Fillable NEW LOAN/REFINANCE APPLICATION FORM (DIRECT) (City of Riverside, California)

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NEW LOAN/REFINANCE APPLICATION FORM (DIRECT) (City of Riverside, California)

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38713-0718 | 1
ICMA-RC • Attn: Workow Management Team • P.O. Box 96220 • Washington, DC 20090-6220 • Toll Free 800-669-7400 • www.icmarc.org • Fax 202-682-6439 RF# C884 RF# C885
ONLINE REQUESTS
Most plans allow you to submit loan requests electronically, enabling ICMA-RC to process your request
immediately and help you realize the benets of a more secure paperless process.
Follow the steps shown below to ensure we are able to process your request in a timely fashion.
1. Access your account online at www.icmarc.org/login
2. Select your plan from Access My Account
3. Click the Loans link on the left-hand side
4. Click Model a Loan and then follow the steps to complete your request
Benets of Submitting Loan Requests electronically via Account Access
1. Streamlined, electronic processing that allows for faster processing of loan applications based on plan
rules
2. No need to mail or fax any paperwork
3. Automated Clearing House (ACH) option for faster receipt of loan proceeds at no additional cost
4. Increased security by eliminating the need for paperwork containing Social Security numbers, personal
information, and bank account numbers (if applicable)
5. Clearer messaging and notications to more easily obtain the status of your application
6. Ability to model and save a loan application until ready to submit the request
7. Ability to upload supporting documentation; e.g., spousal waivers, residential purchase agreements, and
hardship
PAPER REQUESTS
I
f your plan does not allow you to submit your loan requests electronically, you can submit paper forms to initiate
your loan request. Follow the steps shown below to ensure we are able to process your request in a timely fashion.
After your loan application has been reviewed, you will be requested to go online to complete the loan
request process.
To initiate a paper loan request you must review the disclosures in the Additional Information section of
this packet, complete the Maximum Loan Worksheet (this is automatically calculated for you when using
Account Access), complete each section of the enclosed New Loan/Renance Application Form, and fax or mail
the completed form to ICMA-RC. Note that all elds on the form are required and incomplete or illegible
submissions could delay processing of your loan request. e e-mail address eld is required to provide
communications to you regarding your loan request. Please keep a copy of the completed form for your
records.
TIMEFRAME FOR PAYMENTS
Provided that your request is received in good order, with all required information, the loan proceeds and
associated loan documents will be sent within 3 business days. If you submit your request electronically via
Account Access prior to market close, your proceeds will likely be sent the following business day (pending any
review of your application that may be needed).
At ICMA-RC, we take security of our participants retirement assets seriously. We have stringent security
measures in place and we continuously apply enhancements to safe guard your assets.
Additional precautions are taken when processing loan requests. Adding new or changing existing
information on le with ICMA-RC will result in verication of the entry which may delay your loan.
NEW LOAN/REFINANCE APPLICATION FORM (DIRECT)
38713-0718 | 2
ICMA-RC • Attn: Workow Management Team • P.O. Box 96220 • Washington, DC 20090-6220 • Toll Free 800-669-7400 • www.icmarc.org • Fax 202-682-6439 RF# C884 RF# C885
RETIREMENT PLAN LOAN CHECKLIST
Taking out a loan from your employer-sponsored retirement plan is generally preferable to an emergency or hardship
withdrawal, which is subject to income taxes and results in a loss of tax-advantaged growth potential. And knowing a
loan is an option can help you condently save more for your future.
Just make sure you understand a loan’s potential pitfalls and how it works. Use this checklist as a guide.
A Retirement Plan Loan May Be a Good Option
Avoid a home eviction or foreclosure
Pay major medical bills
Pay down high interest rate debt
Make a down payment to qualify for a mortgage
or a lower mortgage rate
But Remember a Loan Can Have Costs, Too
If you reduce your retirement plan contributions, you reduce
your future savings.
Even if you maintain your contributions, the growth of your
account may be less because the outstanding loan balance is
no longer invested.
If you default on a loan, the outstanding loan balance is
treated as a taxable withdrawal and removed from your
account.
Initial and ongoing fees.
