Tsp 78 Form – Fill Out and Use This PDF

I. INFORMATION ABOUT YOU

2.

Last Name

Uniformed Services Account

First Name

Beneficiary Participant Account

Middle Name

3.

TSP Account Number

4.

/ /

Date of Birth (mm/dd/yyyy)

5.

Daytime Phone (Area Code and Number)

7.

Stop direct deposit of my monthly payments to my checking or savings account.

You must complete Sections I and VI on Pages 1 and 2. All other sections of this form are optional; complete only the sections that pertain to the changes you want to make in the handling of your TSP monthly payments.

Remember to keep the TSP informed of any change in your address, since the TSP will send any correspondence related to your account to your address of record. You can change your address at any time by logging into the My Account section of the TSP website (www.tsp.gov). You can also use Form TSP-9, Change in Address for Separated Participant, available on the TSP website or from the TSP.

To ensure that your request is not delayed, carefully type or print the requested information inside the boxes using black or dark blue ink.

SecTION I. Information About You. Provide the requested information in Items 1–5. In Item 1, you must indicate the type of account for which you are requesting action. check only one box. If you want to change monthly payment information for more than one account, you must submit a separate form for each account.

Direct Deposit Information

If you have not previously established direct deposit (electronic funds transfer, EFT) of your monthly payments, you can begin by providing bank account information in Section II.

If your monthly payments are currently going into your bank account by direct deposit and you want to change your bank account information, complete Section II.

If you want to stop receiving payments by direct deposit and receive checks mailed to your home, complete Section III.

Note: If you want to continue to receive payments by direct deposit and your bank account information has not changed, do not complete either section.

SecTION II. Start or change Direct Deposit. Check the box in Item 6 either to begin direct deposit of your payments, or to change your direct deposit information. Provide all of the requested information about your account. If you do not know the 9-digit ACH Routing Number or your checking or savings account number, contact your financial institution for this infor- mation. Direct deposits are made only to financial institutions in the United States.

Be sure your intentions are clear: If you are providing finan- cial institution information to start or change direct deposit of your monthly payments, remember to check the box in Item 6, but do not also check the box in Item 7. You would be provid- ing conflicting information that could cause your form to be rejected.

SecTION III. Stop Direct Deposit. Check the box in Item 7 if you want the TSP to stop sending your monthly payments via direct deposit to your checking or savings account. Do not provide any information in Section II. Once your form is pro- cessed, you will begin receiving your payments by check at your address of record.

Note: Only the portion of your payment that is not being trans- ferred to an IRA or eligible employer plan can be paid by direct deposit. If the TSP determines that the direct deposit informa- tion you provided is incomplete or invalid, your request will be processed, but you will receive your payment in the form of a check mailed to you.

SecTION IV. Stop Transfer of Monthly Payments. Complete this section only if you have already established transfer of your monthly payments to a traditional IRA, eligible employer plan, or Roth IRA, and you want to stop the transfers.

The transfer of the traditional and Roth portions of your ac- count balance are set up in separate transactions. Therefore, you must elect to stop transfers individually by type. Check the boxes that apply.

If you want to begin transfers, change the financial institution to which your transfers are sent, or change the percentage of your payments that is transferred, complete Page 3 and/or

Page 4.

PRIVAcY AcT NOTIce. We are authorized to request the information you provide on this form under 5 U.S.C. chapter 84, Federal Employees’ Retirement System. We will use this information to identify your TSP account and to process your request. In addition, this information may be shared with other Federal agencies for statistical, auditing, or archiving purposes. We may share the information with law enforcement agencies investigating a violation of civil or criminal law, or agencies implementing

a statute, rule, or order. It may be shared with congressional offices, private sector audit firms, spouses, former spouses, and beneficiaries, and their attorneys. We may disclose relevant portions of the information to appropriate parties engaged in litigation and for other routine uses as specified in the Federal Register. You are not required by law to provide this information, but if you do not provide it, we will not be able to process your request.

Single

Married

Married, but withhold at higher single rate

c.

