Class A and S Shares Coverdell Education Savings Account (CESA) Application

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1 MFEDU3416 The Thrivent Financial Guidance Team provides a team of individual representatives to assist you, any of which may assist you at any time. The Thrivent Financial Guidance Team may not offer the full variety of products and services that can be offered by a local representative. If your situation requires a product or service not currently available through the Thrivent Financial Guidance Team, we can put you in contact with a local representative. Whether you purchase a product or service through a Thrivent Financial Guidance Team representative or a local representative, there generally will be no difference in the fees and expenses you will incur. R

2 Class A and S Shares Coverdell Education Savings Account (CESA) Application Section 1 - Type of Account Coverdell Education Savings Account (CESA) Yes No Will the responsible individual have control the entire time the account is open? The responsible individual shall serve as the responsible individual after the designated beneficiary attains the age of majority under state law or until all assets have been distributed from the account and the account terminates. If the responsible individual becomes incapacitated or dies after the designated beneficiary reaches the age of majority under state law, the designated beneficiary shall be the responsible individual. If no box is selected, the election is deemed to be no. Section 2 - Account Owner(s) To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. When you open an account we will ask for your name, address, date of birth and other information that will be used to identify you. This information may be compared with information obtained from a consumer reporting agency, public database or other source. We may also ask to see your driver's license and other identifying documents. Primary Owner (Minor) Information Print first, middle, last name and suffix, as applicable Street/Residential address Mailing address (if different) City State ZIP code City State ZIP code Date of birth Sex Social Security number Primary phone Phone type (cell, home, work) address Responsible Individual Information Print first, middle, last name and suffix, as applicable Street/Residential address Mailing address (if different) City State ZIP code City State ZIP code Date of birth Sex Social Security number Primary phone Phone type (cell, home, work) address Thrivent Mutual Fund accounts are maintained and serviced by Thrivent Financial Investor Services Inc., the registered transfer agent for Thrivent Mutual Funds. The principal underwriter for the Thrivent Mutual Funds is Thrivent Distributors, LLC, member FINRA. Thrivent Mutual Funds are managed by Thrivent Asset Management, LLC. MF29028EDU Page 1 of 7 N2-16

3 Uniform Transfer to Minor Name a successor responsible individual in the event the parent/guardian dies prior to the child reaching the required age. Print first, middle, last name and suffix, as applicable Social Security number Street City State ZIP code Section 3 - Fund Selection 1,000 minimum initial investment amount per fund. Maximum annual contribution to a CESA is 2,000. Dividend and capital gains distributions will be reinvested in additional shares. Mutual Fund Name Thrivent Aggressive Allocation Fund Thrivent Moderately Aggressive Allocation Fund Thrivent Moderate Allocation Fund Thrivent Moderately Conservative Allocation Fund Thrivent Partner Emerging Markets Equity Fund Thrivent Small Cap Stock Fund Thrivent Mid Cap Stock Fund Thrivent Partner Worldwide Allocation Fund Thrivent Large Cap Growth Fund Thrivent Large Cap Value Fund Thrivent Large Cap Stock Fund Thrivent Growth and Income Plus Fund Thrivent Balanced Income Plus Fund Thrivent Diversified Income Plus Fund Thrivent High Yield Fund Thrivent Opportunity Income Plus Fund Thrivent Income Fund Thrivent Municipal Bond Fund Thrivent Government Bond Fund (applicable to S Shares only) Thrivent Limited Maturity Bond Fund Thrivent Money Market Fund Initial Investment Share Class (select one): Complete Section 4 regarding options to reduce your sales charge/service fee. Total initial investment amount A Shares (front end sales load) - indicate the applicable qualification for A Shares (select one): Fund/Account number(s) I currently own other A Share Thrivent Mutual Fund Accounts A member of my household currently owns A Share Mutual Fund Accounts S Shares (Account Service Fee) - complete the Thrivent Investment Management Inc. Account Service Fee Agreement (form MF28932) and submit it with this application. MF29028EDU Page 2 of 7 N2-16

