ICMA-RC Publications & /test Forms

Section 457 Deferred Compensation Plans

• Investing for Your Retirement Goals (1666K)
  This brochure provides a comprehensive summary of the ICMA-RC 457 Deferred Compensation Plan.
• 457 Deferred Compensation Plan Employee Enrollment Form (153K)
  Use this form to enroll in an existing ICMA-RC 457 Deferred Compensation Plan. Please Note: Some employers require employees to use their own forms. Please verify with your employer whether you can use this form.
  • Plan 457 Formulario de Matriculación y de Cambio de Información personal (47K)
• 457 Deferred Compensation Plan Amount of Deferral Change Form (28K)
  Use this form to make changes in the amount of your deferral to your ICMA-RC 457 Deferred Compensation Plan.
• Employee Information Change Form (147K)
  Use this form to make name changes, change in marital status, or beneficiary changes in your existing ICMA-RC 457 Deferred Compensation Plan, 401(a) Money Purchase Plan, or 401(k) Profit Sharing Plan accounts. To make address changes or changes to your funds or allocations, please use Account Access or call 1-800-669-7400. This form is designed to be filled out on and printed from your computer.
• 457 Deferred Compensation Plan Catch-Up Provision Packet (160K)
  ICMA-RC’s 457 Deferred Compensation Plan offers the catch-up provision for those participants who have not always deferred the maximum amount allowed by law. Use this packet to “catch-up” on past contributions before your “normal retirement age.”
• 457 Deferred Compensation Plan Employee Request for Account Transfer (261K)
  Use this packet to transfer assets from a 457 Deferred Compensation plan account with a different financial organization to a 457 plan account with ICMA-RC or from one ICMA-RC 457 plan to another ICMA-RC 457 plan.
  The Request for Account Transfer Packet includes the following inserts which may also be downloaded separately:
  • 457 Deferred Compensation Plan Employee Enrollment Form (153K)
  • Important Notice Regarding Plan Payment 30-day Waiting Period (10K)
  • Special Tax Notice Regarding Plan Payments (55K)
• Trustee-to-Trustee Transfer To ICMA-RC Packet (147K)
  Use this packet to request a direct trustee-to-trustee transfer of assets from an existing eligible employer retirement plan (401 defined contribution, 401 defined benefit, 403(b), 457), or Traditional, or Conduit, or SEP IRA account either with another financial organization or at ICMA-RC to an ICMA-RC 457 plan or 401 plan.
  This form requires that you print three copies: one for ICMA-RC, one for your former retirement plan provider, and one for your own records.
  The Trustee-to-Trustee Transfer to ICMA-RC Packet may require the following forms or documents which may be downloaded separately:
  • 457 Deferred Compensation Plan Employee Enrollment Form (153K)
  • 401 Plan Employee Enrollment Form (120K)
  • Special Tax Notice Regarding Plan Payments (55K)
  • 401 Notice, Explanation and Waiver of Qualified Joint and Survivor Annuity Form (37K)
• Payment Schedule Change Form (105K)
  Use this form to request a change to an existing payment schedule, for example to stop, restart, increase or decrease a payment stream. This form can not be used to initiate a first time withdrawal. This packet includes the following file, which may be downloaded separately:
  • Special Tax Notice Regarding Plan Payments (55K)
• Payment Schedule Tax Withholding Change Form (16K)
  Use this form to request a change to the Federal or state income tax withholding for an existing payment schedule
• Direct Deposit Authorization Form (59K)
  Use this generic form to have your benefit payments deposited directly into your bank account.
• Purchase of Prior Service Credit Packet (50K)
  Use this form to request a transfer of assets from your ICMA-RC 457, 401(a), or 401(k) plan to purchase defined benefit plan prior service credit, purchase “Air Time” service credit, or repay a prior refund from a defined benefit plan.
• Rescission Form (15K)
  Use this form to rescind (cancel) your lump sum, rollover, or co-administrator transfer or rollover request. You must submit three copies of the Rescission form per ICMA-RC account: one for ICMA-RC, one for your employer, and one for your own records.
• Community Property State Spousal Waiver Form (73K)
  Married participants who reside in Community Property law states complete this form when they want to add or change a beneficiary who is not their spouse.

