LOAN REPAYMENT TRANSMITTAL FORM - MassMutual

LOAN REPAYMENT TRANSMITTAL FORM Account Number: _____________________ Sponsor Name: ____________________________________________________________________________

Participant Name: ________________________________ Participant SS#: ____________________________ Origination Date: _________________

Or Loan #: __________________

This is a regular payment _________

This is a loan payoff ___________

Payment Amount $ _________________________ Check #: ___________________________

Please remit this Transmittal Form along with your bank check or money order payable to MassMutual. In the memo line, please state: FBO (Your name)

Personal checks will not be accepted. Mail this form with your check(s) to:

MassMutual Retirement Services PO Box 219062 Kansas City MO 64121-9062 For Overnight Mail: MassMutual Retirement Services 430 W 7th St Kansas City MO 64105

Accelerated payments can be made in multiples of the expected payment amount. This amount can be obtained by accessing your account at www.retiresmart.com, My Account, Loans. Accelerated payments will be applied to principal. Reset

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