Fillable Request for Distribution (City of Riverside, California)

Fill Online, Printable, Fillable, Blank Request for Distribution (City of Riverside, California) Form

Use Fill to complete blank online CITY OF RIVERSIDE, CALIFORNIA (CA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Request for Distribution (City of Riverside, California)

On average this form takes 5 minutes to complete

The Request for Distribution (City of Riverside, California) form is 1 page long and contains:

  • 0 signatures
  • 6 check-boxes
  • 17 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Riverside, California

BROWSE CITY OF RIVERSIDE, CALIFORNIA (CA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Request for Distribution
City of Riverside
Completed forms should be sent to:
Public Agency Retirement Services
P.O. Box 12919, Newport Beach, CA 92658
Fax: (949) 250-1250
admin@pars.org
Legal Name of Participant
Address of Participant
City
State Zip
Phone (
) Date of Birth
Social Security Number
Sex
Type of Plan
457(b) Alternative Retirement System Plan
Qualifying Event (select only one)
Terminated employment with City effective
Retired on
Became permanently and totally disabled on
Died on
There is an executed beneficiary statement in favor of
No longer participates in the Plan effective
(If the participant is still employed by the City, a distribution may only occur if the account balance is
less than $5,000 and the participant has had no deferrals into the plan for a period of 24 consecutive
months)
__
Plan Administrator or Authorized Person Date
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Request for Distribution (City of Riverside, California)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 4 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document