• Present and Future Benefits: A Summary of Your Money Purchase Retirement Plan (505K)
  This brochure provides a comprehensive summary of the ICMA-RC 401(a) Money Purchase Plan.
  • Beneficios para el presente y el futuro (54K)
    Un Resumen de su Plan de Jubilación con Adquisición Monetaria.
• 401 Plan Employee Enrollment Form (120K)
  Use this form to enroll in an existing ICMA-RC 401 Money Purchase or 401 Profit Sharing Plan. Please Note: Some employers require employees to use their own forms. Please verify with your employer whether you can use this form. This form is designed to be filled out on and printed from your computer.
  • Plan 401 Formulario de Inscripción y de Cambio de Información personal (39K)
• 401 Plan Amount of Contribution Change Form (27K)
  Use this form to make changes in the amount of your contribution to your ICMA-RC 401 Money Purchase or 401 Profit Sharing plan. This form is designed to be filled out on and printed from your computer.
• Employee Information Change Form (147K)
  Use this form to make name changes, change in marital status, or beneficiary changes in your existing ICMA-RC 457 Deferred Compensation Plan, 401 Money Purchase Plan, or 401 Profit Sharing Plan accounts. To make address changes or changes to your funds or allocations, please use Account Access or call 1-800-669-7400. This form is designed to be filled out on and printed from your computer.
• Trustee-to-Trustee Transfer To ICMA-RC Packet (147K)
  Use this packet to request a direct trustee-to-trustee transfer of assets from an existing eligible employer retirement plan (401 defined contribution, 401 defined benefit, 403(b), 457), or Traditional, or Conduit, or SEP IRA account either with another financial organization or at ICMA-RC to an ICMA-RC 457 plan or 401 plan.
  This form requires that you print three copies: one for ICMA-RC, one for your former retirement plan provider, and one for your own records.
  The Trustee-to-Trustee Transfer to ICMA-RC Packet may require the following forms or documents which may be downloaded separately:
  • 457 Deferred Compensation Plan Employee Enrollment Form (153K)
  • 401 Plan Employee Enrollment Form (120K)
  • Special Tax Notice Regarding Plan Payments (55K)
  • 401 Notice, Explanation and Waiver of Qualified Joint and Survivor Annuity Form (37K)
• Payment Schedule Change Form (105K)
  Use this form to request a change to an existing payment schedule, for example to stop, restart, increase or decrease a payment stream. This form can not be used to initiate a first time withdrawal. This packet includes the following file, which may be downloaded separately:
  • Special Tax Notice Regarding Plan Payments (55K)
• Payment Schedule Tax Withholding Change Form (16K)
  Use this form to request a change to the Federal or state income tax withholding for an existing payment schedule.
• Direct Deposit Authorization Form (59K)
  Use this generic form to have your benefit payments deposited directly into your bank account.
• Rescission Form (15K)
  Use this form to rescind (cancel) your lump sum, rollover, or co-administrator transfer or rollover request. You must submit three copies of the Rescission form per ICMA-RC account: one for ICMA-RC, one for your employer, and one for your own records.
• Community Property State Spousal Waiver Form (73K)
  Married participants who reside in Community Property law states complete this form when they want to add or change a beneficiary who is not their spouse.

