INSTRUCTIONS: ARIZONA LUMP SUM DISTRIBUTION ELECTION FORM (Form U3)

To elect to receive a lump sum distribution of funds in an Arizona retirement fund for elected officials, public safety personnel or corrections officers, file a form U3. This document can be obtained from the website maintained by these retirement systems.

Arizona Lump Sum Distribution Election Form U3 Step 1: On the first blank line, enter the name of the recipient.

Arizona Lump Sum Distribution Election Form U3 Step 2: On the second blank line, enter the Social Security number of the recipient.

Arizona Lump Sum Distribution Election Form U3 Step 3: On the third blank line, enter the date of the participant in the plan's retirement or death. This is not applicable if the form is being filed by an ex-spouse.

Arizona Lump Sum Distribution Election Form U3 Step 4: In section 1, check the first box if you are selecting a DROP, DROP beneficiary or CORP Reverse DROP election.

Arizona Lump Sum Distribution Election Form U3 Step 5: Check the second box if you are selecting a lump-sum death benefit.

Arizona Lump Sum Distribution Election Form U3 Step 5: In section 2, check the first box if you requesting total distribution to the recipient.

Arizona Lump Sum Distribution Election Form U3 Step 6: Check the second box if you are requesting a rollover. If so, you must list the financial institutions and the specific amount that will go to each as part of this rollover.

Arizona Lump Sum Distribution Election Form U3 Step 7: In section 3, enter your signature on the first blank line.

Arizona Lump Sum Distribution Election Form U3 Step 8: Enter the date on the second blank line.

Arizona Lump Sum Distribution Election Form U3 Step 9: The second page must be completed by every applicable financial institution if you are requesting a rollover. They should indicate your type of account with a check mark.

Arizona Lump Sum Distribution Election Form U3 Step 10: Your financial institution should enter the name of the account holder.

Arizona Lump Sum Distribution Election Form U3 Step 11: Your financial institution should enter your account number.

Arizona Lump Sum Distribution Election Form U3 Step 12: A financial institution representative should sign and date the form, as well as entering their mailing address.