Explore Pros and Cons of Other Available Options
Non-retirement account investments
Cash value life insurance
Home equity loan or line of credit
Government benet programs — www.benets.gov
Reducing other expenses
Understand How Your Retirement Plan Loan Program Works*
Eligibility rules — typically, you may not
borrow more than 50% of your account balance, up to
$50,000, and the minimum loan amount
is $1,000.
Interest rate — generally, loan rates are set monthly, a xed
rate applies for the length of the loan term, and the specic
rate depends on whether or not the loan is for a principal
residence.
Time period — loans must generally be repaid within 5 years,
or within up to 30 years for a principal residence (depending
on your plan rules).
Repayment options — made via automatic bank account
transfer (ACH) and/or payroll deduction (depending on your
plan rules).
One-time origination and ongoing annual fees typically apply.
Loan default scenarios
* Loan rules can vary by plan
To learn more about your retirement plan’s loan program and to apply for a loan, log into your account at
www.icmarc.org/login, select your plan from “Access My Accounts” and then select “Loans” from the left-hand menu.
To learn more, contact your ICMA-RC representative.
38713-0718 | 3
ICMA-RC • Attn: Workow Management Team • P.O. Box 96220 • Washington, DC 20090-6220 • Toll Free 800-669-7400 • www.icmarc.org • Fax 202-682-6439 RF# C884 RF# C885
Maximum Loan Amount Worksheet
(this is automatically calculated for you when applying online via Account Access)
e maximum amount you can borrow from your account is $50,000 or 50% of the account balance, whichever is less. However, the
amount must be reduced by your highest outstanding loan balance over the past 12 months (which, only applies if you have previously
taken a loan from a 457 or qualied 401 plan). e minimum amount you can borrow is $1,000.
EXAMPLE 1
Michael has never taken a loan from his account before and his 457 plan account balance at the close of business yesterday was
$84,000. To calculate the maximum loan amount he is eligible to receive, we need to determine if 50% of his account balance
($84,000 × 50% = $42,000) is greater than or less than $50,000. In this case, 50% of his account balance is less than $50,000,
so the maximum loan amount Michael is eligible to receive is $42,000 (the lesser of the two amounts).
EXAMPLE 2
Kathy has never taken a loan from her account before and her 401 plan account balance at the close of business yesterday was
$240,000. In this case, 50% of Kathy’s balance ($240,000 × 50% = $120,000) is greater than $50,000, so the maximum loan
amount Kathy is eligible to receive is $50,000 (the lesser of the two amounts).
EXAMPLE 3
Pam took a $15,000 loan from her account eight months ago (in the previous calendar year) and her 457 plan account balance at the
close of business yesterday was $130,000. In this case, 50% of Pam’s balance ($130,000 × 50% = $65,000) is greater than $50,000,
but that amount must also be reduced by her highest outstanding loan balance over the past 12 months, so the maximum loan
amount Pam is eligible to receive is $35,000. ($50,000 – $15,000 = $35,000)
MAXIMUM LOAN AMOUNT WORKSHEET
Worksheet Template
Example
(using numbers from
Example 3 above)
1) Enter 50% of your total plan account balance. 1) $
1) $65,000
2) Enter the answer to #1 or $50,000, whichever is less. 2) $
2) $50,000
3) Enter your highest outstanding loan balance over the past 12 months (from all of
your plans combined), if applicable.
3) – $
3) – $15,000
4) Subtract #3 from #2 and you have the maximum amount you are eligible to
receive as a new loan or loan renance.
4) $
(maximum loan amount)
4) $35,000
38713-0718 | 4
ICMA-RC • Attn: Workow Management Team • P.O. Box 96220 • Washington, DC 20090-6220 • Toll Free 800-669-7400 • www.icmarc.org • Fax 202-682-6439 RF# C884 RF# C885
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38713-0718 | 5
ICMA-RC • Attn: Workow Management Team • P.O. Box 96220 • Washington, DC 20090-6220 • Toll Free 800-669-7400 • www.icmarc.org • Fax 202-682-6439 RF# C884 RF# C885
NEW LOAN/REFINANCE APPLICATION FORM (DIRECT)
3
PARTICIPANT SIGNATURE
• Use this form to apply for a new loan or to renance an existing loan.
