Transamerica Retirement Solutions Opt Out Refund Form
This form is for participants who wish to opt out of automatic enrollment in the retirement plan. Participants must complete this form within 90 days of their first automatic deferral. Ensure that all information is accurate for successful processing.
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How do I fill this out?
To fill out this form, start by providing your personal and plan information in Sections A and B. Next, indicate your request in Section C and ensure you sign Section D. Finally, submit the completed form to the Transamerica Plan Administration Service for processing.

How to fill out the Transamerica Retirement Solutions Opt Out Refund Form?
1
Complete Sections A-D.
2
Sign Section D.
3
Submit the form to Transamerica PASS.
4
Ensure all required information is filled out.
5
Keep a photocopy for your records.
Who needs the Transamerica Retirement Solutions Opt Out Refund Form?
1
Employees who are automatically enrolled and want to opt out.
2
Participants wishing to request refunds from their contributions.
3
Individuals looking to adjust their contribution rates to 0%.
4
Anyone who wants to maintain flexibility in retirement planning.
5
Employees needing to ensure compliance with IRS regulations.
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What are the instructions for submitting this form?
To submit this form, fax it to Transamerica at 866-846-2236 or mail it to Transamerica PASS Processing Center at 4333 Edgewood Road NE, Mail Drop 0001, Cedar Rapids, IA 52499. Ensure all sections are completed and signed to avoid processing delays. Retain a photocopy of your submission for your records.
What are the important dates for this form in 2024 and 2025?
Ensure to submit this form within 90 days of your first automatic deferral. Review your plan provisions for any specific deadlines. Stay informed about the IRS guidelines to avoid penalties.

What is the purpose of this form?
The purpose of this form is to allow participants who have been automatically enrolled in the retirement plan to opt out of the program. It ensures that employees can manage their contributions according to personal financial goals. By completing this form, participants affirm their understanding of the plan provisions and the consequences of their election.

Tell me about this form and its components and fields line-by-line.

- 1. Plan Information: Details about the company/employer, plan name, and contract number.
- 2. Participant Information: Personal details such as name, Social Security number, and contact information.
- 3. Election: Statement requesting the opt-out of automatic contributions.
- 4. Required Signatures: Acknowledgment of terms and participant signature.
What happens if I fail to submit this form?
If you fail to submit this form, your automatic contributions will continue, impacting your retirement savings. You will miss the opportunity to adjust your contribution levels or receive a refund. It's crucial to act promptly to secure your desired outcome.
- Ongoing Contributions: Your contributions will keep being deducted, affecting your paycheck.
- Tax Implications: Failure to opt out may lead to unexpected tax liabilities on contributions.
- Retirement Goals: Not opting out could jeopardize your retirement planning efforts.
How do I know when to use this form?

- 1. Automatic Enrollment: For employees wishing to opt out after automatic enrollment.
- 2. Contribution Adjustments: For participants wanting to manage contribution levels.
- 3. Refund Processing: For those requesting refunds for automatic contributions.
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