Blank Maryland 193 PDF Form

Blank Maryland 193 PDF Form

The Maryland 193 form is a Trustee-to-Trustee Distribution Form designed for rollovers within retirement accounts. This form facilitates the transfer of funds from one retirement account to another, ensuring a smooth and tax-efficient process. If you need to complete this form, click the button below for assistance.

The Maryland 193 form serves as a vital document for individuals looking to manage their retirement funds through trustee-to-trustee distributions. Designed specifically for rollovers, this form facilitates the transfer of retirement assets from one financial institution to another, ensuring that individuals can maintain the tax-deferred status of their retirement savings. When completing the form, the payee must provide personal information, including their name, social security number, and contact details, which will be essential for processing the transaction. The form outlines various distribution options, such as withdrawals of accumulated contributions, voluntary funds, or lump-sum benefits, allowing individuals to select the method that best suits their financial needs. Additionally, it emphasizes the importance of directing payments to designated IRA accounts or eligible employer plans, thereby safeguarding the tax benefits associated with retirement savings. Understanding the stipulations of the Maryland 193 form is crucial, as it not only requires the payee's acknowledgment of the distribution conditions but also mandates that the financial institution verifies the information before processing the rollover. This structured approach ensures a smooth transition of funds while adhering to regulatory requirements.

Document Sample

MARYLAND STATE RETIREMENT AGENCY

120 EAST BALTIMORE STREET

BALTIMORE, MARYLAND 21202-6700

TRUSTEE-TO-TRUSTEE DISTRIBUTION FORM

 

 

 

 

 

 

 

 

FOR ROLLOVERS

 

RETIREMENT USE ONLY Form 193 (REV. 4/13)

 

 

SECTION I

 

 

 

 

 

 

 

To be completed by Payee and forwarded to Payee’s financial institution

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

First

M.I.

Social Security

#

 

 

 

 

 

 

 

 

-

-

 

 

 

 

 

 

 

 

 

 

 

MISCELLANEOUS:

 

 

Day Time Phone #

 

 

 

( )

-

-

 

 

HOME ADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ext

 

 

 

 

CITY:

STATE:

ZIP:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF DISTRIBUTION: Check [4] Distribution Type:

Withdrawal of Accumulated Contributions (Form 5)

Withdrawal of Voluntary Funds (Form 742)

Application for Payment of Lump Sum Deferred Vested Benefit (Form 742.1)

Death Benefit (Surviving Spouse of Employee or Retiree) (Form 745)

Withdrawal of Deferred Retirement Option Program (DROP) Account (Forms 505; 757)

Based on the distribution option I selected on my Withdrawal ofAccumulated Contributions (Form 5), Withdrawal of Voluntary Funds (Form 742), Application for Payment of Lump Sum Deferred Vested Benefit (Form 742.1), Death Benefit Claim Form (Form 745) or Withdrawal of DROPAccount (Forms 505; 757), I direct the SRAto do the following:

Check [4] only one option to indicate payment selection.

Pay to me my designated flat dollar refund amount of $___________________.

OR

Pay to me all federal “NON-TAXABLE” funds to be determined at time of payment.

AND

The account balance will be made payable to your designated IRA or Eligible Employer Plan. (Note: distributions to a 457(b) governmental plan or a 403(b) tax sheltered annuity may not exceed the taxable amount.)

I understand the Agency may issue two checks to me: one payable to my order and the other payable to the order of the IRA or Eligible Employer Plan that is to receive my distribution. I understand that I am responsible for promptly delivering the check for my distribution directly to the IRA or Eligible Employer Plan for processing, and I agree to do so.

SRA will not process more than one trustee-to-trustee distribution. Thus, if you want to move funds between IRA’s and/or Eligible Employer Plans, contact the IRA or Eligible Employer Plan to which you are making the direct rollover to deter- mine whether transfers are allowable.

I understand and agree to the above distribution conditions.

PAYEE (Signature)

DATE

If you need assistance in completing this application, telephone a retirement benefits specialist at 410-625-5555 or toll-free at 1-800-492-5909.

