Item Procedure Return to MassMutual? Distribution Form

Transcription

1 Instructions for Requesting a Distribution National Wildlife Federation Tax Deferred Annuity Plan Enclosed are the following items needed to request a distribution from your retirement plan. Please review and complete each of the items as described in the procedures below. Mail the required documents for approval and processing to MassMutual Retirement Services (MassMutual) using the following address. You may also fax completed forms to Regular Mail: Overnight Mail: Fax To MassMutual Retirement Services MassMutual Retirement Services PO Box Bright Meadow Boulevard Hartford, CT Enfield, CT Item Procedure Return to MassMutual? Distribution Form Complete all relevant sections after reading all the information in the package. If you are Yes interested in a hardship withdrawal, please request a hardship withdrawal package. The plan has qualified joint & survivor annuity provisions. If married, please complete the relevant sections as applicable. Your spouse may need to complete certain sections witnessed by a Notary Public or Plan Representative. Sign and date the form. Include all other forms and applications per instructions as applicable. Return this form to the above address for review, approval and processing. There will be a $40 fee charged to your account for the processing of your distribution request QJSA Beneficiary Designation Outstanding Loan Info Direct Rollover Options If you are requesting a form of payment other than lump sum or total rollover (such as in the form of annuity payments or substantially equal installment payments) and the plan is subject to qualified joint & survivor annuity provisions, you may need to update your Beneficiary Designation as instructed in the Joint & Survivor Annuity Waiver section of the Distribution Form. As applicable, complete QJSA Beneficiary Designation Form and return it to the address indicated on the QJSA Beneficiary Designation Form. If you have an outstanding loan and wish to payoff your loan before your final distribution is processed, you may request a loan payoff form to do so. Otherwise your loan will be offset at the time of your distribution. If you are interested in establishing an IRA to roll over your account balance, please complete the appropriate materials or application with your IRA provider. No return to address indicated on QJSA Beneficiary Designation Form Yes return to address indicated on Loan Payoff Form No for IRA Applications Distribution Notice Special Tax Notice These documents contain important information regarding your distribution options and the related restrictions and tax consequences. Read this information carefully before requesting your distribution. No these documents are for your records Participant Service Center Representatives are available by calling the Retirement Plan Information Line at between the hours of 8AM and 8PM Eastern Time. Representatives are available to help you complete the forms, or answer general questions you may have about your distribution or about the plan.

2 National Wildlife Federation Tax Deferred Annuity Plan Distribution Form Plan ID: Participant Information Social Security Number Name Address City State ZIP Phone Number Birth Date Hire Date Marital Status: Address **** Please review all the enclosed Information before proceeding **** 2. Distribution Information Reason for Distribution (select one) No Longer Employed: Termination of Employment Retirement Disability Still Active: Premature Withdrawal of Rollover Assets Distribution Amount (select one) Age 59 ½ Withdrawal I am requesting a Total Withdrawal for the maximum amount available. I am requesting a Partial Withdrawal in the amount of: $ (or %) Note: Partial Withdrawals will be disbursed equally from all current fund balances within total account 3. Payment Election (select one) A. Lump-Sum Payment: I elect to have the entire distribution paid directly to me. I understand this payment will be subject to 20% mandatory federal tax withholding and any applicable state tax withholding. (Please read Cash Payment and Tax Withholding of Important Final Distribution Information). B. Direct Rollover: I elect to have the entire distribution paid as a Direct Rollover. I have indicated in Section 4 detailed instructions for the processing of this rollover distribution. C. Combination Lump-Sum Payment & Direct Rollover: I elect to have a portion of this distribution paid directly to me and the remaining balance paid as a Direct Rollover. I understand payment made directly to me will be subject to 20% mandatory federal withholding and any applicable state withholding. (Please read Cash Payment Section of Important Final Distribution Information). I have indicated in Section 4 detailed instructions for the processing of rollover portion of this distribution. Indicated below is the Lump Sum Amount I would like paid directly to me: Lump-Sum Amount: $ will be paid to me with the remainder to be paid as a Direct Rollover. Any portion of this remaining balance that is not an eligible rollover distribution will also be paid directly to me. D. Periodic / Installment Payment: I elect to have my distribution paid in installments. Please complete Section 5 Periodic / Installment Payment Election of this form. E. Annuity Payment: 1. Normal Form of Plan Benefit: 50% Qualified Joint and Survivor Annuity Payments for married participants or Qualified Life Annuity for single participants: I elect to have my distribution used to purchase a qualified joint and survivor annuity if married or a qualified life annuity if single. Please contact your Plan Administrator for additional details. 2. Qualified Optional Survivor Annuity (QOSA) Form of Plan Benefit: 75% or 100% Qualified Optional Survivor Annuity Payments for married participants (this option available to spousal beneficiaries only). I am the spouse of the deceased participant, and I am requesting the death benefit to be paid in the form of a qualified optional survivor annuity. The Participant and the Spouse waived the QJSA/QPSA prior to the Participant s death and elected the 75% or 100% J&S Please contact your Plan Administrator for additional details. If spousal consent is not completed, then this election is not valid.

