100% of your balance) payment paid to you.

c Rollover Amount $

_______________________ or _______________________%

A rollover allows your DCP funds to be “rolled over” into another qualifying plan, such as an IRA or a 401(k). If you select this

option, also complete the Rollover Agreement section. Rollovers are not available for De Minimus Request withdrawals.

c Transfer under retirement provider Amount $

_______________________ or _______________________%

This is a one-time transfer to another 457 retirement program under your DRS-covered employer (attach letter of acceptance).

Signature Required

By signing this application, I afrm that I have carefully read (or in the case of disability, I have had read to me) and

understand the application for this withdrawal request. All information is complete and true, represents my choices, and

no material fact has been concealed or omitted. I understand that unless a statutory exception exists, my designations,

options and alternatives are permanent after my application has been processed.

Waiver of 30 Day Notice Period: The IRS requires that customers be given 30 days to review options for withdrawal. My

signature here indicates I have reviewed my options and waive this 30 day hold.

Signature Date

Your Social Security or Tax ID number is needed so the DRS record keeper can report to the IRS any funds paid to you.

We will not disclose your information unless required to do so by law. See IRC sections 6041(a) and 6109.

DRS-RK D 506 Page 3 of 3 71625712DISTRIBC

Form Submission (use one of the following options to submit this form)

Fax

Voya Financial

Attn: Washington State DRS

844-449-2546

Mail

Voya Financial

Attn: Washington State DRS

PO Box 389

Hartford, CT 06141

Overnight Delivery

Voya Financial

Attn: Washington State DRS

One Orange Way

Windsor, CT 06095-4774

Tax Withholding

c I have read and agree to the “402(f) Notice of Special Tax Rules on Distributions” included with this form.

Your withdrawal type will determine whether you complete the rest of this section. See the Notice of Special Tax rules

for details. For more information about number of allowances, see the IRS form W-4P. You can also submit the W-4P

form to update your tax withholding information at any time.

State Income Tax withholding is mandatory for some states. If it is required for your state, income tax will be withheld

regardless of any withholding election you make below. State income tax does not apply to Washington State residents.

Lump sum or partial withdrawals These are taxed at a federal withholding rate of 20%. Only complete the withholding

section below if you want to have more than 20% federal withholding.

Rollover This transaction is not taxed and you do not need to complete the rest of this Tax Withholding section.

Federal Withholding

c Married c Single c Married but withhold at Single Rate

Number of Allowances

Optional: To have more tax withheld from your payment, enter any additional withholding here.

Additional Federal Tax Withholding $__________________ Additional State Tax Withholding $__________________

IRS 402(f) Notice of Special Tax Rules on Distributions

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For Payments Not From a

Designated Roth Account

YOUR ROLLOVER OPTIONS

You are receiving this notice because all or a portion of a payment you are receiving from the Plan is

eligible to be rolled over to an IRA or an employer plan. This notice is intended to help you decide whether

to do such a rollover.

This notice describes the rollover rules that apply to payments from the Plan that are not from a designated

Roth account (a type of account with special tax rules in some employer plans). If you also receive a

payment from a designated Roth account in the Plan, you will be provided a different notice for that

payment, and the Plan administrator or the payor will tell you the amount that is being paid from each

account.

Rules that apply to most payments from a plan are described in the “General Information About

Rollovers” section. Special rules that only apply in certain circumstances are described in the “Special

Rules and Options” section.

GENERAL INFORMATION ABOUT ROLLOVERS

How can a rollover affect my taxes?

You will be taxed on a payment from the Plan if you do not roll it over. If you are under age 59½ and do not

do a rollover, you will also have to pay a 10% additional income tax on early distributions (generally,

distributions made before age 59½), unless an exception applies. However, if you do a rollover, you will not

have to pay tax until you receive payments later and the 10% additional income tax will not apply if those

payments are made after you are age 59½ (or if an exception applies).

What types of retirement accounts and plans may accept my rollover?