SECOND PAGE ALSO MUST BE COMPLETED

SECTION II

(TO BE COMPLETED BY FINANCIAL INSTITUTION FOR PURPOSE OF ROLLOVER)

Verify Information in Section I.

Send completed form to: State Retirement Agency, 120 East Baltimore Street, Baltimore, Maryland 21202-6700

Payee’s Name: ______________________________________ Payee’s Social Security No. _________________- -

NAME AND ADDRESS OF FINANCIAL INSTITUTION/ACCOUNT

Name: ___________________________________________________________________________________

Address: _________________________________________________________________________________

City: _________________________________________ State: ________________ Zip: __________________

DEPOSITORACCOUNTTITLE:Inordertoproperlypreparethecheck,theRetirementAgencyneedsthenameofthefinancialinsti- tution/account into which the check will be made payable. Enter in the spaces below this information, up to 34 characters.The check payable to your designated financial institution/account will carry the notation “DIRECT ROLLOVER,” and will contain the name for the individual indicated in Section I. For IRA’s, the check will read payable to: [Information Below] as trustee of IND. RET. ACCT of [Payee in Section I]. For Eligible Employer Plans, the check will read payable to: [Information Below] FBO [Payee in Section I].

ENTER THE PAYEE’S ACCOUNT NUMBER (OPTIONAL):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The arrangement selected by the Payee is: (Check [4] one):

 

 

 

 

 

 

 

Check [4] Box to Affirm that Plan Separately

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Traditional IRA

 

 

 

 

 

 

 

Eligible Employer Plan

 

 

 

 

 

 

 

Accounts for After-Tax Contributions & Earnings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Qualified plan under §401(a), including

 

 

 

 

 

 

 

Check indicates plan separately accounts

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a 401(k) plan

 

 

 

 

 

 

 

for after-tax contributions and earnings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

§403(a) qualified annuity

 

 

 

 

 

 

 

Check indicates plan separately accounts

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Roth IRA

 

 

 

 

 

 

 

 

 

 

 

for after-tax contributions and earnings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

§403(b) tax sheltered annuity

 

 

 

 

 

 

 

Plan may NOT accept after-tax contribu-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

tions from a 401(a) qualified plan

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

§457(b) governmental plan

 

 

 

 

 

 

 

Plan may not accept after-tax contributions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I confirm that the payee, account number and title are correct. Further, I confirm that the plan designated by the payee is (or is intended to be) an IRA, or an Eligible Employer Plan which includes a plan qualified under section 401(a) of the Internal Revenue Code, including a 401(k) plan, profit sharing plan, defined benefit plan, stock bonus plan, and money purchase plan; a section 403(a) annuity plan; a section 403(b) tax sheltered annuity; or an eligible section 457(b) plan maintained by a governmental employer (governmental 457 plan), that the plan designated may accept such payment (including any after-tax contributions, if applicable) and that I am authorized to act on behalf of the designated plan and will accept the direct rollover for the payee and account for it as required by the Internal Revenue Code.

PRINT OR TYPE REPRESENTATIVE’S NAME

SIGNATURE OF REPRESENTATIVE

DATE

AREA CODE/TELEPHONE #:

-

-

 

 

 

 

 

PLEASE READ THIS CAREFULLY

All information on this form, including the individual’s social security number, is required. The information is confidential and will be used only to process payment data from the Maryland State RetirementAgency to the financial institution and its agent. Failure to provide the requested information may prevent or delay release or payment.

If you need assistance in completing this application, telephone a retirement benefits specialist at 410-625-5555 or toll-free at 1-800-492-5909.

FORM 193 (4/13) Pg. 2

File Specifics

Fact Name Description
Purpose The Maryland 193 form is used for trustee-to-trustee distributions for retirement rollovers, ensuring funds are transferred directly between financial institutions without incurring tax penalties.
Governing Law This form operates under Maryland state law, specifically adhering to the regulations set forth by the Maryland State Retirement Agency.
Completion Requirements Payees must complete Section I of the form, providing personal details and selecting the type of distribution they wish to initiate.
Distribution Options Options available include withdrawals of accumulated contributions, voluntary funds, lump sum deferred vested benefits, death benefits, and withdrawals from DROP accounts.
Contact Information If assistance is needed, individuals can contact a retirement benefits specialist at 410-625-5555 or toll-free at 1-800-492-5909.