3 4. Rollover Information (if B. or C. elected in Section 3) Direct Rollover Information: If you elected option B. or C. in Section 3, your payment includes a Direct Rollover. Please complete the information below: Rollover checks will be mailed directly to my address of record and made payable to the financial institution or trust named below. (Please read Direct Rollover Section of Important Final Distribution Information). Direct Rollover to: (Print Clearly) Traditional IRA Make rollover check payable to: Roth IRA* Make rollover check payable to: Eligible Retirement Plan - Make rollover check payable to: *Pre-Tax Distribution to Roth IRA (Roth Conversion) Please note that if you wish to directly rollover pre-tax balances to a Roth IRA, these amounts are taxable in the year of the rollover. Withhold the following amount for Federal Taxes. Complete ONLY if you elected a direct rollover to a Roth IRA. Note that if this is left blank, there will be no Federal Tax Withholding. 10% Other Amount (indicate percentage) % Do Not Withhold Any Federal Taxes on my Roth Conversion 5. Periodic / Installment Payment Election (if D. elected in Section 3) Periodic Distribution Information: Installment payments will be paid in accordance with the information and schedules you indicate below: A. Fixed Period Election: I elect to receive my installment payments over a fixed number of years as indicated below Years (not to exceed life expectancy). B. Fixed Amount Election: I elect to receive my installment payments in a fixed amount of $ until my account is depleted. For option A. and B. above please indicate the payment frequency and months of distribution as follows: Distribution Schedule: Select frequency: Monthly (12x) Quarterly (4x) Semi-annually (2x) Annually (1x) Other (please specify) Select month(s) of distribution: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Payment Method: Check mailed to participant address of record. Direct Deposit to: Bank Checking Account Bank Savings Account. (Please attach voided check or preprinted deposit slip) Special Tax Withholding Elections for installment payments paid over a period of 10 or more years. If installments are paid over a period of less than 10 years each payment will be subject to 20% mandatory federal withholding and any applicable state withholding. If payments are paid over a period of 10 years or more, the participant must make a withholding election below. If no election is made, then 20% federal withholding and any applicable state tax will be withheld. For more information about tax withholding, refer to Important Final Distribution Information. Do not withhold federal or any applicable state tax from the installment payments. Withhold federal tax at the rate of % on the installment payments and withhold any applicable state tax.

4 Spousal Consent Please complete Sections 6, 7, 8 and 9 as applicable. 6. Marital Information (select one) I am not married. I am married and my spouse s written consent is below. I am married and my spouse s written consent to this election is not required because: (check all that apply) My spouse cannot be located. My spouse and I are legally separated and a copy of the court order to that effect is attached (A qualified domestic relations order may still require you to obtain your spouse s consent). My spouse has abandoned me and a copy of the court order to that effect is attached (A qualified domestic relations order may still require you to obtain your spouse s consent). 7. Spouse s Information (if applicable) Spouse s Social Security Number Spouse s Name 8. Qualified Joint and Survivor Annuity: My signature below indicates that I elect to waive the QJSA: As a Participant in the above mentioned Plan, I hereby acknowledge that (1) I have been informed by the Plan Administrator of my right to receive my retirement benefit in the form of a qualified joint and survivor annuity (QJSA) that would guarantee me payments over my life and, if I am married, would guarantee payments to my spouse over my spouse's lifetime if my spouse survived me; (2) I have the right to waive the QJSA form of benefit and elect another form of benefit available under the Plan, and, if I elect payment to be in a form other than lump sum (such as in the form of substantially equal installment payments), to designate beneficiaries to receive my death benefit other than my spouse (if I am married) only if my spouse consents in writing to such waiver and designation of beneficiaries; and (3) any benefit that remains in the plan after a partial withdrawal (not including withdrawals paid in the form of substantially equal installments) continues to be subject to the qualified pre-retirement survivor annuity requirements, which generally provide that death benefits will be paid in the form of a life annuity to my spouse unless I have waived, with my spouse's consent, that form of benefit in accordance with procedures established under the Plan. I confirm that I have read and understand the Important Qualified Joint and Survivor Annuity Notice, Qualified Optional Survivor Annuity Notice, Waiver, and Spousal Consent Information included with this form. I hereby elect to waive the QJSA and instead elect to have benefits paid to me in an alternate form indicated in this distribution form. If I am married, my spouse must consent to this form of payment. Participant Signature Date 9. Spousal Consent: (Must be completed if Married Participant) I hereby consent to the foregoing election by the Participant, my spouse, to waive the qualified joint and survivor annuity form of benefit that (absent the Participant s election and my consent) would have been payable to the Participant while alive and to me had I survived the Participant. I acknowledge that (1) my consent is irrevocable; and (2) that I may receive less money that I would have received under the QJSA benefit form because the elected payment method may result in a reduced payment of the participant s death benefits that would otherwise have been paid to me as guaranteed annuity payments over my lifetime. I hereby confirm that I have read and understand the Important Qualified Joint and Survivor Annuity Notice, Qualified Optional Survivor Annuity Notice, Waiver, and Spousal Consent Information included with this form. I acknowledge that I have the right to limit my consent to a specific optional form of benefit, but hereby relinquish this right and consent to the payment of benefits in the form(s) chosen by the Participant. I understand that I do not have to sign this consent I am signing it voluntarily. Signature of Spouse Date Witness of Spousal Consent Spousal Consent must be witnessed by a NOTARY PUBLIC or an AUTHORIZED PLAN REPRESENTATIVE Witness by a Notary Public OR Witness by Authorized Plan Representative Subscribed and sworn before me this day of Notary Public State of My commission expires Authorized Plan Representative Date

