Forms

To view a form, simply click on its title in the following list.

Forms are provided in this section as viewable PDFs that can be printed. Forms cannot be completed online because they must be filled out, signed and, in some cases notarized, before they can be accepted by Plan Administration.

Accrued Vacation and Other Leave Deferral Change Form

Use this form to establish the amount of accrued leave you would like to defer to your 457 account as a result of your separation from service.

Beneficiary Account Setup and Withdrawal Packet

Are you the beneficiary of a deceased participant's account? If so, use this form to set up a beneficiary account and initiate withdrawals from the deferred comp plan.

Designation of Beneficiary Form

Use this form to designate a beneficiary for your account. Submitting this form will ensure your assets are distributed according to your wishes in the event of your death.

Information Release Authorization Form

Are you the beneficiUse this form to give another person authorization to obtain information regarding your account. This form does not authorize an individual to conduct transactions on your behalf.ary of a deceased participant's account? If so, use this form to set up a beneficiary account and initiate withdrawals from the deferred comp plan.

In-Plan Roth Conversion Form

Are you the beneficiary of a deceased participant's account? If so, use this form to set up a beneficiary account and initiate withdrawals from the deferred comp plan.Use this form to convert eligible pre-tax assets inside your deferred comp plan to after-tax (Roth) assets. The assets you convert to Roth assets are generally subject to federal and state income tax in the year of the conversion. No taxes will be withheld as part of the conversion. .

Monumental Life Insurance Service Request Form - Active Employee

To be completed by active employees, use this form to either discontinue deferrals to your life insurance policy or cancel the policy completely.

Monumental Life Insurance Service Request Form - Separated from Service

To be completed by employees separated from services, use this form to either allow the cash surrender value of your policy to maintain the policy itself or to transfer the cash surrender value to other investment options.

Power of Attorney

Use this form to grant authorization in the capacity of attorney-in-fact.

Pre-Retirement Catch-up Provision Form

Use this form to take advantage of the "Pre-Retirement Catch-up Provision," which allows savers to make additional contributions to the deferred comp plan beyond annual IRS limits.