Refund/Rollover Request Form, 05/2019
THE COMMONWEALTH OF MASSACHUSETTS
State Retirement Board
Main Office: One Winter Street, 8th Floor, Boston, MA 02108 Phone: 617-367-7770 Fax: 617-723-1438 Toll Free (within MA): 1-800-392-6014
Regional Office: 436 Dwight Street, Room 109A, Springfield , MA 01103 Phone: 413-730-6135 Fax: 413-730-6139
mass.gov/retirement
Please notify the State Retirement Board of any change of address.
If you are a surviving spouse, an alternate payee, or another beneciary, you have the same choices as the employee described in
Parts II and III. Thus, you may choose to have an eligible rollover distribution, as described in Section I, paid in a Direct Rollover to an
ELIGIBLE RETIREMENT PLAN or paid to you. If you have the payment paid to you, you can keep it or roll it over yourself to an ELIGIBLE
RETIREMENT PLAN in the same manner as the employee. If you are an alternate payee, you continue to have the same choices as the
employee.
If you are a surviving spouse, an alternate payee, or another beneciary, your payment is generally not subject to the additional 10%
tax penalty described in Section III, even if you are younger than age 59-1/2.
If you are a surviving spouse, an alternate payee, or another beneciary, you may be able to use the special tax treatment for lump
sum distributions, as described in Section III. If you receive a payment because of the employee’s death, you may be able to treat the
payment as a lump sum distribution if the employee met the appropriate age requirements, whether or not the employee had 5 years
of participation in the Retirement System.
HOW TO OBTAIN ADDITIONAL INFORMATION
This notice summarizes only the federal (not state or local) tax rules that might apply to your payment. The rules described above are complex
and contain many conditions and exceptions that are not included in this notice. Therefore, you may want to consult with a professional
tax advisor before you take a payment of your benets from the Retirement System. Also, you can nd more specic information on the tax
treatment of payments from qualied retirement plans in IRS Publication 575, Pension and Annuity Income, and IRS Publication 590, Individual
Retirement Arrangements. These publications are available from your local IRS oce, on the IRS’s Internet Web Site at www.irs.gov or by calling
1-800-TAX-FORMS.
Special Tax Treatment If You Were Born Before January 1, 1936 If you receive a payment that can be rolled over under Section I and is
not rolled over to an ELIGIBLE RETIREMENT PLAN, the payment will be taxed in the year you receive it. Special tax treatment for lump sum,
distributions that may be available to you is described below.
Ten-Year Averaging. If you receive a lump sum distribution and you were born before January 1, 1936, you can make a one-time
election to gure the tax on the payment by using “10-year averaging” (using 1986 tax rates). Ten-year averaging often reduces
the tax you owe.
Capital Gain Treatment. If you receive a lump sum distribution and you were born before January 1, 1936 and if you were a
participant in the Retirement System before 1974, you may elect to have the part of your payment that is attributable to your
pre-1974, participation in the Retirement System taxed as long-term capital gain at a rate of 20%.
There are other limits on the special tax treatment for lump sum distributions. For example, you can generally elect this special
tax treatment only once in your lifetime, and the election applies to all lump sum distributions that you receive in that same year.
If you have previously rolled over a distribution from the Retirement System (or certain other similar plans of the employer), you
cannot use the special averaging treatment for later payments from the Retirement System. If you roll over your payment to a
traditional IRA, you will not be able to use special tax treatment for later payments from the traditional IRA. Also, if you roll over
only a portion of your payment to a traditional IRA, this special tax treatment is not available for the rest of the payment, See IRS
Form 4972 for additional information on lump sum distributions and how to elect the special tax treatment.
Important notice for distributions ON or AFTER January 1, 2002. As explained in this notice, EGTRRA creates new rollover options. However,
a distribution from a qualied plan, like your lump sum distribution payment, is not eligible for capital gains or averaging treatment if there was
a rollover to the plan that would not have been permitted under the law in eect before January 1, 2002. Thus, in order to preserve capital gains
and averaging treatment (if available) for a lump sum distribution payment that is rolled over, the rollover would have to be made to a “conduit
IRA” (i.e. a traditional IRA which only includes the lump sum distribution payment), and then rolled back into a qualied plan.
IV. SURVIVING SPOUSES, ALTERNATE PAYEES, AND OTHER BENEFICIARIES
In general, the rules summarized above that apply to payments to employees also apply to payments to surviving spouses of employees and
to spouses or former spouses who are “alternate payees.” You are an alternate payee if your interest in the Retirement System results from
a domestic relations order, which is an order issued by a court, usually in connection with a divorce or legal separation. Some of the rules
summarized above also apply to a deceased employee’s beneciary who is not a spouse. However, there are some exceptions for payments to
surviving spouses, alternate payees, and other beneciaries that should be mentioned: