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TSA Forms

If you need a form or service that is not provided below, please call our service center at 1.877.884.5050, weekdays from 7 a.m. to 7 p.m. CST. Do you need a mailing address?


Form Name Form Number Description
403(b) Loan Overview Frequently Asked Questions
(pdf 110kb)
15476 Answers to some of the most commonly asked questions about 403(b) TSA loans.
Loan Request and Agreement Section 403(b)/Tax Sheltered Annuity Contract
(pdf 111kb)
119284 Request a loan from your 403(b)/TSA account.
Request for Disbursement
(pdf 687kb)
119262 Request for Disbursement needed in addition to loan app or withdrawal app if subject to Erisa terms.
Begin or Waive Required Minimum Distribution
(pdf 41kb)
119398 Activate your Required Minimum Distribution payments or to waive your RMD withdrawals.
Salary Reduction Amount and Contribution Allocation
(pdf 136kb)
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Start, stop or change the amount of money being withheld from your paycheck, or reallocate your contributions between contracts.

Telephone Exchange Authorization
(pdf 135kb)
119178 Authorize ING to let you or your agent transfer funds over the phone.
Variable Annuity Automatic Reallocation Request
(pdf 110kb)
119181 Automatically reallocate your funds among sub-accounts.
Variable Account Withdrawals/Payments
(pdf 108kb)
119182 Establish a payment schedule to receive periodic (systematic) withdrawals from a variable account.

Need to mail an item?
Please use the following addresses:

General Correspondence
ING Service Center
P.O. Box 5050
Minot, ND 58702-5050

Payment Address
ING Service Center
P.O. Box 5060
Minot, ND 58702-5060

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