Edit, Download, and Sign the Leech Lake Band of Ojibwe Government 401(K) Loan Form
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How do I fill this out?
To fill out this form, you need to provide your personal and loan information accurately. Ensure all fields are completed and attach the original check made payable to Ascensus Trust. Mail the form and check to the provided address.

How to fill out the Leech Lake Band of Ojibwe Government 401(K) Loan Form?
1
Enter your Social Security Number, first and last name, phone number, email address, and plan number.
2
Specify if it's a Loan Payment or Loan Payoff.
3
Provide the loan number, check amount, and date sent to trust.
4
Fill in the submitted by section with your name and date.
5
Mail the completed form and check to Ascensus Trust.
Who needs the Leech Lake Band of Ojibwe Government 401(K) Loan Form?
1
Employees of the Leech Lake Band of Ojibwe who have taken loans from their 401(K) plan.
2
Plan administrators handling loan repayments for the Leech Lake Band of Ojibwe.
3
Payroll coordinators managing loan payment withholdings.
4
Trustees or custodians of the Ascensus Trust responsible for processing loan payoffs.
5
Financial advisors assisting clients with 401(K) loan payoffs.
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What are the instructions for submitting this form?
Mail the completed Loan Payment/Payoff Transmittal Form and original check made payable to Ascensus Trust to: Ascensus Trust, PO Box 10399, Fargo, ND 58106-0399. For overnight submissions, use Ascensus Trust, 1655 43rd Street South, Suite 100, Fargo, ND 58103. Ensure the check is payable to Ascensus Trust and includes the plan number. Use a separate form for each loan amount/payoff and notify the plan administrator if paying off the loan in full to stop payroll withholdings.
What are the important dates for this form in 2024 and 2025?
Ensure to submit your loan payments/payoffs before the processing deadlines in 2024 and 2025. Stay informed about cutoff dates to avoid delays.

What is the purpose of this form?
The Leech Lake Band of Ojibwe Government 401(K) Loan Payment/Payoff Transmittal Form is designed to facilitate non-payroll related loan payoffs. Accurate submission ensures that loan payoffs are processed without delays, making it essential for employees, plan administrators, and payroll coordinators of the Leech Lake Band of Ojibwe. By adhering to the instructions and submitting the form correctly, the loan payoff process can be streamlined and efficient.

Tell me about this form and its components and fields line-by-line.

- 1. Participant Information: Includes fields for Social Security Number, first name, last name, phone number, email address, and plan number.
- 2. Loan Information: Fields for specifying whether it's a loan payment or payoff, loan number, dollar amount of check, and date sent to trust.
- 3. Submitted By: Section for the submitter's name and date.
- 4. Form Submission Instructions: Provides mailing addresses and important notes for submitting the form and check.
What happens if I fail to submit this form?
Failure to submit this form in good order may result in delays or the request being returned unprocessed.
- Processing Delays: Incorrectly submitted forms can cause significant delays in processing your loan payoff.
- Unprocessed Returns: Forms not in good order may be returned unprocessed, causing further inconvenience.
How do I know when to use this form?

- 1. Non-Payroll Loan Payment: When making a loan payment that is not deducted from your payroll.
- 2. Loan Payoff: When paying off the entire loan amount in full.
Frequently Asked Questions
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Yes, you can edit the form on PrintFriendly using our PDF editor.
How do I fill out the personal information section?
Enter your Social Security Number, first name, last name, phone number, email address, and plan number.
How do I indicate whether it's a loan payment or payoff?
Select the appropriate option, either Loan Payment or Loan Payoff.
What details are needed for the loan information section?
Provide the loan number, check amount, and date sent to trust.
Who should I contact if I have questions about this form?
Contact your plan administrator for any questions regarding the form.
How do I submit the completed form?
Mail the completed form and original check to Ascensus Trust at the provided address.
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How can I share my completed form?
Use PrintFriendly's sharing options to email the form or share via a generated link.
What happens if my form is not in good order?
Your request may be delayed or returned unprocessed if the form is not completed properly.
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Yes, you can download the edited form once you have completed the necessary edits.
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