Life and Death Planning for Retirement Benefits

Appendix B: Forms

495

Re: Benefits of [NAME OF DECEASED PARTICIPANT], deceased (hereinafter

“Participant”)

[Alt. 1: From executor, if benefits were payable to participant’s estate]:

I am the [ TITLE, SUCH AS EXECUTOR, ADMINISTRATOR, OR PERSONAL

REPRESENTATIVE] of the estate of the Participant, who was a participant in the Plan. I

enclose a certificate evidencing my appointment. In that capacity, I am transferring the

Participant’s interest in the Plan to the beneficiary/ies of Participant’s estate who is/are entitled

to receive it under [THE TERMS OF PARTICIPANT’S WILL/APPLICABLE INTESTACY

LAW].

[Alt. 2: From trustee of trust named as beneficiary]:

I am the Trustee of the [NAME OF TRUST] (the “Trust”) which was the named

beneficiary of the Participant under the Plan. In my capacity as such Trustee, I am transferring

the Participant’s interest in the Plan to the beneficiary/ies who is/are entitled to receive it under

the terms of the Trust.

[Alt. 1: transfer to one beneficiary]

Accordingly, I hereby instruct and direct you to change the titling of this plan benefit

to “[NAME OF BENEFICIARY TO WHOM THE BENEFIT IS BEING TRANSFERRED]

as successor beneficiary of [NAME OF DECEASED PARTICIPANT].”

[Alt. 2: transfer to several beneficiaries, in separate accounts]

Accordingly, I hereby instruct and direct you to divide the benefit into [NUMBER OF

SEPARATE ACCOUNTS TO BE ESTABLISHED] separate accounts, and to change the

titling of each such account to the name of one of the beneficiaries to whom the benefit is being

transferred “as successor beneficiary of [NAME OF DECEASED PARTICIPANT].” The

names, addresses, and Social Security numbers of the individual beneficiaries of the separated

accounts are: [INSERT].

In accordance with the instructions for IRS Form 1099-R, this transfer is a plan-to-plan

transfer and is not to be treated or reported as a distribution from the Plan. Please advise what

if any further information or documentation you require to complete this transfer.

Yours truly, [SIGNATURE OF EXECUTOR OR TRUSTEE]

5.5 Letter to Administrator Who Won’t Provide Information

See

To the Plan Administrator of the [NAME OF RETIREMENT PLAN] (hereinafter “the Plan”):

Re: Benefits of [NAME OF DECEASED PARTICIPANT], deceased (hereinafter “the

Participant”)

I am the executor of the estate of the Participant, who was a participant in the Plan. I

enclose a certificate evidencing my appointment. I have requested from you certain

information in order that I may fulfill my responsibility to prepare and file a federal estate tax

return for the Participant’s estate. You have informed me that you will provide no information

regarding the Participant’s benefits under the Plan to anyone other than the Participant’s

designated beneficiary. You will not tell me the name of the Participant’s designated

beneficiary. As required by

of the Internal Revenue Code, I will include with the

estate tax return I will file for the Participant’s estate a statement that I am unable to make a

complete return regarding the Participant’s interest in the Plan, and I will submit your name