Rollover | Distribution

I have read and understand the special tax notice regarding plan payments, as required by law.



Hunnex and Shoemaker
701 Fifth Avenue Suite 7310
Seattle, WA 98104-7079


Important: Please sign all pages as indicated. If any pages are incomplete or unsigned, benefits cannot be paid. If your account is over $5000 and you are married, your spouse's signature must be notarized.

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