Tsp Form 77 Request PDF Details

The Thrift Savings Plan (TSP) 77, Request for Partial Withdrawal When Separated, is an essential form for those who have separated from federal service and wish to withdraw a portion of their TSP account balance while leaving the remainder intact. Making a successful withdrawal requires a thorough understanding and careful completion of the TSP-77 form, including adhering to specified eligibility criteria, such as having a vested account balance of at least $1,000 and not having previously requested a partial withdrawal post-separation. The form allows for the direct transfer of the requested withdrawal amount or portions thereof into a traditional IRA, an eligible employer plan, or a Roth IRA, depending on the balance type. Additionally, optional sections on the form cater to those preferring direct deposit or requiring additional tax withholding. Completing the form accurately requires notarization of the participant's signature, and, for married participants under certain plans, spousal consent with notarization is mandated. This structured process ensures that participants can access their savings while still following the TSP’s guidelines and maintaining the integrity of their retirement savings.

QuestionAnswer
Form NameTsp Form 77 Request
Form Length12 pages
Fillable?No
Fillable fields0
Avg. time to fill out3 min
Other namestsp 77 tsp form 77 2008

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Thrift Savings Plan

TSP-77

Request for Partial Withdrawal When Separated

January 2018

Checklist for Completing Form TSP-77,

Request for Partial Withdrawal When Separated

Be sure to read all instructions before completing this form. You can use the TSP website (tsp.gov) to help you complete your request. You will need to log into your ac­ count and access the program on the Withdrawals menu. It has interactive screens that will ill in the appropriate sections of the form. Whether you use the program or not, you must complete and submit the required pages as outlined below, and all pages that are relevant to your request must be submitted as one package.

You must complete and submit Page 1. Remember that you must sign and date the form, and your signature must be notarized.

If you are married, you must also complete and submit Page 2 (either Section VII or VIII depending on your retirement coverage). If you are a married FERS or uniformed services participant, your spouse must also sign the form, and the signature must be notarized.

If you have a traditional (non-Roth) balance and you would like to transfer all or a part of the traditional (non-Roth) portion of your withdrawal, you must check the box in Section III. You and the IRA trustee or plan administrator must complete Page 3. You must include the completed page with your withdrawal request package.

If you have a Roth balance and you would like to transfer all or a part of the Roth portion of your withdrawal, you must check the box in Section III. You and the IRA trustee or plan administrator must complete Page 4. You must include the com­ pleted page with your withdrawal request package. The taxable portion of the withdrawal from the Roth balance will be transferred irst. Nontaxable money will be transferred only if the taxable portion of the withdrawal does not satisfy the participant’s transfer election.

Note: If you would like to transfer all or a part of both the traditional and the Roth portions of your withdrawal, you must check the box in Section III. You and the IRA trustee or plan administrator must complete Page 3 and Page 4, even if the transfer is to the same inancial institution. You must include the completed pages with your withdrawal request package.

 

 

 

 

THRIFT SAVINGS PLAN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TSP-77

 

 

 

 

REQUEST FOR PARTIAL WITHDRAWAL WHEN SEPARATED

I. INFORMATION ABOUT YOU

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

This request applies to my:

 

Civilian Account OR

 

 

Uniformed Services Account

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

 

First Name

 

 

 

 

 

 

 

 

 

 

Middle Name

3.

TSP Account Number

4.

/ /

Date of Birth (mm/dd/yyyy)

5.

Daytime Phone (Area Code and Number)

6.

Foreign address?

7.

Check here.

 

Street Address or Box Number (For a foreign address, see instructions on back.)

Street Address Line 2

8.

City

9.

State

10.

Zip Code

II. PARTIAL WITHDRAWAL REQUEST

11. Amount you want to withdraw: $

 

,

 

 

 

,

 

 

 

.00 (amount must be $1,000 or more)

 

 

 

 

 

 

 

 

 

 

 

III. TRANSFER ELECTION

12.

