Transaction Forms for Pearland ISD - Pearland, TX

Please Note: The list below is for general reference only. Your organization's 403(b)/457(b) Plan(s) may not permit all transaction types listed.

I am seeking to withdraw funds from my 403(b) plan +

I am seeking to obtain a cash distribution +
You have selected a DISTRIBUTION transaction. IRS regulations allow for any individual who is 59 1/2 years of age and/or separated from service to withdraw funds from their 403(b) plan as a DISTRIBUTION.
I am seeking to move 403(b) funds to an IRA +
You have selected a DISTRIBUTION transaction. IRS regulations allow for any individual who is 59 1/2 years of age and/or separated from service to withdraw funds from their 403(b) plan as a DISTRIBUTION.
I am facing a financial hardship, and need an emergency distribution +
You have selected a HARDSHIP transaction. A hardship distribution is a distribution of funds from your 403(b) account due to an immediate and heavy financial need. Six circumstances are deemed by the IRS to constitute an immediate and heavy financial need:
  • Medical expenses for the employee or his/her spouse or dependents
  • Costs for the purchase of a principal residence
  • Tuition and related educational expenses for the employee or his/her spouse or dependents
  • Payments necessary to prevent eviction from or foreclosure on a primary residence
  • Burial or funeral expenses for the employee’s parent, spouse, or dependents
  • Repair of damage to the employee’s principal residence
  • Proof of one or more of the above circumstances must be provided before a hardsip can be approved.
I wish to obtain a 403(b) loan +
You have selected a LOAN transaction. Please ensure you have spoken with your Service Provider before proceeding to ensure that you are eligible for a loan and agree to the terms of repayment.
I am disabled, and wish to take funds from my 403(b) +
You have selected a DISABILITY transaction. Early 403(b) withdrawals are sometimes permissible in the event that you become permanently disabled.
I am seeking to obtain a Service Credit, or to buy-back time +
You have selected a SERVICE CREDIT transaction. A SERVICE CREDIT transaction is a transfer of funds from a 403(b) account to purchase service credit in a tax-qualified defined benefit governmental plan.

I am seeking to move my money (to an IRA, 401(k), etc) +

I am seeking to move my funds to an IRA +
You have selected a DISTRIBUTION transaction. IRS regulations allow for any individual who is 59 1/2 years of age and/or separated from service to withdraw funds from their 403(b) plan as a DISTRIBUTION.
I am seeking to withdraw money from my current/former employer’s 403(b) and move it to a 457 plan +
You have selected a DISTRIBUTION transaction. IRS regulations allow for any individual who is 59 1/2 years of age and/or separated from service to withdraw funds from their 403(b) plan as a DISTRIBUTION.
I am seeking to withdraw money from my current/former employer’s 403(b) and move it to another plan type +
You have selected a DISTRIBUTION transaction. IRS regulations allow for any individual who is 59 1/2 years of age and/or separated from service to withdraw funds from their 403(b) plan as a DISTRIBUTION.

I have not switched employers, but wish to move money from my current 403(b) Service Provider to another 403(b) Service Provider +

I am seeking to move funds from one 403(b) fund company to another fund company under my current employer’s plan +
You have selected an EXCHANGE transaction. An EXCHANGE is defined the transfer of your 403(b) assets from one 403(b) Service Provider to another of your employer’s participating 403(b) Service Providers.
I am seeking to move funds from one 403(b) fund company to another fund company under my previous employer’s plan +
You have selected an EXCHANGE transaction. An EXCHANGE is defined the transfer of your 403(b) assets from one 403(b) Service Provider to another of your employer’s participating 403(b) Service Providers.

I am seeking to move money from another plan type (IRA, 457, or 401(a), etc) into my current employer’s 403(b) Plan +

You have selected a ROLLOVER transaction. A ROLLOVER is defined as moving funds from another form of tax sheltered retirement savings account, such as a 401(k) or IRA, into your 403(b) plan your with one of your employer's participating 403(b) Service Providers.Please note that the acceptance of Rollover funds into a 403(b) Plan is an option item under an employer’s plan. Please call our Service team at 1-877-544-6664 to verify if your employer allows this transaction.