4 Section 4 - Sales Charge/Account Service Fee Reduction Refer to the A Share Prospectus or Account Service Fee Agreement for details regarding Rights of Accumulation, Letter of Intent and other reduced sales charge and reduced Account Service Fee privileges. Thrivent Money Market Fund and Thrivent Limited Maturity Bond Fund are generally not eligible for these reduced sales charge privileges. I understand I may qualify for a reduced sales charge or Account Service Fee as described in the Prospectus and Statement of Additional Information. Rights of Accumulation Link the following accounts in my household to calculate sales charges on current and future purchases of A Share Thrivent Mutual Funds, or to determine the Account Service Fee rate tier when you want the services of a Thrivent Financial representative in connection with your S Share Thrivent Mutual Funds. Personal accounts are linked separately from employer sponsored retirement plans, except in the case of single participant retirement plans. S Shares initially established through ThriventFunds.com are not eligible for a sales discount. List any existing A Shares and S Shares (thru Account Service Fee relationship) Thrivent Mutual Funds/account numbers to be linked for reduced sales charge/account Service Fee. Fund/Account number(s) Letter of Intent (LOI) - A Shares Only I intend to make additional investments to accumulate 50,000 or more, including this initial investment and the value of previous purchases, within the next 13 months. Not available for SEP IRA, SARSEP IRA, Simple IRA or 403(b) retirement plan accounts. I understand that this LOI is specific to the A Share class only. 50, , , ,000 1,000,000 Section 5 - Initial Funding Initial Funding Method Check/Money Order payable to Thrivent Mutual Funds One Time Withdrawal EFT/ACH (complete bank information in Section 7) Transfer/Direct Rollover/Conversion (complete form MF11502) Thrivent Financial Product Complete Withdrawal/Surrender (complete form for life/health, form for variable annuity/settlement option, or form for annuity) Redemption from Thrivent Mutual Fund (complete form MF23433 for personal/business accounts or form MF28938 for retirement accounts) Bank Wire to Funds Investment Amount Section 6 - Ongoing Funding Options Total initial funding amount Automatic Investment Plan (AIP) (EFT/ACH) - complete Automatic Purchase Plan (form MF6568) Automatic Exchange Plan - complete Automatic Exchange Plan (form MF23428) MF29028EDU Page 3 of 7 N2-16

5 Section 7 - Telephone Transactions Yes No Telephone Exchange Yes No Telephone Redemption by Check Yes No Telephone Redemption by Financial Institution EFT/ACH Yes No Telephone Purchase EFT/ACH Bank Information for Electronic Funds Transfer (EFT/ACH) Name of financial institution account owner Evening phone Address of account owner City State ZIP code Name of joint financial institution account owner Name of financial institution Address of financial institution City State ZIP code Type of account Checking Savings Account number Routing number I authorize Thrivent Financial Investor Services Inc. to: (1) make electronic deposits, withdrawals and corrections to my bank account that comply with U.S. law; (2) act on this authorization until I revoke it by contacting us; (3) apply this authorization to any future bank accounts I may designate; (4) make administrative changes to this authorization which I request such as date or amount changes; (5) release any and all information related to this authorization to the third party account owner, and (6) act upon electronic deposit instructions I provide to Thrivent Mutual Funds. Section 8 - Beneficiary Designation Provide all information for primary and contingent beneficiaries. In order to aid in locating your beneficiary upon your death, provide your beneficiary's address and Social Security number, if available. A custodian must be designated for all minor beneficiaries. If Lineal Descendants Per Stirpes (LDPS) is not listed after each name/group, Primary/Contingent will be used. When LDPS is used, upon the death of the named beneficiary, the beneficiary rights transfer to the descendants of the deceased beneficiary (a person who is in direct line to an ancestor), such as child, grandchild, great-grandchild, and on forever. Share percentages must total 100% for primary and 100% for contingent. Use percentages only, not dollar amounts. By signing you are agreeing to all terms of this form. MF29028EDU Page 4 of 7 N2-16

6 Primary Beneficiaries Name of primary beneficiary Select LDPS for this beneficiary Relationship to shareholder Phone City State Social Security/Tax Identification number Date of birth/trust Percentage Name of custodian (if minor) Name of primary beneficiary Select LDPS for this beneficiary Relationship to shareholder Phone City State Social Security/Tax Identification number Date of birth/trust Percentage Name of custodian (if minor) Contingent Beneficiaries (effective only if all primary beneficiaries are deceased) Name of contingent beneficiary Select LDPS for this beneficiary Relationship to shareholder Phone City State Social Security/Tax Identification number Date of birth/trust Percentage Name of custodian (if minor) Name of contingent beneficiary Select LDPS for this beneficiary Relationship to shareholder Phone City State Social Security/Tax Identification number Date of birth/trust Percentage Name of custodian (if minor) MF29028EDU Page 5 of 7 N2-16