How to Use Maryland 193

Filling out the Maryland 193 form is a straightforward process that requires attention to detail. This form is essential for initiating a trustee-to-trustee distribution for rollovers. Ensure that you have all necessary information at hand before you begin. Below are the steps to complete the form effectively.

  1. Start with Section I. Fill in your last name, first name, and middle initial.
  2. Enter your Social Security number in the specified format.
  3. Provide your daytime phone number and home address, including city, state, and ZIP code.
  4. Choose the type of distribution by checking the appropriate box. Options include:
    • Withdrawal of Accumulated Contributions (Form 5)
    • Withdrawal of Voluntary Funds (Form 742)
    • Application for Payment of Lump Sum Deferred Vested Benefit (Form 742.1)
    • Death Benefit (Surviving Spouse of Employee or Retiree) (Form 745)
    • Withdrawal of Deferred Retirement Option Program (DROP) Account (Forms 505; 757)
  5. Indicate your payment selection by checking one of the options provided:
    • Pay to me my designated flat dollar refund amount of $___________________.
    • Pay to me all federal “NON-TAXABLE” funds to be determined at the time of payment.
  6. Understand that the account balance will be made payable to your designated IRA or Eligible Employer Plan.
  7. Sign and date the form in the designated area to acknowledge your understanding of the distribution conditions.
  8. Proceed to Section II. This section must be completed by your financial institution.
  9. Verify the information from Section I and ensure it matches with the financial institution’s records.
  10. Provide the name and address of the financial institution where the rollover will be deposited.
  11. Fill in the depositor account title, ensuring it reflects the correct financial institution/account name.
  12. Optionally, enter the payee’s account number.
  13. Check the appropriate box to affirm that the plan will accept after-tax contributions if applicable.
  14. Have a representative from the financial institution print or type their name, sign, and date the form.
  15. Finally, ensure that the area code and telephone number of the representative are included.

Once you have completed the form, make sure to send it to the State Retirement Agency at the address provided on the form. Keep a copy for your records. If you have any questions or need assistance, consider reaching out to a retirement benefits specialist.

Your Questions, Answered

  1. What is the Maryland 193 Form?

    The Maryland 193 Form is a Trustee-to-Trustee Distribution Form used for rollovers of retirement funds. It allows individuals to transfer their retirement account balances directly to another eligible retirement account without incurring tax penalties. This form is specifically designed for use with the Maryland State Retirement Agency.

  2. Who needs to complete the Maryland 193 Form?

    The form must be completed by the payee, who is the individual receiving the distribution. This includes anyone who has accumulated contributions in a Maryland retirement plan and wishes to roll over those funds to another eligible retirement account, such as an IRA or another employer-sponsored plan.

  3. What information is required in Section I of the form?

    In Section I, the payee needs to provide personal information, including their name, social security number, daytime phone number, and home address. Additionally, they must select the type of distribution they are requesting and indicate their payment selection. This section ensures that the retirement agency has accurate information to process the distribution.

  4. What are the types of distributions available on the Maryland 193 Form?

    The form allows for several types of distributions, including:

    • Withdrawal of Accumulated Contributions
    • Withdrawal of Voluntary Funds
    • Application for Payment of Lump Sum Deferred Vested Benefit
    • Death Benefit for Surviving Spouse
    • Withdrawal of Deferred Retirement Option Program (DROP) Account

    Each option has specific eligibility requirements and implications, so it's important for payees to choose the one that applies to their situation.

  5. How is the payment processed once the form is completed?

    After the payee completes Section I, the form must be sent to their financial institution. The financial institution will then verify the information and complete Section II. Once both sections are completed, the form is sent to the Maryland State Retirement Agency for processing. The agency may issue two checks: one to the payee and another to the designated IRA or eligible employer plan.

  6. What should I do if I need assistance with the Maryland 193 Form?

    If you require help completing the Maryland 193 Form, you can contact a retirement benefits specialist at the Maryland State Retirement Agency. They can be reached at 410-625-5555 or toll-free at 1-800-492-5909. These specialists are available to answer questions and provide guidance on the rollover process.

