HARTFORD

Link to Information on General Account

Form Fill-in Feature. These forms can be filled in online and printed out for mailing to the Treasurer Tax-Collector. Click here for instructions on how to complete fill in forms.

Hartford 401a Forms:

• Enrollment Kit - may be obtained by calling (619) 531-5840. You must complete the Participant Record, Beneficiary Designation/Spousal Consent Form, Release, Hold Harmless and Contribution Election Forms to enroll in the plan. All forms must be submitted to the Deferred Compensation Office, Mail Stop A-49 for processing. Please include your telephone number and use black ink.
  
• Name & Address Change Form - To change name or address.


• Beneficiary Designation/Spousal Consent - To change beneficiary designation. Spousal consent required if beneficiary is other than spouse.


• Hardship Certification - To suspend payroll deduction for a minimum of six months
  
• Rollover Submission - To rollover a qualified Retirement Plan under section 401(a) of the Internal Revenue Code from another plan.
  
• Distribution Forms
  
• Special Tax Notice Regarding Plan Payments - This is a notice of information needed before deciding how to receive the plan benefits. This includes consideration of rollovers.
• Benefit Payment Request - Accompanied by Full Disclosure Statement
• Provider to Provider Account Transfer - To transfer account balance from T. Rowe Price to Hartford,and vice versa.
  
• Electronic Funds Transfer Authorization Agreement - Hartford will access additional charge for this service. Please call Hartford to confirm the amount. Call 1-800-528-9009.
• Investment Election Change/Transfer Request - Call plan provider @ 1-800-528-9009
• Loan Application & Agreement - May be obtained by calling 1-800-528-9009.
• Loan Spousal Consent - May be obtained by calling 1-800-528-9009.

Hartford 457 Forms:

• Enrollment Kit - may be obtained by calling (619) 531-5840. You must complete the Enrollment Record, Disclosure Statement, and Release, Hold Harmless Forms to enroll in the plan. All forms must be submitted to the Deferred Compensation Office and Mail Stop A-49 for processing. Please include your telephone number and use black ink.
  
• Contribution/Information Change Form - To make changes to an account's contributions, name or address.
  
• Investment Election Change/Transfer Request - Please call 1-800-528-9009 to make changes or transfers to any investment elections.
  
• Rollover/Plan to Plan Account Transfer - To rollover a qualified Retirement Plan under section 457 of the Internal Revenue Code from another plan.
  
• Provider to Provider Account Transfer - To transfer account balance from T. Rowe Price to Hartford,and vice versa.
  
• Catch-up Disclosure Agreement
  
• Beneficiary Designation/Spousal Consent - To change beneficiary designation. Spousal consent required if beneficiary is other than spouse.
  
• Pay Out Options
  Withdrawal Request - To request for payout, direct rollover, & purchase of service credits.
  Installment (Systematic) Payment Option - To set up systematic payment option.
  Electronic Funds Transfer Authorization Agreement - Hartford will access additional charge for this service. Please call Hartford to confirm the amount. Call 1-800-528-9009.
 
• Unforeseeable Emergency Withdrawal Request - To request a withdrawal from a 457 Deferred Compensation Plan due to an unforeseeable emergency. This must be submitted directly to the Hartford. Call 1-800-528-9009.