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Forms For Participants

A1 - Authorization for Optional Employee After-Tax Contributions

To elect the amount of after-tax contributions you would like deducted from your paycheck

AFR - Application for Refund

To advise the Fund how to pay your refund

AMA - Application for Monthly Annuity

To elect the type of annuity you would like to receive in retirement

AUT - Automatic Refund/Direct Rollover Election

For payment of accounts valued at $5,000 or less

B1 - Designation of Beneficiary

To name the person(s) who are to receive your account benefits in the event of death

CF - Change Form (Name/Address)

To report changes in address, name or marital status

DBE - Death Benefit Election

To advise the Fund how to pay your beneficiary death benefit

EFT - Electronic Funds Transfer of Annuity Pmts.

For direct deposit payment of your monthly pension benefit.

Guide to Your Monthly Annuity

Fact sheet that describes the different types of annuity options available at retirement

RTH - Request for Release of Information to a Third Party

To authorize the Fund to share your information with another party

Special Tax Notice

An IRS document also known as a 402(f) Notice that describes the tax treatment of your distributions from the Retirement Fund

W-4P - Withholding Certificate for Pension or Annuity Payments

To report how much Federal tax you would like withheld from your monthly annuity payment

Forms For Associations

A1 - Authorization for Optional Employee After-Tax Contributions

To elect the amount of after-tax contributions you would like deducted from your paycheck

Association Profile Form

To report changes to key Association positions such as E.D., CEO, CFO, HR, Payroll, Board President etc.

B1 - Designation of Beneficiary

To name the person(s) who are to receive your account benefits in the event of death

CF - Change Form (Name/Address)

To report changes in address, name or marital status

CSN - Change in Status Notice

To report changes in employee status due to termination of employment or unpaid leave of absence

Election of Contribution Rate

To elect the Association's annual contribution rate

Guide to Your Monthly Annuity

Fact sheet that describes the different types of annuity options available at retirement

NOE - Notification of Enrollment

To enroll an eligible employee into the Fund

PA - Participation Agreement

To commence or resume participation in the Fund by a YWCA Association

REN - Return to Employment

To report the return to active status of a Participant who was on an unpaid leave of absence or when a former Participant is rehired

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How to Complete Forms:

  • Print out desired form.
  • Follow instructions printed on individual form to complete.
  • Sign where required.
  • Return completed form to the Fund.
  • See Contact Us page for mail, fax and e-mail addresses.