FBC 401(a) Loan
FBC 401(a) Loan Authorization Form
Participants desiring to take a loan from any non-Empower 401(a) account should use this form. This form provides the non-Empower approved vendor (investment provider) the authorization for them to process loan requests on behalf of the participant. The approved vendor will likely require their own Loan Form to be completed in order to process the authorized request.
Fax the completed form to (800) 597-8206.
For questions concerning this form please contact National Benefit Services, LLC at 1-800-274-0503 ext. 5.