• Investing for Your Future: A Summary of Your Profit Sharing Retirement Plan (129K)
  This brochure provides a comprehensive summary of the ICMA-RC 401(a) Profit Sharing Plan.
• 401 Plan Employee Enrollment Form (120K)
  Use this form to enroll in an existing ICMA-RC 401 Money Purchase or 401 Profit Sharing Plan. Please Note: Some employers require employees to use their own forms. Please verify with your employer whether you can use this form. This form is designed to be filled out on and printed from your computer.
• 401 Plan Amount of Contribution Change Form (27K)
  Use this form to make changes in the amount of your contribution to your ICMA-RC 401 Money Purchase or 401 Profit Sharing plan. This form is designed to be filled out on and printed from your computer.
• Employee Information Change Form (147K)
  Use this form to make name changes, change in marital status, or beneficiary changes in your existing ICMA-RC 457 Deferred Compensation Plan, 401 Money Purchase Plan, or 401 Profit Sharing Plan accounts. To make address changes or changes to your funds or allocations, please use Account Access or call 1-800-669-7400. This form is designed to be filled out on and printed from your computer.
• Trustee-to-Trustee Transfer To ICMA-RC Packet (147K)
  Use this packet to request a direct trustee-to-trustee transfer of assets from an existing eligible employer retirement plan (401 defined contribution, 401 defined benefit, 403(b), 457), or Traditional, or Conduit, or SEP IRA account either with another financial organization or at ICMA-RC to an ICMA-RC 457 plan or 401 plan.
  This form requires that you print three copies: one for ICMA-RC, one for your former retirement plan provider, and one for your own records.
  The Trustee-to-Trustee Transfer to ICMA-RC Packet may require the following forms or documents which may be downloaded separately:
  • 457 Deferred Compensation Plan Employee Enrollment Form (153K)
  • 401 Plan Employee Enrollment Form (120K)
  • Special Tax Notice Regarding Plan Payments (55K)
  • 401 Notice, Explanation and Waiver of Qualified Joint and Survivor Annuity Form (37K)
• Payment Schedule Change Form (105K)
  Use this form to request a change to an existing payment schedule, for example to stop, restart, increase or decrease a payment stream. This form can not be used to initiate a first time withdrawal. This packet includes the following file, which may be downloaded separately:
  • Special Tax Notice Regarding Plan Payments (55K)
• Payment Schedule Tax Withholding Change Form (16K)
  Use this form to request a change to the Federal or state income tax withholding for an existing payment schedule.
• Purchase of Prior Service Credit Packet (50K)
  Use this form to request a transfer of assets from your ICMA-RC 457, 401(a), or 401(k) plan to purchase defined benefit plan prior service credit, purchase “Air Time” service credit, or repay a prior refund from a defined benefit plan.
• Rescission Form (15K)
  Use this form to rescind (cancel) your lump sum, rollover, or co-administrator transfer or rollover request. You must submit three copies of the Rescission form per ICMA-RC account: one for ICMA-RC, one for your employer, and one for your own records.
• Direct Deposit Authorization Form (59K)
  Use this generic form to have your benefit payments deposited directly into your bank account.
• Community Property State Spousal Waiver Form (73K)
  Married participants who reside in Community Property law states complete this form when they want to add or change a beneficiary who is not their spouse.

• Today and Tomorrow: Your Retirement Plan at Work (123K)
  This brochure provides a comprehensive summary of the ICMA-RC 401(k) Salary Reduction Plan.
• 401 Plan Employee Enrollment Form (120K)
  Use this form to enroll in an existing ICMA-RC 401 Money Purchase or 401 Profit Sharing Plan. Please Note: Some employers require employees to use their own forms. Please verify with your employer whether you can use this form. This form is designed to be filled out on and printed from your computer.
• 401 Plan Amount of Contribution Change Form (27K)
  Use this form to make changes in the amount of your contribution to your ICMA-RC 401 Money Purchase or 401 Profit Sharing plan. This form is designed to be filled out on and printed from your computer.
• Employee Information Change Form (147K)
  Use this form to make name changes, change in marital status, or beneficiary changes in your existing ICMA-RC 457 Deferred Compensation Plan, 401(a) Money Purchase Plan, or 401(k) Profit Sharing Plan accounts. To make address changes or changes to your funds or allocations, please use Account Access or call 1-800-669-7400. This form is designed to be filled out on and printed from your computer.
• Trustee-to-Trustee Transfer To ICMA-RC Packet (147K)
  Use this packet to request a direct trustee-to-trustee transfer of assets from an existing eligible employer retirement plan (401 defined contribution, 401 defined benefit, 403(b), 457), or Traditional, or Conduit, or SEP IRA account either with another financial organization or at ICMA-RC to an ICMA-RC 457 plan or 401 plan.
  This form requires that you print three copies: one for ICMA-RC, one for your former retirement plan provider, and one for your own records.
  The Trustee-to-Trustee Transfer to ICMA-RC Packet may require the following forms or documents which may be downloaded separately:
  • 457 Deferred Compensation Plan Employee Enrollment Form (153K)
  • 401 Plan Employee Enrollment Form (120K)
  • Special Tax Notice Regarding Plan Payments (55K)
  • 401 Notice, Explanation and Waiver of Qualified Joint and Survivor Annuity Form (37K)
• Payment Schedule Change Form (105K)
  Use this form to request a change to an existing payment schedule, for example to stop, restart, increase or decrease a payment stream. This form can not be used to initiate a first time withdrawal. This packet includes the following file, which may be downloaded separately:
  • Special Tax Notice Regarding Plan Payments (55K)
• Payment Schedule Tax Withholding Change Form (16K)
  Use this form to request a change to the Federal or state income tax withholding for an existing payment schedule
• Rescission Form (15K)
  Use this form to rescind (cancel) your lump sum, rollover, or co-administrator transfer or rollover request. You must submit three copies of the Rescission form per ICMA-RC account: one for ICMA-RC, one for your employer, and one for your own records.
• Direct Deposit Authorization Form (59K)
  Use this generic form to have your benefit payments deposited directly into your bank account.
• Community Property State Spousal Waiver Form (73K)
  Married participants who reside in Community Property law states complete this form when they want to add or change a beneficiary who is not their spouse.

