The Empower incoming rollover form is the document you use to move retirement money from a former employer’s plan or an existing IRA into your Empower-managed account. Download it from your participant dashboard at empower.com, fill in your personal details, the source plan information, and the tax character of the funds, then send it to Empower’s processing center along with a check made payable to Empower Trust Company for your benefit. Done correctly, the transfer keeps your savings tax-deferred and avoids the 10% early withdrawal penalty.
What to Gather Before You Start
Pull these together before you open the PDF. A single missing field can stall the transfer for weeks.
- Your Empower account or plan number, taken from your participant dashboard or a recent statement.
- Your Social Security number, required for identity verification and IRS reporting.
- The former plan’s details: the full name of the previous employer or custodian, the plan type (401(k), 403(b), 457(b), traditional IRA, Roth IRA, and so on), and the account number on the old side.
- The exact dollar amount of the distribution. If the old custodian has already cut the check, use that figure.
- The tax character of the money — pre-tax, Roth, or after-tax. This decides which bucket in your Empower account receives the funds. If the old account held both pre-tax and after-tax dollars, any distribution generally includes a proportional share of each.
One worry you can set aside: rollovers do not count against the annual IRA or 401(k) contribution limits.1Internal Revenue Service. Retirement Topics – IRA Contribution Limits You can move $50,000 or $500,000 without touching those caps.
Where to Download the Form
Log in at empower.com and look for a “Forms” or “Account Documents” area on your dashboard. The Incoming Rollover/Transfer form downloads as a PDF.2Empower. Incoming Rollover Processing If you can’t find it, call the number on your Empower statement and ask a representative to send it. Some employer plans publish a plan-specific rollover kit with its own instructions layered over the standard form, so check whether your plan sponsor has a customized version before you use a generic copy.
Working Through the Form
Personal and Account Information
The top section asks for your name, Social Security number, date of birth, mailing address, and Empower account or plan number. Check the account number twice against your dashboard. Transposed digits here are the single most common reason rollover checks sit in limbo.
Source of the Rollover
Identify the distributing plan: institution or employer name, plan type, and the account number on the old side. The form asks whether the money is pre-tax, Roth, or after-tax. Get this right. Empower has to deposit pre-tax money into a pre-tax account and Roth money into a Roth account. If the old plan held both pre-tax and after-tax amounts, the IRS requires each distribution to include a proportional share of both; you cannot cherry-pick the after-tax piece and leave the pre-tax behind.3Internal Revenue Service. Rollovers of After-Tax Contributions in Retirement Plans When the full balance comes out at once, you can direct the pre-tax piece to one destination and the after-tax piece to another.
Investment Election
The form includes a section where you decide how the incoming money gets invested once it posts. Typical options are matching your current allocation percentages, picking specific funds from the plan menu, or defaulting to the plan’s qualified default investment alternative, usually a target-date fund. If you leave this blank, most plans route the money into that default. Pick on purpose. Money parked in a stable-value or money-market default when you intended equities can quietly cost you years of growth.
Signature
Sign and date the form. Your signature certifies the assets are eligible for rollover into the receiving plan. Some plans require spousal consent for certain account types. If your plan requires a medallion signature guarantee for high-value transfers, you’ll need to visit a bank or brokerage in person to have the form stamped. A regular notary will not satisfy that requirement.
Direct Versus Indirect Rollover
The form asks you to specify which kind of rollover this is. The choice drives the entire tax treatment, so understand both before you check the box.
