Edit, Download, and Sign the Rollover In/Plan-to-Plan Transfer In Form 457(b)
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How do I fill this out?
To fill out this form, start by gathering all required personal and plan information. Carefully select your type of request in Section C and provide accurate details in Section D. Make sure to sign and submit the form according to the instructions provided.

How to fill out the Rollover In/Plan-to-Plan Transfer In Form 457(b)?
1
Collect your plan and personal information.
2
Choose the type of request: rollover or transfer.
3
Fill in the details about the account involved.
4
Sign and date the form.
5
Submit the completed form as instructed.
Who needs the Rollover In/Plan-to-Plan Transfer In Form 457(b)?
1
Employees transitioning to a new job need to rollover their retirement funds.
2
Individuals planning for retirement who want to consolidate their accounts.
3
Beneficiaries of a deceased participant seeking to transfer funds.
4
Financial advisors helping clients manage retirement savings.
5
Participants of a previous employer's plan interested in moving funds.
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What are the instructions for submitting this form?
To submit this form, send it along with any required documentation to MassMutual. You can fax it to 1-860-843-3280 or call their Customer Service Center at 1-800-528-9009 for further assistance. Additionally, you can visit retire.hartfordlife.com for online support and submission.
What are the important dates for this form in 2024 and 2025?
For 2024, important deadlines for plan transfers may vary by plan but generally align with year-end and quarterly statements. It's advisable to initiate rollovers before planned employer retirement contributions. For 2025, review your plan's specific dates as they become available.

What is the purpose of this form?
The purpose of this form is to facilitate the transfer or rollover of retirement funds into a 457(b) plan. It allows participants to consolidate their retirement savings from previous employers or accounts into their new retirement plan. Proper use of this form ensures compliance with tax regulations and maintains the tax-deferred status of the funds.

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

- 1. Section A: Plan Information including group number and plan name.
- 2. Section B: Participant Information such as SSN, name, and contact details.
- 3. Section C: Type of Request indicating whether it's a rollover or plan-to-plan transfer.
- 4. Section D: Rollover/Transfer Request detailing the specific amounts and account information.
- 5. Section E: Participant Authorization where the participant signs off.
- 6. Section F: Current Plan Administrator's Acceptance to certify eligibility.
- 7. Section G: Payment Information for where to send checks or electronic transfers.
- 8. Section H: Important Information regarding good order, stale address, and the parties involved.
What happens if I fail to submit this form?
Failure to submit this form correctly may result in delays in processing your rollover or transfer request. Without a complete and accurate submission, your funds could remain in their current account, preventing planned transfers or consolidations. It is crucial to follow all instructions to ensure timely processing.
- Incomplete Information: Sections left blank or inaccurately filled can lead to processing delays.
- Missing Signatures: Without the necessary signatures, your request will not be authorized.
- Incorrect Submission Method: Submitting to the wrong address or department can delay your request.
How do I know when to use this form?

- 1. Job Transition: Employees leaving a job and needing to transfer retirement savings.
- 2. Consolidation of Accounts: Individuals wanting to merge multiple retirement accounts into one.
- 3. Beneficiary Claims: Beneficiaries retrieving funds from deceased plan participants.
- 4. Financial Advisement: Financial advisors assisting clients with retirement fund management.
- 5. Compliance with Plan Rules: Ensuring adherence to internal revenue regulations during transfers.
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How can I ensure my changes are saved?
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Do I need to provide any additional documents?
Yes, attach a current statement of your account when you submit the form.
Where do I submit the completed form?
Please submit your completed form to MassMutual's retirement services as instructed on the form.
Can I get help filling out the form?
Yes, you can reach out to MassMutual's Customer Service for assistance.
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