5 10. Federal Income Tax Withholding MassMutual is required to withhold mandatory 20% for federal income taxes on the taxable portion of your benefit distributed to you as a Cash Payment. You may voluntarily elect to have additional withholding below. I voluntarily elect to have additional withholding of % (whole percentages only) 11. State Income Tax Withholding You may skip this Section if you reside in a state with no income tax or withholding requirement on retirement income. The taxable portion of your payment may be subject to state tax withholding requirements. While MassMutual will withhold based on your state's income tax rules and your election, if applicable, you are responsible for ensuring you satisfy your individual state income tax liability. If you make an election that is not in compliance with your state's income tax withholding rules, then MassMutual will default to your state's income tax withholding requirements. State Income Tax Withholding rules are subject to change at any time. For current state specific tax information pertaining to your resident state, you should contact your tax advisor or your state income tax department. Also note, state tax rules may apply differently depending on your type of distribution (i.e., lump sum, periodic, non-periodic, etc.). In addition, some states allow for an exclusion from income distributions from certain retirement plans - to confirm whether you may qualify to exclude all or a portion of your distribution from income for state taxation purposes, you should consult your plan sponsors or state income tax department. If your state's income taxes are determined based on wage tables, MassMutual is unable to calculate a net amount, you will need to ensure that you have grossed up accordingly. Your request may be delayed if a net amount is requested. Any tax information included in this written or electronic communication was not intended or written to be used, and it cannot be used by the taxpayer, for the purpose of avoiding any penalties that may be imposed on the taxpayer by any governmental taxing authority or agency. Your state tax income tax withholding options are: AR, DE, IA, KS, MD, MA, NC, NE, OK, VT, VA CA, ME, OR, DC These states require mandatory state income tax withholding on taxable distributions. MassMutual is required to withhold state income taxes based on state law. You may not elect out of state income tax withholding. These states require mandatory state income tax withholding. MassMutual is required to withhold state income taxes based on state law unless you elect out of withholding: I elect no state income tax withholding. Note: The District of Columbia only requires mandatory withholding on a lump sum distribution that brings your account balance to zero. If you are requesting a lump sum distribution, then you may not opt out of withholding. AL, AZ, CO, CT, GA, ID, IL, IN, KY, LA, MN, MS, MO, MT, NJ, NM, NY, ND, OH, PA, RI, WV, WI SC, UT These states permit voluntary income tax withholding. You may voluntarily elect state withholding by providing a dollar amount below. If no election is made for these voluntary states identified, MassMutual will not apply any withholding. I voluntarily elect to withhold an amount of $ (whole dollar amount) These states permit voluntary state income tax withholding. You may voluntarily elect state withholding by selecting the box below. If no election is made for these voluntary states identified, then MassMutual will not apply any withholding. Withhold based on my state's tax table formula, if applicable (MassMutual will apply the default tax allowance.) MI Additional State Income Tax Withholding This state requires mandatory state income tax withholding. MassMutual is required to withhold state income taxes based on state law unless you provide alternate withholding instructions by completing a Michigan Withholding Certificate (MI W-4P Withholding Certificate for Michigan Pension and Annuity Payments) and submitting it with this form. I elect to have an additional $ (whole dollar amount) of state income tax withheld from my payments.

6 12. Participant Request & Signature As a Participant of the above - named plan, I hereby request a distribution in the form indicated above, subject to the terms of the plan and the approval of my Employer. I confirm that (1) I have verified that the IRA will accept the direct rollover and is an eligible retirement plan if I have chosen this option; (2) I have received and read the Special Tax Notice Regarding Plan Payments and understand that if I do not elect a direct rollover, the taxable portion of my eligible rollover distribution will be subject to 20% federal and applicable state tax withholding; (3) I understand that I have at least 30 days from the receipt of the Special Tax Notice Regarding Plan Payments to decide whether to make or not to make a rollover of the portion of my account that is an eligible rollover distribution; (4) if the plan or my account is subject to the qualified joint and survivor annuity rules and I am married, I have obtained the consent of my spouse for this distribution in the form indicated and that if I authorize this distribution to be paid less than 30 days after I have received the written explanation of the qualified joint and survivor annuity requirements, that the written explanation was received at least 7 days before my authorization for this distribution; and (5) by signing and returning this form before the end of the 30 day period, I have waived the right to any further time to consider this decision and I am requesting a distribution of the account in accordance with the above elections as soon as possible. Important Note for Participants with a Non-U.S. or Non-U.S. Territory residence address: Please check this box if you are not a resident of the United States or a United States Territory. If the current address is not an address within the U.S. or one of its territories, the Participant or Beneficiary receiving the distribution is required to fill out and return a Citizenship Statement form with the distribution request. Failure to provide a Citizenship Statement will result in U.S. Federal taxes being withheld at a rate of 30% for recipients with a non-u.s. residence address. Please ask your Plan Sponsor for a Citizenship Statement form or call MassMutual's Customer Service Center for a copy. Other Forms completed: Loan Payoff Form (as applicable) QJSA Beneficiary Designation (as applicable) Participant Signature Date ****** Return form as indicated on Instruction Page ****** MassMutual Retirement Services (MMRS) is a division of MassMutual Life Insurance Company (MassMutual) and its affiliated companies and sales representatives.