A direct rollover means the old plan sends the money straight to Empower, either by mailing a check made payable to Empower or by wiring the funds. You never personally control the money. No taxes are withheld, and no deadline presses on you.4Internal Revenue Service. Verifying Rollover Contributions to Plans
An indirect rollover means the old plan paid the distribution to you. Two things happen automatically when an employer plan cuts a check in your name: the plan withholds 20% for federal income taxes, and a 60-day clock starts ticking.5Internal Revenue Service. Topic No. 413, Rollovers From Retirement Plans You must deposit the full original distribution amount, including the 20% that was withheld, into the new account within those 60 days. If you received $40,000 after the old plan withheld $10,000, you have to come up with that $10,000 from your own pocket and deposit the full $50,000. Any shortfall is treated as a taxable distribution and may trigger a 10% early withdrawal penalty if you’re under 59½.6eCFR. 26 CFR 1.402(c)-2 – Eligible Rollover Distributions
Choose direct whenever possible.
Distributions That Cannot Be Rolled Over
Not every dollar leaving a retirement account qualifies. Empower will reject a form that tries to include ineligible money. The IRS excludes these distribution types from employer plans:7Internal Revenue Service. Rollovers of Retirement Plan and IRA Distributions
- Required minimum distributions. Once you’ve reached RMD age, that portion of the distribution has to go to you and cannot be rerouted into another tax-deferred account.
- Hardship withdrawals. Money pulled from a 401(k) for an immediate and heavy financial need is permanently distributed.8Internal Revenue Service. 401(k) Resource Guide – Plan Participants – General Distribution Rules
- Plan loans treated as distributions. If you defaulted on a 401(k) loan and the outstanding balance was reported as a distribution, that amount is ineligible.
- Substantially equal periodic payments. A series of payments calculated over your life expectancy under Section 72(t) cannot be individually rolled over.
- Excess contributions and related earnings. Corrective distributions of amounts that exceeded deferral limits are not rollover-eligible.
For IRA-to-IRA indirect rollovers, one more rule applies: you can complete only one such rollover in any 12-month period. The once-per-year rule does not apply to direct rollovers or to rollovers from an employer plan into an IRA.9Internal Revenue Service. Rollover Chart
Submitting the Form and the Check
Empower offers an online upload tool inside the secure participant dashboard. Digital submission creates an immediate record and usually shaves a few days off processing compared with paper mail.
If a physical check is involved, it must be made payable to Empower Trust Company, LLC FBO [Your Full Legal Name]. “FBO” stands for For the Benefit Of, and it tells Empower the funds belong to your retirement account rather than to you personally as taxable income. If the old plan mailed the check directly to you and it’s already in hand, endorse the back to “Empower Trust Company, LLC” before forwarding it.
The mailing address for rollover checks varies by employer plan. Your form’s instructions page or your Empower rollover kit lists the correct address for your specific plan. Don’t assume the general Empower corporate address works. Many plans use dedicated processing center addresses, and sending to the wrong one delays everything. Ship via a trackable carrier so you have proof of delivery.
What Happens After You Submit
Once Empower receives both the form and the funds, the processing team verifies the distribution qualifies, confirms the tax character, and invests the money according to your elections. There is no officially published processing window, but most participants should expect the funds to appear within roughly one to two weeks. You can monitor progress through the activity or transaction history section of the Empower portal.
When the rollover posts, your account balance updates and Empower typically sends an email or statement notification confirming the deposit. If more than two weeks go by without an update, call Empower’s participant services line. The usual holdups are a check made payable incorrectly, a missing signature, or a mismatch between the tax character on the form and what the distributing plan actually reported.
If You Missed the 60-Day Deadline
An indirect rollover that slipped past 60 days may still be salvageable. The IRS allows plan administrators and IRA trustees to accept late rollover contributions when you provide a written self-certification explaining why you missed the deadline. The certification has to follow the model letter in Revenue Procedure 2020-46 or be substantially similar.10Internal Revenue Service. Accepting Late Rollover Contributions
Valid reasons include serious illness, a postal error, the distributing plan’s delay in releasing the funds, or the death of a family member. Empower can rely on your self-certification as long as it has no information contradicting it. The certification only waives the 60-day requirement; it doesn’t fix other eligibility problems. If you missed the deadline without a qualifying reason, you can request a private letter ruling from the IRS, though that process is slower and involves a user fee.