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Application for
DEFERRED
Retirement Benefits
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Privacy Act Statement
The authority for requesting this information is the TVA Act. The information you furnish will be used in administering the TVA Retirement System and in providing the benefits of that System to System members and retirees and their designated surviving beneficiaries. The information you provide may be shared with contractors engaged in helping the System administer its programs and with Federal, state, and local governmental agencies which have a need to know the information. It may also be used to respond to a Congressional referral. In addition, to the extent that this information indicates a possible violation of civil or criminal law, it may be shared with appropriate Federal, state, or local law enforcement agencies. While you are not required to supply the information requested, it may not be possible to process your elections or provide System benefits if you fail to do so.
Contact Information
TVA Retirement System
400 West Summit Hill Drive, WT 8A
Knoxville, TN 37902
E-mail Address:
Main Number: (865) 632-2672 or
(800) 824-3870
Fax Number: (865) 632-8591
Website: www.tvars.com
Note: Should there be any conflict between the information in this document and the provisions of the various plans, the plan provisions and not this document shall be controlling.
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Contents
Retirement elections for a deferred benefit are made on form RS-9A, Application for Deferred Retirement Benefits, which is contained in this package. The section numbers below refer to the sections of form RS-9A.
Page
Number
Introduction i
Section 1 - Participant Information . 1
Section 2 - Election of When to Begin Deferred Benefit Payments 1
Section 3 - Fixed and Variable Funds Election 1
Section 4 - Survivor Benefit Election for Pension and
Fixed and Variable Funds 2
Section 5 - Beneficiary Designation 2
Section 6 - Acknowledgment of Indebtedness to TVA 2
Section 7 - 401(k) Plan Information 2
Section 8 - Credit for Unused Sick Leave and Military Service
(Original Benefit Structure Participants Only) 3
Section 9 - Signature 3
Additional Information 3
Federal Employees’ Group Life Insurance (FEGLI)
Retiree Medical and Dental Insurance
Federal Long-Term Care Insurance
TVA Payments
August 2013
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Introduction
IMPORTANT: If you have not contacted the TVA Retirement System (TVARS) regarding your eligibility for various benefits, you should call or e-mail TVARS prior to completing your application.
This package contains the Application for Deferred Retirement Benefits and other forms that may apply. It also contains important information and instructions for completing the application. You should also review your most recent Estimate of Deferred Retirement Benefits from TVARS.
Please read all instructions, and complete your forms carefully. Your election of a deferred retirement benefit is final (not revocable). Only the following elections can be changed during the deferral period before payments begin:
· Fixed and Variable Funds Election
· Survivor Benefit Election for Pension and Fixed and Variable Funds
· Beneficiary Designation
If you have any questions on the completion of your application, or if you need additional forms, please contact TVARS.
You should inform your supervisor and your human resource office of your retirement date. Your retirement application should be submitted prior to termination of your employment.
60-Day Filing Deadline - Your retirement application must be filed no later than 60 days from your termination date. If your application is not received by TVARS within 60 days of your termination date, you will be subject to a default benefit. Your retirement benefit will default to a deferred retirement benefit with payments scheduled to begin no later than age 65. If you are subject to the spousal consent requirement under the TVARS Rules and Regulations, the default benefit will be in the form of a 50% joint and survivor annuity. Otherwise, it will be in the form of a single life annuity with no survivor benefit. During the deferral period, you may elect for payments to begin as early as age 55, but no later than age 65. You may also elect a survivor option and name a beneficiary to receive a continuing benefit. Payments cannot begin before age 55 or the date your application is received, whichever is later.
In addition, if you first became a TVARS member on or after January 1, 1996, you have 60 days from your termination date to make a decision regarding distribution of your Fixed and Variable Funds. After 60 days, the Fixed Fund will cease to accrue additional interest. Your options with your funds are: (1) withdraw your total balance, or (2) roll over all or some portion of your balance to an IRA or another qualified retirement plan which will accept a rollover. Any funds not rolled over will be paid directly to you.
Completed retirement forms should be sent to TVARS by mail, e-mail, or fax at:
TVA Retirement System
400 West Summit Hill Drive, WT 8A
Knoxville, TN 37902
E-mail:
Fax: (865) 632-8591
IMPORTANT: TVARS Rules and Regulations and the Office of Personnel Management directives and guidelines specifically prohibit receiving a benefit from both TVARS and the Civil Service Retirement System (CSRS) or Federal Employees Retirement System (FERS) at the same time based on the same period of service. If at any time you begin receiving payments from CSRS or FERS that include credit for your TVARS service, TVARS payments will cease effective on the date your CSRS or FERS payments begin and you will be obligated to repay TVARS for any overpayment that may occur.
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Section 1 of Form RS-9A - Participant Information
Enter your name.
Enter your social security number.
Enter the effective date of your termination.
Enter your daytime phone number.
Enter your date of birth. You must also provide a copy of your birth certificate or passport as verification of your date of birth.
Indicate if you are single or married. If you are married and first became a TVARS member after January 1, 1990, your spouse must complete form RS-200A, Spousal Consent at Retirement, if you:
· Choose B, C, D, or E in section 3, or
· Choose the Maximum, Option 1, or Option 4 in section 4, or
· Designate a beneficiary other than your spouse in section 5.
Enter your mailing address. If your address changes, please notify TVARS in writing as quickly as possible to ensure you receive all information concerning your retirement benefits.