I would like to transfer all or a portion of my withdrawal request to an IRA or eligible employer plan. (Note: You must include the completed applicable transfer page(s) from this form with your withdrawal request package.)

IV. DIRECT DEPOSIT INFORMATIONThis section is optional. Complete this section if you want the portion of your with­ drawal that is not being transferred (Sections IX–XII) directly deposited into your checking or savings account.

13. Type of Account: 14.

Checking

Name of Financial Institution

Savings

15.

 

 

16.

 

ACH Routing Number (Must be 9 digits)

Checking or Savings Account Number

V.ADDITIONAL TAX WITHHOLDINGThis section is optional. If you would like more than the mandatory 20% federal tax withhold­ ing, complete this section. If a portion of your withdrawal is a Required Minimum Distribution, the TSP must withhold 10% of that portion. Withholding does not apply to amounts transferred to IRAs or eligible employer plans or which are otherwise nontaxable (see instructions).

17. In addition to the mandatory 20%, withhold this amount for federal income tax: $

,

.00

VI. CERTIFICATION AND NOTARIZATIONI certify that the information I have provided on all pages of this withdrawal request is true and complete to the best of my knowledge. If I did not complete Section VII or VIII on Page 2, I further certify that I am an unmarried TSP participant. Warning: Any intentional false statement in this application or willful misrepresen­ tation concerning this request is a violation of law that is punishable by a ine or imprisonment for as long as 5 years, or both (18 U.S.C. 1001).

18.

Participant’s Signature

19./ /

Date Signed (mm/dd/yyyy)

20.Notary: Please complete the following. No other acknowledgement is acceptable (see instructions). The person who signed Item 18 is known to or was identiied by me and, before me, signed or acknowledged to have signed

this form. In witness thereof, I have signed below on this

 

 

day of

,

 

 

 

.

 

 

 

 

 

 

Month

 

 

Year

 

 

My commission expires:

 

 

 

 

 

 

 

 

 

 

 

 

Date (mm/dd/yyyy)

Notary’s Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

(

)

 

 

 

Notary’s Printed Name

 

 

 

Notary’s Phone Number

Jurisdiction

Do Not Write Below This Line

FORM TSP-77, Page 1 (1/2018)

PREVIOUS EDITIONS OBSOLETE

* P I I S 0 0 2 3 0 1 0 0 2 0 0 0 0 0 0 0 0 P I I S *

FORM TSP-77, INFORMATION AND INSTRUCTIONS FOR PAGE 1

Use this form if you are separated from federal service and you want to request a one­time­only withdrawal of part of your vested account balance and leave the remainder with the TSP. If you would like to request a withdrawal of your entire vested account balance now, do not complete this form; instead, complete Form TSP­70, Request for Full Withdrawal.

Before completing a withdrawal request, you should read the booklet Withdrawing Your TSP Account After Leaving Federal Service and the TSP tax notice Important Tax Information About Payments From Your TSP Account. If you do not have these materials, you can download them from the TSP website (tsp.gov) or ask your former agency or service for a copy. You can also request them by calling the ThriftLine.

First, make sure you are eligible for a partial withdrawal:

Your vested account balance must be at least $1,000. Your vested account balance is the total amount of your traditional balance and your Roth balance (if any), less any Agency/Serv­ ice Automatic (1%) Contributions and earnings in your account that have not met the time­in­service requirement.

The minimum amount for a partial withdrawal is $1,000.

You cannot have previously made a partial withdrawal after separating from federal service. Only one partial withdrawal is allowed.

You cannot have previously made an age­based in­service withdrawal.

You must be separated from federal service for 31 or more days in order to be eligible for a post­employment withdrawal.

