Fidelity Transfer of Assets Form (TOA) - Your Veolia Benefits Completed Form Examples and Samples
View a filled example of the Fidelity Transfer of Assets Form (TOA) for Your Veolia Benefits. Our sample shows a completed TOA form with real-world data, including a full 401(k) rollover to a Fidelity Rollover IRA after separation from Veolia. Perfect for former and current Veolia employees looking to understand how to correctly fill out the Fidelity TOA form step by step.
Fidelity Transfer of Assets (TOA) – Veolia Benefits Example: Full 401(k) Rollover to IRA
How this form was filled:
This example shows a former Veolia employee initiating a full transfer of their 401(k) balance from their Veolia-sponsored Fidelity workplace account into a personal Fidelity Rollover IRA. The form includes the participant's personal details, the delivering account information, the receiving account details, transfer type selection (full transfer), and a wet signature with date. This is one of the most common use cases for employees who have left Veolia and want to consolidate retirement savings.
Information used to fill out the document:
- Participant Full Name: Maria L. Henderson
- Social Security Number (SSN): XXX-XX-7842
- Date of Birth: 03/14/1978
- Phone Number: 617-555-0193
- Email Address: [email protected]
- Mailing Address: 48 Oakwood Drive, Boston, MA 02108
- Employment Status: Former Employee
- Last Day of Employment at Veolia: 01/31/2025
- Delivering Plan Name: Veolia North America 401(k) Plan
- Delivering Account Number: Z23847610
- Delivering Firm / Custodian: Fidelity Investments (Workplace)
- Receiving Account Type: Fidelity Rollover IRA
- Receiving Account Number: 489-337201
- Receiving Account Holder Name: Maria L. Henderson
- Transfer Type: Full Transfer (100% of assets)
- Asset Type: All Assets (Cash and In-Kind Securities)
- Reason for Transfer: Rollover from employer-sponsored 401(k) after separation from service
- Liquidation Instruction: Transfer in-kind where possible; liquidate remainder
- Signature: Maria L. Henderson
- Date Signed: 02/18/2025
What this filled form sample shows:
- Correctly identified former Veolia employee status with last day of employment listed as January 31, 2025
- Delivering account clearly specified as the Veolia North America 401(k) Plan with Fidelity workplace account number
- Receiving account designated as a Fidelity Rollover IRA to preserve tax-deferred status of funds
- Full Transfer option selected to move 100% of the account balance in a single transaction
- In-kind transfer instruction noted to avoid unnecessary liquidation of invested assets where possible
- Participant's personal and contact information fully completed to prevent processing delays
- Form signed and dated within the same calendar quarter as the separation from service
- Demonstrates a common post-employment retirement account consolidation scenario for Veolia Benefits participants
Form specifications and details:
| Form Name: | Fidelity Transfer of Assets Form (TOA) – Your Veolia Benefits |
| Use Case: | Full 401(k) rollover to Fidelity Rollover IRA after separation from Veolia |
| Plan Sponsor: | Veolia North America |
| Custodian: | Fidelity Investments |
| Transfer Direction: | Veolia 401(k) Workplace Account → Personal Fidelity Rollover IRA |
| Transfer Scope: | Full Transfer (100%) |
| Asset Handling: | In-kind transfer preferred; liquidation of non-transferable assets |
| Applicable Regulation: | IRS Direct Rollover Rules (IRC Section 401(a)(31)) |
| Typical Processing Time: | 5–10 business days after form submission |
| Who Should Use This Form: | Former or retired Veolia employees consolidating retirement savings into a personal IRA |
| Key Pitfall Avoided: | Selecting 'Partial Transfer' instead of 'Full Transfer' when intending to move entire balance |
| Tax Implication: | Direct rollover to Rollover IRA avoids mandatory 20% withholding and potential early withdrawal penalty |
Created: February 24, 2026 03:55 AM
