For Individuals
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Forms

ICMA-RC is posting many forms online here, for the convenience of our investors. Some employers require their employees to use their own forms; please check with your employer first. Please read all instructions and other accompanying literature carefully before completing and submitting these forms.

Tips for Using Adobe Reader

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Some forms can be filled out in your browser, prior to printing. After the form appears on screen in your Acrobat Reader you can fill in the form using your keyboard. This can be a valuable time saver for forms that require more than one copy. Simply fill in the form once and print the number of copies you need.

457 Deferred Compensation Plans

  • 457 Deferred Compensation Plan Employee Enrollment Form
    Use this form to enroll in an existing ICMA-RC 457 Deferred Compensation Plan. Please Note:Some employers require employees to use their own forms. Please verify with your employer whether you can use this form.
  • Contribution Change Form
    Use this form to change the amount of your contributions to your ICMA-RC 457 Deferred Compensation Plan. (Please Note: Roth Contributions are not available in all plans. Please check with your employer or ICMA-RC to confirm availability before selecting the Roth Contribution option.)
  • Employee Information Change Form
    This form is no longer available here. Please use Account Access to change your beneficiary designation and/or marital status. To change your name, please complete the Name Change Form. To make address changes and/or changes to your funds or allocations, please use Account Access or call 800-669-7400.
  • Pre-retirement Catch-Up Form: 457 Deferred Compensation Plans
    ICMA-RC's 457 Deferred Compensation Plan offers the catch-up provision for those participants who have not always deferred the maximum amount allowed by law. Use this packet to "catch-up" on past contributions before your "normal retirement age."
  • Direct Rollover/Transfer to ICMA-RC Packet
    Use this packet to request a direct trustee-to-trustee transfer of assets from an existing eligible employer retirement plan (401 defined contribution, 401 defined benefit, 403(b), 457), or Traditional, or Conduit, or SEP IRA account either with another financial organization or at ICMA-RC to an ICMA-RC 457 plan or 401 plan.
  • Payment Schedule Change Form
    Use this form to request a change to an existing payment schedule, for example to stop, restart, increase or decrease a payment stream. This form can not be used to initiate a first time withdrawal. This packet includes the following file, which may be downloaded separately:
  • Payment Schedule Tax Withholding Change Form
    Use this form to request a change to the Federal or state income tax withholding for an existing payment schedule
  • Direct Deposit Authorization Form
    Use this generic form to have your benefit payments deposited directly into your bank account.
  • Purchase of Prior Service Credit Packet
    Use this form to request a transfer of assets from your ICMA-RC 457, 401(a), or 401(k) plan to purchase defined benefit plan prior service credit, purchase "Air Time" service credit, or repay a prior refund from a defined benefit plan.
  • Rescission Form
    Use this form to rescind (cancel) your lump sum, rollover, or co-administrator transfer or rollover request. You must submit three copies of the Rescission form per ICMA-RC account: one for ICMA-RC, one for your employer, and one for your own records.
  • Community Property State Spousal Waiver Form
    Married participants who reside in Community Property law states complete this form when they want to add or change a beneficiary who is not their spouse.

401(a) Money Purchase Plans

  • 401 Plan Employee Enrollment Form
    Use this form to enroll in an existing ICMA-RC 401 Money Purchase or 401 Profit Sharing Plan. Please Note:Some employers require employees to use their own forms. Please verify with your employer whether you can use this form. This form is designed to be filled out on and printed from your computer.
  • 401 Plan Amount of Contribution Change Form
    Use this form to make changes in the amount of your contribution to your ICMA-RC 401 Money Purchase or 401 Profit Sharing plan. This form is designed to be filled out on and printed from your computer.
  • Employee Information Change Form
    This form is no longer available here. Please use Account Access to change your beneficiary designation and/or marital status. To change your name, please complete the Name Change Form. To make address changes and/or changes to your funds or allocations, please use Account Access or call 800-669-7400.
  • Direct Rollover/Transfer to ICMA-RC Packet
    Use this packet to request a direct trustee-to-trustee transfer of assets from an existing eligible employer retirement plan (401 defined contribution, 401 defined benefit, 403(b), 457), or Traditional, or Conduit, or SEP IRA account either with another financial organization or at ICMA-RC to an ICMA-RC 457 plan or 401 plan.
  • Payment Schedule Change Form
    Use this form to request a change to an existing payment schedule, for example to stop, restart, increase or decrease a payment stream. This form can not be used to initiate a first time withdrawal. This packet includes the following file, which may be downloaded separately:
  • Payment Schedule Tax Withholding Change Form
    Use this form to request a change to the Federal or state income tax withholding for an existing payment schedule.
  • Direct Deposit Authorization Form
    Use this generic form to have your benefit payments deposited directly into your bank account.
  • Rescission Form
    Use this form to rescind (cancel) your lump sum, rollover, or co-administrator transfer or rollover request. You must submit three copies of the Rescission form per ICMA-RC account: one for ICMA-RC, one for your employer, and one for your own records.
  • Community Property State Spousal Waiver Form
    Married participants who reside in Community Property law states complete this form when they want to add or change a beneficiary who is not their spouse.

