A retirement plan exclusively for Housing Authorities

HART Forms

In order to serve you better, HART’s forms are now editable. With an editable form, you can enter the required information using your computer or other device* instead of writing your responses by hand. The completed form can then be printed, signed and submitted to HART for processing.

By submitting forms that were filled in using your computer or other device, you help to reduce the errors and confusion that can sometimes occur with hand-written responses. This allows us to process your forms more quickly and efficiently, and to provide better service for you!

EMPLOYER FORMS Description
 Enrollment Kit Everything you need to get enrolled into the HART Plan.
Form #140 Change of Beneficiary Have you had a Life Event? A marriage, birth of a child, divorce, etc. Complete form to update beneficiary information.
Form #160 Notice Of Change Request to change your after-tax contribution rate or leave of absence status.
Form #165 Employee Information Change Request to have your information updated. This includes SSN, Name, Address, DOB, DOH, DOT, or Participation Date.
Form #170 Voluntary Account Withdrawal Request Form Request withdraw of active employee’s voluntary contributions, plus the Special Tax Notice document.
Form #180A Rollovers Into HART Instructions and form to complete to transfer funds into the HART plan from a qualified retirement plan.
Form #190 Request To Withdraw A Rollover Account Use this form to request a withdraw of any money that was rolled into the HART Plan from a previous employer.
Form #279 Loan Repayment Form Instructions for paying off a loan and the address for mailing the check.
 Unknown Address Form #300 Unknown Address Form #300 – Used to submit information on employees who cannot be located.
 HART Access Authorization Form Form to request access for person(s) to Plan related data through the Plan Sponsor Website
 HART Agency Contact Form Update any Staff Personnel changes, i.e. Executive Director, Billing Spreadsheet Contact
FORMER EMPLOYEEDescription
Form #130 Age 55 or Older ProvisionRequest distribution(s) or to set up recurring monthly or quarterly installment payments. ONLY for terminated or retired employees,age 55 or older.
Form #150 Request For Benefit PaymentRequest for terminated and retired employees to withdraw funds. Includes ALL distribution options available from HART, plus Special Tax Notice.
Retiree Life Insurance Enrollment FormRequest for life insurance coverage to be continued. This is for retiring employees, age 55 or older, with at least 10 years of service and participated in the Housing Authority life insurance program. Limitations may apply.
Rate Table For Retiree – Minnesota LifeChart provides retiree life insurance coverage & monthly premium cost by age.

What’s New With HART?

HART News Flash
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Management Fee Reductions for Vanguard Target Retirement Funds
View Document

Webinar from Financial Engines an Investment Advisory Service

Investing in a Volatile Market

Getting the Most from Your Retirement Plan

Important Plan Changes are coming to both the HART Retirement Plan and the 457(b) Deferred Compensation Plan. Fees and expenses will be revised effective January 1, 2020. Please read the Important Plan Change Notice for all the details.

Information about compliance with IRS Limits for 2022-2024 is now available. These amounts usually change each year, and you can refer to this document to find the correct limits for the years 2021 through 2023.

New Enrollment Kit – documents and forms can now be found in one place. Access them here.

Are you wondering how or where to invest your funds? HART is joining forces with Financial Engines to help you find answers and solutions. Read the official announcement.

Reinventing Retirement