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Forms

The forms listed below are the most frequently used forms. Log in to your account or contact us if you have questions about which form to use. 

Enroll

457 and 401(k) Pre-Tax Participation Agreement (PDF)

Designated Roth 401(k) After-Tax Contributions Participation Agreement (PDF)

Roth IRA Participation Agreement (PDF)

Traditional IRA Participation Agreement (PDF)

Use these forms to:

  • Enroll in the plans
  • Change your contributions
  • Select or change investment options

Refer to the Plan Highlights (PDF) and the Program Summary (PDF) brochures for more details.

Withdraw money

457 Pre-Tax Distribution/Rollover Request Form (PDF)

401(k) Pre-Tax Distribution/Rollover Request Form (PDF)

Roth 401(k) Distribution/Rollover Request Form (PDF)

Deemed IRA Withdrawal/Rollover Packet (PDF)

Use these forms to:

  • Request a payout distribution
  • Select your payout options when you end your employment or retire
  • Restart a distribution

Please read about the tax implications for 457, 401(k) and Deemed IRAs (PDF) regarding rollovers.

457 Unforeseeable Emergency (UE Claim Form) (PDF)

Use this form to:

  • Request an unforeseeable emergency claim from your KDC 457 plan

Financial Hardship Request Instructions and Application – 401(k) (PDF)

Use this form to:

  • Request a financial hardship claim from your KDC 401(k) plan

Manage my account

Name Change Form (PDF)

401(k) Deemed IRA Rollover Form (PDF)

401(k) Transfer Rollover Form (PDF)

Roth IRA Conversion Form (PDF)

457 Plan to Plan Transfer Form (PDF)

Use these forms to:

  • Roll money over from other retirement savings accounts into your KDC account(s)
  • Decide which investments you want the rollover money to go into
  • Consolidate your 457 retirement savings by transferring tax-deferred accounts from other 457 governmental plans into the KDC 457 Plan

457 "Catch-Up" Election Form (PDF)

Use this form to:

  • Participate in the Age 50 and over Catch-Up Provision.
  • Learn more about catch-up options in the Learning Center.

Beneficiary Designation Form (PDF)

Use this form to designate or change beneficiary information:

  • Select primary and contingent beneficiaries
  • Change how your money will be divided between your beneficiaries
  • Remove and add beneficiaries

Direct Deposit Authorization Change Form (PDF)

Use this form to:

  • Add or change your checking or savings information for automatic deposits to your bank account
  • Discontinue direct deposit

ACH Debit Authorization/Change Form (PDF)

Use this form to update ACH information for loan repayments.

Federal and State Income Tax Withholding Change Form (PDF)

Use this form to:

  • Change federal and state income tax information on file

Power of Attorney Instructions and Forms

Instructions for Power of Attorney Process (PDF)

KY Limited POA (PDF)

KY Agent’s Acceptance of POA (PDF)

KY Successor Agent’s Acceptance (PDF)

KY Revocation of LPOA (PDF)

KY Resignation of Agent (PDF)

Account information and notifications

Military Leave

Follow this link to view/print information on how to notify us if you are going on military leave.

Divorce (Domestic Relations Orders)

Please contact us and we can review the information you and your attorney will need to provide in the event of a divorce.

Beneficiary/Alternate Payee Claim

Please contact us if you are a beneficiary or an alternate payee, such as a former spouse or a dependent of a Plan participant.

PDFs require Adobe® Reader®

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NRW-2891KY-KY.8
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