7 Section 9 - Agreements and Signatures By signing this agreement, I acknowledge and represent that I have: Received and reviewed a prospectus for the Fund(s) purchased. Authorized Thrivent Trust Company to act as Custodian and will hold the Custodian harmless for all necessary actions taken by the Custodian when authorized by the Custodial Agreement and beneficiary designation. Read and agree to the Beneficiary Designation Payment Provisions and if applicable the Additional Provisions on this form. Legal capacity and authority to purchase shares of the Thrivent Mutual Funds. Taken independent responsibility for determining all tax matters which may affect this investment. Under penalties of perjury, I certify that: 1. The Taxpayer Identification number/social Security number I have provided on this application is my correct tax identification number, and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS notified me that I am no longer subject to backup withholding, and 3. I am a U.S. person (including a U.S. resident alien). Certification Instructions - You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. I certify that I have: Received, read, and agree to the Disclosures (page 7 of this form) and any other disclosures contained in this form. Read and understood the corresponding Coverdell Education Savings Acccount Custodial Agreement and Disclosure Statement. By establishing my Coverdell Education Savings Acccount, Thrivent Trust Company accepts appointment as Custodian in accordance with the terms and conditions of the Custodial Agreement. Signature of responsible individual/parent and date signed X Section 10 - Broker-Dealer Information Name of registered representative Name of broker-dealer Registered representative number Phone To request a split in your compensation, complete Split Compensation Request (form MF28024). Make check or money order payable to Thrivent Mutual Funds. Regular Mail: Thrivent Mutual Funds PO Box Kansas City, MO Express Mail: Thrivent Mutual Funds 330 W 9th St Kansas City, MO Fax: MF29028EDU Page 6 of 7 N2-16

8 Disclosures Section 7 - Telephone Transactions Your investments can be purchased directly from your bank account into your Thrivent Mutual Fund account or redeemed from your Thrivent Mutual Fund account and deposited into your back account. Your telephone instructions will be recorded by Thrivent Mutual Funds and processed via Automated Clearing House (ACH). ACH transactions may take 3-5 business days to complete. Telephone transactions must be made by 3:00 p.m., Central Time by calling Section 8 - Beneficiary Designation Beneficiary Designation and Payment Provisions This beneficiary designation is effective and revokes all previous beneficiary designations upon: 1) successful completion of the electronic signature process online, or 2) submission to and approval by the Processing Center. If more than one beneficiary designation is received, the designation with the latest date will be honored. If you designate one or more beneficiaries for your account(s), you have the right to change or revoke the beneficiary designation at any time in the future. Beneficiary designation which included the terms "or" or "and/or" will be administered as if the conjunction "and" was used. If two or more persons are named as primary beneficiaries, the death proceeds will be paid equally to the survivors or survivor, unless otherwise directed. The same shall be true for contingent beneficiaries if no primary beneficiaries survive. If none of the beneficiaries survive, proceeds shall be paid to the owner or to the owner's estate. When the term Lineal Descendant Per Stirpes (LDPS) is used; upon the death of a named beneficiary, the beneficiary rights transfer to the lineal descendants of the deceased beneficiary. If a named beneficiary dies without leaving a lineal descendant, that beneficiary's share of the death proceeds will be distributed among the remaining named beneficiaries in proportionate shares. Thrivent Financial accepts the LDPS designation when the individual named is related to the benefit member by blood, marriage, or legal adoption. Children, sons, daughters, brothers, sisters, half-brothers, half-sisters, grandchildren, great-grandchildren, granddaughters and grandsons are the only acceptable group designations. All group designations listed which are named in the singular (e.g. child, son, daughter, brother, sister, half-brother, half-sister, grandchild, granddaughter, grandson) will include all members of that group at time of the account owners death. Group designations do not include step-children unless legally adopted. The words children, issue, grandchildren and children of a deceased child shall include adopted children, adopted issue, adopted grandchildren and adopted children of a deceased child unless otherwise specified. The interest of any beneficiary is subject to any collateral assignment of the account. If you have ever signed a marital property agreement with your spouse or former spouse or lived in a community property state while married, your spouse or former spouse may have rights to the death proceeds of your account even if you choose not to name your spouse as beneficiary. Thrivent Financial is not responsible for determining whether your account or death proceeds are subject to community property laws or a marital property agreement or whether you should obtain spousal consent when naming your beneficiary. Thrivent Financial will not be liable for acting in accordance with the designation on file unless we have received a properly documented community property or marital property agreement claim prior to paying death proceeds. By signing this form, I certify that I have read this consent and determined it is not necessary to have my spouse sign and hold Thrivent Financial harmless. Miscellaneous Information Combined Regulatory Mailing Important Notice Regarding Delivery of Shareholder Documents In an attempt to reduce shareholder costs and eliminate duplication, if two or more members of a household own the same variable contract or mutual fund issued by Thrivent Financial or an affiliate of Thrivent Financial, we generally send only one prospectus, shareholder report or proxy statement for that product to the shared address. If you would like to receive a separate prospectus, shareholder report, or proxy statement, contact us at Consolidate Statements Account/contract owners at the same mailing address can create a Statement Household Group and receive a statement with combined information on all accounts/contracts owned by Group members. This option provides a comprehensive review and reduces separate mailings. Login to Thrivent.com under My Thrivent, select Forms and complete the Statement Household Group Authorization (form 26796). MF29028EDU Page 7 of 7 N2-16

