Form GEN008 "Refund Election" - Alaska

What Is Form GEN008?

This is a legal form that was released by the Alaska Department of Administration - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2020;
  • The latest edition provided by the Alaska Department of Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form GEN008 by clicking the link below or browse more documents and templates provided by the Alaska Department of Administration.

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Download Form GEN008 "Refund Election" - Alaska

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Refund Election
FOR OFFICE USE ONLY
(PERS Tier I/II/III, TRS Tier I/II, JRS)
ALASKA DIVISION OF
Retirement
Benefits
and
Division of Retirement and Benefits
Juneau: (907) 465-4460
Toll-Free: (800) 821-2251
P.O. Box 110203
TDD: (907) 465-2805
alaska.gov/drb
Juneau, AK 99811-0203
Fax: (907) 465-3086
DRB USE ONLY
DB PERS
EMP
BAL
PMT
SE
SIGN
DB TRS
TERM
MAR
10%
WAIVER
CEXP
JRS
(CHECK ONE)
Public Employees’ Retirement System
Teachers’ Retirement System
Judicial Retirement System
SECTION A. PARTICIPANT INFORMATION / TAX REPORTING INFORMATION
NAME (FIRST / M.I. / LAST)
RIN OR LAST FOUR OF SOCIAL SECURITY NUMBER
MAILING ADDRESS (STREET OR P.O. BOX)
CITY
STATE
ZIP+4
EMAIL ADDRESS
HOME TELEPHONE NUMBER
WORK TELEPHONE NUMBER
DATE OF BIRTH (MM / DD / YYYY)
MARITAL STATUS
Married
Divorced
Single
SECTION B. FORM OF PAYMENT REQUESTED
I elect the following lump sum payment:
Payment to Participant: Percent: ________% or Dollar Amount: $____________ (20% mandatory tax withholding required)
(If you would like additional federal income tax withheld, enter additional percent at right ________%)
Direct Transfer/Rollover: Percent: ________% or Dollar Amount: $____________
For a DIRECT TRANSFER/ROLLOVER, please complete the following OR indicate “See Attached” and attach the form from a financial
institution or a new qualified plan which contains the information requested below. Attach that form with your original signature appearing on
the form.
PLAN NAME
ACCOUNT NUMBER (MANDATORY)
PLAN ADDRESS
CITY
STATE
ZIP+4
CONTACT PERSON
TELEPHONE NUMBER
gen008 (Rev. 9/20)
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Refund Election
FOR OFFICE USE ONLY
(PERS Tier I/II/III, TRS Tier I/II, JRS)
ALASKA DIVISION OF
Retirement
Benefits
and
Division of Retirement and Benefits
Juneau: (907) 465-4460
Toll-Free: (800) 821-2251
P.O. Box 110203
TDD: (907) 465-2805
alaska.gov/drb
Juneau, AK 99811-0203
Fax: (907) 465-3086
DRB USE ONLY
DB PERS
EMP
BAL
PMT
SE
SIGN
DB TRS
TERM
MAR
10%
WAIVER
CEXP
JRS
(CHECK ONE)
Public Employees’ Retirement System
Teachers’ Retirement System
Judicial Retirement System
SECTION A. PARTICIPANT INFORMATION / TAX REPORTING INFORMATION
NAME (FIRST / M.I. / LAST)
RIN OR LAST FOUR OF SOCIAL SECURITY NUMBER
MAILING ADDRESS (STREET OR P.O. BOX)
CITY
STATE
ZIP+4
EMAIL ADDRESS
HOME TELEPHONE NUMBER
WORK TELEPHONE NUMBER
DATE OF BIRTH (MM / DD / YYYY)
MARITAL STATUS
Married
Divorced
Single
SECTION B. FORM OF PAYMENT REQUESTED
I elect the following lump sum payment:
Payment to Participant: Percent: ________% or Dollar Amount: $____________ (20% mandatory tax withholding required)
(If you would like additional federal income tax withheld, enter additional percent at right ________%)
Direct Transfer/Rollover: Percent: ________% or Dollar Amount: $____________
For a DIRECT TRANSFER/ROLLOVER, please complete the following OR indicate “See Attached” and attach the form from a financial
institution or a new qualified plan which contains the information requested below. Attach that form with your original signature appearing on
the form.