• Please note all elds are required.
• You will be notied of the status of your loan request via email.
• Please print legibly in black or blue ink if you are not completing this form electronically.
1
PARTICIPANT INFORMATION
Social Security Number:
– –
Zip Code:
–
State:
Employer Plan Number:
Employer Plan Name:
Mailing Address (required):
Email Address (required):
City
Daytime Phone Number:
(
) –
Full Name of Participant:
Last First M.i.
Marital Status
Married Single
2
NEW LOAN/REFINANCE INFORMATION
A. New Loan or Renance (Select One): ........ New Loan OR Renance (Loan # )
B. Amount (Select One): ...................
Maximum amount available OR $
If the dollar amount requested exceeds the amount available for a loan from your account, the loan will be processed for the maximum amount available based on your current account
balance.
C. Loan Term Requested (Select One): .........
Maximum term available OR (enter number of months)
D. Loan Type (Select One):..................
Conventional Primary Residence Loan (attach signed Buyer/Seller agreement)
E. Purpose of Loan or Hardship Reason:
F. Repayment Method (Select One):
Payroll Deduction: Payroll Frequency: Weekly (52) Bi-Weekly (26) Semi-monthly (24) Monthly (12)
ACH Debit (Monthly) — You will be prompted to provide ACH information in Account Access if your plan allows for repayments via ACH. Your loan repayments will typically be
debited from your bank account on the 1st or 15th of each month. Please review the Additional Information section for more information.
I hereby apply for a loan, subject to and in accordance with the terms and provisions of my employer’s plan. I understand that this application will result in a loan origination fee being
deducted from my account balance, if such fee is applicable to my employer’s plan. I also understand that any amortization schedule or loan data received prior to receipt of the actual loan
documents was for illustrative purposes only.
As required by law and under penalty of perjury, I certify that the Social Security Number (Taxpayer Identication Number) I provided is correct and that I have read the Additional
Information section of this form.
Participant Signature:
Date:
/ /
38713-0718 | 6
ICMA-RC • Attn: Workow Management Team • P.O. Box 96220 • Washington, DC 20090-6220 • Toll Free 800-669-7400 • www.icmarc.org • Fax 202-682-6439 RF# C884 RF# C885
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38713-0718 | 7
ICMA-RC • Attn: Workow Management Team • P.O. Box 96220 • Washington, DC 20090-6220 • Toll Free 800-669-7400 • www.icmarc.org • Fax 202-682-6439 RF# C884 RF# C885
ADDITIONAL INFORMATION
e plan sponsor establishes the rules for the plan’s loan program. If you
have questions about the loan rules applicable to your plan, please contact
ICMA-RC.
Eligibility
Only active employees are eligible to request a new loan or renance
an existing loan. e plan sponsor may allow loans to be taken for any
reason or restrict loans to hardship situations only.
Maximum Number of Loans*
You may receive one new loan or renance one loan per calendar year.
Plans may allow up to ve loans to be outstanding at one time.
Loan Amount
e maximum amount of all loans to a participant from the Plan and
all other plans that are either 457(b) plans or qualied employer plans
under Section 72(p)(4) of the Code (e.g., 401(a) plans) shall not exceed
the lesser of:
(1) $50,000, or
(2) One-half of the value of your account.
When calculating the maximum amount you are eligible to borrow,
the lesser value of (1) or (2) above must be reduced by your highest
outstanding loan balance over the last 12 months. e minimum loan
amount is $1,000.*
Repayment Method
Loan repayments will be made by payroll deduction or by ACH debit
from your bank account.
1. Payroll Deduction — With this option, loan repayments are
deducted from your pay by your employer. After your loan is issued,
repayments should begin within two payroll cycles.
2. ACH Debit — With this option, loan repayments are paid directly
from your bank account each month. Loan repayments will generally
be collected on the 1
st
or 15
th
of each month, depending on the day of
the month when your loan request is received.
§ Requests received on the 1
st
–15
th
— Repayments will typically be
paid from your account on the 15
th
day of the month, beginning
with the rst month following your request.
