Forms

Forms

In order to ensure the timely processing of your request, please read the entire form and instructions before completing and return the completed form to the address indicated. Forms that are not received in “good order” will be returned.

Enrollment

In order to enroll in the City of Portland Governmental 457(b) Plan, the following four (4) forms must be completed: Enrollment Form (Voya only), Participation Agreement, Acknowledgement Form, and Beneficiary Designation Form.

Voya Enrollment Form – This Voya form is used to enroll in the City of Portland Governmental 457(b) Deferred Compensation Plan. Note: Not required for Advantis Credit Union)

Participation Agreement Form – This form is used to begin, change or stop elective deductions from your paycheck into the Plan. You must be enrolled in the Plan in order for the deductions to begin. Please return this form to your Human Resources Department.

Acknowledgement Form – Your signature on this form acknowledges that you received all documents and disclosures required for enrollment. This form is required upon enrollment and the restart of payroll deductions.

Beneficiary Designation Form – You are permitted to designate a person(s) who will receive payment of benefits in the event of your death. You designate a beneficiary (or make changes to your previous designation) by completing a Beneficiary Designation Form. The completed form should be returned to the City.

To ensure that death benefits under the Plan are paid to the individual(s) of your choice, you should periodically review your plan beneficiary designation(s) and determine whether any changes are appropriate. This is especially true if you have a life change event (e.g., marriage, birth of a child, divorce or death).

It is important to note that with respect to the beneficiary(ies) you have designated:

  • If you have a change in status, your designation is not necessarily updated automatically. For example, depending on the governing state law, if your spouse is your beneficiary and you get divorced, your ex-spouse may remain your Plan beneficiary until you make a change to your designation.
  • The beneficiary you designate under the Plan is separate from any designation you may have made under the City’s pension plan or group life coverage.

If you are designating a Trust as a beneficiary, this Affidavit of Trust [link to Affidavit PDF] is required to be completed and included with your beneficiary designation form.

If you do not designate a beneficiary under the 457 Plan, in the event of your death, benefits will be paid to your estate. Please refer to the 457 Plan Highlights section of this website for specifics.

PARTICIPATION AGREEMENT FORM – FINAL PAYCHECK ONLY – This form should be returned to your Human Resources Department.

Catch-up FAQ’s, Instructions and Application (2015) – This form provides information on the catch-up elections available under the plan.

Incoming Rollover Acknowledgement Form – In order to rollover benefits into the Plan, the City requires that you complete an Acknowledgment Form. If you are rolling assets into your Voya plan account, you will need to complete a Voya form as well. We have a team of rollover specialists available to assist you with the exchange/rollover process. Please contact your local Voya representative.

Interprovider Transfer Form – This form is used to transfer assets from your Advantis plan account to your Voya plan account or from Voya to Advantis.

Qualified Domestic Relations Order – The procedures that will be used for processing Qualified Domestic Relations Orders and a sample order.

Unforeseeable Emergency Withdrawal Request / Voya Participant – For the eligible reasons If a participant experiences a financial hardship that cannot be relieved by other financial means (insurance, liquidation of assets, and cessation of deferrals into the Plan) and meets the requirements of the Internal Revenue Code and the Plan, a request for withdrawal under this option may be authorized. The participant must call the Customer Service and speak with a CSA who will provide the withdrawal request package.

Unforeseeable Emergency Withdrawal Request / Advantis Participant – For the eligible reasons If a participant experiences a financial hardship that cannot be relieved by other financial means (insurance, liquidation of assets, and cessation of deferrals into the Plan) and meets the requirements of the Internal Revenue Code and the Plan, a request for withdrawal under this option may be authorized. The information package and withdrawal form are available here.

You should consider the investment objectives, risks, and charges and expenses of the mutual funds offered through a retirement plan, carefully before investing. The fund prospectuses and information booklet containing this and other information can be obtained by contacting your local representative. Please read the information carefully before investing.

Not FDIC/NCUA/NCUSIF Insured | Not a Deposit of a Bank/Credit Union | May Lose Value | Not Bank/Credit Union Guaranteed | Not Insured by Any Federal Government Agency

Insurance products issued by Voya Retirement Insurance and Annuity Company, One Orange Way, Windsor, CT 06095-4774. Securities are distributed by Voya Financial Partners, LLC (member SIPC). Custodial account agreements or trust agreements are provided by Voya Institutional Trust Company. Insurance obligations are the responsibility of each individual company. All companies are members of the Voya® family of companies. Securities may also be through other broker-dealers with which Voya has selling agreements. Product and services may not be available in all states. CN-0315-13077-0417