State of New Mexico Participation Agreement for Deferred Compensation Plan

Transcription

1 State of New Mexio Partiipation Agreement for Deferred Compensation Plan DC-4068 (06/2016) For help, please all

2 Things to Remember Please print Payroll Center/Plan Name to ensure that your aount will be set up with the proper NM-PERA Payenter. The Fund Setion is for new enrollments and alloation hanges. We an help you selet your fund hoies. Call us at NMEX (6639). Complete the Authorization setion, and remember to sign and date this Partiipation Agreement. Enlose the ompleted Partiipation Agreement, and any other doumentation in the business reply envelope inluded with this booklet. Remember to have the alloation of your funding options total 100%, in whole perentages, when ompleting the Funding Options setion. If alloations do not total 100% the remaining amounts will be alloated to a LifeCyle fund losest to the year in whih you turn 65 based upon riteria ontained within the Memorandum of Understanding. For your benefiiary designation, the perentage split must total 100% for eah ategory of benefiiary. Please note that the information provided on this Partiipation Agreement will superede any prior information provided, suh as alloations, ontribution amounts, ontribution types, and/or benefiiary information. 2 DC-4068 (06/2016) For help, please all

3 Personal Information Employer Name: Name: Address: Date of Birth: State of New Mexio Deferred Compensation Plan Partiipation Agreement Payroll Center ID (Internal Use Only): Soial Seurity Number: City, State, & Zip Code: Home Phone Number: Gender: Male Female Work Phone Number: Address: Paperless Delivery Paperless Delivery: By providing your address you are onsenting to reeive statements, onfirmations, terms, agreements and other information provided in onnetion with your retirement plan eletronially. Unless you hoose to have statements, aount douments and other douments sent in onnetion with your retirement plan delivered via US Mail to the mailing address of reord by heking the box below, these douments will be made available to you eletronially. I wish to reeive my statements and aount douments via US Mail. Deferral Summary & Payroll Frequeny Old Amount To Funding Options $ $ Universal Life (not available to new partiipants) $ $ Total $ $ New Start Contribution on: Payroll Frequeny: Please selet your payroll frequeny to insure timely proessing. Weekly Monthly Semi-Monthly Bi-Weekly Other Benefiiary Designation Chek here if this is a hange of benefiiary. (Benefiiaries listed below replae any prior designation) PLEASE NOTE: Perentage split must total 100% for eah ategory of benefiiary. If additional spae for benefiiaries is required, attah additional sheets and mark this box: Primary Benefiiary(ies) (must total 100%): Name Relationship Soial Seurity # Phone # Address Date of Birth % Split Name Relationship Soial Seurity # Phone # Address Date of Birth % Split Contingent Benefiiary(ies) (must total 100%): Total = 100% Name Relationship Soial Seurity # Phone # Address Date of Birth % Split Name Relationship Soial Seurity # Phone # Address Date of Birth % Split Total = 100% DC-4068 (06/2016) For help, please all

4 Funding Options (for New Business of Alloation Changes only) Automati Inrease: Dollar Inrease*: $ *If seleted, this dollar inrease will automatially our annually in July. This option is not available through all payroll enters. Please hek with your payroll enter prior to seleting this option. Enroll me in asset rebalaning. I agree to omply with and be bound by the terms and onditions of the servie inluding any restritions imposed by the investment options. I understand I an obtain more information about the servie, its terms and onditions by ontating the NRS Servie Center. PLEASE NOTE: If you do not speify an alloation perentage, your pre-tax payroll dedution amount will be invested in a LifeCyle fund losest to the year in whih you turn 65. If you wish to speify your own asset alloation, please ensure that the total of all funding options equal 100%. Asset Alloation LifeCyle Conservative Portfolio LifeCyle 2020 Portfolio LifeCyle 2025 Portfolio LifeCyle 2030 Portfolio LifeCyle 2035 Portfolio LifeCyle 2040 Portfolio LifeCyle 2045 Portfolio LifeCyle 2050 Portfolio LifeCyle 2055 Portfolio Speialty Inveso Global Real Estate Fund International Aberdeen Emerging Markets Equity Fund Amerian Funds-EuroPaifi Growth Fund Fidelity Diversified International Fund Vanguard Total International Stok Index Fund Small Cap DFA U.S. Small Cap Fund Mid Cap Fidelity Low Pried Stok Fund Prinipal Investors Fund In. - Prinipal MidCap Blend Fund T. Rowe Prie Institutional Mid-Cap Equity Growth Fund Please send me a opy of the Informational Brohure/Prospetus(es). Large Cap Dodge & Cox Stok Fund Fidelity Contrafund Vanguard Institutional Index Fund Balaned Oakmark Equity Inome Institutional Fund Prinipal Diversified Real Asset Fund Bonds Blakrok Inflation Proteted Bond Fund Templeton Global Bond Fund Vanguard Total Bond Market Index Fund Fixed/Cash New Mexio Stable Value Fund 100% Total for both olumns must equal 100% 1,2 1. If the total investment option alloation perentage is greater than 100%, your appliation will be rejeted and your alloations will not be proessed. 2. Speifi share lasses may be assoiated with some funds - please visit the plan website (newmexio457d.om) under About Deferred Compensation for more information. Please ontat me about my other pre-tax investments that I would like to roll into this plan. Please send me forms regarding the Cath-Up Provision. Authorization I authorize my Employer to redue my salary by the above amount whih will be redited to the State of New Mexio Plan. The redution will ontinue until otherwise authorized in aordane with the Plan. The withholding of my deferred amount by my Employer and its payment to the designated investment option(s) will be refleted in the first pay period ontingent on the proessing of this appliation by the Plan Administrator in onjuntion with the set-up time required by my payroll enter. The redution is to be alloated to the funding options in the perentages indiated above. I have read and understand eah of the statements on the front and bak of this form, whih have been drafted in ompliane with the Internal Revenue Code. I aept these terms and understand that these statements do not over all the details of the Plan or produts. Partiipant Signature: Date: Retirement Speialist Signature: Agent Number: Form Return MAIL TO: 4 Nationwide Retirement Solutions 3600 Rodeo Lane, Suite B1 Santa Fe, NM Fax: (505) For assistane with ompleting this form, please all NMEX (6639) DC-4068 (06/2016) For help, please all