There are two ways to request a partial withdrawal:

1.Complete Form TSP­77 (this form) and mail or fax it to the TSP. Note: Your request cannot be processed until your agency or service submits conirmation of your separation to the TSP.

or

2.Use the TSP website (tsp.gov) to begin your withdrawal request. For security reasons, you cannot complete your request online. You will be asked to print out your partially completed with­ drawal request form at the end of your online session. Review the form, complete any missing information, and provide any required signatures and documentation before you mail or fax it to the TSP. Do not change or cross out any of the preilled infor- mation resulting from your entries on the website; the form may not be processed if you do so.

Note: This type of withdrawal cannot process until your agency or service reports your separation to the TSP.

If you are not married and you do not want to transfer any part of your partial withdrawal to a traditional IRA, an eligible employer plan, or a Roth IRA, you only have to complete Page 1 of this form. Sign the form, have it notarized, and submit it to the TSP at the address indicated on the last page of this form.

SECTION I. Complete Items–10. Check whether you are with­ drawing money from a civilian or uniformed services account in Item 1. Check only one box. You cannot withdraw from both accounts using one form. Also, be sure to only check the box for the account representing the employment from which you are separated. If you have two TSP accounts, and you do not check a box, your form will not be processed.

Your TSP account number is the 13­digit number that was issued to you. The address you provide on this form will be used to update the address in your TSP account record. If you have a foreign ad­ dress, check the box in Item 6 and enter the foreign address in Items 7–10 as follows:

First address line: Enter the street address or post ofice box number, and any apartment number.

Second address line: Enter the city or town name, other principal subdivision (e.g., province, state, county), and postal code, if known. (The postal code may precede the city or town.)

City/State/Zip Code ields: Enter the entire country name in the City ield; leave the State and Zip Code ields blank.

If you use an Air/Army Post Ofice (APO) or Fleet Post Ofice (FPO) address, enter that address in the two available address lines (in­ clude the unit designation). Enter APO or FPO, as appropriate, in the City ield. In the State ield, enter AE as the state abbreviation for Zip Codes beginning with 090­098, AA for Zip Codes beginning with 340, and AP for Zip Codes beginning with 962­966. Then enter the appropriate Zip Code.

SECTION II. You may withdraw $1,000 or more. Use a whole dollar amount only. Note: Your withdrawal will be disbursed pro rata (i.e., proportionally) from any traditional (non­Roth) and Roth balances in your account. If your vested account balance is less than $1,000, submit a full withdrawal request using Form TSP­70.

SECTION III. Check the box in this section if you want all or a part of the withdrawal amount you elected in Section II to be transferred to an IRA or eligible employer plan.

To transfer all or a part of the vested, traditional (non­Roth) portion of your withdrawal, you and the IRA trustee or plan administrator must complete Page 3. To transfer all or any part of the Roth portion of your withdrawal, you and the IRA trustee or plan administrator must complete Page 4. To transfer the traditional and Roth portions of your withdrawal, you and the IRA trustee or plan administrator must complete Pages 3 and 4. Note: You must include the complet­ ed applicable transfer pages with your withdrawal request package.

SECTION IV. This section is optional. Complete this section only if you want the TSP to send your partial withdrawal directly to your checking or savings account by means of a direct deposit (electronic funds transfer (EFT)). Provide all of the requested information in this section. If you do not know the 9­digit ACH Routing number or your checking or savings account number, contact your inancial institution for this information. Direct deposits will be made only to inancial institutions in the United States. Note: Only the portion of your withdrawal that is not being transferred to a traditional IRA, eligible employer plan, or Roth IRA can be paid by EFT.

Note: If the TSP determines that the EFT information 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 V. This section is optional. Complete this section if you want the TSP to withhold additional federal income tax from your withdrawal. If you do not complete this section, you will still be subject to the mandatory 20% federal income tax withholding on the TAXABLE portion of payments that you do not transfer directly to a traditional IRA, eligible employer plan, or Roth IRA. The man­ datory withholding tax cannot be waived. If you are a uniformed services participant with a tax­exempt balance, the tax­exempt portion of your withdrawal will not be subject to the mandatory 20% withholding tax. Roth contributions and qualiied Roth earn­ ings are also not subject to mandatory tax withholding. If you complete this section requesting additional tax withholding, you should not complete IRS Form W-4P. Read the TSP tax notice, Important Tax Information About Payments From Your TSP Account for detailed tax rules.

