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Forms

Pension Plan	Trinity Health Pension Plan
Savings Plan	Trinity Health 403(b) After Tax Retirement Savings Plan (RSP) Trinity Health 403(b) Retirement Savings Plan (RSP) Trinity Health 401(k) After Tax Retirement Savings Plan (RSP) Trinity Health 401(k) Retirement Savings Plan (RSP) Trinity Health 401(k) Retirement Savings Plan (RSP) - St. Joe's Ann Arbor (Frozen Plan) Advantage Health 401(k) Retirement Savings Plan (RSP) Trinity Health 457(b) Plan Trinity Health Deferred Compensation Plan for Taxable Entities
Other	Special Tax Notice Regarding Plan Payments for Qualified and 403(b) Plans Appointment of Limited Attorney-in-Fact Participant Employment Transfer Investment Mix Worksheet NEW - Expedited Funds Delivery Form

Trinity Health Pension Plan *TT069026*	Document	Description
Beneficiary	Pension Plan Beneficiary Designation	Use for Beneficiary Designations for the Trinity Health Pension Plan.

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Trinity Health 403(b) RSP TT069026	Document	Description
After-Tax Salary Reduction	After-Tax SalaryReductionAgreement	After-tax SalaryReductionAgreement for the Trinity Health 403(b) Plan.
Beneficiary	403(b) Beneficiary Designation	Use for Beneficiary Designations covering all Plans with an outstanding balance. To elect Beneficiary Designations by each individual Plan, please contact your local on-site Retirement Plan Specialist, or a call center representative at 800-394-5240 to obtain the appropriate Beneficiary Designation Form.
HomeLoan	403(b) HomeLoan	Use for HomeLoans from the Trinity Health 403(b) Plan.
HardshipWithdrawal Request	403(b) HardshipWithdrawal	Use for HardshipWithdrawals from the Trinity Health 403(b) Plan.
In-Service Withdrawal	403(b) In-Service Withdrawal	Use for In-Service Withdrawals from the Trinity Health 403(b) Plan, including after-tax distributions.
Distribution Request (Full)	403(b) Distribution Request	Use for full Distributions from the Trinity Health 403(b) Plan.

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Trinity Health 403(b) RSP TT069066	Document	Description
After-Tax Withdrawal	After-Tax In-Service Withdrawal	Use for After Tax In-Service Withdrawals from the Trinity Health After Tax 403(b) Plan..
Beneficiary	403(b) After-Tax Beneficiary Designation	Use for Beneficiary Designations covering all Plans with an outstanding balance. To elect Beneficiary Designations by each individual Plan, please contact your local on-site Retirement Plan Specialist, or a call center representative at 800-394-5240 to obtain the appropriate Beneficiary Designation Form.
Distribution Request (Full)	403(b) Distribution Request	Use for full Distributions from the Trinity Health 403(b) Plan.

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Trinity Health 401(k) RSP TT080181	Document	Description
After-Tax Salary Reduction	After-Tax SalaryReductionAgreement	After-tax SalaryReductionAgreement for the Trinity Health 401(k) Plan. Please return to your employer.
Beneficiary	401(k) Beneficiary Designation	Use for Beneficiary Designations covering all Plans with an outstanding balance. To elect Beneficiary Designations by each individual Plan, please contact your local on-site Retirement Plan Specialist, or a call center representative at 800-394-5240 to obtain the appropriate Beneficiary Designation Form.
HomeLoan	401(k) HomeLoan	Use for HomeLoans from the Trinity Health 401(k) Plan.
HardshipWithdrawal Request	401(k) HardshipWithdrawal	Use for HardshipWithdrawals from the Trinity Health 401(k) Plan.
In-Service Withdrawal	401(k) In-Service Withdrawal	Use for In-Service Withdrawals from the Trinity Health 401(k) Plan, including after-tax distributions.
Transfer / Rollover Distribution	401(k) Transfer / Rollover Request	Use to request a transfer or direct rollover.
Distribution Request (Full)	401(k) Distribution Request	Use for Distributions from the Trinity Health 401(k) Plan.

