How to request an in-service withdrawal after age 59½ (only available to currently employed participants) These forms are to be used to request an in-service withdrawal from the Ministry Employees Retirement Plan if you are at least 59½ years old and are still currently employed. The forms must be completed before a distribution can be processed. You are limited to only one withdrawal each Plan Year.  Print the entire Distribution Form File. It contains the Request for In-Service Withdrawal After Age 59½ form, Rollover Information form and Special Tax Notices Regarding Your Rollover Options for accounts with or without Roth balances.  Review and complete all applicable areas and fill in all of the applicable blanks.  If you want to have your distribution transferred electronically to your checking or savings account, complete the Direct Deposit information on the Request for In-Service Withdrawal form.  If you want to have your distribution rolled over to a financial institution or retirement plan, complete the Rollover Form.  Sign the forms. (Check the forms for completeness before submitting them. Missing or partial information will delay your distribution.)  The forms (except the Special Tax Notices) should be submitted to your church administrator for them to approve the distribution. If you have any questions about completing these forms, please call 1-800-442-4015 and follow the prompts by entering your Social Security Number and your PIN and then enter "*" followed by zero (0) to reach the Call Center between 8 AM and 8 PM Eastern, Monday through Friday.  Once your completed and signed forms are received, distribution of your in-service withdrawal will be paid in the manner indicated on the form generally within two weeks.  If you have elected to receive a check, your signature on the check will acknowledge your receipt of this distribution.  Please note: The administrative fee for processing a distribution is listed on the distribution form. You may want to take this into account when requesting your in-service distribution amount. MINISTRY EMPLOYEES RETIREMENT PLAN REQUEST FOR IN-SERVICE WITHDRAWAL AFTER AGE 59½ Social Security Number Last Name First Name Mailing Address City Date of Birth (MM/DD/YYYY) Date of Hire (MM/DD/YYYY) Prior Name (if applicable) Middle Initial State Telephone Number Zip Email Address REASON FOR WITHDRAWAL: In-service withdrawal after age 59½ (limited to sources allowed under the terms of your Plan) $ (Amount Requested) ACCOUNT BALANCE INFORMATION: Please call the Voice Response Unit (VRU) at 1 (800) 442-4015 or check the website at www.mcak.com/retirement to determine your current balance. Your distribution will be based on the current market value and vesting at the time processed. FORM OF DISTRIBUTION: Cash lump sum (complete information below for direct deposit to personal account) Direct rollover, complete attached "Rollover Information" form. If not rolling entire distribution, remainder will be paid in cash in a single sum. DIRECT DEPOSIT TO PERSONAL ACCOUNT (OPTIONAL): Make ACH transfer to: Bank name Routing Number Account Number Account Type: Checking Savings FEDERAL TAX WITHHOLDING: If a lump sum payment is $200 or less, no income tax is required to be withheld from it. However, if a payment is more than $200, then 20% is required to be withheld for federal income taxes unless you elect a direct rollover. You should read the attached "Special Tax Notice Regarding Your Rollover Options." It describes federal income tax withholding rules and other special tax rules. Depending on your tax bracket, you may owe estimated tax if your federal withholding is not sufficient to satisfy IRS rules. You may incur penalties if your federal tax withholding plus any estimated tax payments is not enough. NOTE: This form takes the place of the IRS Form W-4P, OMB No. 1545-0074. Read the information carefully, make any desired election, and sign and date the form in the signature section at the bottom of the next page. (1) If you elect a lump sum cash payment, 20% will automatically be withheld from the taxable portion for federal income taxes and forwarded to the IRS. You can elect more withholding than 20%. (A distribution from a Roth 403(b) account is only non-taxable if it is rolled over to an IRA or another qualified plan or if it is deemed a qualified distribution. See the Special Tax Notice Regarding Your Rollover Options for an explanation of a qualified distribution.) Complete the following information only if you want more than 20% withheld: Withhold % of this distribution for federal income tax purposes. (2) If you elect a direct rollover to an IRA or another plan, then no withholding will be made. However, if you elect to roll your distribution to a Roth IRA, you may elect below voluntary withholding on that part. Withhold the following from the portion of this distribution that I am rolling to a Roth IRA: $ or % STATE WITHHOLDING: If required by law, state income taxes will automatically be withheld from your payment. You can elect more withholding than the required minimum. Complete the following only if you want more than the required minimum withheld. Withhold the following dollar amount or percentage from my payment(s): $ or % PARTICIPANT SIGNATURE: I have read the above information and understand the withholding rules as they apply to my distribution from the Plan. I request that my Plan accounts be paid as I have elected above. I have read the "Special Tax Notice Regarding Your Rollover Options". Signature on this form indicates that under penalties of perjury, I certify that my name, address, and social security number shown above are correct. If I have elected a direct rollover, I also certify that the named recipient is eligible to receive a direct rollover. I understand that a $70 initial distribution fee will be deducted from my distribution. The amount of any short term redemption fee required by an investment fund will be deducted before my distribution is processed. (Information regarding short term redemption fees is provided on the Plan's website and fund prospectus.) If I have elected a direct deposit to a personal account, I understand I am responsible for providing accurate bank information and will hold harmless from any damages of any kind any entity that makes a transfer based on my instructions. I also understand that my financial institution may charge a fee for that service. Signed: Date: AUTHORIZATION BY CHURCH ADMINISTRATOR: Approved: Involuntary cash-out Date: Fee management sweep Participant's current vested percent: 100% NOTE: Please verify that all information requested has been completed. Missing information may delay processing of this distribution. Request for Distribution of Termination/Retirement Benefits Page 2 MINISTRY EMPLOYEES RETIREMENT PLAN ROLLOVER INFORMATION Complete this information if you are electing to roll over all or part of your distribution to another retirement plan or IRA. If rolling non-Roth contributions to an IRA, indicate whether they are being rolled to a regular or Roth IRA. Consult your advisor before rolling non-Roth contributions to a Roth IRA. (Roth 403(b)/Roth Rollover account(s) may be rolled over to another retirement plan that accepts Roth 403(b) contributions or a Roth IRA.) This completed form should be attached to the Request For Distribution form. Participant Name: Social Security Number: I am rolling my distribution, excluding any Roth account(s) to (if not rolling entire account, indicate amount being rolled $ remainder will be paid as elected on the Request For Distribution/Withdrawal of Benefits form): Another employer's plan: ; Name of receiving employer plan Street Address or P.O. Box. City, State & Zip Name of trustee/custodian Attn: An IRA or Name of receiving trustee A Roth IRA Street Address or P.O. Box, City, State & Zip Account number or identifier Attn: I am rolling my Roth 403(b) Account/Roth Rollover Account to (if not rolling entire account, indicate amount being rolled $ remainder will be paid as elected on the Request For Distribution/Withdrawal of Benefits form): Another employer's plan: ; Name of receiving employer plan Street Address or P.O. Box, City, State & Zip Name of trustee/custodian Attn: A Roth IRA: Name of receiving trustee Street Address or P.O. Box, City, State & Zip Account number or identifier Attn: Roth 403(b) contributions held in the Roth 403(b) Account / Roth 403(b) Rollover Account were first made (insert date): This distribution is to be completed by automated clearing house ("ACH") process: Name of receiving institution: ABA Transit Number: Account Number: The above information is necessary to ensure that the distribution to be made will have all of the required information on the check when it is prepared. Missing or incorrect information may cause a delay in the preparation of the check. If the trustee or successor employer has provided you with an instructional letter or application form relating to the above rollover, please attach a COPY of that information with this sheet. Participant Signature Request For In-Service Withdrawal After Age 59½ Date April 2013