You may roll over the payment to either an IRA (an individual retirement account or individual retirement

annuity) or an employer plan (a tax-qualified plan, section 403(b) plan, or governmental section 457(b) plan)

that will accept the rollover. The rules of the IRA or employer plan that holds the rollover will determine your

investment options, fees, and rights to payment from the IRA or employer plan (for example, no spousal

consent rules apply to IRAs and IRAs may not provide loans). Further, the amount rolled over will become

subject to the tax rules that apply to the IRA or employer plan.

How do I do a rollover?

There are two ways to do a rollover. You can do either a direct rollover or a 60- day rollover.

If you do a direct rollover, the Plan will make the payment directly to your IRA or an employer plan. You

should contact the IRA sponsor or the administrator of the employer plan for information on how to do a

direct rollover.

If you do not do a direct rollover, you may still do a rollover by making a deposit into an IRA or eligible

employer plan that will accept it. Generally, you will have 60 days after you receive the payment to make

the deposit. If you do not do a direct rollover, the Plan is required to withhold 20% of the payment for

federal income taxes (up to the amount of cash and property received other than employer stock). This

means that, in order to roll over the entire payment in a 60-day rollover, you must use other funds to make

up for the 20% withheld. If you do not roll over the entire amount of the payment, the portion not rolled

over will be taxed and will be subject to the 10% additional income tax on early distributions if you are

under age 59½ (unless an exception applies).

How much may I roll over?

If you wish to do a rollover, you may roll over all or part of the amount eligible for rollover. Any payment

from the Plan is eligible for rollover, except:



Certain payments spread over a period of at least 10 years or over your life or life expectancy (or

the lives or joint life expectancy of you and your beneficiary);



Required minimum distributions after age 70½ (or after death);



Hardship distributions;



ESOP dividends;

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

Corrective distributions of contributions that exceed tax law limitations;



Loans treated as deemed distributions (for example, loans in default due to missed payments

before your employment ends);



Cost of life insurance paid by the Plan;



Payments of certain automatic enrollment contributions requested to be withdrawn within 90

days of the first contribution; and



Amounts treated as distributed because of a prohibited allocation of S corporation stock under an

ESOP (also, there will generally be adverse tax consequences if you roll over a distribution of S

corporation stock to an IRA).

The Plan administrator or the payor can tell you what portion of a payment is eligible for rollover.

If I don’t do a rollover, will I have to pay the 10% additional income tax on early distributions?

If you are under age 59½, you will have to pay the 10% additional income tax on early distributions for any

payment from the Plan (including amounts withheld for income tax) that you do not roll over, unless one of

the exceptions listed below applies. This tax applies to the part of the distribution that you must include in

income and is in addition to the regular income tax on the payment not rolled over.

The 10% additional income tax does not apply to the following payments from the Plan:



Payments made after you separate from service if you will be at least age 55 in the year of the

separation;



Payments that start after you separate from service if paid at least annually in equal or

close to equal amounts over your life or life expectancy (or the lives or joint life

expectancy of you and your beneficiary);



Payments from a governmental plan made after you separate from service if you are a qualified

public safety employee and you will be at least age 50 in the year of the separation;



Payments made due to disability;



Payments after your death;



Payments of ESOP dividends;



Corrective distributions of contributions that exceed tax law limitations;



Cost of life insurance paid by the Plan;



Payments made directly to the government to satisfy a federal tax levy;



Payments made under a qualified domestic relations order (QDRO);



Payments up to the amount of your deductible medical expenses (without regard to whether you

itemize deductions for the taxable year);



Certain payments made while you are on active duty if you were a member of a reserve

component called to duty after September 11, 2001 for more than 179 days;



Payments of certain automatic enrollment contributions requested to be withdrawn within 90

days of the first contribution;



Payments for certain distributions relating to certain federally declared disasters; and



Phased retirement payments made to federal employees.

If I do a rollover to an IRA, will the 10% additional income tax apply to early distributions from the

IRA?

If you receive a payment from an IRA when you are under age 59½, you will have to pay the 10%

additional income tax on early distributions on the part of the distribution that you must include in income,

unless an exception applies. In general, the exceptions to the 10% additional income tax for early

distributions from an IRA are the same as the exceptions listed above for early distributions from a plan.

