Forms and Publications

PERAPlus 401(k) Plan

Forms and Publications

Forms and Publications are provided in this section as viewable files that can be printed. Forms cannot be completed online because they must be filled out, signed and, in some cases notarized, before they can be accepted by the PERAPlus’s 401(k) Plan.

The Hardship Withdrawal Form is now available as a prefilled form. The prefilled form may be accessed at menu option Account, Withdrawals, Request a Withdrawal.

To view the desired package or form, simply click on the title in the following list:

401(k) Contribution Authorization Form

401(k) Plan Loan Partial Prepayment Form

401(k) Participant Information Form

Beneficiary Designation Form

Birth or Adoption Withdrawal Form

Enrollment Package

In Plan Conversion Fact Sheet

In-Plan Conversion Request

Loan Automatic Payment and Direct Deposit Authorization Form

Loan Request Package

Participant Employment Termination Notification Form

PERAPlus Loan Verification

Plan Comparison

Plan Overview

Rollover Form

Roth Comparison Chart – 401(k) Plan

Roth Comparison Chart – 401(k) and 457 Plans

Roth Highlights Fact Sheet - 401(k) Plan

Roth Highlights Fact Sheet – 401(k) and 457 Plans

Special Roth Tax Notice

Special Tax Notice

VRA Fact Sheet

Coronavirus-Related Repayment Form

TD Ameritrade Forms for Self-Directed Brokerage Accounts:

401(k) Self-Directed Brokerage Account Application Form

Fact Sheet

Third Party Trading Form for TD Ameritrade Self-Directed Brokerage Accounts