Plumbing and Steamfitting the Hudson Valley

Forms

Special Tax Notice
This special tax notice is applicable for all distributions from the Annuity Fund.

Normal Distribution Form (Retirement, Termination, Rollover)

Beneficiary or QDRO Distribution Form

Loan Application Form
Loan Payment ACH Authorization Form

Hardship Distribution Form

In-Service Distribution Form (Unemployment Supplement)

Incoming Rollover Request Form
Incoming Rollover Statement Form

(Both forms must be completed for incoming rollovers)

Please note that all completed forms MUST be submitted to the Benefits Office and NOT sent directly to MassMutual.