I am seeking to move money from my former employer’s 403(b) Plan to my current employer’s 403(b) Plan +

You have selected a TRANSFER transaction. A TRANSFER is defined as the moving of your 403(b) assets from a plan under a former employer to that of your current employer. Please note that acceptance of a transfer in or out of a 403(b) is an optional item under an employer’s plan. The ability to submit a transfer request does not guarantee approval. You will be notified if this transaction is not allowed by your previous or current employer’s plan.

As part of a divorce, I am to receive/distribute 403(b) assets +

You have selected a QDRO transaction. Please mail or fax us your signed Qualified Domestic Relations Order (QDRO) for review and approval and click the link below to fill out the QDRO Request Form.

Address:

  • U.S. OMNI
  • 220 Alexander Street, Suite 400
  • Rochester, NY 14607
  • Fax : 585-756-5557
  • Attn: Service Provider Team

The Plan Participant has died and I am seeking a distribution from his/her 403(b) account +

You have selected a DEATH CLAIM transaction. Please be aware that an original Death Certificate will be required in order to process this transaction. If you have not, send a certified copy or the original Death Certificate to the service provider team.

Address:

  • U.S. OMNI
  • 220 Alexander Street, Suite 400
  • Rochester, NY 14607
  • Attn: Service Provider Team

I am seeking to take my Required Minimum Distribution +

You have selected a RMD transaction. The IRS requires participants to make minimum withdrawals each year once they turn age 72 to avoid penalties. Once approved, please hold on to your certificate as it will not expire and can be used for future Required Minimum Distributions without the need to complete the form each year.

Please Note: The list below is for general reference only. Your organization's 403(b)/457(b) Plan(s) may not permit all transaction types listed.

Death Claim +

403(b) / 457
In the unfortunate event that you are the beneficiary of a deceased 403(b) participant, you may want to obtain a distribution from the plan in question. Start by contacting the deceased’s Service Provider to request a distribution as the beneficiary of the plan- if possible, be prepared to supply the Service Provider with a Death Certificate

After obtaining the necessary paperwork from the 403(b) Service Provider, complete the online Death Claim Form. If the Service Provider was not already supplied with the Death Certificate one must be mailed to OMNI. Please note - only the original or a certified copy of the Death Certificate will be accepted, and this document cannot be emailed or faxed. Once we confirm the participant as being deceased, we will email the beneficiary the certificate approval, which should be printed and submitted to the Service Provider with any required paperwork.

Disability +

403(b)
Early 403(b) withdrawals are sometimes permissible in the event that you become permanently disabled. After completing your Service Provider’s distribution paperwork, fill out the online Disability Request Form.

OMNI will verify any necessary information with your current or former employer before authorizing your transaction and emailing you a Certificate of Approval . Typical turnaround time for this transaction is between five and eight business days. Once a certificate of approval has been issued, it should be printed and submitted to your Service Provider with any required paperwork.
457
Not Allowed by IRS

Distribution +

403(b)
IRS regulations allow for any individual who is 59 1/2 years of age and/or separated from service to withdraw funds from their 403(b) plan. If you meet these criteria, your first step will be to contact your 403(b) service provider to request a distribution.

After completing your Service Provider’s distribution paperwork, fill out the online Distribution Request Form. OMNI will verify any necessary information with your current or former employer before authorizing your transaction and will email a Certificate of Approval, which should be printed and submitted to the Service Provider with any required paperwork .
457
IRS regulations allow for any individual who is 70 1/2 years of age (or 59 1/2 depending on your plan's features) and OR separated from service to withdraw funds from their 457 plan. If you meet these criteria, your first step will be to contact your 457 service provider to request a distribution. After completing your Service Provider’s distribution paperwork, fax the completed documents to OMNI’s Service Provider Team at 585-756-5557. In some cases, original paperwork may need to be submitted.

OMNI will verify any necessary information with your current or former employer before authorizing your transaction and returning it directly to your 457 Service Provider for payout. Typical turn around times for this transaction are between five and eight business days. If at any point you would like a status update on the progress of your distribution, feel free to contact OMNI’s Customer Care Team at 877-544-6664.

