.A ICMARC VANTAGEPOINT PAYROLL DEDUCTION IRA ACCOUNT APPLICATION ' ..

D Personal Information (All information must be completed)

Name {last, First and Middle Initial) Mailing Address (Use of P.O. Box also requires Street Address)

Social Security Number City State Zip

Home Phone Number Work Phone Number

Date of Birth Gender Marital Status

__ Female _Male _ _ Married __ Single

The type of IRA I am establishing is a: 0 Vantagepoint Traditional IRA OR D Vantagepoint Roth IRA

Employer Name-----------------------~-- ·

II Contribution Investment Allocation All contributions (initial and future) will be allocated according to this standing allocation until changed via Vantageline, on­line at www.icmarc.org or an Investor Services associate.

If you do not specify a standing contribution investment.allocation, your contributions will be invested in the Vantagepoint Money Market Fund. In addition, if the allocation total'does not add up to 100 percent or if an invalid fund is indicated, th.e amount that cannot be properly allocated will be invested in the Vantagepoint Money Market Fund.

Use whole percentages (e.g., 50 percent, not 331/3 percent). Fill in the

Code

boxes at right with codes of the fund(s) in which you want to invest. .

ALLOCATION

Percent Code Percent I

TOTAL: 100%

Please refer to the Payroll IRA/Education Savings Account Fund Option Sheet for a list of available funds and codes.

II Beneficiary Designation I hereby designate the person(s) named in Section A below as primary beneficiary(ies) to receive payment of the value of my Vantagepoint IRA upon my death. lfthere is no primary beneficiary Jiving at the time of my death, the balance is to be distributed to the contingent beneficiary(ies) I designate in Section 8. Payment to beneficiaries will be made according to rules of succession described in the applicable Vantagepoint Individual Retirement Account Disclosure Statement. If you need more space, please attach a separate piece of paper. (Note • Residents of community property states should consult a financial adviser.)

Section A: Primary Beneficiary{lesl

First Name M.I. Lest Name Share Social Security or Employer Date of Birth/ Beneficiary is: llf trust, pleose give nome, eddress, and trustee's name.I (whole percentages! Identification Number Date of Trust Spouse Other Trust

(lor nonlndiv14ual bROo1i,iaries}

. 1.

2. '

3.

Section B: Contingent Beneficiary(iesl Total=100%

1.

2. Total=100%

VantagepolntTransfer Agents, P.O. Box 17010, Baltimore, MD 21297-1010, Toll Free 1-800-669-7400 FRMIRA-030·200703•C496

11-::Customer Information Verification Please read the attached Instructions for Section 4 prior to completing this Section. Please select only one:

0 Existing Account

D I have attached <1 copy of the required identif ication document.

D I will submit the required identification document to ICMA-RC within 30 days.

D ICMA-RC Representative: Type of ID ID Number Retirement Plans Specialist Name Rep Code

Failure to provide these documents as required by federal law will result in your account being closed with all investments being redeemed at the time of closure and the proceeds mailed to you. ICMA-RC w ill not be responsible for any tax consequences resulting froin your failure to comply with this request. Please see ICMA-RC's Privacy Policy as it pertains to the Patriot Act. If you have any questions or concerns,-please contact an IRA Investor Services Representative at 1-800-669-7400.

D Signature I acknowledge that I have read and agreed to the disclosure in the instructions.

Your Signature Date

x. ____________________________ _ Your Spouse's Signature (if resident of a community property state)

~ r<r1~ Date

Secretary Title

Vantagepoint Transfer Agents, P.O. Box 17010, Baltimore, MD 21297-1010 • Toll Free 1-800-669-7400 FRMIRA-030-200703-C496

457 DEFERRED COMPENSATION PLAN EMPLOYEE ENROLLMENT FORM • Use this form to open an account with the ICMA Retirement Corporation. • Read instructions on the back before completing this form. Please print legibly in blue or black ink.

ICMA RETIREMENT CORPORATION

• To make legal changes (i.e., change of name, marital status, or beneficiary changes) use the Employee Information Change Form. • Return this form to your employer promptly. Your employer must provide this form to ICMA Retirement Corporation before the payroll date of your first deferral. To make

address changes, investment allocation changes or fund transfers, please visit Vantagelink (www.icmarc.org) or use Vantageline (1-800-669-7400).

1 Employer Plan Number Employer Plan Name State

Required Participant --- --- ---------------------- -Information Social Security Number

Information in this box must be ---. --. ----completed to Full Name of Participant avoid processing delays.

Last First M.I.

