Applications, Enrollment & Compliance Forms 2018-07-02T15:21:43+00:00

Forms, Applications, Enrollment and Compliance

Retirement Plan

RBI Benefit Enrollment Form

Rollover Transfer-In Form
(From another plan to PCA)

Distribution, Transfers and Roll-out
(from PCA to another plan)

Rollover Matrix
 (what plans can roll to what plans)


If you are an active employee of a PCA organization and have a PCA Retirement Account, you may take a loan against your PCA retirement account and pay yourself back with interest.  If interested in a loan, please call our office for details, and a loan application, at 678-825-1260.

Investment Option Change Form
(and Balance Transfers)

Hardship Distribution Request

Retirement income-expense worksheet

Retiree Distribution Request Form

W-4P Pension or Annuity Withholding Form
(Current tax year or visit for lastest form)

Organizations (for Treasurers & Administrators)

RBI 2018 Call Package Guidelines

403b Adoption Agreement

Group Insurance Adoption Agreement

Electronic Remittance Contribution Process
(for online Retirement Plan contributions)

Remittance Form PDF
(for mailed Retirement Plan contributions)

Remittance Form XLS
(for mailed Retirement Plan contributions)

Salary Reduction Agreement

Separation, Termination and Severance

Portability and Convertibility

Potential Tax Liability for Life Insurance Plans

Eligibility Matrix
(who is eligible for what insurance)

PCA Group Compensation Update.xls
(necessary for LTD)