Withhold this additional dollar amount: $

,

.00 (Note: You must also complete Item 9b.)

11.

Participant’s Signature

13.

12. / /

Date Signed (mm/dd/yyyy)

SecTION V. Federal Tax Withholding. Complete this section if you want to change the standard Federal tax withholding for the taxable portion of your monthly payments. (There is no tax withholding on any tax-exempt portions of uniformed service and beneficiary participant accounts, on Roth contributions, or on qualified Roth earnings). In order to complete this section, you will need to know whether your payments are expected to last 10 years or more, or less than 10 years. You can use the Monthly Payment Calculator on the TSP website (www.tsp.gov) to calculate the duration of your payments. Note: Withholding does not apply to any amounts transferred to an IRA or eligible employer plan.

If you have chosen monthly payments that will last 10 years or more, the TSP will withhold taxes as if you are a married person with 3 dependents. However, you have other withhold- ing options:

–You may choose to have no withholding by checking the box in Item 9a.

OR

–You may change your withholding marital status and allowances by completing Item 9b. You may use

the IRS Withholding Calculator on the IRS website at www.irs.gov/individuals for help in determining how many withholding allowances to claim.

OR

–You may ask the TSP to withhold an additional amount by completing Item 9c. Note: If you request additional withholding, you must also check the box indicating your withholding marital status and the number of allowances you would like in Item 9b. You may use the IRS Withholding Calculator on the IRS website at www.irs.gov/individuals for help in determining how many withholding allowances to claim. If you do not complete Item 9b, your withdrawal will be processed as if you are a married person with 3 dependents.

Be aware that if you elect not to have Federal income tax withheld from your payments or if you do not have a sufficient amount withheld, you may be responsible for the payment of quarterly estimated taxes. Additionally, if any withholding amount and/or payments of quarterly estimated taxes are not sufficient, you may be subject to penalties under the IRS’ estimated tax rules.

For more information about estimated tax requirements and income tax penalties, refer to IRS Publication 505, Tax Withhold- ing and Estimated Tax. You may be able to avoid quarterly esti- mated tax payments by having enough tax withheld from your TSP payments using this form. You may use IRS Publication 919, How Do I Adjust My Tax Withholding?, to see how the dollar amount you are having withheld compares to your projected Federal income tax for the current year.

If you have chosen monthly payments that will last less than 10 years, the taxable portion of your payments that you do not transfer directly to an IRA or plan is subject to 20% mandatory Federal income tax withholding. For those amounts, you may request additional tax withholding by providing a whole dollar amount in the boxes provided in Item 10.

For more information about the tax implications of your with- drawal, read the TSP tax notices “Important Tax Information About Payments From Your TSP Account” and “Tax Information for TSP Participants Receiving Monthly Payments.”

This section is a substitute for IRS Form W-4P, Withholding certiicate for Pension and Annuity Payments. If you complete this section, you should not complete IRS Form W-4P.

If you include an IRS Form W-4P with the completed withhold- ing section of this form, the withholding information you provide on this form will supersede the information on your submitted Form W-4P.

If you complete this section incorrectly or choose a withhold- ing option that does not apply to your payments, and the rest of your form is completed correctly, your withdrawal will be pro- cessed using your withholding rate on file, or the required IRS withholding rates, if applicable.

SecTION VI: certiication and Notarization. Read the certifi- cation carefully; then sign and date the form in Items 11 and 12.

Please note that the address you provide in Item 13 will not be used to change your address in your TSP account record. It will only be used to notify you if we cannot locate your account based on the information you provided on this form. If you need to change your address, log into My Account on the TSP website or use Form TSP-9, Change in Address for Separated Partici- pant, available on the TSP website or from the TSP.

Your signature must be notarized if you are providing direct deposit or transfer information on Pages 1, 3, or 4; otherwise, your request will not be processed.

If you are only using the form to change your tax withholding, you do not need to have your signature notarized.

Because the form will be filed with a Federal agency in Wash- ington, D.C., the notary must complete the notarization in Item 14. No other acknowledgement is acceptable.

