Yes! You can use AI to fill out Fidelity Investments Transfer/Rollover/Exchange Form
The Fidelity Transfer/Rollover/Exchange Form (form number 022380001) is an official document used by retirement plan participants to transfer, roll over, or exchange assets from a previous employer's retirement plan, IRA, or other investment provider into a Fidelity employer-sponsored retirement account such as a 401(k), 403(b), or 457(b) plan. It is an essential form for consolidating retirement savings, ensuring assets are properly credited to the correct plan type and investment elections. Completing this form accurately is critical to avoid delays, tax complications, or misdirected funds. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
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Form specifications
| Form name: | Fidelity Investments Transfer/Rollover/Exchange Form |
| Number of pages: | 1 |
| Filled form examples: | Form Fidelity Transfer/Rollover/Exchange Form Examples |
| Language: | English |
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How to Fill Out Fidelity Transfer/Rollover/Exchange Form Online for Free in 2026
Are you looking to fill out a FIDELITY TRANSFER/ROLLOVER/EXCHANGE FORM form online quickly and accurately? Instafill.ai offers the #1 AI-powered PDF filling software of 2026, allowing you to complete your FIDELITY TRANSFER/ROLLOVER/EXCHANGE FORM form in just 37 seconds or less.
Follow these steps to fill out your FIDELITY TRANSFER/ROLLOVER/EXCHANGE FORM form online using Instafill.ai:
- 1 Navigate to Instafill.ai and upload the Fidelity Transfer/Rollover/Exchange Form PDF or select it from the available form library to begin filling it out online.
- 2 Complete Section 1 (Your Information) by entering your Social Security number or Tax ID, date of birth, full name, mailing address, and contact details including phone number and email.
- 3 Complete Section 2 (Investment Provider You Are Moving Money From) by providing the name, address, and phone number of your previous investment provider, and attach a copy of your most recent account statement.
- 4 Complete Section 3 (Account(s) or Contract(s) to Move) by entering your account or contract number(s), selecting the account type (403(b), 401(a)/(k), 457(b), or IRA), indicating the source of the account, and specifying the liquidation amount (full or partial).
- 5 Complete Section 4 (Your Fidelity Account Information) by providing the name of the employer sponsoring your Fidelity retirement account, your employment status, the plan type, and plan number if applicable.
- 6 Complete Section 5 (Investment Instructions) by indicating whether assets should follow your current investment elections on file with Fidelity, or by specifying fund names, fund codes, and percentage allocations totaling 100%.
- 7 Obtain the required employer authorized signature in Section 6 if applicable, then review all information, sign and date Section 7, and submit the completed form to Fidelity via the NetBenefits Mobile App, regular mail, or overnight mail.
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Frequently Asked Questions About Form Fidelity Transfer/Rollover/Exchange Form
This form is used to move retirement assets to your Fidelity employer-sponsored retirement account from a previous investment provider. You can also use it to consolidate multiple employer-sponsored retirement accounts currently held at Fidelity.
Anyone who wants to roll over, transfer, or exchange retirement assets from a previous employer's plan, an IRA, or another investment provider into their Fidelity employer-sponsored retirement account needs to complete this form. You must already have a Fidelity retirement account, or you must also complete an Account Application/Enrollment Form.
You must include a copy of your most recent account statement from your previous investment provider. You should also contact your previous provider to find out if any additional paperwork is required on their end before submitting.
No, you must use a separate form for each investment provider you are moving money from. However, a single form does allow you to move up to two accounts or contracts from the same provider using Sections 3A and 3B.
You can move assets from 403(b), 401(a)/(k), governmental 457(b) plans, Rollover IRAs, Traditional IRAs, and SEP IRAs. Note that Roth IRAs, Coverdell IRAs, and nongovernmental 457(b) plans cannot be processed using this form.
A vendor or contract exchange applies to 403(b)-to-403(b) movements within the same employer. An in-plan transfer applies to movements between the same plan types (e.g., 401(k) to 401(k)) within the same employer. A rollover applies to movements from a previous employer's plan or from an IRA to your current Fidelity plan.
Yes, you can choose either a Full Liquidation (100%) or a Partial Liquidation by specifying either a dollar amount or a percentage in Section 3. If you do not specify an amount, Fidelity will default to moving 100% of your balance.