401(a) Profit Sharing Plans

  • 401 Plan Employee Enrollment Form
    Use this form to enroll in an existing ICMA-RC 401 Money Purchase or 401 Profit Sharing Plan. Please Note: Some employers require employees to use their own forms. Please verify with your employer whether you can use this form. This form is designed to be filled out on and printed from your computer.
  • 401 Plan Amount of Contribution Change Form
    Use this form to make changes in the amount of your contribution to your ICMA-RC 401 Money Purchase or 401 Profit Sharing plan. This form is designed to be filled out on and printed from your computer.
  • Employee Information Change Form
    This form is no longer available here. Please use Account Access to change your beneficiary designation and/or marital status. To change your name, please complete the Name Change Form. To make address changes and/or changes to your funds or allocations, please use Account Access or call 800-669-7400.
  • Direct Rollover/Transfer to ICMA-RC Packet
    Use this packet to request a direct trustee-to-trustee transfer of assets from an existing eligible employer retirement plan (401 defined contribution, 401 defined benefit, 403(b), 457), or Traditional, or Conduit, or SEP IRA account either with another financial organization or at ICMA-RC to an ICMA-RC 457 plan or 401 plan.
  • Payment Schedule Change Form
    Use this form to request a change to an existing payment schedule, for example to stop, restart, increase or decrease a payment stream. This form can not be used to initiate a first time withdrawal. This packet includes the following file, which may be downloaded separately:
  • Payment Schedule Tax Withholding Change Form
    Use this form to request a change to the Federal or state income tax withholding for an existing payment schedule.
  • Purchase of Prior Service Credit Packet
    Use this form to request a transfer of assets from your ICMA-RC 457, 401(a), or 401(k) plan to purchase defined benefit plan prior service credit, purchase "Air Time" service credit, or repay a prior refund from a defined benefit plan.
  • Rescission Form
    Use this form to rescind (cancel) your lump sum, rollover, or co-administrator transfer or rollover request. You must submit three copies of the Rescission form per ICMA-RC account: one for ICMA-RC, one for your employer, and one for your own records.
  • Direct Deposit Authorization Form
    Use this generic form to have your benefit payments deposited directly into your bank account.
  • Community Property State Spousal Waiver Form
    Married participants who reside in Community Property law states complete this form when they want to add or change a beneficiary who is not their spouse.

401(k) Retirement Saving Plans

  • 401 Plan Employee Enrollment Form
    Use this form to enroll in an existing ICMA-RC 401 Money Purchase or 401 Profit Sharing Plan. Please Note: Some employers require employees to use their own forms. Please verify with your employer whether you can use this form. This form is designed to be filled out on and printed from your computer.
  • 401 Plan Amount of Contribution Change Form
    Use this form to make changes in the amount of your contribution to your ICMA-RC 401 Money Purchase or 401 Profit Sharing plan. This form is designed to be filled out on and printed from your computer.
  • Employee Information Change Form
    This form is no longer available here. Please use Account Access to change your beneficiary designation and/or marital status. To change your name, please complete the Name Change Form. To make address changes and/or changes to your funds or allocations, please use Account Access or call 800-669-7400.
  • Direct Rollover/Transfer to ICMA-RC Packet
    Use this packet to request a direct trustee-to-trustee transfer of assets from an existing eligible employer retirement plan (401 defined contribution, 401 defined benefit, 403(b), 457), or Traditional, or Conduit, or SEP IRA account either with another financial organization or at ICMA-RC to an ICMA-RC 457 plan or 401 plan.
  • Payment Schedule Change Form
    Use this form to request a change to an existing payment schedule, for example to stop, restart, increase or decrease a payment stream. This form can not be used to initiate a first time withdrawal. This packet includes the following file, which may be downloaded separately:
  • Payment Schedule Tax Withholding Change Form
    Use this form to request a change to the Federal or state income tax withholding for an existing payment schedule
  • Rescission Form
    Use this form to rescind (cancel) your lump sum, rollover, or co-administrator transfer or rollover request. You must submit three copies of the Rescission form per ICMA-RC account: one for ICMA-RC, one for your employer, and one for your own records.
  • Direct Deposit Authorization Form
    Use this generic form to have your benefit payments deposited directly into your bank account.
  • Community Property State Spousal Waiver Form
    Married participants who reside in Community Property law states complete this form when they want to add or change a beneficiary who is not their spouse.

Vantagepoint Individual Retirement Account (IRA)

Vantagepoint Roth IRA Forms

  • Inherited Vantagepoint IRA Account Application Packet
    Use this form if you are a non-spouse beneficiary who wishes to have a direct transfer/rollover of the beneficiary assets from an IRA or qualified retirement plan with another provider to an Inherited Vantagepoint IRA.
  • Vantagepoint IRA Personal Information Change Form
    Use this form to update a name, date of birth, marital status or beneficiaries for a Vantagepoint IRA(s). Please note that this form cannot be used to change other information such as: address changes, or to initiate or change an Automated Investment.

This should be used for all indirect transfers.