7 Important Distribution Information Address Changes Please note that if your address has been changed less than 30 days ago, the distribution cannot be processed without your Employer's approval. If you would like your check mailed to an alternate address, please see Section 10 for Signature Guarantee instructions. Outstanding Loans If you have an outstanding loan balance, note that unpaid loans at the time of termination of employment become due and payable, and are offset by the vested account balance unless a full payoff is received prior to the final distribution. Outstanding loans which are not repaid prior to the final distribution become taxable. Cash Payments and Tax Withholding If you choose to have any portion of your distribution paid directly to you, in a lump sum, mandatory 20% federal tax withholding will be applied to the taxable amount of the distribution. If you are a resident of Arkansas, California, Delaware, Iowa, Kansas, Maine, Maryland, Massachusetts, Mississippi, Nebraska, North Carolina, Oklahoma, Oregon, Vermont, and Virginia applicable state taxes will also be withheld if federal taxes are withheld. This list may change based on changing state tax withholding requirements. Direct Rollover Rollover checks are mailed to your home address on file, but are made payable to the financial institution named on this form. If you choose to have any portion of your distribution amount paid as a direct rollover, that amount will be exempt from mandatory federal and state withholding. You should contact your IRA provider or a representative of your new retirement plan to obtain exact payee instructions. Payments made as periodic installments over a period of 10 years or more are not eligible for direct rollover. Therefore, the mandatory 20% withholding does not apply. In this case, you must complete Section 5 of the form to indicate your voluntary withholding election. Also refer to the Withholding on Periodic Payments section below. If you are required to receive a required minimum distribution (RMD), then the entire minimum distribution must be paid to you BEFORE you authorize a direct rollover. RMD may be required because you are age 70 ½ or older this calendar year and have (i) separated from service or (ii) you are a 5% owner. If you authorize a direct rollover to an IRA or eligible employer-sponsored retirement plan before you have taken the entire required minimum distribution for the year, this will result in an excess rollover contribution to your IRA or retirement plan. You will need to correct this excess rollover contribution by contacting the trustee or custodian of your IRA or retirement plan. This excess rollover contribution may also be subject to tax penalties. Please contact MassMutual if you are not sure whether you have received your required minimum distribution for the current calendar year. Withholding on Periodic Payments Payments made as periodic installments over a period of 10 years or more are not subject to mandatory 20% federal withholding. You may elect not to have withholding apply to your periodic payments. Your election will remain in effect until you revoke it. You may revoke your election at any time by returning the revised Section 5 Special Tax Withholding Election completed, signed, and dated. Any election or revocation will be effective no later than 30 days after receipt of your election. You may make and revoke elections not to have withholding apply as often as you wish. If you do not make a withholding election for periodic payments in Section 5 Special Tax Withholding Election by the date your form is submitted, federal income tax will be withheld from the taxable portion of your pension payments as if you were a married individual claiming three withholding allowances. As a result, no federal income tax will be withheld if the taxable portion of your annual pension payments is less than a certain threshold amount. If you elect not have withholding apply to your retirement plan payments, or if you do not have enough federal income tax withheld from your retirement plan payments, you may be responsible for payment of estimated tax. You may incur penalties under the estimated tax rules if your withholding and estimated tax payments are not sufficient. Note that a voluntary withholding election cannot be made involving accounts for which a name and/ or tax identification number (TIN) is incorrect or missing. See IRS Publication 1586 for information about mandatory withholding when a participant's or beneficiary's TIN is missing or incorrect. Joint & Survivor Information Please refer to the Important Qualified Joint and Survivor Annuity Notice, Waiver, and Spousal Consent Information. Payment Policies All distributions will be made payable to the participant or to the trustee/custodian of an IRA or qualified plan and will be mailed to the Participant's address we have on file, or to the address indicated by the Plan Sponsor. If you elect a partial distribution, your distribution amount will be prorated across all available funds and contribution types unless you request otherwise. You may request a partial distribution to be made from specific funds or if permitted by the plan, contribution types by attaching specific instructions, in writing, to this distribution form. However, your remaining balance in the Plan must be $5,000 or more, not including any rollover money. Acknowledgement The IRS requires that you receive a written Special Tax Notice Regarding Plan Payments prior to receiving such payment. Please read it carefully to understand the rollover rules and the special tax treatment regarding the mandatory income tax withholding rules on lump sum and installment distributions not directly rolled over to another qualified retirement plan or IRA that accepts rollover distributions. You should receive this notice between 180 and 30 days before the time for your distribution. You are entitled to have at least 30 days to consider your distribution option. However, you may affirmatively elect to waive the 30-day period and request a distribution or direct rollover as soon as possible by completing and signing this form.

