CITY OF TALLAHASSEE PENSION ADMINISTRATION
TERMINATION OF EMPLOYMENT PENSION ACTION REQUEST

I am a terminating my employment with the City of Tallahassee and request my contributions and interest earnings thereon in the Defined Benefit Pension Plan be transferred into my Individual Retirement Account (IRA) or to another Employer’s qualified plan. I understand the check sent to my IRA or to another Employer’s qualified plan on my behalf is not subject to withholding.

Rollover checks are made payable to your IRA or your Employer’s qualified plan. To process the rollover, Payroll requires a letter from your Financial Institution verifying the Plan Name, Account Number, and the mailing address.

***Please complete a new COT Pension Beneficiary Form COT Pension Beneficiary Form for payment information in case of your death

- I am terminating my employment with the City of Tallahassee and have at least 5-years of permanent service on my last day of employment.

- I am terminating my employment with the City of Tallahassee and was hired on or prior to September 30, 2017, and I have at least 5-years of permanent service on my last day of employment, or I was hired on or after October 1, 2017, and have at least 10 years of service on my last day of employment.

- I am terminating my employment with the City of Tallahassee and was hired on or prior to July 6, 2021, and I have at least 5-years of permanent service on my last day of employment, or I was hired on or after July 7, 2021, and have at least 10 years of service on my last day of employment.

- I am terminating my employment with the City of Tallahassee and DO NOT have the required service years to vest and receive a pension benefit at a future date. I wish to voluntarily leave my Defined Benefit Pension Plan contributions on deposit for 5-years after leaving my City of Tallahassee employment pending the possibility of being rehired by the same department, without losing credit for the time I have participated actively as a firefighter or police officer. If I am not reemployed as firefighter or police officer with the same department within 5-years of my last day of employment, my contributions shall be returned.

I verify I have read the Vesting Criteria and meet the requirements to vest my pension contributions and interest earnings for my employee class and I acknowledge my responsibilities as a vested pension plan participant.

I am requesting

all contributions and interest earnings, if any, and I acknowledge I have read and understand all the above information in compliance with City Ordinance refunds and rollovers will be processed within 60 days of my termination unless I have any unresolved financial obligations to the City.

I have also read the Special Tax Notice regarding the plan payments and the Vesting Criteria.

I authorize the City to deduct any money owed from one or all the following retirement funds: Pension, MAP/401k, and RSVP/457 to resolve any financial obligations I have to the City prior to the issuance of my refund or rollover request.

If you have questions regarding your pension options, contact our office by phone at 850-891-8543 or email at retirement@talgov.com.
If you have questions about your Empower Retirement Accounts, contact Empower directly at 1-833-540-0407 or visit their website at www.retirewithtalgov.com.