However, there are a few differences for payments from an IRA, including:



The exception for payments made after you separate from service if you will be at least age 55 in

the year of the separation (or age 50 for qualified public safety employees) does not apply.

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

The exception for qualified domestic relations orders (QDROs) does not apply (although a special

rule applies under which, as part of a divorce or separation agreement, a tax-free transfer may be

made directly to an IRA of a spouse or former spouse).



The exception for payments made at least annually in equal or close to equal amounts over a

specified period applies without regard to whether you have had a separation from service.



There are additional exceptions for (1) payments for qualified higher education expenses, (2)

payments up to $10,000 used in a qualified first- time home purchase, and (3) payments for

health insurance premiums after you have received unemployment compensation for 12

consecutive weeks (or would have been eligible to receive unemployment compensation but for

self-employed status).

Will I owe State income taxes?

This notice does not describe any State or local income tax rules (including withholding rules).

SPECIAL RULES AND OPTIONS

If your payment includes after-tax contributions

After-tax contributions included in a payment are not taxed. If a payment is only part of your benefit, an

allocable portion of your after-tax contributions is included in the payment, so you cannot take a payment of

only after-tax contributions. However, if you have pre-1987 after-tax contributions maintained in a separate

account, a special rule may apply to determine whether the after-tax contributions are included in a payment.

In addition, special rules apply when you do a rollover, as described below.

You may roll over to an IRA a payment that includes after-tax contributions through either a direct rollover or

a 60-day rollover. You must keep track of the aggregate amount of the after-tax contributions in all of your

IRAs (in order to determine your taxable income for later payments from the IRAs). If you do a direct rollover

of only a portion of the amount paid from the Plan and at the same time the rest is paid to you, the portion

directly rolled over consists first of the amount that would be taxable if not rolled over. For example, assume

you are receiving a distribution of $12,000, of which $2,000 is after-tax contributions. In this case, if you

directly roll over $10,000 to an IRA that is not a Roth IRA, no amount is taxable because the $2,000 amount

not directly rolled over is treated as being after-tax contributions. If you do a direct rollover of the entire

amount paid from the Plan to two or more destinations at the same time, you can choose which destination

receives the after-tax contributions.

If you do a 60-day rollover to an IRA of only a portion of a payment made to you, the after-tax contributions

are treated as rolled over last. For example, assume you are receiving a distribution of $12,000, of which

$2,000 is after-tax contributions, and no part of the distribution is directly rolled over. In this case, if you roll

over $10,000 to an IRA that is not a Roth IRA in a 60-day rollover, no amount is taxable because the $2,000

amount not rolled over is treated as being after-tax contributions.

You may roll over to an employer plan all of a payment that includes after-tax contributions, but only

through a direct rollover (and only if the receiving plan separately accounts for after-tax contributions

and is not a governmental section 457(b) plan). You can do a 60-day rollover to an employer plan of

part of a payment that includes after-tax contributions, but only up to the amount of the payment that

would be taxable if not rolled over.

If you miss the 60-day rollover deadline

Generally, the 60-day rollover deadline cannot be extended. However, the IRS has the limited authority to

waive the deadline under certain extraordinary circumstances, such as when external events prevented you

from completing the rollover by the 60-day rollover deadline. Under certain circumstances, you may claim

eligibility for a waiver of the 60-day rollover deadline by making a written self-certification. Otherwise, to apply

for a waiver from the IRS, you must file a private letter ruling request with the IRS. Private letter ruling

requests require the payment of a nonrefundable user fee. For more information, see IRS Publication 590-

A, Contributions to Individual Retirement Arrangements (IRAs).

If your payment includes employer stock that you do not roll over

If you do not do a rollover, you can apply a special rule to payments of employer stock (or other employer

securities) that are either attributable to after-tax contributions or paid in a lump sum after separation from

service (or after age 59½, disability, or the participant’s death). Under the special rule, the net unrealized

appreciation on the stock will not be taxed when distributed from the Plan and will be taxed at capital gain

rates when you sell the stock. Net unrealized appreciation is generally the increase in the value of employer

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stock after it was acquired by the Plan. If you do a rollover for a payment that includes employer stock (for

example, by selling the stock and rolling over the proceeds within 60 days of the payment), the special rule

relating to the distributed employer stock will not apply to any subsequent payments from the IRA or employer

plan. The Plan administrator can tell you the amount of any net unrealized appreciation.

