Short Form | Fed Options

Phone Short Form

Include with documentation: Pay Stub, TSP Statement, Social Security Statement, Employee Benefits Statement, DD214 (record of military service).

Step 1 of 12

URL

This field is for validation purposes and should be left unchanged.

Employee & Spouse Information

Phone Rep Name(Required)

Advisor Name(Required)

Phone Rep Email(Required)

Email for Analysis Delivery(Required)

Due Date(Required)

MM slash DD slash YYYY

Please provide 3 days for processing and ensure that due date is at least 1 day before customer appointment.

Employee Name(Required)

Employee DOB(Required)

MM slash DD slash YYYY

Age

Please enter a number from 0 to 100.

Is the employee married?(Required)

Yes

Spouse Name

Spouse DOB

MM slash DD slash YYYY

Spouse Age

Please enter a number from 0 to 100.

Spouse is

Was (is) the spouse a Federal Employee?

Yes

System

Address

Street Address City State ZIP Code

Phone

Retirement System & Employee Type

Retirement System(Required)

CSRS

CSRS OFFSET

FERS / FERS RAE / FERS FRAE

FERS TRANSFER

Employment Type(Required)

REGULAR

LEO (Law Enforcement Officer)/FF (Firefighter)/ CBPO (Customs and Border Protection Officer)

ATC (Air Traffic Control)

FF (Firefighter)

MRT (Military Reserve Technician

CBPO (Customs and Border Protection Officer)

POSTAL

CSRS OFFSET: Date Offset Began

MM slash DD slash YYYY

FERS TRANSFER: Date of Transfer

MM slash DD slash YYYY

Pension and Eligibility

LSCD (Leave SCD-from paystub /LES)(Required)

Retirement SCD (only if you have it)

6C SCD (Date began as LEO, FF, ATC, CBPO) Mandatory for Special Provision employee (hide not a special pro employee)

Retirement Type

When does employee want to retire? (Select One)(Required)

FULLY Eligible (Immediately NO reduction)

FIRST Eligible (MRA+10 Retirement)

Deferred Retirement

Voluntary (EARLY OUT)

Disability

At Age

Please enter a number from 50 to 75.

Voluntary (EARLY OUT) - Offer Date (only when selected above)

MM slash DD slash YYYY

Disability Date (if applicable) (only when selected above)

MM slash DD slash YYYY

Deferred Retirement Date

MM slash DD slash YYYY

Income and Pension Values

Will the employee’s High-3 be based on their CURRENT salary?

Yes

What is current salary amount?(Required)

If NOT: High-3 Salary Amount #1

If NOT: High-3 Salary Amount #2

If NOT: High-3 Salary Amount #3

Social Security Income and Special Retirement Supplement (SRS)

Amount of SS at 62(Required)

Please enter a number greater than or equal to 0.

What age does the employee estimate begin SS Income?

Please enter a number from 0 to 100.

Amount to receive

Please enter a number greater than or equal to 0.

Part Time Service

Has the employee worked Part-Time while contributing to CSRS or FERS?(Required)

Yes

Part-Time Service: From

MM slash DD slash YYYY

Part-Time Service: To

MM slash DD slash YYYY

Part-Time Service: Hours worked per week

Non-Deduction Service

Has the employee ever worked in a Non-Deduction Status when contributions were NOT taken from their pay?(Required)

Yes

Non-Deduction Service: From

MM slash DD slash YYYY

Non-Deduction Service: To

MM slash DD slash YYYY

Was a deposit paid?

Yes

What was the deposit owed?

Please enter a number greater than or equal to 0.

BREAK IN SERVICE / REFUNDED SERVICE

Did the employee ever have a Break in Service of more than 3 days?(Required)

Yes

Break in Service: Dates of service PRIOR to the BREAK (From)

MM slash DD slash YYYY

Break in Service: Dates of service PRIOR to the BREAK (To)

MM slash DD slash YYYY

Break in Service: Date employee RETURNED to federal service

MM slash DD slash YYYY

During break: Did the employee take a Refund of retirement contributions?

Yes

Was a Redeposit made after returning to federal service?

Yes

Amount of Redeposit ($)

Please enter a number greater than or equal to 0.

Military Service Details

Fill in below if Military service = Yes.

Has the employee ever had Military service?(Required)

Yes

If yes, what type of service was it?