In Section 5, you can choose to have the assets invested according to your current investment elections on file with Fidelity by selecting 'Yes.' If you prefer different allocations, select 'No' and list the fund names, fund codes, and percentages, ensuring they total 100%.
An authorized employer signature in Section 6 may be required depending on your plan. To verify whether this section needs to be completed, contact your Human Resources office or call Fidelity at 1-800-343-0860.
Fidelity cannot process your request without your signature and date in Section 7. Make sure to sign and date the form before submitting it, as an incomplete form may delay processing.
You can submit the form digitally using the NetBenefits® Mobile App (tap Actions > Send a Document), by regular mail to Fidelity Investments, PO Box 770002, Cincinnati, OH 45277-0090, or by overnight mail to 100 Crosby Parkway, Mailzone KC1E, Covington, KY 41015.
Yes, AI-powered services like Instafill.ai can help you accurately auto-fill form fields, saving you time and reducing errors. Simply upload the form to Instafill.ai and the tool will guide you through completing each section efficiently.
If you have a flat, non-fillable PDF version of this form, Instafill.ai can convert it into an interactive fillable form. This allows you to type directly into the fields, complete the form digitally, and submit it without needing to print and handwrite your information.
Visit Instafill.ai, upload your Transfer/Rollover/Exchange Form PDF, and the AI will help you auto-fill fields such as your personal information, account details, investment instructions, and liquidation amounts. Once completed, you can download the filled form and submit it to Fidelity via your preferred method.
You can contact Fidelity Investments at 1-800-343-0860 (or dial 711 for the hearing impaired), Monday through Friday, 8 a.m. to midnight Eastern time, excluding New York Stock Exchange holidays (except Good Friday). You can also visit www.netbenefits.com for additional assistance.
Compliance Fidelity Transfer/Rollover/Exchange Form
Validation Checks by Instafill.ai
1
Social Security Number or Tax ID Format Validation
Validates that the Social Security Number or U.S. Tax Identification Number is entered in the correct format (SSN: XXX-XX-XXXX or 9-digit numeric TIN). This field is critical because it is used to identify the account holder and may be used to request asset transfers if no account or contract number is provided. If the SSN/TIN is missing, incorrectly formatted, or contains non-numeric characters, the form cannot be processed and the transfer request will be delayed or rejected.
2
Date of Birth Format and Validity Check
Ensures the Date of Birth field is entered in a valid date format (MM/DD/YYYY) and represents a realistic, non-future date for an account holder. The date of birth is used to verify the participant's identity and may affect eligibility rules, early distribution penalties, and required minimum distribution calculations. An invalid, missing, or future date of birth will cause processing delays and potential compliance issues.
3
Required Personal Information Completeness Check
Verifies that all mandatory personal information fields in Section 1 are completed, including First Name, Last Name, Mailing Address, City, State, and ZIP Code. These fields are required to identify the account holder and ensure correspondence and processed assets are directed to the correct individual. Missing any of these fields will result in an incomplete form that Fidelity cannot process.
4
Phone Number Format Validation
Validates that the Daytime Phone and Evening Phone numbers, if provided, conform to a standard 10-digit U.S. phone number format (e.g., XXX-XXX-XXXX or (XXX) XXX-XXXX) and do not contain letters or special characters. Valid contact numbers are necessary for Fidelity or the previous investment provider to reach the account holder if questions arise during processing. Incorrectly formatted phone numbers may prevent timely communication and delay the transfer.
5
Email Address Format Validation
Checks that the email address field, if populated, follows a valid email format containing a local part, an '@' symbol, a domain name, and a top-level domain (e.g., [email protected]). A valid email address ensures the account holder can receive electronic notifications and correspondence regarding the transfer. An improperly formatted email address may result in failed delivery of important account communications.
6
Previous Investment Provider Information Completeness Check
Ensures that Section 2 is fully completed, including the Name of the investment provider, Provider Street Address, City, State, ZIP Code, and Provider Phone number. This information is required for Fidelity to contact the previous provider and initiate the asset transfer or rollover. If the provider's name or contact information is missing or incomplete, Fidelity will be unable to process the request and the form will be returned.
7
Account or Contract Type Selection Validation
Verifies that at least one account or contract type (403(b), 401(a)/(k), 457(b) governmental, or IRA) is selected in Section 3A, and in Section 3B if a second account is being moved. Selecting the correct account type is critical because it determines how the transaction is classified (rollover, transfer, or exchange) and which IRS rules apply. Failure to select an account type will result in an incomplete form that cannot be processed.