• Contribution Coupon for Vantagepoint IRAs (43K)
  This IRA payment coupon must be submitted when depositing checks to a Vantagepoint IRA account.
• Vantagepoint IRA Funds Brochure (153K)
  This brochure provides short descriptions of the funds available for investment through a Vantagepoint IRA.
• Making the Right Rollover Decision (286K)
  This brochure explains the benefits of moving money in your retirement plan to a Vantagepoint Traditional or Roth IRA, and the procedures for doing so.
• Making the Right IRA Decision (381K)
  This brochure explains the relative benefits and features of a Vantagepoint Traditional IRA vs. a Vantagepoint Roth IRA, as well as instructions for opening an account.
• IRS Form W-4P: Withholding Certificate for Pension or Annuity Payments (91K)
  This form is for U.S. recipients of pensions, annuities, and certain other deferred compensation to indicate the correct amount of federal income tax to withhold from your payment(s).

Vantagepoint Roth IRA Forms

• Vantagepoint Traditional and Roth IRA Account Application (182K)
  Use this form to open a Vantagepoint Traditional or Roth Individual Retirement Account.
• Vantagepoint IRA Personal Information Change Form (67K)
  Use this form to update a name, date of birth, marital status or beneficiaries for a Vantagepoint IRA(s). Please note that this form cannot be used to change other information such as: address changes, or to initiate or change an Automated Investment.
• Vantagepoint Roth and Traditional IRA Custodial Account Agreement & Disclosure Statement (220K)
  This document contains the custodial account agreement terms and conditions for Vantagepoint Traditional and Roth IRAs.
• Vantagepoint IRA Direct Transfer Form (44K)
  Use this form to authorize ICMA-RC Services to receive a transfer of assets to an ICMA-RC Traditional IRA from one of the following:
  1. Non-ICMA-RC Retirement Plan (401, 403B, or 457)
  2. Non-ICMA-RC Traditional IRA
  3. ICMA-RC Traditional IRA
• Vantagepoint IRA Rollover Form (182K)
  Use this form to reinvest assets into a Vantagepoint IRA that you received from:
  1. another Traditional IRA
  2. an eligible retirement plan
  This should be used for all indirect transfers.
• Vantagepoint IRA Recharacterization Form (53K)
  Use this form to recharacterize assets from one IRA type (either Roth or Traditional)—whether the assets are currently held in a Vantagepoint IRA or held at another custodian—to another IRA type (either Roth or Traditional).
• Vantagepoint Payroll IRA Account Application (116K)
  If the employer offers a payroll deduction Vantagepoint IRA, use this form to open a new account. The IRA Payroll Deduction Application includes an authorization form to establish or change the participants payroll deduction.
• Vantagepoint Payroll IRA Authorization Application (116K)
  If the employer offers a payroll deduction Vantagepoint IRA, use this form to open a new account. The IRA Payroll Deduction Application includes an authorization form to establish or change the participants payroll deduction.
• Vantagepoint Roth IRA Conversion Form (142K)
  Use this form to authorize the conversion of all or part of your existing Traditional IRA— whether the assets are currently in a Vantagepoint IRA or held at another institution— to a Vantagepoint Roth IRA.

