Servicing Your Plan - Forms

You must be enrolled in the State of Connecticut Deferred Compensation 457 Plan prior to submitting the following service request forms. In order to ensure the timely processing of your request, please read the entire form and instructions before completing. Forms that are not received in “good order” will be returned. Please return the completed form to the address indicated to ensure the timely processing of your request.

457 Participation Agreement Form- This form is used to begin, change or stop deductions from your paycheck into the 457 Deferred Compensation plan. You must be enrolled in the State of Connecticut 457 plan in order for the deductions to begin. Please return both pages of this form to the ING address located in the upper right hand corner of the form.

Enrollment Form – This form is used to enroll in the State of Connecticut Deferred Compensation 457 Plan.

Beneficiary Designation Form – This form is used to update or change your beneficiary or beneficiaries for your State of Connecticut Deferred Compensation 457 Plan.

Precertification of Incoming Direct Rollover/Transfer – This form is to be used to provide notification to ING of your intent to rollover (or transfer) benefits from another 401(a), 401(k), 403(b), governmental 457(b) plan or traditional IRA into your State of Connecticut Deferred Compensation 457 Account. Please attach a copy of your most recent account statement from your prior plan provider or IRA account to this form.

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Insurance products issued by ING Life Insurance and Annuity Company (ILIAC). The 403(b)(7) is a series of mutual funds offered through a custodial account with ING National Trust.Seminars and securities offered through ING Financial Advisers, LLC (member SIPC), One Orange Way, Windsor, CT 06095-4774, or other broker-dealers with which ILIAC has selling agreements.