8 Important Qualified Joint and Survivor Annuity Notice, Qualified Optional Survivor Annuity Notice, Waiver, and Spousal Consent Information If you are married and have elected to waive the QJSA, you must complete the Spousal Consent Section prior to requesting a withdrawal or distribution from the plan. Qualified Joint & Survivor Annuity Notice If you are not married: You will receive your benefits in the form of a life annuity unless you waive this requirement and elect an alternative form of benefits available under the plan. The qualified joint and survivor annuity (QJSA) for unmarried participants is a life annuity which will pay monthly payments over your lifetime. Should you get married in the future, your account will become subject to the requirement that benefits be paid in the form of a QJSA unless you waive that requirement and obtain the consent of your spouse to this waiver. If you are married, your benefit must be paid to you in the form of a Qualified Joint & Survivor Annuity unless you waive this form of benefit with the consent of your spouse. A QJSA provides you with monthly level payments for the rest of you life and if your spouse survives you, then monthly level payments for your spouse s life that are equal to the stated percentage of the monthly payments you received prior to your death. The QJSA must be actuarially equivalent to a single life annuity for the life of the participant and must provide a survivor benefit equal to at least 50% but not more than 100% of the rate at which such benefits are payable to the Participant during the joint lives of the Participant and spouse. Payments to you and your surviving spouse are guaranteed to be made over your lifetimes. Under the terms of the Plan, for a married participant the QJSA is a Joint and 50% Survivor Annuity. Amount of Payments The amount of level monthly payments payable to you and your spouse under the QJSA will vary depending upon the following factors: the percentage of the survivor portion of the joint and survivor annuity (e.g., 50%, 66 2/3%, 75%, or 100%), the annuity purchase rate used by the insurance company, your age when payments begin, your marital status, the age of your surviving spouse when payments begin, and the amount of your vested account balance that will be used for the purchase of the qualified annuity at the time it is purchased. Your account will also be charged for any commissions or fees related to the purchase of the annuity contract. The Plan Administrator will satisfy the requirement to provide the appropriate qualified joint and survivor annuity by using your vested account balance to purchase an annuity contract from an insurance company. The contract will be distributed to you and you will receive annuity payments directly from the insurance company. The table below is an exhibit of the annuity factors applicable to a married participant of a plan using a Qualified Joint and Survivor Annuity with a 50% survivor annuity OR to an unmarried participant regardless of the percentage of the survivor annuity under the plan. To determine the approximate level monthly payments you will receive, divide your vested account balance by the annuity factor which most closely matches your situation. Determine your age and, if married, your spouse's age as of the birth dates nearest the proposed distribution date. If you are married, one-half of the quotient represents the approximate monthly payment your spouse will receive after your death, if your spouse survives you. Again, this table only applies to married participants in a plan with a joint and 50% survivor annuity or to unmarried participants. Example for 50% Joint & Survivor Annuity. If you are a married participant, you and your spouse are both age 65, and your vested account balance is $1000, your approximate monthly payment is $8.03, determined by dividing $1000 by If your spouse survives you, the approximate monthly payment to your spouse is $4.01 (50% of the payment to you). If you are not married, age 65, and your vested balance is $1000, your approximate lifetime monthly payment is $8.92, determined by dividing $1000 by These approximate monthly payments are only estimates. The insurance company from which the Plan purchases the QJSA may use different factors that will produce a different monthly payment. The Plan Administrator will act upon request to provide a more precise calculation. 6% Annuity Factor Table for a 50% Survivor Annuity (for married participants) and a Life Annuity (for unmarried participants) Married Participant's Age Spouse's Age Annuity Factor Table Unmarried Participant's Age Annuity Factor Ability to Waive the QJSA You may, with the consent of your spouse if you are married, choose to waive the QJSA in order to elect a different form of benefit payment. To do this, you must sign the waiver and, if you are married, have your spouse consent in writing, either in the presence of a Notary Public or an Authorized Plan Representative. This waiver can be executed no earlier than 90 days before your benefits are to begin. You have the right to revoke this waiver and also to execute a subsequent waiver at any time during this period. You will have at least 30 days to consider your decision after receiving the explanation. However, a distribution can be paid less than 30 days after you have received this explanation provided that you have the ability to revoke an affirmative distribution election until the distribution is paid, which can not be less than 7 days after the provision of this notice. A waiver of the QJSA would mean that the value of this benefit would be paid to you in one of the optional forms available under the Plan that you elect. If you elect (and the Plan allows) to take only a partial withdrawal, your election to waive the QJSA will only apply to the amount you withdraw. Any remaining amount will continue to be subject to the qualified pre-retirement annuity form of benefit which guarantees annuity payments after your death to your spouse over your spouse's lifetime, if

