Form MyPBA Screen Shots

Contents
Form 700 – Apply for Benefits ....................................................................................................................................................................................... 2
Form 701 – Payee Information .................................................................................................................................................................................... 16
Form 707 - Designation of Beneficiary for Benefits Owed at Death (Receiving Benefits) ........................................................................................... 20
Form 708 - Designation of Beneficiary (Not Currently Receiving Benefits) ................................................................................................................. 23
Form 710 – Application for Electronic Direct Deposit ................................................................................................................................................. 25
Form 719 - Election to Withhold Federal Income Tax (FIT) from Periodic Payments ................................................................................................. 26

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Form 700 – Apply for Benefits
To apply for benefits online, a participant must have a benefit calculation in MyPBA. The calculation they wish to use will be selected to start the
process. The important elements of the calculation are the date to start receiving benefits and the surviving beneficiary. Both have already
been chosen during the “Request a benefit calculation” process.
If they enter a start date of 6/1/2021 or later, Question 2) will not appear. If they enter a date earlier than 6/1/2021, Question 2) will appear.

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There is an embedded link if they click – Your Benefit, Your Choice – PBGC Benefit Options that takes them to descriptions of the different forms
of benefit.

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If they choose Electronic Direct Deposit:

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There is an embedded link if they click – Your Benefit, Your Choice – PBGC Benefit Options that takes them to descriptions of the different forms
If they choose IRS Instructions:

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There is an embedded link if they click – Your Benefit, Your Choice – PBGC Benefit Options that takes them to descriptions of the different forms
If they choose to enter their own:

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Review – Screen 1 of 3 (user would scroll down)

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Review – Screen 2 of 3 (user would scroll down)

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Review – Screen 3 of 3 (user would scroll down)
User is required to print, sign, and notarize the actual form, even if this transaction is started on MyPBA, therefore, there is no corresponding
screen/field for the spouse consent waiver in MyPBA. The actual form will be required to be submitted.

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Form 701 – Payee Information
When a customer is logging in for the first time and classified as “in pay”, they get this pop up.

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If they select “yes” they are the participant in the plan, they must enter the information on their marital status and spouse name, date of birth
and gender. If they select “no”, they fill in the additional information shown below.

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If they select “yes” they are the participant in the plan, they must enter the information on their marital status and spouse name, date of birth
and gender. Spouse contact entry screen is below.

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Form 707 - Designation of Beneficiary for Benefits Owed at Death (Receiving Benefits)

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The participant can designate multiple beneficiaries by percentage, as long as they all add up to 100%.

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Form 708 - Designation of Beneficiary (Not Currently Receiving Benefits)
This designation is made during the “Request a benefit calculation” process.

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Form 710 – Application for Electronic Direct Deposit

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Form 719 - Election to Withhold Federal Income Tax (FIT) from Periodic Payments

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