INSTRUCTIONS FOR COMPLETING FORMER PARTICIPANT ROLLOVER FORM. 1. If you would like to receive your settlement payment through a rollover to a qualified retirement account, complete this rollover form. You should also keep a copy of all pages of your Former Participant Rollover Form, including the first page with the address label, for your records.
2. Mail your completed Former Participant Rollover Form postmarked on or before [RETURN DATE SET FORTH IN PRELIMINARY APPROVAL ORDER] to the Settlement Administrator at the following address: It is your responsibility to ensure the Settlement Administrator has timely received your Former Participant Rollover Form.