8
Transaction Source Selection and Previous Employer Name Validation
Confirms that exactly one transaction source option is selected per account (Same Employer, Previous Employer, Rollover IRA, or Traditional/SEP IRA) and that if 'A Previous Employer' is selected, the Previous Employer Name field is populated. The transaction source determines how the transfer is classified and processed, and the employer name is required to correctly route the assets. If no source is selected or the employer name is missing when required, the transaction cannot be properly categorized and will be delayed.
9
Liquidation Amount Specification and Format Validation
Validates that a liquidation amount option is selected (Full Liquidation/100% or Partial Liquidation) for each account listed, and that if Partial Liquidation is chosen, either a valid percentage (1–99%) or a positive dollar amount is entered but not both. Specifying the correct liquidation amount ensures that only the intended portion of assets is moved to the Fidelity account. If neither option is selected or the partial amount is invalid, Fidelity will default to liquidating 100% of the account, which may not align with the account holder's intentions.
10
457(b) Plan Compatibility Check
Checks that if 457(b) governmental assets are being moved, the destination Fidelity plan type is also a governmental 457(b) plan, and that nongovernmental 457(b) assets are not being processed through this form. IRS rules strictly require that governmental 457(b) assets be moved only into governmental 457(b) plans, and nongovernmental 457(b) transfers are not supported by this form. Failure to comply with this rule could result in an invalid transaction, tax penalties, or the form being rejected.
11
Roth IRA and Coverdell IRA Exclusion Validation
Ensures that the account type selected in Section 3 is not a Roth IRA or Coverdell IRA, as these account types are explicitly not accepted for rollover through this form. Rolling over ineligible account types would violate IRS regulations and could result in taxable distributions or penalties for the account holder. If a Roth IRA or Coverdell IRA is identified, the form should be flagged and the account holder directed to use the appropriate process.
12
Fidelity Employer and Plan Type Completeness Check
Verifies that Section 4 is fully completed, including the Employer Sponsoring the Fidelity Retirement Account, City and State of Employer, employment status (Yes/No), and the Plan Type for each account being moved (Sections 4A and 4B). This information is required to ensure that incoming assets are credited to the correct Fidelity employer-sponsored retirement account. Missing or inconsistent employer and plan type information will prevent proper crediting of assets and may cause significant processing delays.
13
Investment Instruction Percentage Total Validation
Validates that when specific fund investment instructions are provided in Section 5 (i.e., 'No' is selected for using current investment selection), the sum of all listed fund percentages equals exactly 100%. Each fund entry must also have a fund name and a valid percentage greater than zero. If the percentages do not total 100%, are missing, or are invalid, the entire contribution will be defaulted to the investment elections on file with Fidelity or the plan's default investment option.
14
Participant Signature and Date Presence Validation
Confirms that the participant's signature field (Section 7) is not blank and that the accompanying date is present and formatted as a valid date (MM/DD/YYYY) that is not in the future. The participant's signature certifies the accuracy of the information provided and authorizes the transfer under IRS and plan rules. Without a valid signature and date, Fidelity explicitly states it is unable to process the request, and the form will be returned unprocessed.
15
Employer Authorized Signature and Date Consistency Check
Checks that if the Employer Plan Acceptance section (Section 6) is completed, both the Employer Authorized Signature and the Employer Authorized Printed Name fields are filled in, and that the accompanying date is a valid, non-future date. An authorized employer signature may be required depending on the plan, and an incomplete Section 6 when required will result in the form being rejected. The date on the employer signature must also logically precede or match the participant's signature date to ensure proper sequencing of approvals.
16
Plan Type and Plan Number Consistency Validation
Verifies that the plan type selected in Sections 4A and 4B is consistent with the account or contract type selected in Sections 3A and 3B respectively, and that if a plan number is provided, it corresponds to a valid Fidelity plan for the stated employer. The form notes that if there is a discrepancy between plan type and plan number, the plan type selected will be used, which could result in assets being credited to an unintended account. Flagging inconsistencies between plan type and plan number allows the account holder to confirm their intent before submission.
Common Mistakes in Completing Fidelity Transfer/Rollover/Exchange Form
Many people accidentally transpose digits, leave the field blank, or enter a formatted version (e.g., with dashes) when the form requires a specific format. Since the SSN or Tax ID is used to identify your account and request assets if no account/contract number is provided, an error here can cause significant processing delays or misdirected funds. Always double-check your SSN or Tax ID against an official document before submitting. Tools like Instafill.ai can help auto-populate and validate this field to prevent transcription errors.
