Tax forms decision chart: Tier One/Tier Two

Which tax forms do you need to fill out and send with your application?

The chart below will help you determine which tax forms must accompany your Tier One/Tier Two retirement application.

If you have selected…		…You will need to complete the forms marked with an “X” in the column directly across from the option you selected:		If rolling lump-sum
Option you chose	Payment Type	Form 1 W-4P	Form 2 W-4R Lump Sum Tax Withholding	Form 3 Tier One/Tier Two Program Direct Transfer Rollover Acceptance
Option 1 Option 2 Option 2A Option 3 Option 3A 15-Year Certain Refund Annuity	Monthly benefit	X
Lump Sum 1 Lump Sum 2 Lump Sum 2A Lump Sum 3 Lump Sum 3A	Monthly benefit	X
Lump Sum 1 Lump Sum 2 Lump Sum 2A Lump Sum 3 Lump Sum 3A	Lump-sum benefit		X	X
Total Lump-Sum	Lump-sum benefit		X	X