Mailing Address/Street

- - -------------------- - -------City State Zip Code

. -------- ----------·- - - ----- --Date of Birth Date Employed/Rehired 0 Check if yes Rehired? __ / __ / _ ___ _ _ / __ / _ ___ Month Day Year Month Day Year

Email Address

JobTitle: ______________ ______

Daytime Phone Number Evening Phone Number Gender Marital Stat

( ___ ) - _ _ _ _ ___ ( ___ )· _______ • • • Area Code Area Code M F Married s

us

• ingle

2 Name Date of Birth Relationship to vou Social S.CUritv Number % of benefit

Beneficiary Primary Beneficiaries: 0 Spouse O Other: Designation L L

L I 0 Spouse 0 Other:

L L 0 Spouse 0 Other:

Contingent Beneficiaries, if any:

L L 0 Spouse 0 Other:

L L 0 Spouse O Other:

L L 0 Spouse 0 Other:

3 I authorize my employer to defer % or$ ed to from my pay each pay period to be contribut

Amount of my ICMA-RC account, starting on __ / _ _ / _ _ _ _ (effective date). Deferral

Please indicat e which type(s) of deferrals are included in the above amount:

0 Normal deferral

0 Catch-up contributions: Please indicat e ONE of the following types of catch-up rules you are using:

0 " pre-retirement " provision OR 0 " age 50" provision

4 Fill in the boxes at r ight with codes of the ALLOCATION fund(s) you w ant to invest in. A list of funds and

Allocation of codes can be found on the Investment Options Code Percent Code Perce Contributions

Note: Please sheet. See Instruction 4 on the back o f t his form. make sure

nt

percent amounts

Stat e law, local law, or your employer may place total 100%.

restrictions on investment in these f unds. TOTAL= 100%

5 I acknowledge that I have read and agree to the disclosure (see 5 & 6 on the back of this form).

Employee Signature

Participant Signature Date Employee ID (for Employer Use Only/

6 Employer's Authorizat ion Authorized Employer Official's Signature Date

ICMA Retirement Corporation • Attn. Records Management Unit • P.O. Box 96220 • Washington, DC 20090-6220 • Toll Free 1-800,669-7400 • En Espaliol llame al 1-800-669-8216 • www.icmarc.org

Pl.EASE RETURN THIS COPY TO ICMA-RC FRM570-004-200307-0 1

457 DEFERRED COMPENSATION PLAN EMPLOV-'EE 'ENROLLMENT FORM INSTRUCTIONS

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Before you complete this forrtl, please read the accomP,a.hyiog · . " literature so you understand the plan's provisions: To make . future changes to your account such as address and/or fund transfers, pl<!!ase use Vanfagelink (www.icmarc.org) or Vantageline (1-800~669-7400). . .

IMPORTANT l'JOTE: Please do not delay in submitting this form. If we do not !have your form by the time we receiv-e your first defP.rral, we will be unable to invest your retirement plan assets, and they will be returned t o yom employer.

-· .

You will receive a confirmation of your enrollment. You w iil also receive a quarterly financial statement. Please review these carefully.

1. PARTICIPANT INFORMATION P!ease complete this section carefuily. The employer plan number · is available from your employer or ICIVlA-RC investor Services at 1-800-669-7400. ..

2. BENEFICIARY DESIGNATION Print beneficiaries' names and Soda'tSecurity Numbers and designate their re!ationsf:lip to vpu and ,he percentage to be received. The IRS has certain rules governing disbursement of funds to beneficiaries. These rules are out:ined in your er'npiover's plan and in ICMA-RC's Participant and Beneficiary Withdrawal Packets. ' · ·

3. AMOUNT OF DEFERRAL · IRS regulations allow you to defer the lesser of (1) the full 100% of your gross income after subtracting any Sect ion 414(hl picke·d-up contributions (mandatory employee contributions to 401 qualified retirement plans made w ith ·pre-tax doilars). or (2) a dollar limit ii:i effect for that year. if you fire age)'i0 cr:.older, you may n:ra.ke additional annual catch-up contributions of a dollar iirnit in effect for that year. In addit ion, t here are special catch-up provisions during the three years prior to the calendar ye_;r of normal retirement age. For the applicable dollar limits, please log on to www.icmarc.org or contact Investor Services at 1-800-669-7400 . . The minimum contribution is $25 (biweekly) or $12.50 (weekly) ,_,er pay period. A partici,:ia1"1t 111dy i1i.c1 east:, dee, tM:::.e, a(icl/or start, stop ar,d restart contributions by execut ing appropriate forms and will be effecti1•e, if practical, the pa'i period subsequent to receipt of documents by the Administrator. J.f you defer more thari allowed under IRS regulations, it is your responsibility to correct the error.