Exchange +

403(b) / 457
This refers to the transfer of your 403(b) assets from one 403(b) Service Provider to another of your employer’s participating providers. As with a rollover, you will want to obtain paperwork from your receiving vendor (who must be on your current employer’s list of participating vendors), to initiate this transaction.

After contacting your sending provider to obtain any paperwork that may be required, complete the online Exchange Request Form. OMNI will email the certificate of approval within 2-3 business days, which should be printed and submitted to your Service Provider with their required paperwork.

Hardship +

403(b)
A hardship distribution is a distribution of funds from your 403(b) account due to an immediate and heavy financial need. Seven circumstances are deemed by the IRS to constitute an immediate and heavy financial need:
  • Medical expenses for the employee or his/her spouse or dependents
  • Costs for the purchase of a principal residence
  • Tuition and related educational expenses for the employee or his/her spouse or dependents
  • Payments necessary to prevent eviction from or foreclosure on a primary residence
  • Burial or funeral expenses for the employee’s parent, spouse, or dependents
  • Repair of damage to the employee’s principal residence
  • Expenses and losses incurred on account of a FEMA declared disaster
Other requirements particular to hardship distributions are:
  • The amount of the hardship distribution cannot exceed the amount of the immediate and heavy financial need.
  • Hardship distributions can only be made from employee contributions and qualified employer non-elective and matching contributions made to a non-custodial account.
Your employer has hired U.S. OMNI to authorize hardship distributions from its 403(b) plan. Accordingly, OMNI only approves hardship distributions meeting one of the seven categories and requires supporting documentation. Particular requirements and examples of supporting documentation for each of the categories are listed below.

1. Medical expenses for the employee or his/her spouse or dependents
REQUIREMENTS:
Expenses must not be covered by insurance. If the participant is not the recipient of the medical care, documentation showing the relationship must be provided (e.g. copy of federal tax return; marriage certificate)
SUPPORTING DOCUMENTATION:
- Medical bill dated within the last 3 months showing the amount due
- Explanation of benefits from your insurance company dated within 3 months
- Notice from collection agency dated within 3 months
- Estimate of treatment costs from your doctor dated within 3 months

2. Costs for the purchase of a principal residence
REQUIREMENTS:
Costs do not include mortgage payments
SUPPORTING DOCUMENTATION:
- Purchase contract AND Good Faith Estimate (if applicable).
- Purchase contract must be signed by both buyer and seller.
- Purchase contract must include selling price and property address.
- Closing date in purchase contract must not have passed

3. Tuition and related educational expenses for the employee or his/her spouse or dependents
REQUIREMENTS:
Educational expenses must be for the next 12 months of post secondary education
SUPPORTING DOCUMENTATION:
- Tuition, room and board and/or meal plan bill not covered by financial aid or loans
- Written estimate of book costs Lease agreement for off campus housing
- Written estimate of projected costs AND course catalog information and fee schedules on educational institution letterhead
- If the employee is not the student, documentation showing the relationship must be provided (e.g. copy of federal tax return; marriage certificate)

4. Payments necessary to prevent eviction from or foreclosure on a primary residence
REQUIREMENTS:
The eviction date or date for payment must not have passed
SUPPORTING DOCUMENTATION:
- Eviction notice showing the monthly rental amount and amount necessary to prevent eviction
- Notice of delinquency showing the amount of past due rent
- Foreclosure notice from the mortgage company showing the amount that is past due
- Notice from the mortgage company showing the amount past due in mortgage payments and payment deadline to avoid foreclosure
- Court order indicating foreclosure and an amount that is necessary to prevent foreclosure and payment deadline date
- Letter from an attorney indicating the amount necessary to reinstate the mortgage or redeem the property and payment deadline date

5. Burial or funeral expenses for the employee’s parent, spouse, or dependents
SUPPORTING DOCUMENTATION:
- Documentation demonstrating the relationship must be provided (e.g. copy of death certificate; copy of federal tax return; copy of participant birth certificate )
- Statement from the funeral home showing the related costs and services
- Statement from the cemetery for burial costs

6. Repair of damage to the employee’s principal residence
REQUIREMENTS:
Expenses must be for the repair of damage caused by an event that is sudden or unexpected. (Home improvements do not qualify)
SUPPORTING DOCUMENTATION:
- Contractors estimate or bill showing the cause of damage and cost of repair and dated within the last 3 months
- Explanation of insurance benefits showing any repairs not covered by insurance

7. Expenses and losses (including loss of income) incurred by the Employee on account of a FEMA declared disaster, provided that the Employee's principal residence or principal place of employment at the time of the disaster was located in an area designated by FEMA for individual assistance with respect to the disaster.
SUPPORTING DOCUMENTATION:
- Contractor estimates or bill relating to repairs to residence damage caused by the FEMA disaster.
- Receipts for employee expenses that were incurred because of the FEMA disaster area.