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Trinity Health 401(k) RSP St. Joseph Ann Arbor (Frozen Plan) TT080182	Document	Description
Beneficiary	401(k) Beneficiary Designation	Use for Beneficiary Designations covering all Plans with an outstanding balance. To elect Beneficiary Designations by each individual Plan, please contact your local on-site Retirement Plan Specialist, or a call center representative at 800-394-5240 to obtain the appropriate Beneficiary Designation Form.
HomeLoan	401(k) HomeLoan	Use for HomeLoans from the (Trinity Health) Saint Joseph Mercy Health System 401(k) Plan.
HardshipWithdrawal Request	401(k) HardshipWithdrawal	Use for HardshipWithdrawals from the (Trinity Health) Saint Joseph Mercy Health System 401(k) Plan.
In-Service Withdrawal	401(k) In-Service Withdrawal	Use for In-Service Withdrawals from the (Trinity Health) Saint Joseph Mercy Health System 401(k) Plan.
Transfer / Rollover Distribution	401(k) Transfer / Rollover Request	Use to request a transfer or direct rollover.
Distribution Request (Full)	401(k) Distribution Request	Use for full Distributions from the (Trinity Health) Saint Joseph Mercy Health System 401(k) Plan.

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Advantage Health 401(k) RSP TT080183	Document	Description
Beneficiary	401(k) Beneficiary Designation	Use for Beneficiary Designations for the (Trinity Health) Advantage Health 401(k) Plan.
HomeLoan	401(k) HomeLoan	Use for HomeLoans from the (Trinity Health) Advantage Health 401(k) Plan.
HardshipWithdrawal Request	401(k) HardshipWithdrawal	Use for HardshipWithdrawals from the (Trinity Health) Advantage Health 401(k) Plan.
In-Service Withdrawal	401(k) In-Service Withdrawal	Use for In-Service Withdrawals from the(Trinity Health) Advantage Health 401(k) Plan.
Transfer / Rollover Distribution	401(k) Transfer / Rollover Request	Use to request a transfer or direct rollover.
Distribution Request (Full)	401(k) Distribution Request	Use for full Distributions from the (Trinity Health) Advantage Health 401(k) Plan.

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Trinity Health 401(k) TT080202	Document	Description
After-Tax Distribution Request	After Tax Distribution Request	Use for after-tax distributions from the Trinity Health 401(k) Plan.
Beneficiary	401(k) After-Tax Beneficiary Designation	Use for Beneficiary Designations covering all Plans with an outstanding balance. To elect Beneficiary Designations by each individual Plan, please contact your local on-site Retirement Plan Specialist, or a call center representative at 800-394-5240 to obtain the appropriate Beneficiary Designation Form.

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Trinity Health 457 (b) Plan TI097382	Document	Description
Beneficiary	457 (b) Beneficiary Designation	Use for Beneficiary Designations covering all Plans with an outstanding balance. To elect Beneficiary Designations by each individual Plan, please contact your local on-site Retirement Plan Specialist, or a call center representative at 800-394-5240 to obtain the appropriate Beneficiary Designation Form.

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Trinity Health Deferred Compensation Plan for Taxable Entities TQ097383	Document	Description
Beneficiary	Beneficiary Designation	Use for Beneficiary Designations covering all Plans with an outstanding balance. To elect Beneficiary Designations by each individual Plan, please contact your local on-site Retirement Plan Specialist, or a call center representative at 800-394-5240 to obtain the appropriate Beneficiary Designation Form."
HardshipWithdrawal Request	Hardship Withdrawal	Use for Hardship Withdrawals from the Trinity Health Deferred Compensation Plan.

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Trinity Health Participant Employment Transfer TQ097383	Document	Description
Transfer	Employment Transfer	Use to request a transfer of participant records within Trinity Health.

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Trinity Health Investment Mix Worksheet Trinity Health Retirement Savings Plan	Document	Description
Investment Mix	Investment Mix Worksheet	These sample investment mixes are offered to help you create or fine-tune your own investment strategy, based on your time horizon for investing.

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Trinity Health Expedited Funds Delivery Request Trinity Health Retirement Savings Plan	Document	Description
Expedited Funds Delivery Request	Expedited Funds Delivery Request Form	Use this form to request expedited delivery of your funds, regarding your accompanying loan or distribution request.

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