If you have an outstanding loan that is being offset

If you have an outstanding loan from the Plan, your Plan benefit may be offset by the outstanding amount of

the loan, typically when your employment ends. The offset amount is treated as a distribution to you at the

time of the offset. Generally, you may roll over all or any portion of the offset amount. Any offset amount that

is not rolled over will be taxed (including the 10% additional income tax on early distributions, unless an

exception applies). You may roll over offset amounts to an IRA or an employer plan (if the terms of the

employer plan permit the plan to receive plan loan offset rollovers).

How long you have to complete the rollover depends on what kind of plan loan offset you have. If you have a

qualified plan loan offset, you will have until your tax return due date (including extensions) for the tax year

during which the offset occurs to complete your rollover. A qualified plan loan offset occurs when a plan loan

in good standing is offset because your employer plan terminates, or because you sever from employment. If

your plan loan offset occurs for any other reason, then you have 60 days from the date the offset occurs to

complete your rollover.

If you were born on or before January 1, 1936

If you were born on or before January 1, 1936 and receive a lump sum distribution that you do not roll

over, special rules for calculating the amount of the tax on the payment might apply to you. For more

information, see IRS Publication 575, Pension and Annuity Income.

If your payment is from a governmental section 457(b) plan

If the Plan is a governmental section 457(b) plan, the same rules described elsewhere in this notice

generally apply, allowing you to roll over the payment to an IRA or an employer plan that accepts rollovers.

One difference is that, if you do not do a rollover, you will not have to pay the 10% additional income tax on

early distributions from the Plan even if you are under age 59½ (unless the payment is from a separate

account holding rollover contributions that were made to the Plan from a tax-qualified plan, a section 403(b)

plan, or an IRA). However, if you do a rollover to an IRA or to an employer plan that is not a governmental

section 457(b) plan, a later distribution made before age 59½ will be subject to the 10% additional income

tax on early distributions (unless an exception applies). Other differences include that you cannot do a

rollover if the payment is due to an “unforeseeable emergency” and the special rules under “If your payment

includes employer stock that you do not roll over” and “If you were born on or before January 1, 1936” do not

apply.

If you are an eligible retired public safety officer and your payment is used to pay for health

coverage or qualified long-term care insurance

If the Plan is a governmental plan, you retired as a public safety officer, and your retirement was by reason of

disability or was after normal retirement age, you can exclude from your taxable income Plan payments paid

directly as premiums to an accident or health plan (or a qualified long-term care insurance contract) that your

employer maintains for you, your spouse, or your dependents, up to a maximum of $3,000 annually. For this

purpose, a public safety officer is a law enforcement officer, firefighter, chaplain, or member of a rescue

squad or ambulance crew.

If you roll over your payment to a Roth IRA

If you roll over a payment from the Plan to a Roth IRA, a special rule applies under which the amount of the

payment rolled over (reduced by any after-tax amounts) will be taxed. However, the 10% additional income

tax on early distributions will not apply (unless you take the amount rolled over out of the Roth IRA within 5

years, counting from January 1 of the year of the rollover).

If you roll over the payment to a Roth IRA, later payments from the Roth IRA that are qualified distributions

will not be taxed (including earnings after the rollover). A qualified distribution from a Roth IRA is a payment

made after you are age 59½ (or after your death or disability, or as a qualified first-time homebuyer

distribution of up to $10,000) and after you have had a Roth IRA for at least 5 years. In applying this 5-year

rule, you count from January 1 of the year for which your first contribution was made to a Roth IRA.

Payments from the Roth IRA that are not qualified distributions will be taxed to the extent of earnings after

the rollover, including the 10% additional income tax on early distributions (unless an exception applies). You

do not have to take required minimum distributions from a Roth IRA during your lifetime. For more

information, see IRS Publication 590-A, Contributions to Individual Retirement Arrangements (IRAs), and IRS

Publication 590-B, Distributions from Individual Retirement Arrangements (IRAs).