SECTION VI. Read the certiication carefully and sign and date the form. Your signature must be notarized; otherwise, your request cannot be processed. Because the form will be iled with a federal agency in Washington, D.C., the notary must complete the notariza­ tion in Item 20. No other acknowledgement is acceptable.

Form TSP­77 (1/2018)

PREVIOUS EDITIONS OBSOLETE

Name:

TSP Account Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Last, First, Middle)

VII. MARRIED FERS AND UNIFORMED SERVICES PARTICIPANTSYour spouse must consent to your withdrawal. Your spouse’s signature must be notarized.

21.Spouse: By signing below, I consent to this withdrawal from my spouse’s Thrift Savings Plan account. I understand that the amount withdrawn will not be available later for the purchase of a joint and survivor annuity.

Spouse’s Name (Last, First, Middle)

22.

Spouse’s Signature

23.

/ /

Date Signed (mm/dd/yyyy)

24.Notary: Please complete the following. No other acknowledgement is acceptable (see instructions).

The person who signed Item 22 is known to or was identiied by me and, before me, signed or acknowledged to have

signed this form. In witness thereof, I have signed below on this

 

day of

 

 

,

 

 

.

 

 

 

 

 

 

Month

 

 

Year

My commission expires:

 

 

 

 

 

 

 

 

 

 

 

Date (mm/dd/yyyy)

Notary’s Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

[seal]

Notary’s Printed Name

 

Notary’s Phone Number

 

 

 

 

 

 

 

 

 

Jurisdiction

25.Participant: If you cannot obtain your spouse’s signature, provide your spouse’s name (Item 21) and Social Security number on the right, and submit Form TSP­16, Exception to Spousal Requirements (TSP­U­16 for uniformed services), with the required documentation.

 

 

 

­

 

 

­

 

 

 

 

 

 

 

Spouse’s Social Security Number

VIII. MARRIED CSRS PARTICIPANTSYour spouse must be notiied of your withdrawal request.

26.

Spouse’s Name (Last, First, Middle)

27.Is your spouse’s address the same as your address in your TSP record?

28.

 

 

 

 

Don’t know spouse’s address.

 

 

 

­

 

 

­

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

No (Complete Items 28–32.)

 

(Provide spouse’s SSN and submit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form TSP­16.)

Spouse’s Social Security Number

 

 

 

 

Spouse has

foreign address? 29. Street Address or Box Number (For a foreign address, see instructions.) Check here.

Street Address Line 2

30.

City

31.

State

32.

Zip Code

Do Not Write Below This Line

Form TSP-77, Page 2 (1/2018)

PREVIOUS EDITIONS OBSOLETE

FORM TSP-77, INFORMATION AND INSTRUCTIONS FOR PAGE 2

Spouses’ rights apply to all partial withdrawals from your TSP account. If you are married (even if separated from your spouse), you must comply with the spouses’ rights require­ ments outlined below:

Spouses’ Rights for Partial Withdrawals

Classiication

Requirement

Exceptions

 

 

 

FERS/

Spouse must provide

Whereabouts unknown

Uniformed

notarized consent to the

or exceptional circum­

Services

partial withdrawal.

stances

CSRS

Spouse must be notiied of

Whereabouts unknown

 

the request for a partial

 

 

withdrawal.

 

 

 

 

SECTION VIIMarried FERS and uniformed services partici- pants. By law, your spouse has the right to a joint and survivor annuity with a 50% survivor beneit, level payments, and no cash refund, unless your spouse waives the right to that annu­ ity. By consenting to the partial withdrawal on this form, your spouse acknowledges that any amount disbursed now will not be available later for the purchase of such an annuity.

