To receive a distribution from your savings account, please complete and submit the form below.


After receiving your request, a customer service representative will contact you to explain the steps required to process the distribution request.


    Name (required)

    Phone Number (required)

    Employer (required)

    Email Address(required)



    The Labor Alliance Savings Trust Fund provides that you are allowed to transfer all or part of an “eligible rollover distribution” directly from the Plan to another qualified pension plan or to an individual retirement arrangement (“IRA”). If you have received this form, you are about to receive one or more “eligible rollover distribution” described below. This notice and election form explains the Plan rules for electing to have your distribution(s) rolled over. Please also read the attached notice, Special Tax Notice Regarding Plan Payments.


    An “eligible rollover distribution” generally means any distribution over $200, or monthly payments totaling over $200 in a single year which are paid out over a period shorter than ten years. Under your Plan, total lump sum distributions, and installment payments for a fixed period of less than ten years, are eligible rollover distributions.


    If you elect to have an eligible distribution rolled over directly, your entire distribution (or the portion you designate, if at least $500) will be paid to the trustee(s) for the transferee plan or IRA. If you do not elect to roll your distribution over directly, your distribution will be paid directly to you, less a mandatory 20% withholding of federal income tax as required by law.


    To elect to have your distribution(s) rolled over, you must complete this form and return it to the Administration Office.