After you complete the form, make a copy for your records.

Mail the original to:

Thrift Savings Plan

P.O. Box 385021

Birmingham, AL 35238

Or fax to: 1-866-817-5023

Note: Do not mail and fax your request. The TSP will automati- cally cancel the second request it receives. If you need to make a change or correction on your form, call the TSP to cancel your first request.

If you have questions, call the toll-free ThriftLine at 1-TSP-YOU-FRST (1-877-968-3778) or the TDD at

1-TSP-THRIFT5 (1-877-847-4385). Outside the U.S. and Canada, please call 404-233-4400 (not toll free).

15.Transfer

.0% of the traditional (non-Roth) portion of my payments to the IRA or plan identified in Section VIII,

16.Type of Account:

17.

Traditional IRA

Eligible Employer Plan

Roth IRA

18.

Check this box if tax-exempt balances are accepted into the account identified above.

Make check payable to

If needed, use these boxes to supplement “check payable to” information above.

Street Address

–

}The financial institution or plan will need to use this information to identify the account that will receive the transfer.

20.

Typed or Printed Name of Certifying Representative (Last, First, Middle)

21.

Signature of Certifying Representative

()

Daytime Phone (Area Code and Number)

22. / /

Date Signed (mm/dd/yyyy)

SecTION VII. You may transfer all or any part of the traditional (non-Roth) portion of your payments to a traditional IRA, eli- gible employer plan, or Roth IRA. Enter a percentage between 1 and 100% in Item 15. Do not enter decimals or a percentage over 100%. If you decide to transfer the traditional portion of your payments to a Roth IRA, be aware that Roth IRAs accept only after-tax dollars. As a result, you must pay tax on the amount you transfer, and the tax liability is incurred for the year of the transfer. We strongly encourage you to consult with a tax advisor regarding your eligibility for, and the tax consequences of, making the transfer.

The taxable portion of payments that are not transferred directly to a traditional IRA, eligible employer plan, or Roth IRA are subject to mandatory 20% Federal income tax withhold- ing. (See Section V.) Read the TSP tax notices “Important Tax Information About Payments From Your TSP Account” and “Tax Information for TSP Participants Receiving Monthly Payments.”

SecTION VIII. If you choose to transfer all or any part of the traditional portion of your payments to a traditional IRA, eligible employer plan, or Roth IRA, your inancial institution or plan administrator must complete this section before you submit this form to the TSP (unless you are currently transferring traditional money and your inancial institution information has not changed).

Do not submit the transfer forms of inancial institutions or plans; the TSP cannot accept them.

The institution or plan to which the payment is to be transferred must be a trust established inside the United States (i.e., the 50 states and the District of Columbia).

The financial institution or plan should retain a copy of Page 3 to identify the account to which the check should be deposited when it is received. If the transfer is to a traditional IRA or Roth IRA, the institution accepting the transfer should submit Form 5498, IRA Contribution Information, to the IRS. The TSP will re- port all payments and transfers to you and to the IRS on Form

1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.

Information for the IRA or Plan: Complete Section VIII and re- turn this form to the participant identified at the top of the page. The financial institution or plan administrator must ensure that the account described here is a traditional IRA, eligible em- ployer plan, or Roth IRA.

Type of Account and Account Number. Indicate whether the transfer is to a traditional IRA, eligible employer plan, or Roth IRA in Item 16. In Item 17, enter the account number, if avail- able, of the IRA or plan to which the money is to be transferred. If an account number is not available, provide information that will help you identify the check when it is sent to you.

Transfer of Tax-exempt Balances. Some accounts have tax-exempt balances from pay subject to the combat zone tax exclusion. Check the box in Item 18 if tax-exempt balances are accepted into the account identified in Item 17. If the partici- pant’s traditional (non-Roth) balance includes tax-exempt contributions, the taxable portion of the monthly payments from the traditional balance will be transferred first. Tax-exempt money will be transferred only if the taxable portion of the pay- ments does not satisfy the participant’s transfer election and the plan or IRA accepts tax-exempt money. If the plan or IRA does not accept tax-exempt money, that portion of the payment will be paid directly to the participant.

