Plan Forms Updated: 2/22/12

457 Deferred Compensation Plan
• Participant Enrollment Governmental 457/401(a) Form 94kb
• Beneficiary Form 457/401(a) Plan 61kb
• In-coming Plan-to-Plan Transfer Form 82kb
• Personal Information Change Request Form for Retired or Inactive Employees 233kb
• Payroll Authorization-Agency Transfer Return to Work 53kb
• Payroll Authorization-One Time Deferral 79kb
• Standard Catch-Up Forms 181kb
• Uniformed Service Leave Make-Up Form 92kb
• Distribution/Direct Rollover/Transfer Request Form 371kb
• Special Tax Notice 279kb
• Electronic Fund Transfers (ACH) 64kb
• W-4P Form 256kb
• Unforeseen Emergency Withdrawal Form 166kb
• Death Benefit Claim Form 209kb
• Self-Directed Brokerage Account - Agreement/Release Form 800kb
• Commissions and Service Fees 106kb
• Termination Certification Form 72 kb

Annuity
• Five Annuity Questions 47kb
• MetLife Guaranteed Income Program 3.9mb

Cash Match Plan
• Participant Enrollment Governmental 457/401(a) Form 94kb
• Beneficiary Form 457/401(a) Plan 61kb
• 401(a) Incoming Transfer/Direct Rollover Form 82kb
• Personal Information Change Request Form for Retired or Inactive Employees 233kb
• Distribution/Direct Rollover/Transfer Request Form 176kb
• Electronic Fund Transfers (ACH) 62kb
• W-4P Form 256kb
• Death Benefit Claim Form 209kb
• Uniformed Service Leave Make-Up Form 92kb
• Self-Directed Brokerage Account - Agreement/Release Form 800kb
• Commissions and Service Fees 106kb

Annuity
• Five Annuity Questions 47kb
• MetLife Guaranteed Income Program 3.9mb

Optional Retirement Plan for Political Appointees
• Participant Enrollment Governmental 401(a) Form 84kb
• Beneficiary Form 401(a) Plan 57kb
• 401(a) Incoming Transfer/Direct Rollover Form 80kb
• Personal Information Change Request Form for Retired or Inactive Employees 233kb
• Electronic Fund Transfers (ACH) 62kb
• W-4P Form 256kb
• Death Benefit Claim Form 409kb
• Distribution/Direct Rollover Request Form 212kb
• Self-Directed Brokerage Account - Agreement/Release Form 800kb
• Commissions and Service Fees 106kb
• Certification of Eligibility to Participate 42kb
• Termination Certification Form 69kb
• Notice of Return to Covered Employment 115kb

Annuity
• Five Annuity Questions 47kb
• MetLife Guaranteed Income Program 3.9mb

Optional Retirement Plan for School Superintendents
• Participant Enrollment Governmental 401(a) Form 84kb
• Beneficiary Form 401(a) Plan 236kb
• 401(a) Incoming Transfer/Direct Rollover Form 80kb
• Plan-toPlan Transfer to ORP 80kb
• Personal Information Change Request Form for Retired or Inactive Employees 233kb
• Electronic Fund Transfers (ACH) 62kb
• W-4P Form 256kb
• Death Benefit Claim Form 409kb
• Distribution/Direct Rollover Request Form 212kb
• Self-Directed Brokerage Account - Agreement/Release Form 800kb
• Commissions and Service Fees 106kb
• Certification of Eligibility to Participate 105kb
• Termination Certification Form 148 kb
• Notice of Return to Covered Employment 115kb

Annuity
• Five Annuity Questions 47kb
• MetLife Guaranteed Income Program 3.9mb

Virginia Supplemental Retirement Plan
• Participant Enrollment Governmental 401(a) Form 79kb
• Beneficiary Form 401(a) Plan 236kb
• 401(a) Incoming Transfer/Direct Rollover Form 260kb
• Personal Information Change Request Form for Retired or Inactive Employees 233kb
• Electronic Fund Transfers (ACH) 64kb
• W-4P Form 256kb
• Death Benefit Claim Form 408kb
• Distribution/Direct Rollover Request Form 212kb
• Self-Directed Brokerage Account - Agreement/Release Form 800kb
• Commissions and Service Fees 106kb

Administrative Forms
• Request for Mistake-of-Fact Review 8kb
• Social Security Change Form for Active Employees 52kb

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