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									NAPA 401(k) SAVINGS PLAN ADOPTION AGREEMENT The undersigned, _________________________ ("Adopting Employer"), by executing this Adoption Agreement, hereby adopts the NAPA 401(k) Savings Plan and its related trust (the "Plan"). By entering into this Adoption Agreement, the Adopting Employer adopts the Plan in full as if the Adopting Employer were a signatory to the Plan. The National Association of Professional Agents and/or its Affiliates (“NAPA”), by executing this Adoption Agreement, hereby consents to the adoption of the Plan by the Adopting Employer. Single Participant or All Highly Compensated Employees This Adoption Agreement for use by an Adopting Employer with one Employee who is or may become eligible to participate or whose Employees are all Highly Compensated Employees. Effective Date Initial Adoption: This is the Adopting Employer’s initial adoption of the Plan and the “Effective Date” is _______________________. Amendment of Plan: This Adoption Agreement is an amendment of the Adopting Employer’s previous adoption of the Plan and the “Effective Date” of this amendment is _______________________. The “Effective Date” of the Adopting Employer’s initial adoption of the Plan was ____________________. ♦ ♦ ♦ ♦ ♦ Discretionary Nonelective "profit sharing" Contributions A Participant’s share of discretionary nonelective (“profit sharing”) contributions, if any, made by the Adopting Employer will be determined in accordance with the pro-rata allocation formula set forth in the Plan. ♦ ♦ ♦ ♦ ♦ The Adopting Employer agrees that it is adopting the Plan for the benefit of its Employees (as such term is defined in the Plan). Adopting Employer agrees to properly disclose to NAPA all information reasonably required by NAPA for the proper administration of the Plan. Adopting Employer understands that if the Plan as adopted by the Adopting Employer becomes "top-heavy” (as defined in Section 416 of the Internal Revenue Code), a minimum contribution may have to be made to the Plan on behalf of the Adopting Employer’s “non-key employees” (as defined in Section 416 of the Internal Revenue Code). If the Plan as adopted by the Adopting Employer becomes top-heavy, Adopting Employer agrees to make any minimum contribution required by law and Adopting Employer acknowledges that it is solely responsible for any such required contribution.

Adopting Employer acknowledges that it is solely responsible for any discretionary nonelective contributions to be made to the Plan on behalf of Adopting Employer’s Employees. The Adopting Employer agrees that NAPA has made no representations to the Adopting Employer regarding the legal or financial impact of the adoption of the Plan by the Adopting Employer. The Adopting Employer agrees to hold NAPA harmless against any claims, taxes or costs of any kind incurred by the Adopting Employer as a result of the adoption of the Plan and the Adopting Employer's failure to fulfill its obligations and duties with respect to the Plan. The Adopting Employer agrees to indemnify NAPA for any claims, taxes or costs incurred by NAPA at any time as a result of the Adopting Employer's failure to fulfill its obligations and duties with respect to the Plan. The Adopting Employer recognizes that it is in its best interest to have the Plan reviewed by legal counsel to ensure that the Plan as adopted by the Adopting Employer is suitable and appropriate for adoption by the Adopting Employer. By executing this Adoption Agreement, the Adopting Employer agrees to all of the obligations, responsibilities and duties imposed with respect to the Plan, including the responsibility for making all required contributions to the Plan on behalf of its Employees. The Adopting Employer hereby agrees to the provisions of the Plan and, in witness of their agreement, the Adopting Employer and NAPA have executed this Adoption Agreement on this ____ day of ___________________, _________.

Name of Adopting Employer:________________________________ E.I.N.: _____________________ Signed By:___________________________________ Title:____________________________ Date of Birth:____ - _____ - ________ License Date with AFLAC:___________________ SSN:_______ - _____ - __________ Address:_________________________________ _________________________________

NAPA Signed By:___________________________________ Title:____________________________
181025v3 2734.044229

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AUTHORIZATION TO MAKE FUNDS TRANSFERS ON A REGULAR BASIS TO: AFLAC FEDERAL CREDIT UNION (“the CREDIT UNION”)