9 your spouse survives you, unless you have waived that requirement in accordance with the Plan's procedures. If you elect installment distributions, however, your election to waive the QJSA form of benefit will apply to the whole account, and any benefit that remains unpaid at your death will be paid in accordance with the designation of beneficiary(ies) you have made under the plan, provided your spouse consented to the designation. In that case, the named beneficiary(ies) may be someone other than your spouse and the death benefit may be paid in a form other than a life annuity to your spouse, which your spouse would have received had the benefit been paid in the form of a QJSA and your spouse survived you. Your named beneficiary(ies) under the plan will be able to choose the method by which the death benefit is paid from among the forms of benefit available under the plan at the time the benefit is paid. Financial Effect of your Election to Waive the QJSA If you do not choose to waive the QJSA form of benefit, under the QJSA you will receive income for the rest of your life, and these payments will continue to your spouse if your spouse survives you at a rate determined by the type of survivor annuity your plan provides. For example, if the QJSA provided under the plan is a Joint and 50% Survivor Annuity, your spouse will receive payments that are equal to 50% of the payments made to you. The QJSA will not pay death benefits to any other beneficiary(ies) but your spouse and will continue until your spouse's death. If you waive the QJSA form of benefit, the benefit may be paid in a form other than a qualified annuity. If you elect to waive the QJSA, you may elect one of the alternative forms of benefit payment in accordance with procedures established by the Plan Administrator; for example, by completing the appropriate distribution form. If you elect substantially equal installment payments, you will receive payments over a period of time that you have selected in accordance with the Plan. The amount of each installment will be determined by dividing your remaining account balance by the number of unpaid installments. The death benefit will be the remaining vested account balance, if any, at the time of your death and will be paid in the form(s) elected by your beneficiary(ies) under the plan. Your account balance will remain invested and will continue to experience earnings and losses over the period that installment distributions are paid. If lump sum distributions or partial withdrawals are provided for under the Plan and elected by you or your beneficiary(ies), the Plan Administrator will provide a notice describing the tax ramifications at the time the distribution is requested, and your account will remain invested and will continue to experience earnings and losses until the lump sum or partial withdrawal is requested and paid. Investment gains and losses will affect the amount of your payment. Generally, you will be able to roll over a lump sum or partial withdrawal to an eligible retirement plan or IRA in order to defer taxation on the taxable portion of the distribution. No death benefit will be paid by the Plan to your beneficiaries unless a vested balance remains in your Plan account at the time of your death. Investment gains and losses will increase or decrease the amount of your installment payments. If your designated beneficiary is your spouse, your spouse will also be able to roll over a lump sum or partial distribution. Nonspouse beneficiaries generally cannot roll over a death benefit. If you elect to withdraw only a portion of your vested account, the remaining portion will continue to be subject to the requirement that it be paid in the form of a qualified pre-retirement survivor annuity if you die and your spouse survives you, unless you have waived the qualified pre-retirement survivor annuity form of benefit in accordance with the Plan's procedures. If you wish to be paid the remaining portion of your account in the future, at that time you must waive the requirement that it be paid in the form of a QJSA and, if you are married, obtain your spouse's consent. There is no reduction of a participant's normal retirement benefit as a result of the participant's election for, or waiver of, the QJSA because both the QJSA and any other form of retirement benefit payment are based upon the participant's actual vested account value and are not subsidized. Qualified Optional Survivor Annuity (QOSA) Notice Under the terms of your plan, if you elect to waive the qualified joint and survivor form of benefit (with your spouse s informed consent, if you are married), you may choose amongst the alternate forms of benefit available under your plan. One of those alternate forms of benefit is a Qualified Optional Survivor Annuity (QOSA). If you are married: If you choose the QOSA form of benefit, you will receive your retirement benefit in the form of a joint and survivor annuity, and if your spouse survives you, your spouse will receive a survivor annuity that is equal to 50% or 75% of the benefit paid to you. Which survivor benefit applies depends upon the QJSA provided under your plan, accordingly: If the survivor percentage of the plan s QJSA is less than 75%, then the QOSA must be equal to 75%: If the survivor percentage of the plan s QJSA is equal to or greater than 75%, then the QOSA must be equal to 50%. If you are not married: If you choose the QOSA form of benefit, you will receive your benefit in the form of a life annuity. If you are married, a QOSA provides you with monthly level payments for the rest of your life and, if your spouse survives you, monthly level payments for your spouse for life that are equal to a stated percentage of the monthly payment you received prior to your death. The QOSA must be actuarially equivalent to a single life annuity for the life of the participant, and must provide a survivor benefit equal to 50% or 75% of the rate at which such benefits are payable to the Participant during the joint lives of the Participant and spouse. Which rate applies is explained above. Payments to you and your surviving spouse are guaranteed to be made over your lifetimes. If you are not married, the QOSA is a life annuity, which will pay monthly payments over your lifetime and stop at your death. Amount of Payments for Qualified Optional Survivor Annuity (QOSA) The amount of level monthly payments payable to you and your spouse under the QOSA will vary depending upon the following factors: the percentage of the survivor portion of the joint and survivor annuity, which is 75% or 50% under the terms of your plan, the annuity purchase rate used by the insurance company, your age when payments begin, your marital status, the age of your surviving spouse when payments begin, and the amount of your vested account balance that will be used for the purchase of the qualified annuity at the time it is purchased. Your account will also be charged for any commissions or fees related to the purchase of the annuity contract. The Plan Administrator will provide the appropriate qualified optional survivor annuity by using your vested account balance to purchase an annuity contract from an insurance company. The contract will be distributed to you and you will receive annuity payments directly from the insurance company. The table below is an exhibit of the annuity factors applicable to a married participant of a plan using a Qualified Optional Survivor Annuity with a 75% and 50% survivor annuity OR to an unmarried participant regardless of the percentage of the survivor annuity under the plan.