9 Membership Application Congratulations and Welcome! You are joining a unique membership-owned organization of Christians. At Thrivent Financial for Lutherans (Thrivent), you are more than a consumer of financial products and services; you also join millions of other members who want to be wise with money, live generously, and by doing so, strengthen Christian communities. Member Protection, Community Support. Thrivent is a special not-for-profit organization. When you buy a Thrivent insurance or annuity product, you gain more than financial protection for you and your family -- you also help strengthen Christian communities. The tax exemption we receive as a fraternal benefit society allows us to direct money we would otherwise pay in taxes to support Thrivent's local chapters and our members' efforts as they give back to their communities. Our Common Bond. Essential to Thrivent's structure is our common bond among members. More than 100 years ago, our Lutheran founders created an organization called to help members support one another and their communities. We honor our heritage and welcome Christians* seeking to live out their faith. *For more information on Thrivent's Christian Common Bond, visit Thrivent.com/christiancalling. Statement of Christian Common Bond: I am age 16 or older and am applying for membership with Thrivent and a local Thrivent chapter or member network, or I am age 18 or older and applying for membership on behalf of a youth under age 16. Name of person applying for membership (print first, middle, and last name) Street (address correction requested) City State ZIP code Phone number address* Date of birth Gender Male Female * address is required for authentication when applying online for membership. address is optional for any other membership application submission. Select one of the following: I am a Christian, seeking to live out my faith; or I am the spouse of a Christian who seeks to live out his or her faith; or If applying on behalf of a youth under age 16, the youth is being raised in the Christian faith. The Thrivent Way. We are a membership organization of Christians, and our members are our owners. Our purpose is to serve our members and society by guiding both to be wise with money and live generously. We believe that all we have is a gift from God and that generosity is an expression of faith. We succeed when our members, their families and their communities thrive. I agree to support and further The Thrivent Way, and verify that the information I provided is true and correct. Signature of proposed member (age 16 or older) or parent/guardian of youth age 0-15 and date signed (mm/dd/yyyy) R of 1

10 Form W-9 (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: Individual/sole proprietor or C Corporation S Corporation Partnership Trust/estate single-member LLC Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) Note: For single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. Other (see instructions) 5 Address (number, street, and apt. or suite no.) Requester s name and address (optional) 4 Exemptions (codes apply only to certain entities; not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 6 City, state, and ZIP code 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Employer identification number Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below), and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Signature of U.S. person Date General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: Form 1099-INT (interest earned or paid) Form 1099-DIV (dividends, including those from stocks or mutual funds) Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) Form 1099-S (proceeds from real estate transactions) Form 1099-K (merchant card and third party network transactions) Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) Form 1099-C (canceled debt) Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2. By signing the filled-out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information. Cat. No X Form W-9 (Rev )

