Forms

Account Updates
Description	Download
Beneficiary Designation Log in to choose or change the designated beneficiary for your account. This will ensure an immediate update to your beneficiary information.	Login
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.	View
Approved Domestic Relations Orders - Defined Contribution Account(s) The Code of Virginia authorizes VRS to make a direct payment to a former spouse if the court awards your former spouse part of your benefit. In this situation, provide this form to your attorney to submit.	View
Deferrals/Special Situations
Description	Download
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.	View
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 MissionSquare Retirement.	View
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.	View
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.	View

Distributions
Description	Download
Distribution Request Log in to your account and select Withdrawals to request a full, partial, installment, or required minimum distribution (RMD) from your account.	Login
In-Service Distribution Request Form Log in to your account and download the In-Service Distribution Request Form to request: a withdrawal from money that was previously rolled into the plan from another retirement plan, or an age 70.5 withdrawal	Login
Workforce Transition Act (WTA) Distribution/Rollover Request Form Log in to your account and download the Workforce Transition Act (WTA) Distribution/Rollover Request Form if you have separated employment and are receiving benefits under WTA.	Login
Direct Rollover/Transfer Request Form Log in to your account and download the Direct Rollover/Transfer Request Form to request a rollover or transfer from the plan.	Login
Request for Transfer to Purchase Service Credit Use this form to request to transfer contribution funds from your plan to VRS to purchase service credit.	View
457 Emergency Withdrawal Form Log in to your account and download the 457 Emergency Withdrawal Form to review the guidelines and request a withdrawal of funds due to an unforeseeable emergency.	Login
De Minimis Distribution Form Log in to your account and download the De Minimis Distribution Form.	Login
Beneficiary Claim Request Form This form is used by beneficiaries to claim account assets when a participant has passed away.	View
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.	View

Incoming Rollovers
Description	Download
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.	View
Coronavirus-Related Distribution (CRD) Repayment Form Use this form to repay your CRD within three years of taking the distribution.	View

Enrollments - Wage/Hourly Employees Only
Wage/Hourly Participant Enrollment Form Use this form to enroll in the Commonwealth of Virginia 457 Deferred Compensation Plan only if you are a wage/hourly employee and not benefit-eligible. Salaried employees enroll online or call Participant Services at 877-DC-PLAN1 (877-327-5261). To enroll online: (1) set up your online access and log in, (2) select Enroll from the COV 457 Deferred Comp Plan dropdown menu, then (3) follow the Enroll instructions.	View

Enrollments - Wage/Hourly Employees Only

Description

Download

Wage/Hourly Participant Enrollment Form
Use this form to enroll in the Commonwealth of Virginia 457 Deferred Compensation Plan only if you are a wage/hourly employee and not benefit-eligible. Salaried employees enroll online or call Participant Services at 877-DC-PLAN1 (877-327-5261). To enroll online: (1) set up your online access and log in, (2) select Enroll from the COV 457 Deferred Comp Plan dropdown menu, then (3) follow the Enroll instructions.

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Account Access
Description	Download
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.	View

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