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Forms

For your convenience, we have provided forms that are common to almost all plans. You will need Adobe Acrobat Reader® to view the forms, which are in pdf format.

Please fax back the completed and signed forms to us at 650-879-1847. If you have any questions while completing the forms, please call your administrator.

Loan application

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Most but not all plans allow loans for any purpose. By law, loans are limited to 50% of your vested balance. A loan must be repaid within 5 years on a payroll deduction basis. (This term can be much longer if you are using your loan to purchase your principal residence.) The payments go directly to your 401(k) account and include principal and interest. The interest rate for loans varies from time to time depending on the rate financial institutions are charging at the time you take out your loan. Once the loan has been taken out, the interest rate remains fixed. If you default on the loan it becomes a taxable distribution to you.

Hardship application

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A hardship withdrawal is allowed by many plans. The reasons for hardship are limited to the purchase of a principal residence, to prevent eviction or foreclosure, to pay for unforeseen medical expenses, or to pay college tuition and expenses for an immediate family member. Many restrictions are imposed on you if you take a hardship withdrawal. Read the application carefully.

City 401(H) plan

Request for Reimbursement

Retiree medical reimbursement plan forms

Beneficiary designation

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Designate specific individuals to receive plan benefits

Distribution application

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If you are a terminated employee and wish to rollover your balance to an IRA or another 401(k) plan, of if you wish to take a cash out of your balance, please complete this form. We have included the Special Tax Notice Regarding Plan Payments which summarizes the tax consequences of your distribution options. Please consult an accountant or attorney if you have questions about the tax consequences of your distribution.

This Distribution Application is not applicable to Defined Benefit Pension Plans. If you are a participant or sponsor of a Defined Benefit Pension Plan, please contact your plan administrator.

Plan sponsor forms & worksheets

General plan information form

We have provided a copy of these commonly requested documents for the convenience of plan sponsors.

Annual 5500 Questionaire

If you determine that you need to make an adjustment to your bond coverage while you are completing the Annual 5500 Questionaire, you may chooose to use Colonial Surety Company as your bond resource.

Census Data Spreadsheet (Excel document)

Use this spreadsheet for test data or to submit proposals.