Fillable PRE-RETIREMENT CATCH-UP FORM (City of Hampton)

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PRE-RETIREMENT CATCH-UP FORM (City of Hampton)

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Pre-retirement CatCh-UP Form 457 DeFerreD ComPensation Plans PKt570-004-20575-201404-12 | 1
Use the enclosed form to declare your Normal Retirement Age (NRA) and initiate pre-retirement catch-up contributions to your current
employer’s 457 deferred compensation plan. We encourage you to read the instructions prior to submitting your request.
457 PLAN CATCH-UP PROVISIONS
1. Pre-Retirement Catch-Up — Allows eligible participants
to contribute an additional amount over the regular
deferral limit in eect for the year (up to double the
regular limit), to make up for years in which they did not
contribute the maximum amount they were eligible to
contribute under their current employer’s plan. To take
advantage of this provision:
• Complete the enclosed Pre-Retirement Catch-Up Form.
• Submit the completed form to your employer
2. Age 50 Catch-Up — Allows participants who attain age
50 (or older) during the year to contribute an additional
amount over the regular deferral limit in eect for the year.
To take advantage of this provision:
• Complete the Contribution Change Form (available
online at www.icmarc.org/forms).
• Submit the completed form to your employer.
Please note that the “Age 50” and “Pre-Retirement” catch-up
provisions may not both be used in the same calendar year.
ADDITIONAL INFORMATION
e information in this section is intended to provide you with
more detailed information related to the pre-retirement catch-
up provision.
Eligibility — Pre-Retirement Catch-Up
You are eligible to make pre-retirement catch-up contributions
if all of the following are true:
1. You are within three years of reaching the normal
retirement age under the plan, which must be at least the
age you are eligible to retire with unreduced retirement
benets from your employer’s pension plan.
2. You are currently employed and participating in your
employer’s 457 deferred compensation plan.
3. You did not contribute the maximum amount you were
eligible to contribute for one or more years since 1979.
Maximum Pre-Retirement Catch-Up Contribution Amount
e maximum annual total contribution is equal to double
the normal deferral limit in eect for the year. You must have
sucient unused deferrals to contribute the maximum amount.
457 Plan Contribution Limit 2014 2013
Annual Deferrals $17,500 $17,500
“Pre-Retirement” Catch-Up
$17,500
($35,000 total)
$17,500
($35,000 total)
“Age 50” Catch-Up
$5,500
($23,000 total)
$5,500
($23,000 total)
* After 2014, the annual deferral and catch-up limits will increase in
$500 increments to correspond with ination rate increases (new limits
are announced in October or November each year, and the limits will
not necessarily increase every year). All contribution limits apply to the
combination of pre-tax and Roth contributions.
Declaration of Normal Retirement Age
You can only make pre-retirement catch-up contributions in
the three years immediately preceding the year of your declared
normal retirement age. e year of your declared NRA can
be any year during or after which you are eligible to receive
unreduced benets from your employer’s pension plan (or a
money purchase pension plan in which you also participate if
you are not eligible to participate in a dened benet plan), but
cannot be later than the year that you attain age 70½.
Unless an alternate NRA is specied by your employer, the
ICMA-RC 457 plan uses age 70½ as your NRA.
Your declaration of NRA is irrevocable once you begin making
pre-retirement catch-up contributions.
Qualied Police Ofcers and Fireghters
Under a special rule, qualied police ocers and reghters
†
can designate a normal retirement age earlier than other plan
participants, but not earlier than age 40.
†
is special rule is available to a “qualied police or reghter” as dened
under section 415(b)(2)(h)(ii)(I) of the Internal Revenue Code as a
participant with “…at least 15 years of service…as a full time employee of
any police or re department which is organized by the State or political
subdivision to provide police protection, reghting services, or emergency
medical services for any area within the jurisdiction of such State or political
subdivision.”
IMPORTANT NOTES
• You cannot make catch-up contributions in the year of
your declared NRA.
PRE-RETIREMENT CATCH-UP FORM
457 DEFERRED COMPENSATION PLANS
Pre-retirement CatCh-UP Form 457 DeFerreD ComPensation Plans PKt570-004-20575-201404-12 | 2
• You are not required to make catch-up contributions in all
three years leading up to the year of your declared NRA.
• You are not required to retire in the year of your declared
NRA.
• e pre-retirement catch-up provision can only be used one
time with your current employer.
TOTAL UNUSED DEFERRALS
e dierence between the amount you were eligible to
contribute to your current employer’s plan since 1979 and the
amount you actually contributed. Use the below worksheet to
calculate your total unused deferrals.
Enter the amount you contributed to your current employer’s
457 plan for each year that you were eligible to participate in
the plan.