Name and Mailing Address. Provide the name and mailing address information in the boxes provided in Item 19 exactly as you want it to appear on the front of the transfer check. You will need to identify the account to which the transfer should be deposited from the information contained in these boxes.

The certifying representative must provide the requested information in Items 20–22. If we need to contact the financial institution or plan for more information, the individual named here will be used as the contact person.

23.Transfer

.0% of the Roth portion of my payments to the IRA or plan identified in Section X, or to my

24.Type of Account:

25.

Roth IRA

Eligible Employer Plan — Roth Account

Make check payable to

If needed, use these boxes to supplement “check payable to” information above.

Street Address

–

}The financial institution or plan will need to use this information to identify the account that will receive the transfer.

27.

Typed or Printed Name of Certifying Representative (Last, First, Middle)

28.

Signature of Certifying Representative

()

Daytime Phone (Area Code and Number)

29. / /

Date Signed (mm/dd/yyyy)

SecTION Ix. You may transfer all or any part of the Roth portion of your payments to a Roth IRA or a Roth account maintained by an eligible employer plan. Enter a percentage between 1 and 100% in Item 23. Do not enter decimals or a percentage over 100%.

Roth contributions are not subject to mandatory Federal income tax withholding because they are not taxable upon distribution. However, if you have not met the conditions neces- sary for your Roth earnings to be qualified (i.e., paid tax-free), any Roth earnings that are not transferred directly to a Roth IRA or to a Roth account maintained by an eligible employer plan are taxable and are subject to the mandatory 20% Federal income tax withholding. Roth earnings become qualified when the following two conditions have been met: (1) 5 years have passed since January 1 of the calendar year in which you made your first Roth contribution and (2) you have reached age 59½ or have a permanent disability. Note: The TSP cannot certify to the IRS that you meet the Internal Revenue Code’s definition of a disability when your taxes are reported. Therefore, you must provide the justification to the IRS when you file your taxes.

Read the TSP tax notices “Important Tax Information About Payments From Your TSP Account” and “Tax Information for TSP Participants Receiving Monthly Payments.”

SecTION x. If you choose to transfer all or any part of the Roth portion of your payments to a Roth IRA or a Roth account main- tained by an eligible employer plan, your inancial institution or plan administrator must complete this section before you submit this form to the TSP (unless you are currently trans- ferring Roth money and your inancial institution information has not changed).

Do not submit transfer forms of inancial institutions or plans; the TSP cannot accept them.

The institution or plan to which the payment is to be trans- ferred must be a trust established inside the United States (i.e., the 50 states and the District of Columbia).

The financial institution or plan should retain a copy of Page 4 to identify the account to which the check should be deposited when it is received. If the transfer is to a Roth IRA, the insti- tution accepting the transfer should submit Form 5498, IRA Contribution Information, to the IRS. The TSP will report all payments and transfers to you and to the IRS on Form 1099-R, Distributions From Pensions, Annuities, Retirement or Profit- Sharing Plans, IRAs, Insurance Contracts, etc.

Information for the IRA or Plan: Complete Section X and re- turn this form to the participant identified at the top of the page. The financial institution or plan administrator must ensure that the account described here is a Roth IRA or a Roth account maintained by an eligible employer plan.

Type of Account and Account Number. Indicate whether the transfer is to a Roth IRA or to a Roth account maintained by an eligible employer plan in Item 24. In Item 25, enter the account number, if available, of the IRA or plan to which the money is to be transferred. If an account number is not available, provide information that will help you identify the check when it is sent to you.

Name and Mailing Address. Provide the name and mailing address information in the boxes provided in Item 26 exactly as you want it to appear on the front of the transfer check. You will need to identify the account to which the transfer should be deposited from the information contained in these boxes.

The certifying representative must provide the requested information in Items 27–29. If we need to contact the financial institution or plan for more information, the individual named here will be used as the contact person.