Your spouse gives consent to a partial withdrawal from your TSP account by completing, signing, and dating Items 21–23. Your spouse’s signature must be notarized (Item 24). Because this form will be iled with a federal agency in Washington, D.C., the notary must complete the information in Item 24. No other acknowledgement is acceptable.

If you cannot obtain your spouse’s signature, please provide your spouse’s Social Security number in Item 25. The TSP cannot process your withdrawal unless you have an excep­ tion on ile or if you apply for—and receive—an exception to the spouses’ rights requirements. Exceptions are granted in RARE circumstances. If you wish to apply for an exception, you can do so by submitting Form TSP­16 (TSP­U­16 for uni­ formed services), Exception to Spousal Requirements, along with this form.

SECTION VIIIMarried CSRS participants. By law, the TSP must notify your spouse of your partial withdrawal. Provide your spouse’s name in Item 26. If your spouse’s address is the same as your address in your TSP record, check “Yes” in Item 27. Otherwise, check “No” in Item 27 and complete Items 28–32. If you do not know your spouse’s whereabouts, check the third box in Item 27 and provide your spouse’s Social Secu­ rity number. The TSP cannot process your withdrawal unless you have an exception on ile or if you apply for—and receive— an exception to the spouses’ rights requirements. Exceptions are granted in RARE circumstances. If you wish to apply for an exception, you can do so by submitting Form TSP­16, Exception to Spousal Requirements, along with this form.

If your spouse has a foreign address, check the box in Item 28 and enter the foreign address in Items 29–32 as follows:

First address line: Enter the street address or post ofice box number, and any apartment number.

Second address line: Enter the city or town name, other princi­ pal subdivision (e.g., province, state, county), and postal code, if known. (The postal code may precede the city or town.)

City/State/Zip Code ields: Enter the entire country name in the City ield; leave the State and Zip Code ields blank.

If your spouse uses an Air/Army Post Ofice (APO) or Fleet Post Ofice (FPO) address, enter that address in the two available address lines (include the unit designation). Enter APO or FPO, as appropriate, in the City ield. In the State ield, enter AE as the state abbreviation for Zip Codes begin­ ning with 090­098, AA for Zip Codes beginning with 340, and AP for Zip Codes beginning with 962­966. Then enter the appropriate Zip Code.

Form TSP­77 (1/2018)

PREVIOUS EDITIONS OBSOLETE

Name:

TSP Account Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Last, First, Middle)

TRANSFERTRADITIONAL

You and the IRA trustee or plan administrator must complete this page if you checked the box in Item 12 and you want to transfer all or a part of the traditional (non-Roth) portion of your withdrawal to a traditional IRA, eligible employer plan, or a Roth IRA. Your traditional TSP balance consists of traditional contributions, tax­exempt contributions, all agency/service contributions, and the earnings associated with these contributions. Note: If you choose to transfer the traditional portion of your withdrawal to a Roth IRA, you will have to pay tax on that portion when you ile your tax return for the year.

IX. YOUR TRANSFER ELECTION FOR TRADITIONAL BALANCEAfter you complete this section, take or send this page (including the instructions on the back) to your IRA or plan. Your IRA trustee or plan administrator must complete Section X. You must submit the completed package in order for your transfer to be processed.

33. Transfer

 

 

 

.0% of the traditional (non-Roth) portion of my withdrawal to the IRA or plan identiied in

 

 

 

Section X. Note: You must also complete Section III on Page 1.

X.TRANSFER INFORMATION FOR TRADITIONAL BALANCEThis section is to be completed by the IRA trustee or plan administrator. The account described here must be a traditional IRA, eligible employer plan, or a Roth IRA. Please return this completed form to the participant. Do not submit transfer forms of inancial institutions or plans.

34.

35.

36.

37.