  7. Are there any restrictions on the types of accounts that can receive the rollover?

    Yes, there are specific restrictions regarding which accounts can accept rollovers. The receiving account must be an eligible IRA or employer-sponsored plan, such as a 401(k) or 403(b). Additionally, distributions to certain plans, like 457(b) governmental plans, may have limitations on the amount that can be rolled over. It is advisable to check with the receiving institution regarding their policies on accepting rollovers.

  8. What happens if I do not provide all required information on the form?

    Failure to provide the necessary information on the Maryland 193 Form may delay the processing of your distribution. Incomplete forms can lead to complications, including potential tax penalties or the inability to complete the rollover. It is essential to ensure all sections are filled out accurately before submission.

Common mistakes

  1. Failing to provide a complete social security number. Ensure that all digits are included, as this is crucial for processing.

  2. Not signing the form. The signature of the payee is necessary to validate the request.

  3. Choosing more than one distribution option. Only select one option to avoid confusion and delays.

  4. Leaving the dollar amount blank. Specify the exact amount you wish to withdraw to ensure proper processing.

  5. Not providing the correct mailing address. An incomplete or incorrect address can lead to delays in receiving your funds.

  6. Ignoring the instructions for trustee-to-trustee transfers. Familiarize yourself with the rules to avoid complications.

  7. Forgetting to complete the second page. This section is essential for the financial institution’s processing.

  8. Using outdated forms. Always check to ensure you have the most recent version of the form to avoid issues.

  9. Not contacting the financial institution beforehand. Confirm with them that they can accept the rollover to prevent any surprises.

Documents used along the form

The Maryland 193 form is a crucial document for individuals looking to manage their retirement funds through trustee-to-trustee distributions. When dealing with retirement benefits, there are several other forms and documents that often accompany the Maryland 193 form. Each of these documents serves a specific purpose in ensuring that the distribution process is handled smoothly and in compliance with regulations.

  • Withdrawal of Accumulated Contributions (Form 5): This form is used by members of the Maryland State Retirement System who wish to withdraw their accumulated contributions upon termination of employment. It outlines the member's request and provides necessary details to process the withdrawal.
  • Withdrawal of Voluntary Funds (Form 742): Members can use this form to withdraw any voluntary contributions they have made to their retirement account. It allows for the direct access of these additional funds, which may have been contributed beyond mandatory amounts.
  • Application for Payment of Lump Sum Deferred Vested Benefit (Form 742.1): This document is for individuals who have left employment but are entitled to a lump sum payment from their retirement plan. It helps initiate the payment process for those who have vested benefits but have not yet retired.
  • Death Benefit Claim Form (Form 745): This form is essential for the surviving spouse or designated beneficiary of a deceased member. It enables them to claim any death benefits due from the retirement system, providing necessary information to process the claim efficiently.
  • Withdrawal of Deferred Retirement Option Program (DROP) Account (Forms 505; 757): This form is used by members who have participated in the DROP program and wish to withdraw funds from their DROP account. It outlines the specifics of the withdrawal and ensures compliance with program rules.

Understanding these accompanying forms can help individuals navigate the complexities of retirement fund management more effectively. Each document plays a vital role in the overall process, ensuring that members can access their benefits in a timely and organized manner.

Similar forms

The Maryland 193 form shares similarities with the IRS Form 5305, which is used for establishing a Traditional Individual Retirement Account (IRA). Both forms facilitate the transfer of funds into retirement accounts, ensuring that individuals can manage their retirement savings effectively. While the Maryland 193 form focuses on trustee-to-trustee distributions for state retirement plans, Form 5305 primarily serves as a template for individuals to open a Traditional IRA. Both documents emphasize the importance of accurate information and compliance with federal regulations, underscoring the significance of proper documentation in retirement planning.

Another document akin to the Maryland 193 form is the IRS Form 60, which is utilized for rollovers from qualified plans to IRAs. Similar to the Maryland 193 form, Form 60 outlines the necessary steps for completing a rollover, ensuring that funds are transferred correctly without incurring tax penalties. Both forms require detailed information about the payee and the receiving financial institution. They aim to protect individuals' retirement funds and provide a clear pathway for moving assets between accounts, reinforcing the importance of maintaining tax-advantaged status.