Hardship Requests require completed service provider paperwork along with supporting documentation, and must be accompanied by OMNI’s Hardship Distribution Request Form. Supporting documentation can be scanned and uploaded through the website or faxed to 585-756-5557.
457
See Unforseeable Emergency (below)

Unforeseeable Emergency Withdrawal +

403(b)
See Hardship section above
457
This is a distribution of funds from your 457 account due to severe financial need. Four circumstances are deemed by the IRS to constitute a severe need:
  • Medical expenses for the employee or his/her spouse or dependents
  • Payments necessary to prevent eviction from or foreclosure on a primary residence
  • Burial or funeral expenses for the employee’s parent, spouse, or dependents
  • Repair of damage to the employee’s principal residence
Other requirements particular to an Unforeseeable Emergency Withdrawal are:
  • The amount of the distribution cannot exceed the amount of the severe financial need.
  • Unforeseeable Emergency distributions can only be made from employee contributions and cannot be made from earnings on those contributions.
Your employer has hired U.S. OMNI to authorize Unforeseeable Emergency Withdrawals from its 457 plan. Accordingly, OMNI only approves distributions meeting one of the four categories and requires supporting documentation. Particular requirements and examples of supporting documentation for each of the categories are listed below.

1. Medical expenses for the employee or his/her spouse or dependents
REQUIREMENTS:
Expenses must not be covered by insurance. If the participant is not the recipient of the medical care, documentation showing the relationship must be provided (e.g. copy of federal tax return; marriage certificate)
SUPPORTING DOCUMENTATION:
- Medical bill dated within the last 3 months showing the amount due
- Explanation of benefits from your insurance company dated within 3 months
- Notice from collection agency dated within 3 months
- Estimate of treatment costs from your doctor dated within 3 months

2. Payments necessary to prevent eviction from or foreclosure on a primary residence
REQUIREMENTS:
The eviction date or date for payment must not have passed
SUPPORTING DOCUMENTATION:
- Eviction notice showing the monthly rental amount and amount necessary to prevent eviction
- Notice of delinquency showing the amount of past due rent
- Foreclosure notice from the mortgage company showing the amount needed to reinstate the mortgage
- Notice from the mortgage company showing the amount past due in mortgage payments and payment deadline to avoid foreclosure
- Court order indicating foreclosure and an amount that is necessary to prevent foreclosure and payment deadline date
- Letter from an attorney indicating the amount necessary to reinstate the mortgage or redeem the property and payment deadline date

3. Burial or funeral expenses for the employee’s parent, spouse, or dependents
SUPPORTING DOCUMENTATION:
- Documentation demonstrating the relationship must be provided (e.g. copy of death certificate; copy of federal tax return; copy of participant birth certificate )
- Statement from the funeral home showing the related costs and services
- Statement from the cemetery for burial costs

4. Repair of damage to the employee’s principal residence
REQUIREMENTS:
Expenses must be for the repair of damage caused by an event that is sudden or unexpected. (Home improvements do not qualify)
SUPPORTING DOCUMENTATION:
- Contractors estimate or bill showing the cause of damage and cost of repair and dated within the last 3 months
- Explanation of insurance benefits showing any repairs not covered by insurance

All Unforeseeable Emergency Withdrawal requests must be accompanied by OMNI’s 457 Unforeseeable Emergency Withdrawal Request Form.

Loan +

403(b) / 457
Many Service Providers allow for participants to take a loan against the assets held in their plan. If your Service Provider allows for loans, you will start the process by contacting them directly to request this transaction. It is important to note that Loans will need to be repaid (often with interest). Your Service Provider will work with you to decide on the technicalities of your loan, including the manner in which it will be repaid.