Filers frequently confuse plan types such as 403(b), 401(a)/(k), 457(b) governmental, and IRA, especially when they are unsure of what their previous employer offered. Selecting the wrong type can cause the transaction to be processed incorrectly — for example, treating a rollover as a transfer or vice versa — which may have tax consequences. Always refer to your most recent account statement from the previous provider or call them directly to confirm the exact plan type before checking a box.
The checklist explicitly requires a copy of the most recent statement from the previous investment provider, yet many people forget to attach it. Without this document, Fidelity may be unable to verify account details or contact the previous provider, leading to delays or rejection of the request. Before mailing or submitting digitally, confirm that the statement is attached and that it is recent enough to reflect current account information.
The form requires filers to specify whether the account being moved is from the same employer, a previous employer, a Rollover IRA, or a Traditional/SEP IRA, and each selection triggers a different transaction type (exchange, in-plan transfer, or rollover). Many people select the wrong source because they don't understand the distinction, which can result in the wrong transaction type being processed and potential tax or penalty issues. Carefully read the descriptions in Section 3 of the instructions and consult Fidelity at 1-800-343-0860 if you are unsure.
The form explicitly states that Roth IRAs and Coverdell IRAs cannot be accepted, and that transfers from nongovernmental 457(b) plans are not supported on this form. People unfamiliar with these restrictions may attempt to initiate such a transfer, causing the request to be rejected or returned. Review the account type restrictions in Section 3 of the instructions carefully, and contact Fidelity directly to discuss alternative options for these account types.
Some filers forget to specify a liquidation amount, while others intend a partial liquidation but fail to enter either a dollar amount or a percentage, leaving the field incomplete. If no amount is specified, Fidelity will default to moving 100% of the account balance, which may not be the filer's intention. Always clearly select either 'Full Liquidation/100%' or 'Partial Liquidation' and, if partial, enter either the exact dollar amount or percentage — not both — to avoid ambiguity.
A common error is listing fund names and percentages that do not add up to exactly 100%, or leaving the investment instructions section blank while also not selecting 'Yes' for current investment elections. When percentages don't total 100% or instructions are invalid, the entire contribution defaults to the investment elections on file, which may not align with the filer's goals. Double-check that all fund percentages sum to exactly 100%, and if you want to use your current elections, explicitly check 'Yes.' AI-powered tools like Instafill.ai can automatically validate percentage totals to prevent this error.
Filers sometimes enter a nickname, abbreviation, or incorrect version of their employer's name rather than the exact name as it appears on their Fidelity account statement or enrollment paperwork. A mismatch in the employer name can cause Fidelity to be unable to match the form to the correct plan, delaying or preventing the transfer. Always copy the employer name exactly as it appears on your Fidelity statement or enrollment documents, and contact Fidelity if you are unsure.
Many filers overlook Section 6 entirely, not realizing that an authorized employer signature may be required depending on the plan. Submitting the form without this signature when it is required will result in the form being returned unprocessed, causing significant delays. Contact your Human Resources office or Fidelity at 1-800-343-0860 before submitting to confirm whether an employer signature is needed for your specific plan.
The form cannot be processed without the participant's signature and date in Section 7, yet this is one of the most frequently missed steps, especially when filers are focused on completing the complex earlier sections. An unsigned form will be returned, restarting the entire process and potentially delaying the transfer by weeks. Before submitting, use the form's checklist to confirm that Section 7 is signed and dated, and ensure the date matches the day of submission.
The instructions clearly state that a separate form must be used for each investment provider, but filers with multiple accounts at different institutions sometimes try to list all providers on one form. This causes confusion in processing and may result in only one provider being contacted or the entire request being rejected. If you are moving assets from more than one investment provider, complete and submit a separate Transfer/Rollover/Exchange Form for each one.
Many filers assume that submitting the Fidelity form is all that is required, not realizing that their previous investment provider may have its own required forms, surrender charge disclosures, or authorization procedures. Failing to complete the previous provider's paperwork can stall or block the transfer entirely, even after Fidelity has processed their portion. Always contact your previous investment provider before or immediately after submitting this form to ask if any additional documentation is required on their end.
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