PLAN NAME
ACCOUNT NUMBER (MANDATORY)
PLAN ADDRESS
CITY
STATE
ZIP+4
CONTACT PERSON
TELEPHONE NUMBER
gen008 (Rev. 9/20)
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SECTION C. SPOUSE WAIVER
. NOT FOR USE BY EX-SPOUSE
(on account balances $5,000 or greater)
(See Section D)
(NAME)
I,__________________
_____________________, agree to the election of the “Form of Payment requested” made in Section B.
SPOUSE SIGNATURE
DATE (MM / DD / YYYY)
Signature witnessed by one of the following: Retirement and Benefits Representative or Postmaster (must include postmaster stamp)
WITNESS SIGNATURE
DATE (MM / DD / YYYY)
TITLE
OR,
SIGNATURE WITNESSED BY A NOTARY
(DAY)
(MONTH)
(YEAR)
(NAME)
On this_
_day of_______
_______20_
_, personally appeared before me ______________
________________ whose identity
I proved on the basis of satisfactory evidence to be the signer of the spouse’s signature above, and he/she acknowledged that he/she executed it.
NOTARY PUBLIC
COMMISSION EXPIRES (MM / DD / YYYY)
SEAL OR
POSTMASTER STAMP
STATE OF
CITY OR COUNTY OF
RESIDING AT
REQUIRED
SECTION D. EX-SPOUSE REQUIRED DOCUMENTATION
If you were married for any length of time while contributing to the Public Employees’ Retirement System (PERS), Teachers’ Retirement System (TRS),
or Judicial Retirement System (JRS) and are now divorced or remarried, please send a court-certified copy of your divorce/ dissolution decree and the
property settlement or documents stating division of property/funds along with this Refund Election form. We will not process your refund request if
we do not have the appropriate ex-spousal documentation.
SECTION E. REINSTATEMENT OF SERVICE / SB 141
(PERS and TRS only. Participant must initial.)
With this election, I fully understand that, if I refund my employee contributions, Senate Bill 141 prohibits me from reinstating this service, which forfeits
my benefit rights under my current PERS / TRS tier.
_________ YOU MUST INITIAL HERE
SECTION F. PAYMENT AUTHORIZATION APPROVAL
I have read all of the instructions and the Special Tax Notice Regarding Plan Payments attached to this form. I understand that I forfeit my eligibility for
benefits and my tier rights if I refund my employee contributions. I further understand that, in order to be valid, elections must conform to the Plan
requirements. I understand that it is my duty to inform you of any Qualified Domestic Relations Order, Child Support Enforcement Order, or Internal
Revenue Service Order that entitles another person to a portion of my account or benefits. I also understand that I must make all changes to my election
prior to the payment date, and I cannot make changes after that date. I hereby certify that the information that I have supplied is true and correct and that
making a false or fraudulent statement(s) for the purpose of obtaining benefit is a criminal and civil offense punishable by law.
The Internal Revenue Service requires that you be given 30 days to review the options described in Section B. You may waive this right by checking the
box below. If you do not waive this 30-day review, PERS / TRS / JRS must delay processing your payment for an additional 30 days.
I WAIVE MY RIGHT OF THE 30-DAY REVIEW PERIOD FOR A DIRECT TRANSFER/ROLLOVER, OR PAYMENT TO PARTICIPANT.
(See General Information.)
In completing this form, I acknowledge that a person who knowingly makes a false statement, or falsifies or permits to be falsified, a record of the retirement
system in an attempt to defraud the system, is guilty of a class A misdemeanor, which, upon conviction, is punishable by a fine of not more than $500.00 or by
imprisonment for not more than twelve months or both. AS 39.35.670; AS 11.56.210. I also acknowledge that a person who obtains funds and/or benefits by
deception may be subject to prosecution for other crimes, including theft, which may be charged as misdemeanors or felonies with potential fines and penalties
including imprisonment. I also acknowledge that a person who obtains funds and/or benefits from the system unlawfully may also be required to make restitution.
