Pbgc Form 710 PDF Details

When participating in a pension plan, workers expect to have their retirement years supported and secure. This is why understanding the Pension Benefit Guaranty Corporation (PBGC) Form 710 as an employee or retiree is so important. It outlines the type of protection you are entitled to, any applicable premiums you may need to pay, and other details related to your retirement income security under PBGC-administered plans. In this blog post we'll be discussing everything you need to know about PBGC Form 710—what it covers, when it needs to be submitted, what happens if can't file on time ,and more!

QuestionAnswer
Form NamePbgc Form 710
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names710 pbvgcxudo form

Form Preview Example

Application for Electronic Direct Deposit

PBGC Form 710

Approved OMB 1212-0055 Expires 09/30/11

Pension Benefit Guaranty Corporation.

P.O. Box 151750, Alexandria, Virginia 22315-1750

For assistance, call 1-800-400-7242

Plan Name: FX.PrismCase.CaseTitle.XF

 

Plan Number: FX.PrismCase.CaseIdNmbr.XF

Participant Name : FX.PrismCust.FullName.XF

Date Printed: 12/03/2010

 

Date of Plan Termination: FX.PrismCase.DOPT.XF

 

 

 

INSTRUCTIONS: Please complete this form to have PBGC send your pension benefit payments directly to your bank or other financial institution through electronic direct deposit (EDD). This form may also be used for an Electronic Transfer Account (ETA). Your name must be on the account. If you have questions, call our Customer Contact Center at 1-800-400-7242. Print clearly with dark ink.

1. General information about you

Plan Name (as shown on check)

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

First Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Middle Name

 

 

 

 

 

Other Name(s) Used

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Social Security Number

 

 

 

 

 

PBGC Plan Number

 

 

 

 

 

 

 

 

 

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

 

 

 

 

Apartment / Route Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

Country

 

 

 

 

 

 

 

 

 

 

Email (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Daytime Phone

(

 

 

 

)

 

 

 

 

 

-

EXTENSION

x

Evening Phone

(

 

 

 

)

 

 

 

 

 

-

2.Signature I hereby authorize PBGC to deposit my pension benefit funds into my account. I understand that I may change this election in the future.

SIGNATURE

DATE

CONTINUE

Application for Electronic Direct Deposit

Form 710, page 2 of 2

Plan Number: FX.PrismCase.CaseIdNmbr.XF

Participant Name: FX.PrismCust.FullName.XF

3.Financial institution information Please provide the information in this section to have your payment sent directly to a financial institution. The information is available from your financial institution or can be found on your checks, account statement or deposit slip. The sample check below shows the location of your 9-digit routing number and account number. If you are unsure of the routing number or your account number, contact your financial institution. You can cancel or change this arrangement by calling PBGC at 1-800- 400-7242. The financial institution can cancel it by sending you a written notice.

Name of Financial Institution

Mailing Address

City

 

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of contact person

 

Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Routing Number

Account Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name(s) on the Account (Your name must be on the Account)

Account Type

Checking

Savings

PLEASE SIGN & DATE THIS FORM ON PAGE 1