10 Example for 50% Optional Survivor Annuity. To determine the approximate level monthly payments you will receive, divide your vested account balance by the annuity factor which most closely matches your situation. Determine your age and, if married, your spouse s age as of the birth dates nearest the proposed distribution date. If you are married, 1/2 of the quotient represents the approximate monthly payment your spouse will receive after your death, if your spouse survives you. Again, this table only applies to married participants in a plan with a joint and 50% optional survivor annuity or to unmarried participants. For example, if you are a married participant, you and your spouse are both age 65 and your vested account balance is $1000, your approximate monthly payment is $8.03, determined by dividing $1000 by If your spouse survives you, the approximate monthly payment to your spouse is $4.01 (one half of the payment to you). If you are not married, age 65, and your vested balance is $1000, your approximate lifetime monthly payment is $8.92, determined by dividing $1000 by Example for 75% Optional Survivor Annuity. To determine the approximate level monthly payments you will receive, divide your vested account balance by the annuity factor which most closely matches your situation. Determine your age and, if married, your spouse s age as of the birth dates nearest the proposed distribution date. If you are married, 3/4 of the quotient represents the approximate monthly payment your spouse will receive after your death, if your spouse survives you. Again, this table only applies to married participants in a plan with a joint and 75% optional survivor annuity or to unmarried participants. For example, if you are a married participant, you and your spouse are both age 65 and your vested account balance is $1000, your approximate monthly payment is $7.65, determined by dividing $1000 by If your spouse survives you, the approximate monthly payment to your spouse is $5.74 (75% of the payment to you). If you are not married, age 65, and your vested balance is $1000, your approximate lifetime monthly payment is $8.92, determined by dividing $1000 by These approximate monthly payments are only estimates. The insurance company from which the Plan purchases the QJSA may use different factors that will produce a different monthly payment. The Plan Administrator will, upon request, provide a more precise calculation. 6% Annuity Factor Table for a 50% or 100% Survivor Annuity (for married participants) and a Life Annuity (for unmarried participants) Married Participant's Age Spouse's Age 50% Annuity Factor Table 100% Annuity Factor Table Unmarried Participant's Age Annuity Factor Ability to Choose Alternate Methods for Benefit Payments You can only choose this method for the payment of benefits if you have waived, with the informed consent of your spouse, the requirement to receive the plan s retirement benefit in the form of a qualified joint and survivor annuity (QJSA). To do this, you must sign the waiver and, if you are married, have your spouse consent in writing, either in the presence of a Notary Public or an Authorized Plan Representative. This waiver can be executed no earlier than 180 days before your benefits are to begin. You have the right to revoke this waiver and also to execute a subsequent waiver at any time during this period. You will have at least 30 days to consider your decision after receiving the explanation. However, an alternate form of benefit can be paid less than 30 days after you have received this explanation provided that you have the ability to revoke an affirmative distribution election until the benefit is paid, which can not be less than 7 days after the provision of this notice. If the QJSA is waived in this manner, you have the ability to choose amongst the alternative methods of benefit payment. Under the terms of your plan, you must have the ability to choose the QOSA as described herein. For detailed information about these requirements including the alternative forms of benefit available under your plan, and the financial effects of an election to waive the QJSA, review the Qualified Joint and Survivor Annuity (QJSA) Notice. Beneficiary Designation If you are married, then your spouse is automatically your primary beneficiary, unless you elect a non-spouse beneficiary with spousal consent. Designating non-spouse beneficiaries should be performed by completing a QJSA Beneficiary Designation Form.

11 National Wildlife Federation Tax Deferred Annuity Plan Loan Payoff and Repayment Form Plan ID: Participant Information Social Security Number Name Address City State ZIP Daytime Phone Evening Phone Address Employer / Location Birth Date Hire Date **** Please review all the enclosed Information before proceeding **** If you are requesting a loan payoff of an outstanding loan, you will need to take the following steps. Call the Retirement Information Line at between the hours of 8AM and 8PM Eastern Time. Representatives are available to help you determine the current outstanding balance of your loan. If you have loan repayments deducted through payroll, then the Service Center Representative can assist you in determining the loan payoff amount based on when you expect to send your payment and how many payroll repayments will process in the interim. The loan payoff amount may change on a daily basis, as interest accrues on the outstanding loan balance. Therefore, if the final payment you submit exceeds the loan payoff amount by $10 or less, the excess amount will be credited to your account as interest earnings. Any overpayments in excess of $10 will be returned to you. Speak with a Service Center Representative and alert them that you will be sending in a loan payoff check. They will freeze your loan for up to 30 days so no additional interest accrues while your payoff is in process. If your loan payoff is not received within the freeze period, interest will accrue from the original date that the freeze was placed on the loan. Make certified check, money order or cashier s check payable to National Wildlife Federation Tax Deferred Annuity Plan FBO [Name of Participant]. Be sure to write your Social Security Number on the check. Please note that personal checks will not be accepted. Return loan payoff along with this form to the address indicated below for processing. If you want to submit outstanding payments missed, you will need to take the following steps. Make certified check, money order or cashier s check payable to National Wildlife Federation Tax Deferred Annuity Plan FBO [Name of Participant]. Be sure to write your Social Security Number on the check. Return loan repayment along with this form to the address indicated below for processing. Your loan payoff and repayments will be posted to your account upon receipt at MassMutual Retirement Services. You may call the Retirement Plan Information Line at to verify that your loan payoff and repayments have been processed. Your payroll department will be notified to cease loan repayment deductions from your paycheck once your loan payoff has processed. 2. Loan Payoff Information Please complete the following if you want to pay off the outstanding loan balance in full. The enclosed certified check, money order, or cashier s check in the amount of $ should be used to pay my loan # in full. 3. Loan Repayment Information Please complete the following if you want to submit outstanding payments missed. The enclosed certified check, money order, or cashier s check in the amount of $ should be applied to my loan #. 4. Signature - Please sign, date, and return this form along with your payment. Signature Return to following address Regular Mail Overnight Mail MassMutual Retirement Services MassMutual Retirement Services PO Box Bright Meadow Boulevard Hartford, CT Enfield, CT Date MassMutual Retirement Services (MMRS) is a division of MassMutual Life Insurance Company (MassMutual) and its affiliated companies and sales representatives. Page LNPYFF1216

