Forms

The forms listed below are the most frequently used forms. Log in to your account or contact us if you have questions about which form to use. You may also enroll, change your deferral amount, investments, sign up for asset rebalancing and update beneficiaries online by logging in to your account.

Manage My Money

Kent County 457 Payout Form (PDF)
Kent County parks 401(k) Payout Form (PDF)


Use these forms to: 

  • Select your payout options when you end your employment or retire
  • Request a payout
  • Stop current payouts
  • Restart a payout
  • Defer payout until Required Minimum Distribution (RMD) is required at age 70½

Manage My Account

Automatic Deposit Authorization

Use this form to:

  • Add or change your checking or savings information for automatic deposits to your bank account

Account Information and Notification

457 Beneficiary/Alt Payee Payout Request Form (PDF) 

Use this form if you're a beneficiary or an alternate payee, such as a former spouse or a dependant of a Plan member:

  • Report the death of a Plan member. Please remember to submit a certified copy of the death certificate if you are reporting the death of a plan member.
  • Update your beneficiary information.
  • Request a payout.

401(k) Beneficiary/Alt Payee Payout Request Form (PDF) 

Use this form if you're a beneficiary or an alternate payee, such as a former spouse or a dependant of a Plan member:

  • Report the death of a Plan member. Please remember to submit a certified copy of the death certificate if you are reporting the death of a plan member.
  • Update your beneficiary information.
  • Request a payout.

Transfer Assets into the Plan

Incoming Assets Form (PDF) 

Use this form to:

  • Roll money over from other retirement savings accounts into the Plan.

Participation Agreement (PDF) 

Use this form to:

  • Enroll in the Plan

Distribution of Rollover Assets (PDF) 

Use this form to:

  • Take a distribution from assets rolled into the Plan from another retirement plan.

Special Tax Notice Regarding Plan Payments (PDF)

This notice explains how you can continue to defer federal income tax on your retirement plan savings in the Plan and contains important information you will need before you decide how to receive your Plan benefits.

Paper Forms

For all remaining forms, please contact your local Retirement Specialist.

Brian Wanless
Retirement Specialist
616-304-8417
wanlesb@nationwide.com

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