Trsnyc Form Rw116 PDF Details

The Trsnyc Rw116 form serves a critical function for members of the Teachers' Retirement System (TRS) looking towards retirement and considering the management of their additional member contributions (AMCs). It meticulously guides applicants through the process of withdrawing (and/or directly rolling over) the employee portion of their AMCs at the time of retirement. Essential for those previously enrolled in the Age 55 Retirement Program, it caters to retirees aged 62 or above under specific active service conditions and those retiring under Ordinary Disability or Accident Disability retirement. With a provision for a direct rollover to eligible Individual Retirement Arrangements (IRAs) or successor programs, the form emphasizes the tax implications of such withdrawals while providing options for distribution methods, including direct withdrawal. Completeness, accuracy, and adherence to the stipulated requirements are emphasized across its sections, from personal information in Part A, election of dispersal method in Part B, attestation in Part C, to notarization in Part D. It underscores the IRS's role in taxing the taxable portion of withdrawn funds, setting clear expectations for applicants regarding the potential financial impact and tax liabilities, thereby ensuring that members are well-informed about the process and its ramifications. Moreover, the requirement for the “QPP Direct Rollover Election Form” for those opting for a rollover highlights the form's attention to detail and the comprehensive approach towards managing retirement funds effectively.

QuestionAnswer
Form NameTrsnyc Form Rw116
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesIRAs, DM13, EFT, attestation

Form Preview Example

APPLICATION FOR WITHDRAWAL OF

ADDITIONAL MEMBER CONTRIBUTIONS

AT RETIREMENT

INSTRUCTIONS

PLEASE READ CAREFULLY

•฀฀฀Please฀ile฀this฀application฀if฀you฀elect฀to฀withdraw฀(and/or฀directly฀roll฀over)฀the฀employee฀portion฀of฀your฀ Additional฀Member฀Contributions฀(AMCs).

•฀฀฀You฀may฀use฀this฀application฀if฀you฀were฀previously฀enrolled฀in฀the฀Age฀55฀Retirement฀Program฀and฀one฀of฀ the฀following฀applies:฀฀฀

➢You฀retired฀at฀age฀62฀or฀above฀and฀met฀the฀following฀requirements:฀

•฀฀฀You฀were฀in฀active฀service฀immediately฀prior฀to฀your฀effective฀retirement฀date;฀

•฀฀฀You฀were฀in฀active฀service฀for฀a฀total฀of฀at฀least฀six฀months฀out฀of฀each฀of฀the฀two฀ twelve-month฀periods฀preceding฀your฀retirement.

➢฀You฀retired฀under฀Ordinary฀Disability฀or฀Accident฀Disability฀retirement.

•฀฀฀If฀you฀elect฀to฀directly฀roll฀over฀all฀or฀part฀of฀the฀taxable฀portion฀of฀your฀withdrawal฀to฀one฀or฀more฀eligible฀ Individual฀Retirement฀Arrangements฀(IRAs)฀or฀other฀successor฀programs,฀you฀must฀attach฀a฀completed฀ “QPP฀Direct฀Rollover฀Election฀Form”฀(code฀RW29)฀with฀this฀application.฀In฀all฀cases,฀the฀tax-free฀portion฀of฀ your฀withdrawal฀will฀be฀paid฀directly฀to฀you.

•฀฀฀For฀your฀convenience,฀TRS฀forms฀and฀publications฀are฀available฀on฀our฀website.฀If฀you฀require฀additional฀ assistance,฀we฀encourage฀you฀to฀contact฀our฀Member฀Services฀Center฀at฀1฀(888)฀8-NYC-TRS.

In฀Part฀A:฀฀All฀information฀must฀be฀provided.

In฀Part฀B:฀฀You฀must฀elect฀how฀your฀withdrawal฀will฀be฀distributed.

You฀may฀elect฀to฀receive฀your฀withdrawal฀through฀one฀of฀the฀following฀methods฀or฀a฀combination:

•฀฀Direct฀Withdrawal,฀in฀which฀the฀withdrawal฀would฀be฀made฀payable฀directly฀to฀you.