4. ALLOCATION Of= CONTRIBUTIONS . . ·Yoi.r may place your confributions in one fund'or in any combina­tion of funds, although your empl'oyer may place restrictions on .. investment in certain fonds. If the allocation total does not add up to 100 pe.rcent then the remainder wil l be allocated to the PLUS Fund. If .no selection is given your contribution will be alfocated to the default fund selected by yom employer. Use whole percent­ages (e.g., 50 percent, not 33 1/3 percent). Do not use fixed dollar amounts. Please see the Vantage Trust Company's Making Sot1nd Investment Decisions: A Retirement Investment Gufde and the · appropriate prospectus for t'u11 descriptions ol the fu nids.

PLEASE NOTE:-This wil l affect c~~t~-ibutions only. To specify t~ l · al'location for your rollover contributions, please complete a

L~ust~-e-to~T~~~~e~- to ~C-MA R~~ireme:t C~r~~rat~~~~~m. __ ·- _

·s a/s. AUTHORlZED SIGNATURES •Once you have completed this form, ~ign it and s_ubmit it to your employer for approval. ·

Note that by signing this fcrm you acknowledge that you agree to th_~, following:

I have received a,1d read the current '/antage_Trust Company's Making Sound Investment Decisions: A r,etirement Investment Guide ari"d tlie appropriate prospectus·. I understand that the ICMA Retirerri~nt Corporation has established required procedures for Internet and telephone transfers that include personal identifica­tion numbers; recording of instruct ions, and w ritten confirmations.· If ailow_ed by my employer and in the event I choose to transfer funds by Internee or telephone. I agree tnat neither Vantage Trust .Company,' the IC MA.Retirement Corporation, ICl\:1A-RC Services, LLC, nor Vantagepoint Transfer Age ms, L.LC, will be Ii able for ;,my loss, cost, or eKpense fo,· acting upon any Internet or telephone instructions believed by it to be genuine and in accordance with the required procedures. . i

""An authciriiiiig 'sigriafore-does non=epresent an· obligation to use ths teiephor1e transfer feature available on Vantagel1ne.

Weit:ome to the /CMA Retirement Co1pr.,ration!

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457 DEFERRED COMPENSATION PLAN AMOUNT OF DEFERRAL CHANGE FORM ICMA RETIREMENT CORPORATION

To the Employer: ICMA-RC provides this form for your convenience. You do NOT have to use it if you prefer your own internal method for employees to request changes in their payro ll deduction amount.

To the Employee: Use this form to make changes in the amount of your deferral to your ICMA-RC 457 Deferred Compensation Plan.

Once you have completed this form, please submit it directly to your employer for payro ll deduction updates.

You should have already establ ished an ICMA-RC deferred compensation plan account. If not, please be sure to complete the 457 Defe"ed Compensation Plan Employee Enrollment Form and promptly return it to your employer. The enro llment form m ust be completed and submitted before deferrals can start.

Normal Deferral: IRS regulations al low you to deferthe lesser of (1) 100% o f your gross compensation less any Section 41 4(h) p icked­up employer contributions, or (2) a dollar limit in effect for that year. This limit includes any employer contributions made on your behalf. Only future compensation may be deferred.

Catch-Up Provision: As you near retirement, you may make addit ional contributions under the "pre-retirement catch-up provision" (up to double the amount of the normal contribution l imit in effect for that year) OR the .. age 50 catch-up provision". Note: The "pre• retirement catch-up provision" and "age 50 catch-up provision" cannot be combined in t he same plan year. Please read ICMA-RC's 457 Catch-Up Provision packet for more information.

For the dollar limits applicable, please log on to www.icmarc.org or contact Investor Services at 1-800-669· 7 400.

Employee Name: _____ ____ _________ _ Employee ID or SSN: ______ _

Employer Name: __________________ _ State: _________ _

I authorize my employer to defer ____ _ % or .$ ___________ from my pay each pay period to be

contributed to my ICMA-RC account. Change to be effective on _ _ I _ _ I ____ . month day year

Please indicate w hich type(s) of deferrals are included in t he above amount:

D Normal contribution

D Catch-up contributions: Please indicate ONE of t he fo llowing types of catch-up rules you are

using:

D "pre-retirement" provision

D "age 50" provision

Employee Signature

Employer Signature

Date

Date

Note: Please do not forward a copy of this form to ICMA-RC. This form is for employer use only.

r RM570-085-200305-360

EMPLOYEE INFORMATION CHANGE FORM Use this form to make name, marital status, or beneficiary changes in your existing ICMA Retirement Corporation 457 Deferred Compensation Plan, 401 Money Purchase Plan, or 401 Profit-Sharing Plan accounts.

ICMA RfflR™ENT COR~OAATION

For address changes, Investment allocation changes or fund transfers, use Vantagellnk (www.lcmarc.org) or Vantageline (1-800-669-7400).

If you w ish to make a change to your payroll deduction, please use the 457 Deferred Compensation Plan Amount of Deferral Change Form or the 401 Amount of Contribution Change Form, depending upon your retirement plan type.