Section 2 of Form RS-9A - Election of When to Begin Deferred Benefit Payments
Deferred benefit payments may not begin before attained age* 55 if you are a member of the Original Benefit Structure or actual age 55 if you are a member of the Cash Balance Benefit Structure. Payments must begin before age 65.
If you elect a survivor option that provides for your beneficiary to receive a continuing monthly benefit and you die before your payments begin, your beneficiary’s benefit will begin when you would have reached age 55, or immediately if you are over age 55 at your death. If no continuing monthly benefit is elected, your beneficiary will only receive a refund of your balance in the Fixed and Variable Funds (if any).
*Attained age is your actual age plus credit for any annual leave forfeited after January 1, 1980, and, at your election, credit for your unused sick leave balance.
Section 3 of Form RS-9A - Fixed and Variable Funds Election
Your balance consists of your contributions to the Fixed and Variable Funds and the earnings on those contributions. Prior to termination of your employment, you have the option to transfer your total balance to the 401(k) Plan. This may be done by completing form RS-114, Transfers During Employment of Fixed and Variable Funds to the 401(k) Plan. Please refer to the Tax Calculation Information for TVA Retirement System Immediate and Deferred Payments (available from TVARS) for an explanation of the tax implications of this transfer as compared to a withdrawal or rollover.
If you do not have Fixed and Variable Funds at retirement, skip to Section 3. If you do have a balance at retirement, the options are listed below. The process for calculating the taxable portion of your Fixed and Variable Funds, as well as how the taxable and nontaxable portions are allocated, is somewhat complex. Please contact TVARS if you need additional information on how this process works.
A. If you first became a TVARS member on or after January 1, 1996, you may not elect to receive your Fixed and Variable Funds as a monthly benefit and must withdraw and/or roll over your total balance. After 60 days, the Fixed Fund will cease to accrue additional interest.
If you first became a member before January 1, 1996, you may elect to receive your total balance as a monthly benefit. Check the box under item A if you elect to receive your total balance as a monthly benefit.
If you choose a monthly benefit, your Fixed Fund will continue to accrue interest at the applicable rate approved by the TVARS Board. Your balance in the Variable Fund will continue to fluctuate with the general stock market.
Before your payments begin, you may transfer any percentage or dollar amount of your balance between the Fixed and Variable Funds once per calendar month. Transfer requests received by Fidelity Investments by 4 p.m. (Eastern Time) will be processed at that day’s closing net asset value. Contact Fidelity Investments at (800) 354-7121 or at www.mysavingsatwork.com. Once payments begin, transfers between funds of your entire balance are allowed once every 12 months by contacting TVARS.
B-E Instructions
You may elect a partial or total withdrawal or rollover at termination. If you elect a partial withdrawal or rollover, you have the option of withdrawing or rolling over the remaining balance at any time before your deferred retirement benefit begins.
Upon distribution of your funds, your right to the deferred pension (provided by TVA’s contributions to TVARS) will not be affected (except the pension shall be surrendered when all or any portion of your creditable service is used to establish benefit credits under another retirement plan for Federal Government employees financed in whole or in part by the Federal Government).
If you do not withdraw any of your Fixed and Variable Funds at termination, you have the option to withdraw or roll over your total balance any time before your deferred benefit payments begin.
B. You may elect to withdraw your total balance. Check the box under item B if you elect to withdraw your total balance. Any taxable money paid to you is subject to an automatic 20% income tax withholding and may also be subject to an additional 10% early withdrawal penalty.
C. You may elect to roll over only the taxable portion of your balance. Check the box under item C if you elect to roll over only the taxable portion of your balance which will be paid as specified on form RS-201. Only taxable funds will be rolled over, and all of your nontaxable balance will be paid directly to you.
D. You may elect to roll over your total balance. Check the box under item D if you elect to roll over your total balance which will be paid as specified on form RS-201.
E. You may elect to allocate your balance among the following: monthly benefit (if eligible), withdrawal, direct rollover. Check the box under item E. Your funds will be paid as specified on form RS-250.
Any funds not withdrawn or rolled over will continue to accrue interest as noted in section A above.
If you choose to withdraw any taxable funds, you should carefully consider the tax consequences. Please refer to the Eligible Rollover Notice included in this package and the Tax Calculation Information for TVA Retirement System Immediate and Deferred Payments. You may also want to consult your personal tax advisor.
If you elect a direct rollover of your funds to an institution other than Fidelity Investments, you and a representative from your financial institution need to complete form RS-201, Direct Rollover of Fixed and Variable Funds. You will receive a check made payable to you for your part of the distribution. You will also receive a check made payable to the financial institution you specify for any funds being rolled over.
If you elect to roll over your funds to Fidelity Investments, complete form RS-201, Direct Rollover of Fixed and Variable Funds. You will receive a check made payable to you for your part of the distribution. You will also receive a check made payable to Fidelity Investments for any funds being rolled over. The check made payable to Fidelity should be sent with a Fidelity Rollover Application to Fidelity. To request a Fidelity Rollover Application, contact Fidelity at (800) 354-7121.
Section 4 of Form RS-9A - Survivor Benefit Election for Pension and Fixed and Variable Funds
Please check your election. You may elect to receive the maximum benefit paid during your lifetime with nothing payable upon your death, or you may choose to have a reduced benefit during your lifetime with provisions for a survivor benefit.