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If you do a rollover to a designated Roth account in the Plan

You cannot roll over a distribution to a designated Roth account in another employer’s plan. However, you

can roll the distribution over into a designated Roth account in the distributing Plan. If you roll over a

payment from the Plan to a designated Roth account in the Plan, the amount of the payment rolled over

(reduced by any after-tax amounts directly rolled over) will be taxed. However, the 10% additional tax on

early distributions will not apply (unless you take the amount rolled over out of the designated Roth

account within the 5-year period that begins on January 1 of the year of the rollover).

If you roll over the payment to a designated Roth account in the Plan, later payments from the designated

Roth account that are qualified distributions will not be taxed (including earnings after the rollover). A qualified

distribution from a designated Roth account is a payment made both after you are age 59½ (or after your

death or disability) and after you have had a designated Roth account in the Plan for at least 5 years. In

applying this 5-year rule, you count from January 1 of the year your first contribution was made to the

designated Roth account. However, if you made a direct rollover to a designated Roth account in the Plan

from a designated Roth account in a plan of another employer, the 5-year period begins on January 1 of the

year you made the first contribution to the designated Roth account in the Plan or, if earlier, to the designated

Roth account in the plan of the other employer. Payments from the designated Roth account that are not

qualified distributions will be taxed to the extent of earnings after the rollover, including the 10% additional

income tax on early distributions (unless an exception applies).

If you are not a Plan participant

Payments after death of the participant. If you receive a distribution after the participant’s death that you do

not roll over, the distribution will generally be taxed in the same manner described elsewhere in this notice.

However, the 10% additional income tax on early distributions and the special rules for public safety officers

do not apply, and the special rule described under the section “If you were born on or before January 1,

1936” applies only if the participant was born on or before January 1, 1936.

If you are a surviving spouse. If you receive a payment from the Plan as the surviving spouse of

a deceased participant, you have the same rollover options that the participant would have had,

as described elsewhere in this notice. In addition, if you choose to do a rollover to an IRA, you

may treat the IRA as your own or as an inherited IRA.

An IRA you treat as your own is treated like any other IRA of yours, so that payments made to you

before you are age 59½ will be subject to the 10% additional income tax on early distributions

(unless an exception applies) and required minimum distributions from your IRA do not have to start

until after you are age 70½.

If you treat the IRA as an inherited IRA, payments from the IRA will not be subject to the 10%

additional income tax on early distributions. However, if the participant had started taking

required minimum distributions, you will have to receive required minimum distributions from

the inherited IRA. If the participant had not started taking required minimum distributions from

the Plan, you will not have to start receiving required minimum distributions from the inherited

IRA until the year the participant would have been age 70½.

If you are a surviving beneficiary other than a spouse. If you receive a payment from the Plan

because of the participant’s death and you are a designated beneficiary other than a surviving

spouse, the only rollover option you have is to do a direct rollover to an inherited IRA. Payments

from the inherited IRA will not be subject to the 10% additional income tax on early distributions. You

will have to receive required minimum distributions from the inherited IRA.

Payments under a qualified domestic relations order. If you are the spouse or former spouse of the

participant who receives a payment from the Plan under a qualified domestic relations order (QDRO), you

generally have the same options and the same tax treatment that the participant would have (for example,

you may roll over the payment to your own IRA or an eligible employer plan that will accept it). However,

payments under the QDRO will not be subject to the 10% additional income tax on early distributions.

If you are a nonresident alien

If you are a nonresident alien and you do not do a direct rollover to a U.S. IRA or U.S. employer plan, instead of

withholding 20%, the Plan is generally required to withhold 30% of the payment for federal income taxes. If the

amount withheld exceeds the amount of tax you owe (as may happen if you do a 60-day rollover), you may

request an income tax refund by filing Form 1040NR and attaching your Form 1042-S. See Form W-8BEN for

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claiming that you are entitled to a reduced rate of withholding under an income tax treaty. For more information,

see also IRS Publication 519, U.S. Tax Guide for Aliens, and IRS Publication 515, Withholding of Tax on

Nonresident Aliens and Foreign Entities.

