"Delaware 457(B) Plan Sick vacation Deferral Form" - Delaware

Delaware 457(B) Plan Sick vacation Deferral Form is a legal document that was released by the Delaware Office of the State Treasurer - a government authority operating within Delaware.

Form Details:

  • Released on November 5, 2018;
  • The latest edition currently provided by the Delaware Office of the State Treasurer;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Delaware Office of the State Treasurer.

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Download "Delaware 457(B) Plan Sick vacation Deferral Form" - Delaware

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Please fax completed form to the Office of the State Treasurer at (302) 677-7031
Sick\Vacation Deferral
State of Delaware 457(b) Plan
Notice to employee:
If you are not currently enrolled in the 457(b) plan, contact Voya Financial at (800) 584-6001 or
www.delawaredefer.com
to enroll
before retirement your date.
The Office of State Treasurer must receive this signed form no later than the end of the month prior to the month you will receive your
payout check (the check includes your accumulated sick and vacation pay).
Date of Retirement
Date of Payout Check:
or Separation:
Sick Leave Payout:
Vacation Leave Payout
Additional Salary:
Total Gross Pay:
$19,000
$6,000
Please note that amount deferred are before State and Federal taxes but not before social security
taxes.
__________________________________
_______________
Please verify your payout information with your Payroll Representative, sign and date the form, and fax it to the attention of
the Office of the State Treasurer at (302) 677-7031.
Last updated 11.5.18
Please fax completed form to the Office of the State Treasurer at (302) 677-7031
Sick\Vacation Deferral
State of Delaware 457(b) Plan
Notice to employee:
If you are not currently enrolled in the 457(b) plan, contact Voya Financial at (800) 584-6001 or
www.delawaredefer.com
to enroll
before retirement your date.
The Office of State Treasurer must receive this signed form no later than the end of the month prior to the month you will receive your
payout check (the check includes your accumulated sick and vacation pay).
Date of Retirement
Date of Payout Check:
or Separation:
Sick Leave Payout:
Vacation Leave Payout
Additional Salary:
Total Gross Pay:
$19,000
$6,000
Please note that amount deferred are before State and Federal taxes but not before social security
taxes.
__________________________________
_______________
Please verify your payout information with your Payroll Representative, sign and date the form, and fax it to the attention of
the Office of the State Treasurer at (302) 677-7031.
Last updated 11.5.18