CFNC.org/NC529 800-600-3453 CFI Form C430 (02/17)
NC 529 Plan
North Carolina’s National College Savings Program
Redeposit Request Form
Please print clearly in capital letters and dark ink.
Name of Participant (First, Middle, Last, Suffix)
Check type and enter the number.
Social Security or Taxpayer Identification Number
Account Number
$ , .
Amount Being Redeposited
Date of Refund from Beneficiary’s Eligible Institution (month, day, year)
Date of Original Distribution (month, day, year)
$ , .
Amount of Original Distribution
By signing this form and submitting it to College Foundation, Inc., the Program Administrator, I confirm that I have read the instructions in the gray
box above, my redeposit request meets all the criteria listed, and I hereby certify that all of the information in this form is true, complete and correct.
I understand that it is my responsibility to maintain accurate records as may be required by the IRS to substantiate the redeposit of refunded
Qualified Higher Education Expenses for tax purposes and that requests to redeposit funds that do not meet IRS requirements may be deemed
new Contributions and tax consequences and penalties may apply.
_________________________________________________________________
Signature of Participant Date (month, day, year)
Mail to:
NC 529 Plan
P.O. Box 40877
Raleigh, NC 27629-0877
Overnight or
registered
mail:
NC 529 Plan
2917 Highwoods Blvd.
Raleigh, NC 27604
Fax to:
919-835-2304
Email to:
savings@cfnc.org
For questions or forms, contact the Program
Administrator: College Foundation, Inc.
NC529.org 800-600-3453
919-828-4904 (Raleigh)
One of the College Foundation of North Carolina (CFNC) services
helping students and families plan, apply and pay for college.
If your Beneficiary’s school refunded a portion of Qualified Higher
Education Expenses that were paid using funds from a Qualified
Withdrawal from your NC 529 Plan Account, you may request that
those funds be redeposited into the same Account to avoid certain tax
consequences and penalties, as long as you meet the IRS
requirements.
1. You must redeposit the refund from your Beneficiary’s Eligible
Institution into an NC 529 Plan Account for the same Beneficiary
from which the original distribution was taken;
2. You must submit this request to have your refund redeposited within
60 days of the date of the refund;
3. You may only redeposit a refund of Qualified Higher Education
Expenses;
and
4. Your redeposit must not exceed the amount of the original
distribution from
our Account.
Make checks payable to: “NC 529 Plan”
SSN
TIN
1 Participant Information
2 Participant Signature – You Must Sign Below
Please print, sign, and mail to the NC 529 Plan.