Type of Account:

 

 

 

Traditional IRA

 

 

Eligible Employer Plan

 

Roth IRA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IRA/Plan Account Number or Other Customer ID

Check this box if tax­exempt balances are accepted into the account identiied above.

Provide the name and mailing address information below exactly as it should appear on the front of the check.

Make check payable to

City

 

 

 

 

 

The inancial

 

 

 

 

 

institution

 

 

 

 

 

or plan will

 

 

 

 

 

 

 

 

 

 

need to use

 

 

 

 

 

this information

 

 

 

 

 

 

 

 

 

 

to identify the

 

 

 

 

 

 

 

 

 

 

account that

 

 

 

 

 

will receive

 

 

 

 

 

 

 

 

 

}the transfer.

 

 

 

 

State

Zip Code

I conirm the accuracy of the information in this section and the identity of the individual named above. As a representative of the inancial institution or plan to which the funds are being transferred, I certify that the inancial institution or plan agrees to accept the funds directly from the Thrift Savings Plan and deposit them into the IRA or eligible employer plan identiied above.

38.

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

39.

Signature of Certifying Representative

Do Not Write Below This Line

()

Daytime Phone (Area Code and Number)

40. / /

Date Signed (mm/dd/yyyy)

Form TSP-77, Page 3 (1/2018)

PREVIOUS EDITIONS OBSOLETE

FORM TSP-77, INFORMATION AND INSTRUCTIONS FOR PAGE 3

You may elect to transfer all or part of your partial withdrawal to a traditional IRA, an eligible employer plan, or a Roth IRA. The type of plan to which you can transfer your withdrawal depends on whether your withdrawal consists of a traditional (non­Roth) balance, a Roth balance, or both.

If you would like to transfer all or any part of the traditional (non-Roth) portion of your withdrawal to an IRA or eligible employer plan, complete Page 3.

If you would like to transfer all or any part of the Roth portion of your withdrawal to a Roth IRA or eligible employer plan, complete Page 4.

If you would like to transfer all or any part of both the tradi­ tional and Roth portions of your withdrawal to separate plans or to the same plan, you must complete Page 3 and Page 4.

SECTION IX. You may transfer all or any part of the traditional (non-Roth) portion of your withdrawal to a traditional IRA, eli­ gible employer plan, or Roth IRA. Enter a percentage between 1 and 100% in Item 33. Do not enter decimals or a percentage over 100%. If you decide to transfer to a Roth IRA, be aware that Roth IRAs accept only after­tax 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.

Payments that are not transferred directly to a traditional IRA, eligible employer plan, or Roth IRA are subject to mandatory 20% federal income tax withholding. (See Section V.) Read the TSP tax notice Important Tax Information About Payments From Your TSP Account for detailed tax rules.

SECTION X. If you choose to transfer all or any part of the traditional (non-Roth) portion of your withdrawal to a tradi­ tional 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.

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 inancial 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 report all payments and transfers to you and to the IRS on Form 1099­R, Distributions From Pensions, Annuities, Retire­ ment or Proit­Sharing Plans, IRAs, Insurance Contracts, etc.

Information for the IRA or Plan: Complete Section X and return this form to the participant identiied at the top of the page. The inancial institution or plan administrator must ensure that the account described here is a traditional IRA, eligible employer 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 34. In Item 35, enter the account num­ ber, if available, of the IRA or plan to which the money is to be transferred. If an account number is not available, pro­ vide information that will help you identify the check when it is sent to you.

Transfer of Tax-Exempt Balances. A uniformed services participant may have contributed tax­exempt money from pay earned in a combat zone to his or her traditional bal­ ance. Check the box in Item 36 if tax­exempt balances are accepted into the account identiied in Item 34. If the participant’s traditional balance includes tax­exempt con­ tributions, the taxable portion of the withdrawal from the traditional balance will be transferred irst. Tax­exempt money will be transferred only if the taxable portion of the withdrawal does not satisfy the participant’s transfer elec­ tion and the plan or IRA accepts tax­exempt balances. If the plan or IRA does not accept tax­exempt balances, that por­ tion 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 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 38–40. If we need to contact the inancial institution or plan for more information, the individual named here will be used as the contact person.