PARTICIPANT SIGNATURE
DATE (MM / DD / YYYY)
SOCIAL SECURITY NUMBER
LAST DAY WORKED (MM / DD / YYYY)
SECTIONS A, B, C (IF APPLICABLE), E, AND F MUST BE COMPLETED PRIOR TO PROCESSING. IF NOT, THIS FORM WILL BE RETURNED TO
THE PARTICIPANT. THIS FORM SUPERSEDES ALL OTHER REVISIONS.
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REFUND ELECTION FORM INSTRUCTIONS
GENERAL INFORMATION
Eligibility
You will first be eligible for payment after you have been terminated from employment for 60 days. To receive payment, you must submit a current
completed Refund Election form.
Payments
AFTER you are eligible for payment (60 days from your termination date), refunds are normally issued and mailed the following Wednesday after the
30-day review period from the date the completed Refund Election form is received. You may however, waive this 30-day review period by checking the
waiver box in Section F. If you waive this review period, your refund normally will be issued and mailed the following Wednesday after receipt of the
completed Refund Election form.
Service
Refunded service cannot be used to satisfy vesting, retirement, or disability eligibility requirements. Refunding your employee contributions means you
forfeit your entitlement to benefits.
Rollovers/Transfer
Direct rollovers/transfer will be allowed only if the rollover eligible amount is over $200.
EX-SPOUSE’S OR QUALIFIED DOMESTIC RELATIONS ORDER (QDRO)
If you were married during your employment and the divorce or dissolution document indicates that you are solely entitled to the entire account balance,
you must supply us a court-certified copy of the divorce decree and the property settlement that has been approved by the court that indicates you are
entitled to the entire account.
If a Qualified Domestic Relations Order (QDRO) exists that already allocates a portion of your account to an alternate payee or ex-spouse, you must
supply a court-certified copy of that order.
INCOME TAX AND PENALTY INFORMATION
The State of Alaska and the Division of Retirement and Benefits do not give tax advice.
You are solely responsible to determine how federal
tax law affects your particular situation.
You should contact the Internal Revenue Service or your tax advisor as necessary.
Federal Law requires this plan to provide recipients of eligible rollover distributions a written explanation of the rollover rules, the withholding
requirements, and the tax treatment of amounts not rolled over. Following is the notice as required by the Internal Revenue Service.
Special Tax Notice Regarding Plan Payments For Plan Qualified Under Section 401(A) —
Alaska Defined Benefit PERS, TRS, and JRS
This notice explains how you can continue to defer federal income tax on your retirement savings in the State of Alaska Public Employees Retirement
System, the Alaska Teachers’ Retirement System, and the Judicial Retirement System (the “Plan”) and contains important information you will need
before you decide how to receive your Plan benefits.
This notice is provided to you by the Alaska Division of Retirement and Benefits (your “Plan Administrator”) because all or part of the payment that you
will soon receive from the Plan may be eligible for rollover by you or your Plan Administrator to a traditional IRA or an eligible employer plan. A rollover is
a payment by you or the Plan Administrator of all or part of your benefit to another plan or IRA that allows you to continue to postpone taxation of that
benefit until it is paid to you. Your payment cannot be rolled over to a SIMPLE IRA or a Coverdell Education Savings Account (formerly known as an
education IRA). An “eligible employer plan” includes a plan qualified under section 401(a) of the Internal Revenue Code, including a 401(k) plan,
profit-sharing plan, defined benefit plan, stock bonus plan, and money purchase plan; a section 403(a) annuity plan; a section 403(b) tax-sheltered
annuity; and an eligible section 457(b) plan maintained by a governmental employer (governmental 457 plan).
An eligible employer plan is not legally required to accept a rollover. Before you decide to roll over your payment to another employer plan,
you should find out whether the plan accepts rollovers and, if so, the types of distributions it accepts as a rollover.