The Maryland 193 form also resembles the IRS Form 1099-R, which reports distributions from pensions, annuities, retirement plans, and IRAs. While the 193 form is used to initiate a rollover or distribution, Form 1099-R serves as a record of that transaction for tax purposes. Both documents are crucial in the lifecycle of retirement funds, as they ensure that individuals have the necessary information for reporting income and understanding tax implications. The connection between these forms highlights the ongoing administrative requirements tied to retirement savings.

Lastly, the Maryland 193 form is similar to the IRS Form 8606, which is used to report nondeductible contributions to Traditional IRAs and distributions from Roth IRAs. Like the Maryland 193 form, Form 8606 helps track the movement of funds and ensures compliance with tax regulations. Both documents require careful attention to detail and accurate reporting, emphasizing the importance of understanding one’s tax situation when managing retirement accounts. This relationship illustrates the interconnectedness of various forms in the realm of retirement planning and tax compliance.

Dos and Don'ts

When filling out the Maryland 193 form, it’s important to follow certain guidelines to ensure a smooth process. Here’s a list of what to do and what to avoid:

  • Do provide accurate personal information, including your full name and Social Security number.
  • Do clearly indicate the type of distribution you are requesting by checking the appropriate box.
  • Do ensure that your designated financial institution's name and address are correctly filled out.
  • Do double-check the account number, if provided, for accuracy.
  • Do sign and date the form to confirm your agreement with the distribution conditions.
  • Don't leave any required fields blank, as this may delay processing.
  • Don't check more than one distribution option; only select one.
  • Don't forget to send the completed form to the correct address: State Retirement Agency, 120 East Baltimore Street, Baltimore, Maryland 21202-6700.
  • Don't hesitate to contact a retirement benefits specialist if you have questions or need assistance.

By following these guidelines, you can help ensure that your form is processed efficiently and accurately.

Misconceptions

Here are some common misconceptions about the Maryland 193 form:

  • Misconception 1: The Maryland 193 form is only for retirees.
  • This form is not limited to retirees. It can also be used by individuals who are withdrawing accumulated contributions or voluntary funds.

  • Misconception 2: I can submit the form without any supporting documents.
  • Submitting the Maryland 193 form typically requires additional documentation, depending on the type of distribution selected. Ensure all necessary forms are included.

  • Misconception 3: I can choose any amount for distribution.
  • The form requires you to specify a flat dollar amount or select non-taxable funds. You cannot choose an arbitrary amount without following these guidelines.

  • Misconception 4: The form guarantees immediate payment.
  • Filling out the form does not guarantee immediate payment. Processing times can vary based on the agency and the specific details of the request.

  • Misconception 5: I can have multiple trustee-to-trustee distributions at once.
  • The Maryland State Retirement Agency only processes one trustee-to-trustee distribution at a time. Plan ahead to avoid delays.

  • Misconception 6: The form can be submitted online.
  • The Maryland 193 form must be completed and mailed to the State Retirement Agency. It is not available for online submission.

Key takeaways

When filling out and using the Maryland 193 form for trustee-to-trustee distributions, there are several important considerations to keep in mind. Here are four key takeaways:

  • Complete the Form Accurately: Ensure that all personal information, such as your name, Social Security number, and address, is filled out correctly. Any inaccuracies can lead to delays in processing your request.
  • Choose the Right Distribution Type: Carefully select the appropriate distribution type that applies to your situation. This could range from a withdrawal of accumulated contributions to a death benefit claim. Each option has different implications for your retirement funds.
  • Understand Payment Options: You must indicate how you want your distribution processed. You can choose to receive a flat dollar refund or have the funds sent directly to your designated IRA or eligible employer plan. Be aware that you are responsible for delivering any checks you receive to the appropriate institution.
  • Consult with Financial Institutions: Before initiating a rollover, contact the financial institution receiving your funds to confirm that they accept direct rollovers. This step is crucial to ensure a smooth transfer of your retirement assets.

By keeping these points in mind, you can navigate the Maryland 193 form process more effectively and make informed decisions about your retirement funds.