Forms • Benefit Resources, Inc.

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Employee Forms

Salary Deferral Election

Roth Salary Deferral Election

Beneficiary Designation

Distribution Election

Direct Rollover Information

Cash Payment Information

Payments that cannot be rolled over

Surviving Beneficiary Information

Loan Application

Hardship Application

Rollover Request

Employer Forms

Broker QDIA Request

Census Template (print version)

Census Template (Excel version)

Roth 401(k) Information

Sample Policy Statements

Distribution Policy

Loan Policy

Company Representatives, post to Secure File Transfer or
fax or mail to BRI directly.