•฀฀฀Direct฀Rollover,฀in฀which฀all฀or฀part฀of฀the฀taxable฀portion฀of฀your฀withdrawal฀would฀be฀made฀payable฀directly฀to฀an฀eligible฀IRA(s)฀or฀ other฀successor฀program(s).

If฀you฀are฀receiving฀payments฀from฀TRS฀via฀Electronic฀Fund฀Transfer฀(EFT)฀to฀your฀checking฀or฀savings฀account,฀you฀may฀be฀eligible฀ to฀have฀your฀Direct฀Withdrawal฀also฀forwarded฀to฀this฀account.฀If฀you฀are฀not฀eligible฀to฀receive฀your฀withdrawal฀via฀EFT,฀it฀will฀be฀ mailed฀to฀your฀home฀address.

If฀you฀elect฀to฀directly฀roll฀over฀all฀or฀part฀of฀your฀withdrawal฀of฀your฀AMCs,฀you฀must฀ile฀a฀“QPP฀Direct฀Rollover฀Election฀Form”฀in฀ conjunction฀with฀this฀application.

In฀Part฀C:฀฀You฀must฀read฀the฀attestation฀and฀sign฀and฀date฀this฀form.

In฀Part฀D:฀฀You฀must฀have฀this฀application฀notarized.

RW116 (10/11)

CONTINUED ON PAGE 2

PAGE 1

CONTINUED฀FROM฀PAGE฀1

TAX CONSEQUENCES

•฀฀฀The฀taxable฀portion฀of฀any฀withdrawn฀Qualiied฀Pension฀Plan฀(QPP)฀funds฀is฀taxable฀upon฀receipt฀and฀will฀be฀reported฀to฀ the฀Internal฀Revenue฀Service฀(IRS)฀in฀January฀following฀the฀calendar฀year฀in฀which฀it฀is฀distributed.฀The฀IRS฀requires฀that฀ TRS฀withhold฀20%฀of฀any฀taxable฀amount฀you฀withdraw฀that฀you฀do฀not฀instruct฀TRS฀to฀directly฀roll฀over฀into฀an฀eligible฀ IRA(s)฀or฀other฀successor฀program(s).฀This฀20%฀will฀be฀forwarded฀to฀the฀IRS฀and฀credited฀toward฀your฀taxes฀for฀the฀year฀of฀ distribution.฀(Within฀60฀days฀of฀the฀distribution฀date,฀you฀may฀roll฀over฀any฀taxable฀amount฀you฀receive,฀or฀roll฀over฀the฀entire฀ amount฀of฀the฀distribution฀by฀replacing฀the฀20%฀withheld฀by฀TRS฀with฀money฀from฀other฀sources.)

RW116 (10/11)

CONTINUED ON PAGE 3

PAGE 2

APPLICATION FOR WITHDRAWAL OF

ADDITIONAL MEMBER CONTRIBUTIONS

AT RETIREMENT

Please฀read฀the฀instructions฀before฀completing฀this฀application.

(NOTE:฀Please฀print฀in฀black฀or฀blue฀ink,฀and฀initial฀any฀changes฀that฀you฀make฀on฀this฀application.)

PART฀A:฀฀All฀information฀must฀be฀provided.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

First฀Name฀

 

MI฀

Last฀Name฀฀

 

฀

 

Social฀Security฀Number฀(last฀4฀digits฀only)

 

 

 

 

 

 

 

 

 

 

 

 

 

X

 

 

X

 

X

 

 

 

 

X

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Permanent฀Home฀Address฀

 

฀

฀

 

 

฀

 

Apt.฀No.฀ TRS฀Membership฀Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City฀

 

฀

State฀฀ Zip฀Code฀

 

฀

 

Primary฀Phone฀Number฀(Check฀one:฀฀฀฀฀฀฀Home฀฀฀฀฀฀฀Work฀฀฀฀฀฀฀Mobile)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(฀

