RI 38-117, Rollover Election

United States
Office of Personnel Management
Retirement Operations Center
PO Box 45
Boyers, PA 16017-0045

OMB Approval 3206-0212

Rollover Information
Claim number



CSA
Case name
This notice dated
Please reply by

This letter explains an important election available to you that will affect your lump-sum payment. You have until the “reply
by” date shown above to decide how you want your benefit to be paid. The enclosed “Special Tax Notice Regarding
Rollovers” explains how the election affects your payment. Please read carefully all of the information provided with this
letter before making your decision.
Rollover Allowed

Effective January 1, 2002, you are permitted to roll over certain benefits paid after December 31, 2001, into an individual
retirement arrangement (IRA), the Thrift Savings Plan, or an eligible employer plan under certain conditions. If the U.S.
Office of Personnel Management (OPM) pays the taxable portion of your payment as a direct rollover, no tax is withheld.
See note regarding Roth IRAs on the reverse. If OPM pays the taxable portion to you, 20% Federal income tax must be
withheld, but to defer income tax you have the option to roll over part or all of the taxable portion yourself within 60 days
after you receive the payment. You may then apply for a refund of the 20% withheld when you file your tax return. You may
roll over any non-taxable portion of your payment, as well as any taxable portion, subject to the following conditions.



You can roll over the taxable portion to an IRA, an eligible employer plan, or your own open account with the Thrift
Savings Plan.



You can roll over the taxable portion to an IRA, but you must keep track of the taxable and non-taxable amounts in
the IRA. You can also roll over the non-taxable portion to an eligible employer plan, if the plan certifies that it is
willing to accept the payment in a direct trustee-to-trustee transfer from OPM and to account for the payment in
accordance with tax law. The plan makes this certification on the enclosed Rollover Election form, RI 38-117.
You cannot roll over the non-taxable portion to the Thrift Savings Plan.



Your taxable portion and your non-taxable portion are shown below under “Description of Payment.”

Description of Payment

You are due a lump-sum payment for ________________________________________.
The amount of your payment is _____________________________________________.
The taxable portion is ____________________________________________________.
The non-taxable portion is ________________________________________________.
(Continued on reverse side)

Previous edition is not usable.

RI 38-118
Revised November 2025

Election Options

The enclosed “Rollover Election” form provides two options for receiving your benefit. Please select one option and return
your completed election in the enclosed pre-addressed envelope to reach the Office of Personnel Management (OPM) by the
date shown at the top of this letter.
If you choose Option A, we will make the distribution payable to you, less 20% tax withholding on the taxable portion, and
send it to your regular payment address. To defer income tax you have the option to roll over part or all of the taxable portion
yourself within 60 days after you receive the payment.* You may include part or all of the non-taxable portion with the
rollover of the taxable portion.
If you choose Option B, we will make all or part of the distribution payable to the individual retirement arrangement
[(IRA(s)] or eligible employer plan you specify, with no tax withheld, and send it to you or to the account you specify.*
We will pay to no more than two IRAs or plans including the Thrift Savings Plan. We will make any remainder of the
benefit payable to you, less 20% tax withholding on any remaining taxable portion, and send it to your regular payment
address. To defer income tax you have the option to roll over part or all of the remaining taxable portion yourself within 60
days after you receive the payment. If you choose Option B, the amount you elect to roll over must be $500.00 or more.
You may include part or all of the non-taxable portion with the rollover of the taxable portion.
*Please note: The IRS has ruled that you cannot defer income tax on a rollover into a Roth IRA.
If you elect Option B, Part 4 must be completed by the financial institution administering your IRA or by your eligible
employer plan before we can process your election.
Tax Information

See the enclosed “Special Tax Notice Regarding Rollovers.” Consult a qualified tax advisor or the Internal Revenue Service
if you need more information on tax matters.
Questions

If you have questions about the rollover election, you may send us e-mail at retire@opm.gov or call the OPM Retirement
Information Office, 1-888-767-6738, Monday through Friday, 7:30 a.m. to 7:45 p.m., Eastern time. Hearing impaired
respondents should use the Federal Relay Service by dialing 711 or their local communications provider to reach a
Communications Assistant. Address written inquiries to:
U.S. Office of Personnel Management
Retirement Operations Center
P.O. Box 45
Attn: Rollovers
Boyers, PA 16017-0045

Please furnish the claim number shown on the other side of this notice when contacting OPM and give us your daytime
telephone number and your e-mail address.
Important

If you do nothing, we will make payment to you after the “reply by” date shown on the front of this page, less 20% tax on
the taxable portion, and send it to your regular payment address. You have the option to rollover part or all of the taxable
portion yourself tax free within 60 days after you receive the payment.
Enclosures: Special Tax Notice Regarding Rollovers, RI 37-22
Rollover Election, RI 38-117
Return Envelope
Privacy Act Statement
Pursuant to 5 U.S.C. § 552a(e)(3), this Privacy Act Statement serves to inform you of why OPM is requesting the information on this form. Authority: OPM is authorized
to collect the information requested on RI 38-118, pursuant to Public Law 107-16, which discuss the Internal Revenue Code that allows an individual to roll over the posttax portion of certain distributions from OPM. Purpose: This form is used to explain the payment election. Routine Uses: The information requested on this form may be
shared as a "routine use" to other Federal agencies and third-parties when it is necessary to process your application. For example, OPM may share your information with
other Federal, state, or local agencies and organizations in order to determine benefits under their programs, to obtain information necessary for a determination of your
disability retirement benefits, or to report income for tax purposes. OPM may also share your information with law enforcement agencies if it becomes aware of a violation
or potential violation of civil or criminal law. A complete list of the routine uses can be found in the OPM/CENTRAL 1 Civil Service Retirement and Insurance Records
system of records notice, available at www.opm.gov/privacy. Consequences of Failure to Provide Information: Failure to provide this information would prevent OPM
compliance with the current law.
Public Burden Statement
The public burden to complete this information collection is estimated at 40 minutes per response, including time for reviewing instructions, searching data sources,
gathering and maintaining the data needed, and completing and reviewing the collected information. An agency may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing this burden to the Office of Personnel Management, RS Publications Team at
RSPublicationsTeam@opm.gov. Current information regarding this collection of information -- including all background materials -- can be found at https:/
www.reginfo.gov/public/do/PRAMain by using the search function to enter either the title Rollover Information or 3206-0212.
Reverse of RI 38-118
Revised November 2025