If this request requires your employer's approval, submit the completed form for signature befori:! forwarding it to ICMA-RC . (If you fax the form to ICMA•RC, please do not mail the original.)

1 Personal Information (All information in this section must be completed.)

2 Name Change (Note: For name changes, you must attach a copy of a legal document (copy of driver's license, etc.) and have Employer 8PfXOV8I.}

3 Primary Beneficiary Change (Please read important benelicia,y infcxmation on the back of this fom1 before completing this secrion.)

4 Contingent Beneficiary Change (Please reao important

beneficiary infmnation on the back of this fcxm before compledng this seclion.)

5 Marital Status Change • Please check one box.

6 Authorizations

Employer Plan Number Employer Plan Name

Social Security Number

Full Name of Participant

Last

Make this change ONLY to the following plan(s):

Employer Plan Number:

Employer Plan Number:

FuU New Name of Participant

Last

First

Employer Plan Name:

Employer Plan Name:

First

State

_____ ______ State:

_ __________ State:

M.I.

M.1.

Complete this section ONLY if you want to change or add a primary beneficiary. Otherwise, If you do not complete this section, your primary

#1 above. If you have other ICMA-RC accounts with please fill out one form for each employer account.

beneficiary information will be according to your previous designation.

The changes you indicate here will apply only to the plan account you incflCated in section other employers and you wish to make a primary beneficiary change to those aa:ounts,

The primary beneficiary lnfonnatlon you Indicate here will supercecle previously submitted determine the primary beneficiaries entitled to all or a portion of your plan account.

information and will be used by ICMA-RC to

I '-·,, ,,.,_ .. , .. ....., I

Dau~ W:Ditlb

I D - ~:::"""' 0 Spouse O Other:

% of benefit •

•Must total 100%. Use whole percerntages only.

Complete this section ONLY if you want to change or add a contingent beneficiary. Otherwi se, if you do not complete this section, your contingent beneficiary information will be aa:ording to your previous designation.

The changes you indicate here wiU apply only to the plan account you Indicated In section other employers and you wish to make a contingent beneficiary change to those accounts,

#1 above. If you have other ICMA-RC accounts with please fill out one form for each employer account

The contingent beneficiary information you indicate here wiU supercede previously su bmitted information and will be used by ICMA-RC to determine the oontingent beneficiaries entitled to all or a portion of your plan accooot.

Name of Contingent Beneficiary(ies) Date of Binh

Make this change ONLY to the following plan(s):

Employer Plan Number:

Employer Pian Number:

New Marital Status: • Married •

Participant Signature Date

Spousal Signature Date

Relationship to you

0 Spouse O Other:

0 Spouse O Other:

Employer Plan Name:

Employer Plan Name:

Single

Social Sea.rity Nlmber % of benefit •

*Must total 100%. Use whole percentages only.

___________ State:

_ __________ State:

Employer Sig nature (rf requited) Date

All 401 plans with marital rights require the spouse as beneficiary, unless your spouse waives this

ng here. 100% primary right by signi

ICMA Retirement Corporation• P.O. Box 96220 • Washington, DC 20090-6220 • Toi Free 1-800-669-7400 • En Espaf\ol llame al 1-800-669-8216 • www.lcmarc.org FRM570-00S-200312-385

Important Beneficiary Information

To ensure that any assets you have remaining in your account at your death are distributed according to your wishes, it is important that you provide as much information as possible about each of your beneficia­ries. If we cannot locate your beneficiaries upon your death, your assets will be disbursed to your estate.

The IRS has certain rules governing disbursement of funds to beneficiaries. For example, some· plans require that a spouse be named primary beneficiary unless he/she waives his/her rights. These rules are outlined in your employer's plan and in ICMA-RC's Participant and Beneficiary Withdrawal Packets. Please be sure to review this information thoroughly before designating beneficiaries on this form.

If you choose more than one beneficiary without indicating percentages, or if the percentages you al locate to your beneficiaries combined do not total 100%, we will allocate equal percentages totaling 100%.

Primary Beneficiary(ies) You may designate one or more persons to receive your assets upon your death. Be sure to use only whole percentages.

Contingent BeneficiaryOes} If none of your primary beneficiaries are living upon your death, your assets will be distributed to your contingent beneficiary(ies). You may specify one or several persons. Be sure to use only whole percent­ages.

If there is not enough space to add your beneficiaries, you may attach a separate sheet if necessary. Please check the appropriate box to indicate which type(s) of beneficiary you are changing, and write "see attached sheet" in the box(es) under "Name of Beneficiary".

Note: If a Social Security Number is not provided for beneficiaries, and/or ICMA-RC cannot locate the named beneficiaries, the account balance will be paid to your estate.