12 DISTRIBUTION NOTICE The Plan is required to provide you with information that explains your distribution options and the federal income tax implications of a Plan distribution prior to the receipt of assets from your account. As a Plan participant you must receive these notices (the Distribution Notice and the Special Tax Notice enclosed) at least thirty (30) days prior to your distribution. If you received the notice more than one hundred eighty (180) days prior to taking a distribution, you must receive either a new notice or a notice summary. You have the ability to waive the remaining unexpired notice period if you elect a payment from the Plan prior to the expiration of the 30 day period. Please note that the value of your account will continue to increase or decrease based on market performance until it is distributed or forfeited, as appropriate, in its entirety. Your Right to Defer Distribution and Direct Account Investments. If you have terminated employment and your balance in the Plan is over $5,000, you may choose to defer the distribution of your account until a later date. If you elect to defer the distribution of your account, you may continue to direct the investment of your account among the investment options offered by the Plan. Your account will continue to be subject to market fluctuation based upon its investment. For more information on the investment options available under the Plan, please consult your Plan enrollment kit, log on to your internet account or contact your Plan Administrator. Your Ability to Rollover Your Account. You may elect to have the balance of your account paid to you directly or to the custodian or trustee of another eligible retirement plan (including an IRA). Please note that the taxable portion of the distributed amount will be included in your taxable income at the time of the distribution (unless you elect to directly rollover the balance) and will no longer be invested in the investment options available under the Plan. The attached Special Tax Notice explains the federal income tax consequences of eligible rollover distributions and the types of retirement plans which may receive such distributions. Your Consent Not Required for Distribution of De Minimus Amounts. The Plan may pay out certain account balances below $5,000 without your consent in accordance with the terms of the Plan, which are described in the Plan s Summary Plan Description ( SPD ). If your account balance is below $5,000 and otherwise subject to the Plan s cash-out provisions, the Plan may pay a distribution of your account balance to you or to an eligible retirement plan on your behalf as determined by the Plan Administrator. However, in such event the Plan will notify you of the pending distribution and you may generally elect to rollover the distribution. All notices will be sent to your address of record on file with the Plan; if you move please inform the Plan of your new address to ensure that you continue to receive these important materials. You should consult with a tax advisor prior to requesting a distribution to determine the financial impact of each form of distribution. Your Plan s Distribution Option(s) The distribution options offered in your Plan are described in the Plan s SPD and/or in a Summary of Material Modifications ( SMM ). If your plan requires that you (and your spouse, if you are married) consent to any distribution that is not in the form of a qualified annuity, you must also be provided with a notice describing this annuity form of benefit and the procedures for waiving it, if you would prefer an alternate form of benefit. The SPD and SMM also contain information describing the form and timing of distribution payments. Please contact your Plan Administrator to request a copy of the SPD and/or SMM. SPECIAL TAX NOTICE YOUR ROLLOVER OPTIONS You are receiving this notice because all or a portion of a payment you are receiving from the Plan is eligible to be rolled over to an IRA or an employer plan; or if your payment is from a Designated Roth Account (a type of account with special tax rules in some employer plans), to a Roth IRA or Designated Roth Account in an employer plan. This notice is intended to help you decide whether to do such a rollover. This notice describes the rollover rules that apply to payments from the Plan. To the extent that the rules differ based on whether the payment is from a Designated Roth Account or from an account that is not a Designated Roth Account, the differences will be identified in each applicable section of this notice. In addition, if you receive a payment from a Designated Roth Account and a payment from an account that is not a Designated Roth Account in the Plan, you may contact the Plan administrator or the Plan s recordkeeper for assistance in determining the amount that is being paid from each account. Rules that apply to most payments from a plan are described in the General Information About Rollovers section. Special rules that only apply in certain circumstances are described in the Special Rules and Options section. General Information About Rollovers How can a rollover affect my taxes? Not a Designated Roth Account: You will be taxed on a payment from the Plan if you do not roll it over. If you are under age 59½ and do not do a rollover, you will also have to pay a 10% additional income tax on early distributions (unless an exception applies). However, if you do a rollover, you will not have to pay tax until you receive payments later and the 10% additional income tax will not apply if those payments are made after you are age 59½ (or if an exception applies). If you do a rollover to a Roth IRA, a special rule applies under which the amount of the payment rolled over (reduced by any after-tax amounts) will be taxed; please see the If you rollover your payment from an account which is not a Designated Roth Account to a Roth IRA section under Special Rules and Options below. Designated Roth Account: After-tax contributions included in a payment from a Designated Roth Account are not taxed, but earnings might be taxed. The tax treatment of earnings included in the payment depends on whether the payment is a qualified distribution. If a payment is only part of your Designated Roth Account, the payment will include an allocable portion of the earnings in your Designated Roth Account. STN Rev 1.10 Page 1 of 5