11 Form W-9 (Rev ) Page 2 Note. If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: l An individual who is a U.S. citizen or U.S. resident alien, l A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, l An estate (other than a foreign estate), or l A domestic trust (as defined in Regulations section ). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States: l In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity, l In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the trust, and l In the case of a U.S. trust (other than grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a saving clause. Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form Backup Withholding What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 28% of such payments. This is called backup withholding. Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Part II instructions on page 3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See Exempt payee code on page 3 and the separate Instructions for the Requester of Form W-9 for more information. Also see Special rules for partnerships on above. What is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code on page 3 and the Instructions for the Requestor of Form W-9 for more information. Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account, for example, if the grantor of a grantor trust dies. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of 50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a 500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Line 1 You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return If this form W-9 is for a joint account, list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9. a. Individual. Generally, enter the name shown on your tax return. Iif you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last name shown on your social security card, and your new last name. Note. ITIN applicant: Enter your individual name as it was entered on your Form W-7 application, line 1a. This should also be the same as the name you entered on the Form 1040/1040A/1040EZ you filed with your application. b. Sole proprietor or single-member LLC. Enter your individual name as shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, or "doing business as" (DBA) name on line 2. c. Partnership, LLC that is not a single-member LLC, C Corporation, or S Corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2. d. Other entities. Enter your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on line 2. e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a "disregarded entity." See Regulations section (c)(2)(iii). Enter the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S. owner's name is required to be provided on line 1. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, "Business name/disregarded entity name." If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN.

12 Form W-9 (Rev ) Page 3 Line 2 If you have a business name, trade name, DBA name, or disregarded entity name, you may enter it on line 2. Line 3 Check the appropriate box in line 3 for the U.S. federal tax classification of the person whose name is entered on line 1. Check only one box in line 3. Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a partnership for U.S. federal tax purposes, check the "Limited Liability Company" box and enter "P" in the space provided. If the LLC has filed Form 8832 or 2553 to be taxed as a corporation, check the "Limited Liability Company" box and in the space provided enter "C" for C corporation or "S" for S corporation. If it is a single-member LLC that is a disregarded entity, do not check the "Limited Liability Company" box; instead check the first box in line 3 "Individual/sole proprietor or single-member LLC." Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space in line 4 any code(s) that may apply to you. Exempt payee code. Generally, individuals (including sole proprietors) are not exempt from backup withholding. Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends. Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions. Corporations are not exempt from backup withholding with respect to attorneys' fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC. The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space in line An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2) 2--The United States or any of its agencies or instrumentalities 3--A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities 4--A foreign government or any of its political subdivisions, agencies, or instrumentalities 5--A corporation 6--A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession 7--A futures commission merchant registered with the Commodity Futures Trading Commission 8--A real estate investment trust 9--An entity registered at all times during the tax year under the Investment Company Act of A common trust fund operated by a bank under section 584(a) 11--A financial institution 12--A middleman known in the investment community as a nominee or custodian 13--A trust exempt from tax under section 664 or described in section 4947 The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13. IF the payment is for... Interest and dividend payments Broker transactions Barter exchange transactions and patronage dividends Payments over 600 required to be reported and direct sales over 5,000 Payments made in settlement of payment card or third party network transactions 1 THEN the payment is exempt for... All exempt payees except for 7 Exempt payees 1 through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to Exempt payees 1 through 4 Generally, exempt payees 2 1 through 5 See Form 1099-MISC, Miscellaneous Income, and its instructions. 1 Exempt payees 1 through 4 2 However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys fees, gross proceeds paid to an attorney reportable under section 6045(f), and payments for services paid by a federal executive agency Exemption from FATCA reporting code. The following code identifies payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may indicate that a code is not required by providing you with a Form W-9 with "Not Applicable" (or any similar indication) written or printed on the line for a FATCA exemption code. A--An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37) B--The United States or any of its agencies or instrumentalities C--A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities D--A corporation the stock of which is regularly traded on one or more established securities markets, as described in Regulations section (c)(1)(i) E--A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section (c)(1)(i) F--A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state G--A real estate investment trust H--A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I--A common trust fund as defined in section 584(a) J--A bank as defined in section 581 K--A broker L--A trust exempt from tax under section 664 or described in section 4947(a)(1) M--A tax exempt trust under a section 403(b) plan or section 457(g) plan Note. You may wish to consult with the financial institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed. Line 5 Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will mail your information returns. Line 6 Enter your city, state, and ZIP code. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on this page), enter the owner s SSN (or EIN, if the owner has one). Do not enter the disregarded entity s EIN. If the LLC is classified as a corporation or partnership, enter the entity s EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at You may also get this form by calling Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling TAX-FORM ( ). If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write Applied For in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering Applied For means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8.

