FBC 457(b) Dist./Rollover
FBC 457(b) Dist./Rollover Authorization Form
Participants desiring to take a distribution or rollover from any non-Empower 457(b) account should use this form. This form provides the non-Empower approved vendor (investment provider) the authorization for them to process distribution and rollover requests on behalf of the participant. The approved vendor will likely require their own Distribution or Rollover 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.