  • Vantagepoint IRA Recharacterization Form
    Use this form to recharacterize assets from one IRA type (either Roth or Traditional)-whether the assets are currently held in a Vantagepoint IRA or held at another custodian-to another IRA type (either Roth or Traditional).
  • Vantagepoint Payroll IRA Account Application
    If the employer offers a Payroll deduction Vantagepoint IRA, use This form to open a new account. the IRA Payroll deduction Application includes an Authorization form to establish or Change the participants Payroll deduction.
  • Vantagepoint Roth IRA Conversion Form
    Use this form to authorize the conversion of all or part of your existing Traditional IRA- whether the assets are currently in a Vantagepoint IRA or held at another institution- to a Vantagepoint Roth IRA.

Vantagepoint Traditional IRA Forms

  • Inherited Vantagepoint IRA Account Application Packet
    Use this form if you are a non-spouse beneficiary who wishes to have a direct transfer/rollover of the beneficiary assets from an IRA or qualified retirement plan with another provider to an Inherited Vantagepoint IRA.

This should be used for all indirect transfers.

  • Vantagepoint IRA Direct Transfer Form
    Use this form to authorize ICMA-RC Services to receive a transfer of assets to an ICMA-RC Traditional IRA from one of the following:
    1. Non-ICMA-RC Retirement Plan (401, 403B, or 457)
    2. Non-ICMA-RC Traditional IRA
    3. ICMA-RC Traditional IRA
  • Vantagepoint IRA Recharacterization Form
    Use this form to recharacterize assets from one IRA type (either Roth or Traditional) - whether the assets are currently held in a Vantagepoint IRA or held at another custodian - to another IRA type (either Roth or Traditional).
  • Vantagepoint Roth IRA Conversion Form
    Use This form to authorize the conversion of all or part of your existing Traditional IRA- whether the assets are currently in a Vantagepoint IRA or held at another institution- to a Vantagepoint Roth IRA.
  • Vantagepoint Payroll IRA Account Application
    If the employer offers payroll deduction Vantagepoint IRA, use this form to open a new account. The IRA Payroll Deduction Application includes an authorization form to establish change the participants payroll deduction.
  • Special Tax Notice Regarding Plan Payments
    This notice explains how you can continue to defer federal income tax on your retirement savings in your employer's 457 deferred compensation plan or 401 qualified retirement plan and contains important information you will need before you decide how to receive your Plan benefits.
  • The Vantagepoint Funds Prospectus
    This prospectus gives you information about The Vantagepoint Funds that you should know before investing. You should read this prospectus carefully and retain it for future reference. It contains important information, including how each Fund invests and the services availabe to shareholders.
  • Transferring Your ICMA-RC Retirement Plan Account to a Vantagepoint IRA Packet
    This packet contains all materials needed to transfer your ICMA-RC retirement plan account into a Vantagepoint IRA. All of the components of the packet are listed below:
    • Vantagepoint IRA Direct Transfer Form
      Use this form to authorize ICMA-RC Services to receive a transfer of assets to an ICMA-RC Traditional IRA from one of the following:
      1. Non-ICMA-RC Retirement Plan (401, 403B, or 457)
      2. Non-ICMA-RC Traditional IRA
      3. ICMA-RC Traditional IRA
    • Custodial Account Agreement & Disclosure Statement
      Custodial account agreement terms and conditions for Vantagepoint Tradition IRAs.
    • Vantagepoint Payroll IRA Account Application
      If the employer offers a payroll deduction Vantagepoint IRA, use this form to open a new account. The IRA Payroll Deduction Application includes an authorization form to establish or change the participants payroll deduction.
    • Vantagepoint Roth IRA Conversion Form
      Use this form to authorize the conversion of all or part of your existing Traditional IRA- whether the assets are currently in a Vantagepoint IRA or held at another institution- to a Vantagepoint Roth IRA.
    • 401 Notice, Explanation and Waiver of Qualified Joint and Survivor Annuity
      This form applies to all married participants in Money Purchase Plans, and to married participants in Profit Sharing Plans with Full Spousal Rights.
    • Special Tax Notice Regarding Plan Payments
      This notice explains how you can continue to defer federal income tax on your retirement savings in your employer's 457 deferred compensation plan or 401 qualified retirement plan and contains important information you will need before you decide how to receive your Plan benefits.
    • Vantagepoint IRA Funds Investment Options July 2012
      This brochure provides short descriptions of the funds available for investment through a Vantagepoint IRA.
    • The Vantagepoint Funds Prospectus
      This prospectus gives you information about The Vantagepoint Funds that you should know before investing. You should read this prospectus carefully and retain it for future reference. It contains important information, including how each Fund invests and the services availabe to shareholders.

Vantagepoint IRA Withdrawal Forms

  • Withdrawal
    To request a 100% withdrawal, partial withdrawal, or installments (regular periodic withdrawals), please call Investor Services at 800-669-7400 for the proper form.
  • Transfer to another provider
    To transfer your Vantagepoint IRA to another IRA provider, You must complete the other providers' forms. please contact the other provider and ask for the necessary forms.

Vantagepoint Coverdell Educational Savings Account (ESA) Forms

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