Distribution — Rollover Use this form to request a rollover distribution from your 401(a), 401(k), 403(b) or 457(b) governmental employer plan. Fill in by hand using CAPITAL letters and black ink, or on screen (if PDF). If you need more room for information, use a copy of the relevant page. 1. Account Owner/Participant, requested as a rollover . A Previous Employer. For 403 ( b ) and 401(a)/(k) plans, this is a rollover transaction. For governmental 457( b ) plans, this is a rollover unless Fidelity receives direction to process as a transfer. A Rollover IRA. This is a rollover transaction. After-tax value may not be rolled from an IRA. A Traditional IRA or SEP IRA.
Distribution — Rollover Use this form to request a rollover distribution from your 401(a), 401(k), 403(b) or 457(b) governmental employer plan. Fill in by hand using CAPITAL letters and black ink, or on screen (if electronic file). If you need more room for information or signatures, use a.
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Transfer /Rollover/Exchange Form Instructions, Transfer /Rollover/Exchange Form Instructions, Transfer /Rollover/Exchange Form Instructions, Questions? Distribution — Rollover – Fidelity Investments
