ICMA-RC honored the ING versions of forms that were completed by participants as of Friday, January 17, 2014. ING forms received after January 17, 2014 will not be processed and you will be notified to use the updated ICMA-RC form.
|Beneficiary Designation Form
Complete this form to choose or change the designated beneficiary for your account. You can also log in to your account and complete this online to ensure an immediate update to your beneficiary information.
|Personal Information Change Request For Inactive Wage/Part-Time Employees
Use this form to change your name and/or marital status if you are currently employed by the Commonwealth in a non-benefit-eligible position or if you are retired and not a VRS deferred member/retiree. If you are a VRS retirement plan member, you will need to provide your name change to your employer. If you are a retiree from the VRS retirement plan, please contact VRS to update your name.
|Standard Catch-up Form
This packet is used for the Standard Catch-Up feature that is available in the Commonwealth of Virginia 457 Deferred Compensation Plan.
|Payroll Authorization - One-Time Deferral Form
This form can be used to notify your Payroll Officer that you would like to make a one-time deferral into your Commonwealth of Virginia 457 Deferred Compensation Plan. It cannot be used to change your contribution election on file with ICMA-RC.
|457 Uniform Service Leave Make-up Form
This packet is completed by participants who served in the military, returned to the workforce and are making additional contributions under USERRA.
|Dual Employment Form
This form is used by participants who work for more than one employer participating in the Commonwealth of Virginia 457 Deferred Compensation Plan and wish to make contributions from both employers.
|Distribution/Direct Rollover/Transfer Request Form
Use this packet to request a withdrawal from the Commonwealth of Virginia 457 Deferred Compensation Plan when you have separated from service. If you are currently employed with an employer providing the plan, you can also use this form to withdraw your assets that have been rolled into the plan or if you have reached age 70.5.
|457 Emergency Withdrawal Form
For participants who are actively employed with an employer providing the plan, this publication provides guidelines for the withdrawal of funds due to an unforeseeable emergency, as well as the form required to request such a withdrawal.
|De Minimis Distribution Form
Use this form if you are currently employed, have less than $5,000 in the Commonwealth of Virginia 457 Deferred Compensation Plan, have not contributed for two years and wish to withdraw funds.
|Beneficiary Claim Request Form
This form is used by beneficiaries to claim the assets of the Commonwealth of Virginia 457 Deferred Compensation Plan when a participant has passed away.
|IRS Form W-4P: Withholding Certificate for Pension or Annuity Payments
Use this form if you would like to change your tax withholding on your distribution. Submit this form with the Distribution/Direct Rollover/Transfer Request Form from the separate packet described above.
|Incoming Direct Rollover Form
Use this form to request a direct rollover of your assets from your previous employer’s retirement plan (401(a), 401(k), Governmental 457(b), 403(b), Federal Thrift Savings) to your Commonwealth of Virginia 457 Deferred Compensation Plan.
|Enrollments - Wage Employees Only|
|Wage Participant Enrollment Form
Use this form to enroll in the Commonwealth of Virginia 457 Deferred Compensation Plan only if you are a wage employee and not benefit-eligible. Salaried employees can enroll online or call Investor Services at 1-877-DC-PLAN1 (1-877-327-5261).
|Account Access Code Form
This form is used in special situations in which an additional security level is needed when contacting Investor Services. Review the instructions for more details.
|Information Release Authorization
Use this form to authorize a third party to obtain information regarding your account. Please note that it does not authorize this individual to conduct transactions on your behalf.