You should also find out
about any documents that are required to be completed before the receiving plan will accept a rollover. Even if a plan accepts rollovers, it might not
accept rollovers of certain types of distributions, such as after-tax amounts. If this is the case, and your distribution includes after-tax amounts, you may
wish instead to roll your distribution over to a traditional IRA or split your rollover amount between the employer plan in which you will participate and a
traditional IRA. If an employer plan accepts your rollover, the plan may restrict subsequent distributions of the rollover amount or may require your
spouse’s consent for any subsequent distribution. A subsequent distribution from the plan that accepts your rollover may also be subject to different tax
treatment than distributions from this Plan. Check with the administrator of the plan that is to receive your rollover prior to making the rollover.
If you have additional questions after reading this notice, you can contact your plan administrator indicated on the front of the form.
SUMMARY
There are two ways you may be able to receive a Plan payment that is eligible for rollover:
1. Certain payments can be made directly to a traditional IRA that you establish or to an eligible employer plan that will accept it and hold it for your
benefit (“DIRECT ROLLOVER”); or
2. The payment can be PAID TO YOU.
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REFUND ELECTION FORM INSTRUCTIONS
If you choose a DIRECT ROLLOVER:
• Your payment will not be taxed in the current year and no income tax will be withheld.
• You choose whether your payment will be made directly to your traditional IRA or to an eligible employer plan that accepts your rollover. Your
payment cannot be rolled over to a SIMPLE IRA or a Coverdell Education Savings Account because these are not traditional IRAs.
• The taxable portion of your payment will be taxed later when you take it out of the traditional IRA or the eligible employer plan. Depending on the
type of plan, the later distribution may be subject to different tax treatment than it would be if you received a taxable distribution from this Plan.
If you choose to have a Plan payment that is eligible for rollover PAID TO YOU:
• You will receive only 80% of the taxable amount of the payment, because the Plan Administrator is required to withhold 20% of that amount and
send it to the IRS as income tax withholding to be credited against your taxes.
• The taxable amount of your payment will be taxed in the current year unless you roll it over. Under limited circumstances, you may be able to use special
tax rules that could reduce the tax you owe. However, if you receive the payment before age 59-1/2, you may have to pay an additional 10% tax.
• You can roll over all or part of the payment by paying it to your traditional IRA or to an eligible employer plan that accepts your rollover within 60
days after you receive the payment. The amount rolled over will not be taxed until you take it out of the traditional IRA or the eligible employer plan.
• If you want to roll over 100% of the payment to a traditional IRA or an eligible employer plan, you must find other money to replace the 20% of the
taxable portion that was withheld. If you roll over only the 80% that you received, you will be taxed on the 20% that was withheld and that is not
rolled over.
Your Right to Waive the 30-Day Notice Period
Generally, neither a direct rollover nor a payment can be made from the plan until at least 30 days after your receipt of this notice. Thus, after receiving
this notice, you have at least 30 days to consider whether or not to have your withdrawal directly rolled over. If you do not wish to wait until this 30-day
notice period ends before your election is processed, you may waive the notice period by making an affirmative election indicating whether or not you
wish to make a direct rollover. Your withdrawal will then be processed in accordance with your election as soon as practical after it is received by the
Plan Administrator.
ADDITIONAL INFORMATION ON PAYMENTS
Payments That Can and Cannot Be Rolled Over
Payments from the Plan may be “eligible rollover distributions.” This means that they can be rolled over to a traditional IRA or to an eligible employer
plan that accepts rollovers. Payments from a plan cannot be rolled over to a SIMPLE IRA or a Coverdell Education Savings Account. Your Plan
administrator should be able to tell you what portion of your payment is an eligible rollover distribution.
After-tax Contributions
If you made after-tax contributions to the Plan, these contributions may be rolled into either a traditional IRA or to certain employer plans that accept
rollovers of the after-tax contributions. The following rules apply:
• Rollover into a Traditional IRA. You can roll over your after-tax contributions to a traditional IRA either directly or indirectly. Your plan
administrator should be able to tell you how much of your payment is the taxable portion and how much is the after-tax portion.
