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Get Ma Rs-34951-03 2016-2024

Plan account: • a cash payment • a direct rollover to an eligible retirement plan or IRA • a transfer to purchase Permissive Service Credit under a governmental defined benefit plan, if the plan permits • a direct payment of Qualified Health Insurance Premiums, if the plan permits • a transfer to another provider within this Plan or to another 457(b) plan • a distribution pursuant to a Qualified Domestic Relations Order (QDRO) Do not use this form if you want to request: • a requi.

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