 

 

 

฀฀฀฀฀

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

฀฀

 

฀

 

฀

 

 

฀

 

฀

 

Alternate฀Phone฀Number฀(Check฀one:฀฀฀฀฀฀฀Home฀฀฀฀฀฀฀Work฀฀฀฀฀฀฀Mobile)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(฀

 

 

 

฀฀฀฀฀

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please฀keep฀your฀personal฀information฀with฀TRS฀up฀to฀date.฀฀We฀will฀update฀our฀records฀based฀on฀the฀information฀you฀provide฀ above,฀so฀do not enter a temporary address;฀instead,฀TRS฀suggests฀that฀you฀consult฀the฀U.S.฀Postal฀Service฀about฀having฀your฀mail฀ forwarded฀on฀a฀temporary฀basis.฀฀To฀register฀any฀changes฀to฀your฀permanent฀address฀(and/or฀phone฀number),฀please฀access฀our฀ website฀or฀ile฀a฀“Member’s฀Change฀of฀Address฀Form”฀(code฀DM13)฀with฀TRS.

If฀you฀are฀providing฀new฀information฀above,฀please฀indicate฀the฀effective฀date:฀฀

PART฀B:฀฀Please฀elect฀ONE฀of฀the฀following฀choices฀and฀write฀your฀initials฀in฀the฀space฀provided฀next฀to฀your฀choice.

___฀

I฀ want 100% of my withdrawal paid directly to me. I understand that TRS is required to withhold 20% of the taxable amount distributed, that this amount will be forwarded to the IRS, and that I may claim the amount as federal tax paid on my tax return for the year of distribution.

฀

฀

฀

___฀

Please฀elect฀how฀you฀would฀like฀to฀receive฀your฀payment;฀see฀EFT฀eligibility฀requirements฀on฀page฀1.

฀฀฀฀฀฀฀by฀Mail฀฀฀฀฀฀฀฀฀฀via฀EFT฀(If฀you฀are฀ineligible฀to฀receive฀your฀payment฀via฀EFT,฀a฀check฀will฀be฀mailed฀to฀your฀home฀address.)

฀

฀

฀

฀

OR

I฀ want to roll over ALL OR PART of the taxable portion of my withdrawal, and I have therefore attached a “QPP Direct

Rollover Election Form” (code RW29) to this form.

RW116 (10/11)

CONTINUED ON PAGE 4

PAGE 3

CONTINUED฀FROM฀PAGE฀3

PART฀C:฀฀Please฀complete฀the฀following฀and฀sign฀and฀date฀below฀in฀the฀presence฀of฀a฀notary.

I certify that I have retired from my TRS-eligible position and hereby apply to withdraw the employee portion of my Additional Member Contributions (AMCs). I have read the accompanying instructions, including the eligibility requirements for this withdrawal, and I certify that the information I have provided above is accurate to the best of my knowledge.

MEMBER’S฀SIGNATURE฀________________________________________ DATE฀(M/D/Y)฀____________________________

PART฀D:฀฀TO฀BE฀COMPLETED฀BY฀A฀NOTARY฀(NOTE:฀Attestation฀made฀outside฀the฀U.S.฀must฀be฀executed฀before฀an฀American฀consul.)

State฀of฀฀

)

฀

)฀s.s.:

County฀of฀฀ __________________________ )

฀On฀the฀_______________฀day฀of฀__________________________,฀__________,฀before฀me฀personally฀appeared฀the฀person

฀known฀to฀me฀to฀be฀______________________________________________________________________________,฀

the฀individual฀who฀executed฀the฀foregoing฀instrument฀and฀acknowledged฀to฀me฀that฀(s)he฀executed฀the฀same. Signature:฀______________________________________________________________฀

Oficial฀Title:฀________________________________________฀Expiration฀Date฀of฀Commission:฀________________________

RW116 (10/11)

PAGE 4

Trsnyc Form Rw116 isn’t the one you’re looking for?

Related Documents