5 New Mexio Deferred Compensation Plan Memorandum of Understanding The purpose of this memo is to ensure that you fully understand the major terms, restritions and osts of the State of New Mexio Deferred Compensation Plan. However, it does not over all the details of the Plan. Please refer to the Plan Doument for speifi details. I understand and aknowledge the following: 1. I understand that my partiipation in the Plan is governed by the terms and onditions of the Plan Doument. The produt information brohure and fund prospetuses are available upon request at or by alling NMEX(6639). 2. The total annual deferral amount to all 457 plans is the lesser $18,000 or 100% of inludible ompensation. Under ertain irumstanes, additional amounts above the limit may be deferred into the Plan if (1) I will obtain age 50 or older during the alendar year, or (2) I am within three years of Normal Retirement Age and did not defer the maximum amount in prior years. The Plan Doument provides additional details about deferral limits. Deferrals in exess of maximum amounts are not permitted and will be onsidered taxable inome when refunded. It is my responsibility to ensure my deferrals do not exeed the annual limit.contributions to other Setion 457 plans may limit the maximum amount I may defer under the Plan. 3. I understand that by seleting the automati inrease option, my payroll ontributions will automatially inrease annually in July, by the dollar or perentage amount seleted. I may stop the automati inreases at any time by alling NMEX (6639), or by ompleting a new Partiipation Agreement. 4. I understand that all funds held pursuant to the Plan are held in a ustodial aount for my exlusive benefit or the benefit of my benefiiaries. I may withdraw funds from the Plan only upon severane from employment; at age 70 1/2 (if deferrals have stopped); upon an unforeseeable emergeny approved by the Plan; or I may take a one time in-servie withdrawal if my aount value is $5,000 or less (as adjusted) and I have not deferred into the Plan for two or more years. In some ases withdrawal for purhase or repayment of servie redits in a governmental defined benefit plan (pension) may be permitted. Additionally, funds may be withdrawn upon my death. All withdrawals of funds must be in ompliane with the Internal Revenue Code and appliable regulations, some of whih are expressed in the Plan Doument. Amounts rolled into the Plan from another eligible retirement plan that are maintained in a separate Rollover Aount may be distributed at any time, upon request. 5. Generally, my distributions must begin no later than April 1st following the year I reah age 70 1/2. If I work beyond age 70 1/2, generally, my distributions must begin no later than April 1st following the year I have a severane from employment or retire. Please onsult your plan doument for further details. All distributions are taxable as ordinary inome and subjet to inome tax in the year reeived. My distributions must be made in a manner that satisfies the minimum distribution requirements of IRC Se. 401(a)(9), whih urrently requires benefits to be paid at least annually over a period not to extend beyond my life expetany. Failure to meet minimum distribution requirements may result in the payment of 50% federal exise tax. 6. The funds in my aount may be eligible for rollover to a traditional IRA or to an eligible retirement plan. The Speial Tax Notie Regarding Plan Payments provides detailed information about my options. Due to important tax onsequenes related to distributions, I have been advised to onsult a tax advisor. I expressly assume the responsibility for tax onsequenes relating to any distribution, and I agree that neither the Plan nor the Plan Administrator shall be responsible for those tax onsequenes. 7. To that and a orresponding, no more than 25% of deferrals an be used to pay life insurane premiums. Life insurane is not available to new partiipants. 8. I understand that all produts are optional. DC-4068 (06/2016) For help, please all

