Certifying that all the information provided in conjunction with this distribution request is true and accurate to the
best of my knowledge and I understand that misrepresentations or incorrect information my delay or cause the request to be declined.
There may be tax implications associated with the requested distribution; please see your financial advisor, tax advisor or
investment provider for further details. Arista Consulting Group understands that your personal information and privacy are important,
and we make every effort to ensure that the information you submit for a distribution is recorded accurately, retained securely, and
used only for the purpose intended. Please note that relevant information about your distribution may be shared with, and between,
employers, 403(b)/457(b) investment providers and Arista Consulting Group.