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I would like to rollover $ dollar amount or percent amount % of my vested balance to another qualified retirement plan.
I would like to rollover $ dollar amount or percent amount % of my vested balance to a Traditional IRA Roth IRA
Please issue a distribution paid directly to me equal to $ dollar amount or percent amount % of my vested balance. I understand that there is a $25.00 processing fee for distribution.
By electing a Direct Deposit (ACH) and by signing below, I hereby authorize ASC TRUST LLC 1.) to initiate credit entries to the depository financial institution named above 2.) to initiate debit entries to adjust for processing errors. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law.
Further, I understand that my distribution may be subject to 20% Mandatory Federal Income Tax Withholding. Read the Special Tax Notice for more details.