Form TSP­77 (1/2018)

PREVIOUS EDITIONS OBSOLETE

Name:

TSP Account Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Last, First, Middle)

TRANSFERROTH

You and the IRA trustee or plan administrator must complete this page if you checked the box in Item 12 and you want to transfer all or a part of the Roth portion of your withdrawal to a Roth IRA or to a Roth account maintained by an eligible employer plan. Your Roth TSP balance consists of any of your own contributions that you designated as Roth when you made your contribution election and the earnings associated with these contributions. Withdrawals of Roth contributions are paid tax­free. The earnings associated with these contributions are paid tax­free only if 5 years have passed since January 1 of the calendar year in which you made your irst Roth contribution and you have reached age 59½ or have a permanent disability. (See instructions.)

XI. YOUR TRANSFER ELECTION FOR ROTH BALANCEAfter you complete this section, take or send this page (includ­ ing the instructions on the back) to your IRA or plan. Your IRA trustee or plan administrator must complete Section XII. You must submit the completed package in order for your transfer to be processed.

41. Transfer

 

 

 

.0% of the Roth portion of my withdrawal to the IRA or plan identiied in Section XII.

 

 

 

Note: You must also complete Section III on Page 1.

XII. TRANSFER INFORMATION FOR ROTH BALANCEThis section is to be completed by the IRA trustee or plan admin-

istrator. The account described here must be a Roth IRA or a Roth account maintained by an eligible employer plan. Please

return this completed form to the participant. Do not submit transfer forms of inancial institutions or plans.

42.Type of Account:

Roth IRA

Eligible Employer Plan—Roth Account

43.

IRA/Plan Account Number or Other Customer ID

44.Provide the name and mailing address information below exactly as it should appear on the front of the check.

Make check payable to

City

 

 

 

 

 

The inancial

 

 

 

 

 

 

 

 

 

 

institution

 

 

 

 

 

or plan will

 

 

 

 

 

need to use

 

 

 

 

 

this information

 

 

 

 

 

to identify the

 

 

 

 

 

account that

 

 

 

 

 

will receive

 

 

 

 

}the transfer.

 

 

 

 

State

Zip Code

I conirm the accuracy of the information in this section and the identity of the individual named above. As a representative of the inancial institution or plan to which the funds are being transferred, I certify that the inancial institution or plan agrees to accept the funds directly from the Thrift Savings Plan and deposit them into the IRA or eligible employer plan identiied above.

45.

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

46.

Signature of Certifying Representative

Do Not Write Below This Line

()

Daytime Phone (Area Code and Number)

47. / /

Date Signed (mm/dd/yyyy)

Form TSP-77, Page 4 (1/2018)

PREVIOUS EDITIONS OBSOLETE

FORM TSP-77, INFORMATION AND INSTRUCTIONS FOR PAGE 4

SECTION XI. You may transfer all or any part of the Roth por­ tion of your withdrawal to a Roth IRA or to a Roth account maintained by an eligible employer plan. Enter a percentage between 1 and 100% in Item 41. 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 nec­ essary for your Roth earnings to be qualiied (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 em­ ployer plan are taxable and are subject to the mandatory 20% federal income tax withholding. Roth earnings become quali­ ied when the following two conditions are met: (1) 5 years have passed since January 1 of the calendar year in which you made your irst 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 deinition of a disability when your taxes are reported. There­ fore, you must provide the justiication to the IRS when you ile your taxes.

Read the TSP tax notice Important Tax Information About Payments From Your TSP Account for detailed tax rules.