Name of Credit Union Member:__________________________________________________________________ Member’s Mailing Address:_____________________________________________________________________ Member’s City, State, Zip:______________________________________________________________________ Agent’s Credit Union Membership Number:________________________________________________________ Person or Entity to receive transferred funds (“Transferee”): NAPA as General Agent for various insurers (not including AFLAC). By signing this Agreement, I authorize the Credit Union to deduct from my funds on deposit and transfer, on a monthly basis, the following specified amount of funds (“Funds”) to the above-named Transferee. I understand and agree that the Credit Union shall have no obligation to transfer such amount of Funds to the Transferee in the event (a) the total amount of all indebtedness, obligations (including other transfers of Funds with a higher priority) and liabilities then due and owing by me to the Credit Union exceeds (b) the amount of Funds I then have on deposit with the Credit Union. Amount of Funds, if available, to be transferred monthly to Transferee: $___________________ ** This authorization shall continue until revoked by me or by the Credit Union. I understand that I have the right to stop future transfers to the Transferee by notifying the Credit Union in writing. Such written notice must be received by the Credit Union not later than the 20th day of the month before the next transfer of Funds is scheduled to be made. I acknowledge that this authorization is not intended to result in the creation of a trust, either express or implied, and that the Credit Union is acting only as a transfer agent, not as my trustee. I am an independent contractor currently appointed with AFLAC and authorized to solicit applications for insurance as is provided in a written agreement. I understand that I will receive a quarterly accounting statement from the Credit Union which will identify the amount of Funds, if any, deducted and transferred and the date that the transfer took place. I understand and agree that this is the only information that I will receive from the Credit Union with respect to said transfers and that I will not receive a specific notice from the Credit Union with respect to a failure or inability to make a transfer of Funds to Transferee. I will make arrangements with Transferee for it to send me notice if a monthly transfer of Funds is not made and notice of any other information Transferee deems important. I agree that the Credit Union has no responsibility or liability to insure that any policy of insurance I have obtained is or remains in effect, is not canceled or is not renewed, is adequate or covers certain risks or claims or that the premiums with respect thereto have been paid. I further understand and agree that the Credit Union’s liability under this authorization shall be limited to the amount of any unauthorized or lost transfer of funds and that the Credit Union will not be responsible or liable under any circumstances (including the negligence of the Credit Union) for the consequences, if any, of not making a transfer of Funds. I hereby release and hold the Credit Union harmless from any other claims, losses, disputes, damages, including all other actual, consequential, special or punitive damages, and related costs.

________________________________________________________ Signature of Member

____________________________ Date

AUTHORIZATION TO MAKE FUND TRANSFERS ON A REGULAR BASIS TO: AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS (“AFLAC”) ATTN: AGENT’S ACCOUNTING

Name of Independent Agent:____________________________________________________________________ Agent’s Mailing Address:______________________________________________________________________ Writing #:_______________________________________________ SSN:__________-__________-_________ Agent’s Credit Union Membership #:__________________ Person or Entity to receive transferred funds (“Transferee”): AFLAC Federal Credit Union By signing this Agreement, I authorize AFLAC to deduct from my earned commissions as shown on my accounting statement and transfer, on a monthly basis, the following specified amount of funds (“Funds”) to the above-named Transferee. I understand and agree that AFLAC shall have no obligation to transfer such amount of Funds to the Transferee in the event: the total amount of all indebtedness, obligations and liabilities then due and owing by me to AFLAC including, but not limited to, all debit balances, loans, chargebacks exceeds the amount of my earned commissions as shown on my accounting statement. In the event that the entire amount of Funds specified below is not available, then I authorize AFLAC to transfer to Transferee that amount that is available. Amount of Funds, if available, to be transferred monthly to Transferee: $____________________ ** This authorization shall continue until revoked by me of by AFLAC. I understand that I have the right to stop future transfers to the Transferee by notifying AFLAC in writing. Such written notice must be received by AFLAC not later than the 20th day of the month before the next transfer of Funds is scheduled to be made. However, I understand and agree that I shall not have the right to revoke the Transfer of Funds to pay for a debt owed to the Credit Union under a promissory note signed by me. If I am indebted to the AFLAC Federal Credit Union upon termination of my Agreement, whether voluntary or involuntary, or if any note on which I am maker or guarantor becomes delinquent, I direct that any monies due me, after paying any sums owed to AFLAC, be paid to the Credit Union unless my AFLAC accounting statement is in a credit balance. I acknowledge that this authorization is not intended to result in the creation of a trust, either express or implied, and that the Credit Union is acting only as a transfer agent, not as my trustee. I am an independent contractor currently appointed with AFLAC and authorized to solicit applications for insurance as is provided in a written agreement. This Authorization is subject to the terms of the arbitration provisions in said Agreement. I understand that I will receive a monthly accounting statement from AFLAC that will identify the amounts of Funds, if any, deducted and transferred and the date the transfer took place. I understand and agree that this is the only information that I will receive from AFLAC with respect to said transfers and that I will not receive a specific notice form AFLAC with respect to a failure or inability to make a transfer of Funds of Transferee. I agree that AFLAC has no responsibility or liability with respect to the actions, omissions or other activities of the Credit Union or any Transferee of the Credit Union and that AFLAC has not, in any way, endorsed or recommend any Trustee of the Credit Union. I understand and agree that AFLAC’s liability under this authorization shall be limited to the amount of any unauthorized or lost transfer of funds and that AFLAC will not be responsible or liable under any circumstances (including the negligence of AFLAC) for the consequences, if any, of not making a transfer of Funds. I hereby release and hold AFLAC harmless from any other claims, losses, disputes, damages, including all other actual, consequential, special or punitive damages, and related to costs. _____________________________________________________________ _________________________