Subtract the amount of your actual contribution from the
maximum amount you were eligible to contribute to the plan
each year, and enter the amount in the “Unused Deferrals”
column.
Add the amounts entered in the “Unused Deferral” column for
each year to calculate your total unused deferral amount.
Unused Deferral Worksheet
1
Year
Maximum
Contribution Actual Contribution
Unused Deferrals
(Maximum–Actual)
2014 $17,500
2013 $17,500
2012 $17,000
2011 $16,500
2010 $16,500
2009 $16,500
2008 $15,500
2007 $15,500
2006 $15,000
2005 $14,000
2004 $13,000
2003 $12,000
2002 $11,000
2001 $8,500
2000 $8,000
1999
2
$8,000
TOTAL $
1
e maximum contribution is the dollar amount shown above or 100%
of your compensation for the year, whichever is less. Prior to 2002, the
maximum percentage contribution was 25% of your gross compensation and
your actual contribution amount must include any 401(k) contributions
made during the year.
2
Prior to 1998, the maximum contribution was $7,500.
EXAMPLE — “Pre-Retirement” Catch-Up
John declared age 70, which he will attain in the year 2015,
as his normal retirement age. He is eligible to make catch-up
contributions in the three years immediately preceding the year
of his NRA: 2014, 2013, and 2012.
Maximum Regular Contribution (2012–2014)
$52,000 = ($17,000 + $17,500 + $17,500)
Maximum “Pre-Retirement” Catch-Up Contribution
(2012–2014)
$52,000 =($17,000 + $17,500 + $17,500)
Maximum Total Contribution (2012–2014)
$104,000 = [$52,000 (regular) + $52,000 (catch-up)]
In order to make the maximum catch-up contribution of
$52,000, John must complete the Unused Deferral Worksheet
and show that he has at least $52,000 of unused deferrals
for years when he was eligible to participate in his current
employer’s 457 plan.
• Even though John is eligible to make catch-up
contributions totaling $52,000 from 2012–2014, he is not
required to do so. He might make catch-up contributions
in 2012, and then his circumstances change and he ends
up not making any catch-up contributions in 2013 or
2014. If so, he would still be eligible to take advantage
of the “age 50” catch-up provision in future years but he
would not be eligible to make pre-retirement catch-up
contributions to this employer’s plan at any point in the
future.
• Even though John has declared age 70 as his NRA, he is
not prohibited from retiring before (or after) the date when
he attains age 70.
Contact ICMA-RC
If you have any questions or need help completing the form
on the following page or the unused deferral worksheet on
this page, please contact ICMA-RC’s Investor Services at
800-669-7400.
0.00
Pre-retirement CatCh-UP Form 457 DeFerreD ComPensation Plans PKt570-004-20575-201404-12 | 3
PRE-RETIREMENT CATCH-UP FORM
Use this form to declare your normal retirement age and initiate pre-retirement catch-up contributions to your employer’s 457 deferred
compensation plan. Please complete all sections of the form.
1. EMPLOYER PLAN INFORMATION
2. DECLARATION OF NORMAL RETIREMENT AGE (NRA)
3. CONTRIBUTION AMOUNT (EACH PAY PERIOD)
4. TOTAL UNUSED DEFERRALS
I hereby designate age , which I will attain in the year , as my Normal Retirement Age for the purpose of using the “Pre-
Retirement” catch-up provision. I understand that:
• I will be eligible to take advantage of the special pre-retirement catch-up provision only in the three years immediately preceding the year of my
declared Normal Retirement Age only. (For example: If I will attain my declared Normal Retirement Age in 2017, I will be eligible to make catch-
up contributions in 2014, 2015 and 2016)
• is election is irrevocable after I begin using the pre-retirement catch-up provision.
Employer Plan Number:
3 0
Employer Plan Name:
Social Security Number:
– –
Permanent Street Address:
City:
State: Zip Code:
Date of Birth: (//)
/ /
Daytime Phone Number:
(
) –
Marital Status:
Married
Single
Full Name of Participant:
  
Contributions will begin as soon as administratively possible following the month in which this form is signed. Specify the total percentage and/or
dollar amounts you wish to contribute each pay period.
Pre-tax contributions of % or $ . OR Roth* contributions of % or $ .
*Please check with your employer to conrm that Roth contributions are available before selecting this option.
Total Unused Deferrals $
Complete the Unused Deferral Worksheet contained in the instructions to calculate your total unused deferrals. e amount of your pre-retirement
catch-up contributions (i.e., the amount above the normal annual deferral limit you contribute during the three-year catch-up period) cannot exceed
the amount of your total unused deferrals.
5. PARTICIPANT SIGNATURE
6. EMPLOYER AUTHORIZATION
e information provided is true and accurate and I understand my declaration of normal retirement age is irrevocable.
Employee Signature:
Date: / /
By signing, the employer conrms that the participant’s declaration of normal retirement age in Section 2 is valid.
Authorized Employer Ocial’s Signature:
Date: / /
Authorized Employer Ocial’s Name and Title (P P):
0.00
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PRE-RETIREMENT CATCH-UP FORM (City of Hampton)

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Completed 3 August 2020

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