SECTION XII. If you choose to transfer all or any part of the Roth portion of your withdrawal to a Roth IRA or to a Roth ac­ count maintained by an eligible employer plan, your inancial institution or plan administrator must complete this section before you submit this form to the TSP.

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

Information for the IRA or Plan: Complete Section XII and return this form to the participant identiied at the top of the page. The inancial institution or plan administrator must en­ sure 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 main­ tained by an eligible employer plan in Item 42, and in Item 43 enter the account number, if available, of the IRA or plan to which the money is to be transferred. If an account num­ ber 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 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 45–47. If we need to contact the inan­ cial institution or plan for more information, the individual named here will be used as the contact person.

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 ofices, private sector audit irms, spouses, former spouses, and beneiciaries, and their attorneys. We may disclose relevant portions of the information to appropriate parties engaged in litigation and for other routine uses as speciied 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.

Form TSP­77 (1/2018)

PREVIOUS EDITIONS OBSOLETE

After completing your withdrawal request, 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 automatically cancel the second request it receives. If you need to make a change or correction on your form, call the TSP to cancel your irst request. If the TSP has processed your form prior to receiving your call, your transaction cannot be reversed.

If you have questions, call the toll­free ThriftLine at 1­877­968­3778 or the TDD at 1­877­847­4385. Outside the U.S. and Canada, please call 404­233­4400 (not toll free).

Form TSP-77 (1/2018)

PREVIOUS EDITIONS OBSOLETE

How to Edit Tsp Form 77 Request Online for Free

When using the online PDF editor by FormsPal, you're able to fill in or edit Tsp Form 77 Request here. In order to make our editor better and simpler to work with, we constantly develop new features, with our users' suggestions in mind. To get the process started, take these basic steps:

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1. Whenever filling in the Tsp Form 77 Request, ensure to include all of the important blank fields within the corresponding area. It will help to expedite the process, which allows your details to be processed fast and accurately.

Stage number 1 in filling in Tsp Form 77 Request

2. The third step is usually to fill out these particular blank fields: Savings, ACH Routing Number Must be digits, Checking or Savings Account Number, V ADDITIONAL TAX WITHHOLDING This, In addition to the mandatory, VI CERTIFICATION AND NOTARIZATION, request is true and complete to, Participants Signature Notary, day of, Date Signed mmddyyyy, Month, Year, Date mmddyyyy, Notarys Signature, and Notarys Phone Number.

Step no. 2 in filling out Tsp Form 77 Request

3. Within this part, examine Notarys Printed Name, Jurisdiction, Do Not Write Below This Line, Notarys Phone Number, P I I S P I I S, and FORM TSP Page PREVIOUS EDITIONS. These will have to be completed with highest focus on detail.

Tsp Form 77 Request conclusion process outlined (part 3)

As for Do Not Write Below This Line and P I I S P I I S, ensure that you double-check them in this section. Those two could be the key fields in the form.

4. Your next paragraph needs your input in the subsequent places: Name, Last First Middle, TSP Account Number, VII MARRIED FERS AND UNIFORMED, spouses signature must be notarized, Spouse By signing below I consent, the amount withdrawn will not be, Spouses Name Last First Middle, Spouses Signature, Date Signed mmddyyyy, Notary Please complete the, day of, Month, Year, and Date mmddyyyy. Just remember to enter all of the required info to move further.

The best way to complete Tsp Form 77 Request part 4

5. As a final point, the following final subsection is precisely what you should wrap up before submitting the PDF. The blanks under consideration include the next: Date mmddyyyy, Notarys Signature, seal, Notarys Printed Name, Jurisdiction, Notarys Phone Number, Participant If you cannot obtain, Spouses Social Security Number, VIII MARRIED CSRS PARTICIPANTS, Spouses Name Last First Middle, Is your spouses address the same, Yes, No Complete Items, Dont know spouses address Provide, and Spouses Social Security Number.

Part no. 5 of submitting Tsp Form 77 Request

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