This form is for all newly eligible employees to

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ed ? e m N or f a Participant Election Form 401(k) Investment Form 403(b) Investment Form Investor Profile Have you had a change in your family, such as a birth, death, divorce or marriage? If so, your Participant Beneficiary Form may need updating. Do you need help choosing an investment portfolio? Complete the Investor Profile and an Assurity Advisors representative will contact you. This and other forms are located on this Web site. The forms directory is located on the left side of our home page under Qualified Plans. Click on the form you need. A listing of the available forms follows: This form is for all newly eligible employees to enroll in the plan. When this form is received, an Investment Advisor will review the form and send a letter recommending allocations. This form is used when a 401(k) participant wants to make a change to their existing funds or future investment elections. This form is used when a 403(b) participant wants to make a change to their existing funds or future investment elections. Complete this form to receive a suggested asset allocation model tailored to your risk tolerance. Use this form when a participant would like to make a change to their designated beneficiary. This form can be used to request a hardship distribution from the plan. Not all plans allow hardships; check with your plan administrator. This form can be used to request a participant loan. Not all plans allow loans; check with your plan administrator. This form must be completed to start minimum distributions. This form is used when an employee would like to roll money from a prior employer plan or IRA. This form allows a 401(k) participant to elect quarterly automatic rebalancing on their account. This form allows a 403(b) participant to elect quarterly automatic rebalancing on their account. Participant Beneficiary Form Hardship Distribution Form Participant Loan Application Minimum Required Distribution Form Qualified Rollover Form 401(k) Automatic Rebalancing Form 403(b) Automatic Rebalancing Form H138-0509

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