If you roll over after-tax contributions to a traditional IRA, it is your responsibility to keep track of, and report to the Service on the applicable
forms, the amount of these after-tax contributions. This will enable the nontaxable amount of any future distributions from the traditional IRA to be
determined. Once you roll over your after-tax contributions to a traditional IRA, those amounts CANNOT later be rolled over to an employer plan.
• Rollover into an Employer Plan. You can roll over after-tax contributions from an employer plan that is qualified under Code section 401(a) or a
section 403(a) annuity plan to another such plan using a direct rollover if the other plan provides separate accounting for amounts rolled over,
including separate accounting for the after-tax employee contributions and earnings on those contributions. You can also roll over after-tax
contributions from a section 403(b) tax-sheltered annuity to another section 403(b) tax-sheltered annuity using a direct rollover if the other
tax-sheltered annuity provides separate accounting for amounts rolled over, including separate accounting for the after-tax employee contributions
and earnings on those contributions. You CANNOT roll over after-tax contributions to a governmental 457 plan.
If you want to roll over your after-tax contributions to an employer plan that accepts these rollovers, you cannot have the after-tax contributions
paid to you first. You must instruct the Plan Administrator of this Plan to make a direct rollover on your behalf. Also, you cannot first roll over
after-tax contributions to a traditional IRA and then roll over that amount into an employer plan.
The following types of payments cannot be rolled over:
• Payments Spread over Long Periods. You cannot roll over a payment if it is part of a series of equal (or almost equal) payments that are made
at least once a year and that will last for your lifetime (or a period measured by your life expectancy), or your lifetime and your beneficiary’s
lifetime (or a period measured by your joint life expectancies), or a period of 10 years or more.
• Required Minimum Payments. Beginning when you reach age 70-1/2 or retire, whichever is later, a certain portion of your payment cannot be
rolled over because it is a “required minimum payment” that must be paid to you. Special rules apply if you own more than 5% of your employer.
• Corrective Distributions. A distribution that is made to correct a failed nondiscrimination test or because legal limits on certain contributions were
exceeded cannot be rolled over.
The Plan Administrator of this Plan should be able to tell you if your payment includes amounts which cannot be rolled over.
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REFUND ELECTION FORM INSTRUCTIONS
Direct Rollover
A DIRECT ROLLOVER is a direct payment of the amount of your Plan benefits to a traditional IRA or an eligible employer plan that will accept it. You
can choose a DIRECT ROLLOVER of all or any portion of your payment that is an eligible rollover distribution, as described in Part I above. You are not
taxed on any taxable portion of your payment for which you choose a DIRECT ROLLOVER until you later take it out of the traditional IRA or eligible
employer plan. In addition, no income tax withholding is required for any taxable portion of your Plan benefits for which you choose a DIRECT
ROLLOVER. This Plan might not let you choose a DIRECT ROLLOVER if your distributions for the year are less than $200.
• DIRECT ROLLOVER to a Traditional IRA
You can open a traditional IRA to receive the direct rollover. If you choose to have your payment made directly to a traditional IRA, contact an IRA
sponsor (usually a financial institution) to find out how to have your payment made in a direct rollover to a traditional IRA at that institution. If you
are unsure of how to invest your money, you can temporarily establish a traditional IRA to receive the payment. However, in choosing a traditional
IRA, you may wish to make sure that the traditional IRA you choose will allow you to move all or a part of your payment to another traditional IRA
at a later date, without penalties or other limitations. See IRS Publication 590, Individual Retirement Arrangements, for more information on
traditional IRAs (including limits on how often you can roll over between IRAs).
• DIRECT ROLLOVER to a Plan
If you are employed by a new employer that has an eligible employer plan, and you want a direct rollover to that plan, ask the plan administrator
of that plan whether it will accept your rollover. An eligible employer plan is not legally required to accept a rollover. Even if your new employer’s
plan does not accept a rollover, you can choose a DIRECT ROLLOVER to a traditional IRA. If the employer plan accepts your rollover, the plan
may provide restrictions on the circumstances under which you may later receive a distribution of the rollover amount or may require spousal
consent to any subsequent distribution. Check with the plan administrator of that plan before making your decision.