Active-Duty

Reserve

Academy

Active-Duty: From

MM slash DD slash YYYY

Active-Duty: To

MM slash DD slash YYYY

Active-Duty: Deposit paid?

Yes

Active-Duty: Amount owed

Please enter a number greater than or equal to 0.

Reserve: From

MM slash DD slash YYYY

Reserve: To

MM slash DD slash YYYY

Reserve: Deposit paid?

Yes

Reserve: Amount owed

Please enter a number greater than or equal to 0.

Reserve: From

MM slash DD slash YYYY

Reserve: To

MM slash DD slash YYYY

Reserve: Deposit paid?

Yes

Reserve: Amount owed

Please enter a number greater than or equal to 0.

Academy: From

MM slash DD slash YYYY

Academy: To

MM slash DD slash YYYY

Reserve Academy

Yes

Academy: Amount owed

Please enter a number greater than or equal to 0.

If the employee Retired from Military service, which type was it?

Active-Duty

Reserves

Is the employee collecting VA pay?

Yes

Amount of VA pay $ / month

THRIFT SAVINGS PLAN (TSP)

WHILE WORKING

Does the employee contribute to Traditional TSP?

Yes

Percentage Paid to Traditional TSP

Please enter a number from 0 to 100.

$ /PP

Please enter a number greater than or equal to 0.

Does the employee contribute to Roth TSP?

Yes

Percentage Paid to Roth TSP

Please enter a number from 0 to 100.

$ /PP

Please enter a number greater than or equal to 0.

Assets

Fund Choices

Current Balance ($)

Future Allocation (%)

G Fund Balance

Please enter a number greater than or equal to 0.

G Fund Allocation

Please enter a number from 0 to 100.

F Fund Balance

Please enter a number greater than or equal to 0.

F Fund Allocation

Please enter a number from 0 to 100.

C Fund Balance

Please enter a number greater than or equal to 0.

C Fund Allocation

Please enter a number from 0 to 100.

S Fund Balance

Please enter a number greater than or equal to 0.

S Fund Allocation

Please enter a number from 0 to 100.

I Fund Balance

Please enter a number greater than or equal to 0.

I Fund Allocation

Please enter a number from 0 to 100.

L INCOME

L Income Fund Balance

Please enter a number greater than or equal to 0.

L Income Fund Allocation

Please enter a number from 0 to 100.

L 2025

L 2025 Fund Balance

Please enter a number greater than or equal to 0.

L 2025 Fund Allocation

Please enter a number from 0 to 100.

L 2030

L 2030 Fund Balance

Please enter a number greater than or equal to 0.

L 2030 Fund Allocation

Please enter a number from 0 to 100.

L 2035

L 2035 Fund Balance

Please enter a number greater than or equal to 0.

L 2035 Fund Allocation

Please enter a number from 0 to 100.

L 2040

L 2040 Fund Balance

Please enter a number greater than or equal to 0.

L 2040 Fund Allocation

Please enter a number from 0 to 100.

L 2045

L 2045 Fund Balance

Please enter a number greater than or equal to 0.

L 2045 Fund Allocation

Please enter a number from 0 to 100.

L 2050

L 2050 Fund Balance

Please enter a number greater than or equal to 0.

L 2050 Fund Allocation

Please enter a number from 0 to 100.

L 2055

L 2055 Fund Balance

Please enter a number greater than or equal to 0.

L 2055 Fund Allocation

Please enter a number from 0 to 100.

L 2060

L 2060 Fund Balance

Please enter a number greater than or equal to 0.

L 2060 Fund Allocation

Please enter a number from 0 to 100.

L 2065

L 2065 Fund Balance

Please enter a number greater than or equal to 0.

L 2065 Fund Allocation

Please enter a number from 0 to 100.

Total

Current Balance Total ($)

Total current balance dollar amount

Future Allocation Total (%)

Total future allocation percentage

Please upload any supporting files

Drop files here or

Max. file size: 50 MB.

Phone Short Form

Employee & Spouse Information

Retirement System & Employee Type

Pension and Eligibility

Retirement Type

Income and Pension Values

Social Security Income and Special Retirement Supplement (SRS)

Part Time Service

Non-Deduction Service

BREAK IN SERVICE / REFUNDED SERVICE

Military Service Details

THRIFT SAVINGS PLAN (TSP)

Assets

Fund Choices

Current Balance ($)

Future Allocation (%)

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