Welcome To
NC Lifetime Income

NC 401 (k) / Deferred Compensation Plans Transfer Benefit Suitability Form

Please provide the following information so SECU staff can help you determine if the transfer benefit may be suitable for you.
*
 
Daytime Street Address
*
 
 
City
*
 
State
*
 
*
 
* - 
* - 
*
 
 
Date of Birth
Month
*
Day
*
Year
*
Spouse’s Date of Birth (if applicable)
Month
Day
Year
 
*
 
Desired Effective Date of the Transfer Benefit
   
Month
*
Day
*
Year
*
Monthly Household Income
 
  
 
$
 
  
 
Start Date if Not Receiving
  
Month
Day
Year
 
  
 
$
 
  
 
Start Date if Not Receiving
  
Month
Day
Year
 
  
 
$
 
  
 
$
 
 
  
 
$
 
 
  
 
$
 
 
  
 
$
 
 
   
 
   
  
Monthly Household Expenses – Limited Time
 
  
 
$
 
  
 
End Date (if any)
  
Month
Day
Year
 
  
 
$
 
  
 
End Date (if any)
  
Month
Day
Year
 
   
 
   
  
Monthly Household Expenses – Ongoing
  
  
  
   
Household Savings Balances
 
  
 
$
 
  
 
$
 
 
  
 
$
 
  
 
$
 
  
 
$
 
 
   
 
   
  
If you hope to leave an inheritance, please indicate the amount
  
State Employees' Credit Union, There is a difference!
LGFCU, Local Government Federal Credit Union
North Carolina ORBIT, Online Retirement Benefits through Integrated Technology