6 Memorandum of Understanding 9. If an alloation is made to a losed or unavailable investment option, the alloation will be made to the default option, the Lifeyle Portfolio fund losest to the year in whih the partiipant would turn 65, based upon the following riteria: Birth Date/Year Range Fund 1953 and prior New Mexio Conservative Portfolio New Mexio LifeCyle 2020 Portfolio New Mexio LifeCyle 2025 Portfolio New Mexio LifeCyle 2030 Portfolio New Mexio LifeCyle 2035 Portfolio New Mexio LifeCyle 2040 Portfolio New Mexio LifeCyle 2045 Portfolio New Mexio LifeCyle 2050 Portfolio 1988 and after New Mexio LifeCyle 2055 Portfolio If the total investment option alloation perentage equals less than 100%, the differene will be invested in the default option. If the total investment option alloation perentage is greater than 100%, my appliation will be rejeted and my alloations will not be proessed. 10. The earliest your enrollment or ontribution hange an start is the first day of the month following your ompleted request. Please remember, your employer s proessing shedule will determine the atual effetive date of the ontribution. It is the Plan Sponsor s/pay Center s responsibility to ensure deferrals do not ommene too early. ASSET ALLOCATION OPTIONS The LifeCyle portfolios are omprised of underlying investment strategies available in the Plan on a stand alone basis. The Portfolios themselves are not registered investment options. The LifeCyle portfolios are administered by Nationwide Retirement Solutions aording to diretion provided by the Board of the Publi Employees Retirement Assoiation of New Mexio based on advie from the Plan s investment onsultant. The LifeCyle portfolios are designed to provide diversifiation and asset alloation aross several types of investments and asset lasses, primarily by investing in underlying investment strategies that are made available in the Plan on a stand alone basis. Asset alloation does not guarantee returns or insulate you from potential losses. There are no additional fees assoiated with the LifeCyle portfolios, but you are indiretly paying a proportionate share of the appliable fees and expenses of the underlying investment strategies in eah portfolio. STABLE VALUE OPTION 1. The State of New Mexio Stable Value Fund is omposed of investments managed by Galliard Capital Management. 2. These assets, and all new money (effetive July 1, 2012), will be invested and managed by Galliard Capital Management. 3. The projeted performane of the underlying seurities in the portfolio will be ombined to provide a blended return. MUTUAL FUND OPTIONS 1. I understand that the Net Asset Value of a mutual fund hanges on a daily basis and that there is no guarantee of prinipal or investment return. 2. The value of amounts alloated to mutual fund options will vary depending upon the value of the hosen mutual funds and ould result in either a gain or loss. I have reeived and reviewed the partiipating fund prospetuses. Some mutual funds may impose a short term trade fee. Please read the underlying prospetuses arefully. 3. I understand that pursuant to the Plan Doument, deferred amounts will be invested per my seletion of funding options speified on the Partiipation Agreement or as otherwise amended. ADMINISTRATION FEE An annualized $52.00 administration fee, billed quarterly, is harged and would redue your aount value. For new partiipants, this fee is waived for the first two quarters or until your aount balane has reahed $1,000; whihever ours sooner. 6 DC-4068 (06/2016) For help, please all

7 Memorandum of Understanding CONSENT TO PAPERLESS DELIVERY AND ACCESS By providing your address here, you are agreeing and onsenting to reeive and view plan benefit statements, orrespondene and onfirmations, and other ommuniations eletronially. These materials will be provided through an message notifying you that eletroni douments are available online for you to view and print. This replaes all written ommuniation assoiated with your Retirement Plan(s) servied by Nationwide and you will no longer reeive these douments via U.S. Mail. By providing your onsent to eletroni delivery, you are aknowledging and onfirming that you are onsenting to reeive Plan Communiations eletronially, as they are now available or as they may be required or beome available in the future and that you have aess to view and print your douments eletronially from the website and to save them from your omputer or other eletroni devie. If you would like to reeive the above referened douments in paper form via U.S. Mail you an do so by ontating Customer Servie at NMEX (6639) and requesting paper. You may opt out of eletroni delivery of your plan related douments at any time. There is no additional ost to reeive douments in paper format via U.S. Mail. CHANGING YOUR ADDRESS AND YOUR PAPERLESS DELIVERY PREFERENCES You are able to update your address or hange your Paperless Delivery Preferenes anytime either on the website or via Customer Servie. YOUR RIGHT TO REVOKE CONSENT You have the right to revoke your onsent to reeive douments eletronially. Your onsent shall be effetive until you revoke it by hanging your delivery preferenes on the website or via Customer Servie by seleting U.S. Mail delivery. DC-4068 (06/2016) For help, please all

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