Vantagepoint Traditional IRA Forms

• Vantagepoint Traditional and Roth IRA Account Application (182K)
  Use this form to open a Vantagepoint Traditional or Roth Individual Retirement Account.
• Vantagepoint Roth and Traditional IRA Custodial Account Agreement & Disclosure Statement (220K)
  This document contains the custodial account agreement terms and conditions for Vantagepoint Traditional and Roth IRAs.
• Vantagepoint IRA Rollover Form (182K)
  Use this form to reinvest assets into a Vantagepoint IRA that you received from:
  1. another Traditional IRA
  2. an eligible retirement plan
  This should be used for all indirect transfers.
• Vantagepoint IRA Recharacterization Form (53K)
  Use this form to recharacterize assets from one IRA type (either Roth or Traditional) — whether the assets are currently held in a Vantagepoint IRA or held at another custodian — to another IRA type (either Roth or Traditional).
• Vantagepoint Roth IRA Conversion Form (142K)
  Use this form to authorize the conversion of all or part of your existing Traditional IRA— whether the assets are currently in a Vantagepoint IRA or held at another institution— to a Vantagepoint Roth IRA.
• Transferring Your ICMA-RC Retirement Plan Account to a Vantagepoint IRA Packet (812K)
  This packet contains all materials needed to transfer your ICMA-RC retirement plan account into a Vantagepoint IRA. All of the components of the packet are listed below:
  • Transferring Your ICMA-RC Retirement Plan Account to a Vantagepoint IRA (199K)
    Use this packet to request a Direct Transfer from an ICMA-RC retirement plan (401 or 457) to your Vantagepoint Traditional IRA.
  • Transfer to Vantagepoint Traditional IRA Form (105K)
    Use this form to transfer your ICMA-RC retirement plan assets to a Vantagepoint Traditional IRA account with ICMA-RC.
  • Vantagepoint IRA Direct Transfer Form (44K)
    Use this form to authorize ICMA-RC Services to receive a transfer of assets to an ICMA-RC Traditional IRA from one of the following:
    1. Non-ICMA-RC Retirement Plan (401, 403B, or 457)
    2. Non-ICMA-RC Traditional IRA
    3. ICMA-RC Traditional IRA
  • Custodial Account Agreement & Disclosure Statement (220K)
    Custodial account agreement terms and conditions for Vantagepoint Tradition IRAs.
  • Vantagepoint Payroll IRA Account Application (116K)
    If the employer offers a payroll deduction Vantagepoint IRA, use this form to open a new account. The IRA Payroll Deduction Application includes an authorization form to establish or change the participants payroll deduction.
  • Vantagepoint Payroll IRA Authorization Application (116K)
    If the employer offers a payroll deduction Vantagepoint IRA, use this form to open a new account. The IRA Payroll Deduction Application includes an authorization form to establish or change the participants payroll deduction.
  • Vantagepoint Roth IRA Conversion Form (142K)
    Use this form to authorize the conversion of all or part of your existing Traditional IRA— whether the assets are currently in a Vantagepoint IRA or held at another institution— to a Vantagepoint Roth IRA.
  • 401 Notice, Explanation and Waiver of Qualified Joint and Survivor Annuity (72K)
    This form applies to all married participants in Money Purchase Plans, and to married participants in Profit Sharing Plans with Full Spousal Rights.
  • Special Tax Notice Regarding Plan Payments (55K)
    This notice explains how you can continue to defer federal income tax on your retirement savings in your employer’s 457 deferred compensation plan or 401 qualified retirement plan and contains important information you will need before you decide how to receive your Plan benefits.
  • Vantagepoint IRA Funds Brochure Feb 2005 (153K)
    This brochure provides short descriptions of the funds available for investment through a Vantagepoint IRA.
  • The Vantagepoint Funds Prospectus
    This prospectus gives you information about The Vantagepoint Funds that you should know before investing. You should read this prospectus carefully and retain it for future reference. It contains important information, including how each Fund invests and the services availabe to shareholders.

Vantagepoint IRA Withdrawal Forms

• Withdrawal
  To request a 100% withdrawal, partial withdrawal, or installments (regular periodic withdrawals), please call Investor Services at 1-800-669-7400 for the proper form.
• Transfer to another provider
  To transfer your Vantagepoint IRA to another IRA provider, you must complete the other providers’ forms. Please contact the other provider and ask for the necessary forms.

Vantagepoint Coverdell Educational Savings Account (ESA) Forms

• Vantagepoint Coverdell Education Savings Account Application (137K)
  Use this document to establish a Coverdell Education Savings Account (ESA) with the ICMA-RC.
• Custodial Account Agreement and Disclosure Statement for Vantagepoint Coverdell Education Savings Accounts (127K)
  This document contains the custodial account agreement terms and conditions for Vantagepoint Coverdell Education Savings Accounts
• Vantagepoint Payroll IRA and Vantagepoint Coverdell ESA Fund Options Sheet (50K)
  This two-page document lists the funds available for investment through an ICMA-RC Payroll IRA or Coverdell ESA, along with the alphanumeric fund codes used for processing by ICMA-RC.
• Vantagepoint Coverdell Education Savings Account Direct Transfer & Rollover Form (137K)
  Use this form to authorize ICMA-RC Services to receive a transfer of Education Savings Account assets directly from another custodian without your having taken receipt of the funds or to reinvest assets you received directly from an Education Savings Account at another custodian.