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403(b) Plan Questionnaire – New IRS 403(b) Regulations
 
To complete your questionnaire online, please input each answer then press the tab key to advance. Answer all questions, and when you’re done, please submit or print your form right away; the system will not save your answers.

Fields marked with an * are required fields

I. CONTACT INFORMATION
* Church/Employer Name:
 
* Street Address:
 
* City:
 
* State:
 
* Zip:
 
* Telephone #:
(in xxx-xxx-xxxx format)
 
Church Email Address:
 
* Primary Contact:
 
* Preferred Contact Method
(Choose one of three. Change your choice by making another selection):
 
Church Phone
Church Email
US Mail to Church Address

II. OTHER PLANS

The new 403(b) regulations make the employer responsible for the administrative activities of their retirement plan.  These responsibilities include, but are not limited to, tracking contribution limits and certifying distribution and loan requests across all 403(b) plans the employer offers to ensure no employees are exceeding any IRS limits.  If your church/organization currently participates in or has participated in more than one 403(b) retirement plan, your church/organization is responsible to coordinate activity among these different retirement plans.  Partnering with MMBB will greatly simplify what you need to do.

* 
Does your church/organization currently participate in or have you ever participated in any 403(b) plans other than those offered by The Ministers and Missionaries Benefit Board (Retirement Plan offered under The Benefits for Life Program, The Tax Deferred Annuity, or The Annuity Supplement)?

 
Yes (complete next section)
No
Not Sure
 
If yes, for each other plan please list the plan name and  Administrative Service Provider for each plan. Examples of Administrative Service Providers include TIAA-CREF, Fidelity Investments, State Farm Insurance Company.

Other Plan 1:
Plan Name:
 
Service Provider:
 

Other Plan 2:
Plan Name:
 
Service Provider:
 

Other Plan 3:
Plan Name:
 
Service Provider:
 
Print it and fax it to:
1 (800) 986-6782
Print it and mail it to:
MMBB
475 Riverside Drive, Suite 1700
New York, NY 10115-0049