After completing your Service Provider’s Loan Paperwork, fill out OMNI’s Loan Request Form. OMNI will contact your Service Provider to confirm your eligibility and the maximum amount you may borrow. OMNI will then email a certificate of approval within 3-5 business days, which should be printed and submitted to your Service Provider with their required paperwork.

If the amount requested exceeds the available loan amount, OMNI will issue an approval for the maximum amount allowed by the Service Provider. We strongly advise confirming the available amount with your Service Provider before submitting this request.

Qualified Domestic Relations Order (QDRO) +

403(b) / 457
A Qualified Domestic Relations Order (QDRO) is a court order necessary for the distribution of a participant’s account to a former spouse. A QDRO is commonly separate from a judgment of divorce, and provides the specifics of how the funds are to be divided.

OMNI will review the court order to ensure compliance with applicable regulatory requirements. Upon approval of the court order, OMNI will forward its findings to the distributing service provider(s) and all other parties involved. OMNI also reviews drafts of orders prior to submission to a judge for signature in an effort to facilitate a smooth transaction once the signed order is submitted to OMNI for approval. Please note the service provider(s) may require additional paperwork to complete the transaction and an original or certified copy of the court order.

Court orders may be sent via fax to OMNI’s Service Provider Team at 585-756-5557 or mailed to 220 Alexander Sreet, Suite 400, Rochester, NY 14607 .

Please be advised that once OMNI has been notified of a divorce – whether completed or pending – no transactions taken on the account will be approved until we receive the signed QDRO (if former spouse has a claim) or the Judgement of Divorce and Settlement Agreement confirming that the former spouse has no claim on the account.

Required Minimum Distribution +

403(b) / 457
Required minimum distribution from Plan where participant is within the calendar year of attaining the age of 72 or later. For more details, please visit our Transaction Information page or contact OMNI.

Rollover +

403(b)
In the event that you are moving funds from another form of tax sheltered retirement savings account, such as a 401(k) or IRA, to your 403(b) plan, your first step will be to contact OMNI to confirm whether this transaction is allowed under your employer’s plan . If so, you should establish a 403(b) plan with one of your employers Participating Providers. After establishing your plan, obtain your receiving vendor’s rollover paperwork.

Once you have received the Service Provider paperwork, complete the online Rollover Request Form. OMNI will email the certificate of approval within 2-3 business days, which should be printed and submitted to your Service Provider with their required paperwork.

Please note OMNI’s Rollover Form is classified as the transfer of funds from a non-403(b) account into a 403(b). For transfers out of the 403(b) plan into any other type of retirement plan (such as 401(k) or IRA), please use OMNI’s Distribution Form.
457
In the event that you are moving funds from another form of tax sheltered retirement savings account, such as a 401(k) or IRA, to your 457 plan your first step will be to establish a 457 plan with one of your employers Participating Providers. After establishing your plan, obtain your receiving vendor’s rollover paperwork, or obtain a Letter of Acceptance (LOA) indicating their ability to accept your funds.

After contacting your sending provider to obtain any paperwork that may be required, fax the completed documents to OMNI’s Service Provider Team at 585-756-5557. In some cases, original paperwork may need to be submitted.

Service Credit +

403(b) / 457
Transfer of funds from a 403(b) account to purchase service credit in a tax-qualified defined benefit governmental plan (i.e., pension plan).

To request approval for the purchase of service credit, obtain any Service Provider paperwork and fill out the Service Credit Request Form. OMNI will email the certificate of approval, which should be printed and submitted to the Service Provider directly.

Transfer +

403(b) / 457
This refers to the transfer of your 403(b) assets from a plan under a former employer to that of your current employer. Your first step should be to establish a 403(b) plan with one of your current employer’s Participating Providers. After establishing the plan, obtain any paperwork that is required for the transfer of funds and complete the online Transfer Request Form. OMNI will email the certificate of approval within 2-3 business days, which should be printed and submitted to your Service Provider with their required paperwork

Please note that a transfer is an optional transaction for employers. The ability to submit a transfer request does not guarantee that a transfer will be approved by either the former or the current employer. If a transfer is not allowed by an employer’s plan, you will be notified accordingly.

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