Other special rules

If a payment is one in a series of payments for less than 10 years, your choice whether to make a direct

rollover will apply to all later payments in the series (unless you make a different choice for later

payments).

If your payments for the year are less than $200 (not including payments from a designated Roth account in

the Plan), the Plan is not required to allow you to do a direct rollover and is not required to withhold federal

income taxes. However, you may do a 60-day rollover.

Unless you elect otherwise, a mandatory cashout of more than $1,000 (not including payments from a

designated Roth account in the Plan) will be directly rolled over to an IRA chosen by the Plan administrator or

the payor. A mandatory cashout is a payment from a plan to a participant made before age 62 (or normal

retirement age, if later) and without consent, where the participant’s benefit does not exceed $5,000 (not

including any amounts held under the plan as a result of a prior rollover made to the plan).

You may have special rollover rights if you recently served in the U.S. Armed Forces. For more information

on special rollover rights related to the U.S. Armed Forces, see IRS Publication 3, Armed Forces’ Tax Guide.

You also may have special rollover rights if you were affected by a federally declared disaster (or similar

event), or if you received a distribution on account of a disaster. For more information on special rollover

rights related to disaster relief, see the IRS website at www.irs.gov.

FOR MORE INFORMATION

You may wish to consult with the Plan administrator or payor, or a professional tax advisor, before taking

a payment from the Plan. Also, you can find more detailed information on the federal tax treatment of

payments from employer plans in: IRS Publication 575, Pension and Annuity Income; IRS Publication

590-A, Contributions to Individual Retirement Arrangements (IRAs); IRS

Publication 590-B, Distributions from Individual Retirement Arrangements (IRAs); and IRS Publication 571,

Tax-Sheltered Annuity Plans (403(b) Plans). These publications are available from a local IRS office, on

the web at www.irs.gov, or by calling 1-800-TAX-FORM.

* * *

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Notice of Your Right to Defer Distributions

The Rules under Section 411(a) of the Internal Revenue Code require the delivery of this notice prior to the

payment of distributions from 401(k) and other retirement plans subject to ERISA. If you are a participant in a

non-ERISA plan, this notice is not legally required, but still provides important information that merits your

consideration.

As a terminated participant, you will make a decision about what to do with your retirement savings. Depending

on Plan rules you may elect to (1) leave the assets in your Plan account until a later date (subject to IRS

minimum distribution requirements), (2) take a distribution of your assets from your Plan account, or (3) roll over

your assets from your Plan account to another retirement plan vehicle (including an IRA). When considering

which alternative is best for you, you should consider the economic consequences which include evaluating any

new investment options available to you if you move your account monies and the respective investment fees

and expenses associated with any new investment option.

Your plan may have special rules that could affect your decision to keep money in the Plan as a terminated

participant. Such rules could impact the level of benefits that you could later receive or affect your distribution

options when you later attempt to receive a distribution from the plan. If your plan has special rules, the

portions of your Plan’s Summary Plan Description that address your benefit level(s) and distribution rights

would provide additional details.

If you decide to keep your money in the Plan, you may continue to invest in any of the Plan’s investment

options and the monies in your account will continue to defer federal income tax.

If you decide to take money out of the Plan, any amount that is not directly rolled over to an IRA or another

eligible plan will be subject to 20% income tax withholding. Any amount that is received and not rolled over

within 60 days must be included in your taxable income and may be subject to an additional 10% penalty tax if

you received the amount before age 59½. If you decide to keep your money in the Plan, you must begin taking

at least a minimum payment beginning April 1

of the calendar year following the year you reach age 70½ or

retire, whichever is later.

To learn more about your distribution options under the Plan including available investment options and fees, or to request a

copy of the Plan SPD, please contact a Customer Service Representative or visit the Plan website using the

toll-free number or URL provided to you as part of this package.

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DCP In-Service Withdrawal (Washington)

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