§ Requests received after the 15
th
— Repayments will typically be
paid from your account on the 1
st
day of the month, beginning
with the second month following your request. For example, if your
request is received on April 21, your rst loan repayment will be
collected on June 1.
Example of When Your First Loan Payment Will be Due
If We Receive Your Loan Application
On…
Then the Due Date for Your
First Repayment Is…
Apr. 1 (or any day from Apr. 1 through Apr. 15) May 15
Apr. 21 (or any day from Apr. 16 through Apr. 30) June 1
DISCLOSURES
Origination and Annual Maintenance Fees
A $75* origination fee is charged when your loan request is processed
and a $50* maintenance fee is charged annually. ese fees are deducted
directly from your retirement plan account. You may want to consider
other sources for small loans, as the fees for taking a loan from your
employer-sponsored retirement plan may be signicant in relation to the
size of the loan.
ACH Repayment Rejected Fee
If a loan repayment scheduled to be paid via ACH debit is rejected due
to insucient funds, invalid bank account information, or account
closure, a fee will be charged to your account. e fee is $20 for the rst
occurrence and $50 for each subsequent occurrence.
Loans from Other Plans
Outstanding loans from employer-sponsored retirement plans, including
those with ICMA-RC and any plans with other providers, may reduce the
amount you are eligible to borrow. IRS regulations require that you take
any such loans into consideration when determining the amount you are
eligible to borrow.
Deemed Distributions
If a scheduled repayment is still unpaid at the end of the calendar
quarter following the calendar quarter in which the repayment was
due, any outstanding loan amount will be treated as a distribution. e
principal balance and accrued interest will be reported to the IRS as a
taxable distribution. Plan sponsors are obligated to comply with federal
regulations regarding the administration of the plan’s loan program and
must monitor loan repayments to help prevent against loans being treated
as distributions.
Loan Repayment Terms
e repayment terms, including the interest rate, amount and frequency
will be based on the options you select and cannot be changed once you
accept the loan terms. Loan repayments reduce the outstanding loan
balance by the amount of the repaid principal. Interest paid is credited as
earnings on the investment in the note.
Please be aware that if you elect to make loan repayments via payroll
deduction, you will not be able to change to ACH debit repayments after
separating from service with the plan sponsor.
Paying Your Loan O Early
You may elect to make additional loan repayments to completely pay o
an outstanding loan without being subject to a penalty or additional fee.
Please note that no repayment date may be “skipped.” Repayments made
ahead of schedule will not be refunded. If you elect to completely pay o
your current outstanding loan balance, no further interest will accrue.
To submit pre-payments, please use the Loan Payment/Payo Coupon
form found in Account Access or by contacting ICMA-RC.
SPECIAL CIRCUMSTANCES
Qualied Joint and Survivor Annuity
(Applies to some 401 Plans only)
If you are a married participant withdrawing assets from a 401 plan, and
the employer has selected the Qualied Joint and Survivor Annuity as
the default form of payment, you and your spouse must also complete
the Waiver of Qualied Joint and Survivor Annuity Form.is form is
available online at www.icmarc.org/forms or by contacting ICMA-RC.
Roth Assets (if applicable)
If your 457 or 401(k) plan allows Roth contributions, any Roth assets
in your account will be included when calculating the amount you are
eligible to borrow, but these amounts are generally not available to be
included as part of the actual loan.
*May dier for some plans.
38713-0718 | 8
ICMA-RC • Attn: Workow Management Team • P.O. Box 96220 • Washington, DC 20090-6220 • Toll Free 800-669-7400 • www.icmarc.org • Fax 202-682-6439 RF# C884 RF# C885
Summary Description
is publication provides a summary of the rules governing the loan
options available in ICMA-RC 457 or 401 plan accounts. e actual rules
governing the plan are contained in state retirement laws and the federal
tax code. is publication is a summary, written in less legalistic terms. It
is not a complete description of the law. If there are any conicts between
what is written in this publication and what is contained in the law, the
applicable law will govern.
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NEW LOANREFINANCE APPLICATION FORM (DIRECT) (City of Riverside, California)

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Completed 4 August 2020

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