• DIRECT ROLLOVER of a Series of Payments
If you receive a payment that can be rolled over to a traditional IRA or an eligible employer plan that will accept it, and it is paid in a series of
payments for less than 10 years, your choice to make or not make a DIRECT ROLLOVER for a payment will apply to all later payments in the
series until you change your election. You are free to change your election for any later payment in the series.
• Change in Tax Treatment Resulting from a DIRECT ROLLOVER
The tax treatment of any payment from the eligible employer plan or traditional IRA receiving your DIRECT ROLLOVER might be different than if
you received your benefit in a taxable distribution directly from the Plan. For example, if you were born before January 1, 1936, you might be
entitled to ten-year averaging or capital gain treatment, as explained below. However, if you have your benefit rolled over to a section 403(b)
tax-sheltered annuity, a governmental 457 plan, or a traditional IRA in a DIRECT ROLLOVER, your benefit will no longer be eligible for that
special treatment. See the sections below entitled “Additional 10% Tax if You Are under Age 59-1/2” and “Special Tax Treatment if You Were
Born before January 1, 1936.”
Payments Paid To You
If your payment can be rolled over (see Part I on page 3) and the payment is made to you in cash, it is subject to 20% federal income tax withholding on
the taxable portion (state tax withholding may also apply). The payment is taxed in the year you receive it unless, within 60 days, you roll it over to a
traditional IRA or an eligible employer plan that accepts rollovers. If you do not roll it over, special tax rules may apply.
Income Tax Withholding:
• Mandatory Withholding
If any portion of your payment can be rolled over under Part I above and you do not elect to make a DIRECT ROLLOVER, the Plan is required by
law to withhold 20% of the taxable amount. This amount is sent to the IRS as federal income tax withholding. For example, if you can roll over a
taxable payment of $10,000, only $8,000 will be paid to you because the Plan must withhold $2,000 as income tax. However, when you prepare
your income tax return for the year, unless you make a rollover within 60 days (see “Sixty-Day Rollover Option” below), you must report the full
$10,000 as a taxable payment from the Plan. You must report the $2,000 as tax withheld, and it will be credited against any income tax you owe
for the year. There will be no income tax withholding if your payments for the year are less than $200.
• Voluntary Withholding
If any portion of your payment is taxable but cannot be rolled over under Part I, the mandatory withholding rules described above do not apply. In
this case, you may elect not to have withholding apply to that portion. If you do nothing, an amount will be taken out of this portion of your
payment for federal income tax withholding. To elect out of withholding, ask the Plan Administrator for the election form and related information.
• Sixty-Day Rollover Option
If you receive a payment that can be rolled over under Part I, you can still decide to roll over all or part of it to a traditional IRA or to an eligible
employer plan that accepts rollovers. If you decide to roll over,
you must contribute the amount of the payment you received to a traditional
IRA or eligible employer plan within 60 days after you receive the
payment. The portion of your payment that is rolled over will not be taxed
until you take it out of the traditional IRA or the eligible employer plan.
You can roll over up to 100% of your payment that can be rolled over under Part I, including an amount equal to the 20% of the taxable portion
that was withheld. If you choose to roll over 100%, you must find other money within the 60-day period to contribute to the traditional IRA or the
eligible employer plan, to replace the 20% that was withheld. On the other hand, if you roll over only the 80% of the taxable portion that you
received, you will be taxed on the 20% that was withheld.
EXAMPLE: The taxable portion of your payment that can be rolled over under Part I above is $10,000, and you choose to have it paid to you. You will
receive $8,000, and $2,000 will be sent to the IRS as income tax withholding. Within 60 days after receiving the $8,000, you may roll over the entire
$10,000 to a traditional IRA or an eligible employer plan. To do this, you roll over the $8,000 you received from the Plan, and you will have to find $2,000
from other sources (your savings, a loan, etc.). In this case, the entire $10,000 is not taxed until you take it out of the traditional IRA or an eligible
employer plan. If you roll over the entire $10,000, when you file your income tax return you may get a refund of part or all of the $2,000 withheld.
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