[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-301280-105":53,"doc-detail-301280-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","distribution-form-fax-completed-forms","Distribution Form - Fax Completed Forms","","Distribution Form for retirement funds from the SchoolsFirst FCU/Nationwide Retirement Builder Plan or SchoolsFirst FCU 457(b) plan, including instructions for retirement fund distribution, beneficiary death distribution, withdrawal reason selection, and payment scheduling. Collects participant and beneficiary identifying information, withdrawal type (one-time or periodic), fund allocation percentages, tax withholding elections, and delivery method. Includes participant/beneficiary certification and waiver of the 30-day review notice, plus TPA/custodian boxes and processing timing.",{"@graph":63,"@context":123},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/distribution-form-fax-completed-forms/301280/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/distribution-form-fax-completed-forms/301280.png","ImageObject",442,249,{"name":88,"@type":89},"wps_ap_test_251126_0180","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-24","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",6,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115,119],{"name":106,"@type":107,"acceptedAnswer":108},"What is this Distribution Form used for?","Question",{"text":109,"@type":110},"It initiates a one-time or periodic distribution of retirement funds from the specified SchoolsFirst FCU/Nationwide or SchoolsFirst FCU 457(b) plan. The form also supports death distributions when applicable.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"When will I receive Form 1099-R after submitting this request?",{"text":114,"@type":110},"Form 1099-R is provided in January of the year following the distribution for tax filing purposes.",{"name":116,"@type":107,"acceptedAnswer":117},"How do I choose between one-time and periodic payments?",{"text":118,"@type":110},"Select the Payment Type as One-time Payment or Periodic Payments. For periodic payments, you can choose the processing frequency (monthly, quarterly, semi-annually, or annually).",{"name":120,"@type":107,"acceptedAnswer":121},"What delivery and payment options are available?",{"text":122,"@type":110},"You may select delivery by regular mail, overnight check, sending to a SchoolsFirst FCU account, or a wire option where applicable. Wire funds require a voided check attachment, and wire is not available for periodic distributions.","https://schema.org",{"og:url":78,"og:type":125,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":127,"canonical":78},"index,follow",{"doc_id":129,"site_id":56},301280,1790178766,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":88,"user_avatar":134,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":140,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":61,"update_tm":144,"read_time":9},8796095027276,"https://avatar.qwps.com/avatar/d3BzX2FwX3Rlc3RfMjUxMTI2XzAxODA=","Distribution Form  \nPAGE 1 OF 2 FAX COMPLETED FORMS TO: 714.258.4051  \n\n| Submission of this form initiates a one-time or periodic distribution of retirement funds from the SchoolsFirst FCU/Nationwide Retirement Builder Plan or SchoolsFirst FCU 457(b) DCP Share Certificate. You will receive a Form 1099-R in January of the year following the distribution for tax filing purposes. Do not use this form when requesting a rollover or transfer.\u003Cbr>Note: Please allow 5-7 business days for the processing of this request. |\n| --- |\n| 1 Participant Information\u003Cbr>First Name Last Name Social Security Number (REQUIRED) Date of Birth Street Address City State Zip Code Phone \\# School District Email Address |\n| 2 Reason For Withdrawal\u003Cbr> Separated from Employment/Retired [Date: ___________ ]\u003Cbr> Over Age 59 ½  Age 72\u003Cbr> Correction of Excess Contribution [Year: ______________ ]\u003Cbr>Provide documentation for Disability or Death\u003Cbr> Permanent and Total Disability (403b)  Death (Complete Section 3)\u003Cbr>Note: Part-time, substitute and adjunct employees are not considered separated from employment. |\n\n3 Death Distribution – Beneficiary Information Participant Date of Death:  \nSurviving Spouse:  Yes  No  \nComplete this section only if requesting a death distribution. ________________________  \nPlease provide a copy of the participant’s death certificate and the beneficiary’s photo ID. Each beneficiary must complete their own form.  \nBeneficiary Name  \nSocial Security Number (REQUIRED)  \nDate of Birth  \nBeneficiary Mailing Address City State Zip Code Phone \\#  \n4 Withdrawal Instructions  \nA. Distributing Plan Type:  \n 403(b)  Roth 403(b)  401(a)  457(b) (Select the appropriate 457(b) below)  \n  SchoolsFirst FCU 457(b) DCP Share Certificate   \n Nationwide Retirement Builder Plan 457(b) DCP Member \\# DCP Share ID  \nB. Payment Type:  \n One-time Payment  \n Periodic Payments (Processed on the 1st business day of the month)  \n1) Action:  \n Begin  Change  Cancel  \n2) Frequency:  \n Monthly  Quarterly (January, April, July, October)  Semi-Annually  Annually (Indicate Month   )  \nC. Amount:  \n Full Withdrawal  \n\n|  Partial Withdrawal/Periodic Payment Amount\u003Cbr> $   Gross (Amount Before Taxes – Default)  RMD (Required Minimum Distribution) |  Net (Amount After Taxes) |\n| --- | --- |\n\nPAGE 2 OF 2 FAX COMPLETED FORMS TO: 714.258.4051  \n\n| D. Fund Selection Options: (Funds will be liquidated from your Nationwide account proportionally unless otherwise specified) |  |  |  |\n| --- | --- | --- | --- |\n|  | Fund Name | Fund Code | Percentage % |\n|  | Fund Name | Fund Code | Percentage % |\n| 5 | Tax Withholding\u003Cbr>Distributions paid directly to you will be subject to mandatory withholdings. If you are under 59 ½, an additional 10% withdrawal penalty may apply upon tax filing.\u003Cbr>Federal: 20% +   %(additional percentage)\u003Cbr>CA State*: 2% +   %(additional percentage)\u003Cbr>*Varies by state | For RMD | amount only, no taxes are withheld unless indicated below. Please elect the following tax withholdings:\u003Cbr>Federal:   % State:   % |\n\n6 Delivery Method  \n Check by Regular Mail  Overnight Check ($20 fee)  \n Send to my SchoolsFirst FCU Account  \nMember Number:   Share ID:    Wire Funds (Wire option not available for periodic distributions)  Send to an Outside Financial Institution (Not available on DCP Share Certificate)  Wire Funds *Please attach a voided check  \n  Checking  Savings  Your Financial Institution  \nName on Account Routing \\# Account \\#  \n7 Signatures  \nI certify that I am the proper party to receive payments from this plan, and that all information provided by me, including my tax identification number is true and accurate. I further certify that no tax advice has been given to me by the Employer or the Trustee/Custodian and that all decisions regarding this withdrawal are my own. I certify that I have been given written notification of my distribution options and have had the opportunity to consider the decision whether or not to elect a direct rollover for a m","cbCaijYnIlo4pdHN","https://ap.wps.com/l/cbCaijYnIlo4pdHN","pdf",237541,"English","# Participant Information\n# Reason For Withdrawal\n## Death Distribution – Beneficiary Information\n## Withdrawal Instructions\n# Tax Withholding\n# Delivery Method\n# Signatures","[{\"question\":\"What is this Distribution Form used for?\",\"answer\":\"It initiates a one-time or periodic distribution of retirement funds from the specified SchoolsFirst FCU/Nationwide or SchoolsFirst FCU 457(b) plan. The form also supports death distributions when applicable.\"},{\"question\":\"When will I receive Form 1099-R after submitting this request?\",\"answer\":\"Form 1099-R is provided in January of the year following the distribution for tax filing purposes.\"},{\"question\":\"How do I choose between one-time and periodic payments?\",\"answer\":\"Select the Payment Type as One-time Payment or Periodic Payments. For periodic payments, you can choose the processing frequency (monthly, quarterly, semi-annually, or annually).\"},{\"question\":\"What delivery and payment options are available?\",\"answer\":\"You may select delivery by regular mail, overnight check, sending to a SchoolsFirst FCU account, or a wire option where applicable. Wire funds require a voided check attachment, and wire is not available for periodic distributions.\"}]","Distribution Form - Fax Completed Forms | PDF",1789780670]