Signature of Agent

Date

Contribution Enrollment and Change Request
401(k) Savings Plan (Agents without W2 Employees)
Name
Last First MI

Social Security #
Street

Mailing Address
City State ZIP Code

Please check one: New Participant (enrolling for the first time)
New participants need to designate a beneficiary(ies) through Wachovia.

Current Participant –
discontinuing their existing elections Aflac Writing Number(s) for Deduction

Current Participant – making a change to their existing elections
Please select either a set dollar figure or a percentage of monthly commission for one or both contribution options. One or more Aflac writing number(s) can be used for each contribution type. The maximum pre-tax deferral allowed for 2005 is $14,000 if under 50 and $18,000 if over 50 years old. I elect to defer the following amount from my commissions as a pre-tax contribution: Agents may contribute the lesser of 100% of earned income or $42,000 in combined Deferral and Profit Sharing Contributions. Please see your tax advisor to ensure all contributions you make to the plan are deductible. I elect to contribute the following amount as a profit sharing contribution: TOTAL CONTRIBUTION AMOUNT OR PERCENTAGE

Contribution Type

$/Month

% of Monthly Commissions

Deferral Contributions

Profit Sharing Contributions

Contribution Funding
Contributions will be funded by an automatic debit from: please check one option

Aflac Credit Union account. Please complete the Aflac Credit Union Authorization to Make Funds Transfers form. (If you are not currently an active Aflac Credit Union Member, please contact the Aflac Credit Union to establish an account.) Other ACH account. Amount must be a set dollar figure, please attach a voided check

Investment Selection
Investment selection is easy through Participant Account Services' 800 number or the Plan Internet site. (When calling Participant Account Services or logging on to the Plan Internet site, you will need your Social Security Number and Personal Identification Number (PIN) to access your account. The first time you call Participant Account Services or log on to the Plan Internet site, your PIN is set as the last four digits of your Social Security Number.)

Plan Internet Site: www.wachovia.com/401k

Participant Account Services: 1-800-377-9180

Investment Election(s)
I understand that my contributions will automatically be invested in the Wachovia Diversified Stable Value Fund until I contact Wachovia to select my investment mix. I understand that if I do not contact Wachovia to select my investments, all contributions will remain in the Wachovia Diversified Stable Value Fund. Once I have made investment elections, all future contributions will be invested as I directed.

Participant Signature:

Date:

The NAPA benefits described herein are sponsored, administered and endorsed solely by NAPA for independent insurance agents. Any contributions you direct from the Aflac Federal Credit Union are made at your direction for your convenience. By partnering in the NAPA arrangement you acknowledge and agree that neither Aflac nor the Aflac Federal Credit Union is responsible for the content, administration, investment options or investment performance of the NAPA arrangement.

PLEASE RETURN COMPLETED FORM TO NAPA (fax 800-411-4771)


								
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