13 Form W-9 (Rev ) Page 4 Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1, 4, or 5 below indicate otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on line 1 must sign. Exempt payees, see Exempt payee code earlier. Signature requirements. Complete the certification as indicated in items 1 through 5 below. 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. Other payments include payments made in the course of the requester s trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. What Name and Number To Give the Requester For this type of account: 1. Individual 2. Two or more individuals (joint account) 3. Custodian account of a minor (Uniform Gift to Minors Act) 4. a. The usual revocable savings trust (grantor is also trustee) b. So-called trust account that is not a legal or valid trust under state law 5. Sole proprietorship or disregarded entity owned by an individual 6. Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulations section (b)(2)(i) (A)) For this type of account: 7. Disregarded entity not owned by an individual 8. A valid trust, estate, or pension trust 9. Corporation or LLC electing corporate status on Form 8832 or Form Association, club, religious, charitable, educational, or other taxexempt organization 11. Partnership or multi-member LLC 12. A broker or registered nominee 13. Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments 14. Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulations section (b)(2)(i) (B)) Give name and SSN of: The individual The actual owner of the account or, if combined funds, the first 1 individual on the account The minor 2 The grantor-trustee 1 The actual owner 1 The owner 3 The grantor* Give name and EIN of: The owner Legal entity 4 The corporation The organization The partnership The broker or nominee The public entity The trust 1 List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person s number must be furnished. 2 Circle the minor s name and furnish the minor s SSN. 3 You must show your individual name and you may also enter your business or DBA name on the "Business name/disregarded entity" name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN. 4 List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships on page 2. *Note. Grantor also must provide a Form W-9 to trustee of trust. Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal information such as your name, SSN, or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: l Protect your SSN, l Ensure your employer is protecting your SSN, and l Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at or submit Form For more information, see Publication 4535, Identity Theft Prevention and Victim Assistance. Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at or TTY/TDD Protect yourself from suspicious s or phishing schemes. Phishing is the creation and use of and websites designed to mimic legitimate business s and websites. The most common act is sending an to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. The IRS does not initiate contacts with taxpayers via s. Also, the IRS does not request personal detailed information through or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts. If you receive an unsolicited claiming to be from the IRS, forward this message to You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (TIGTA) at You can forward suspicious s to the Federal Trade Commission at: or contact them at or IDTHEFT ( ). Visit IRS.gov to learn more about identity theft and how to reduce your risk. Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.

14 Required Minimum Distribution Request Member ID Section 1 - General Information Name of participant/owner (print first, middle, last name and suffix, as applicable) Fund/Account number(s) Phone Section 2 - Required Minimum Distribution (RMD) Information The RMD will be made proportionately from each fund/account or allocation period. Specific fund/accounts cannot be selected for the distribution. One-Time Age 70 1/2 Distribution - Required Beginning Date (RBD) RBD - Applies to the year the participant attains age 70 1/2 and only to non-inherited fund/accounts. I have or will be attaining age 70 1/2 and would like to delay my initial RMD payout to a date from 1/1 but prior to 4/1 of the year after I turn age 70 1/2. If selecting this option, also complete Ongoing Automatic Distribution. Payout date - / month day 1-28 Use only days If no date is selected, payout will occur on March 7. Ongoing Automatic Distribution Day of withdrawal - (select 1-28) Withdrawal month(s) - (select all that apply): Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec If a date and/or month is not selected, the withdrawal will default to the 7th of each month. IRS Joint Life Expectancy Table (Only applicable to Non-inherited fund/accounts.) My sole primary beneficiary is my spouse who is more than 10 years younger than I am. Spouse's date of birth - Section 3 - Method of Distribution Send amount(s) by: Check Direct Deposit Complete bank information below. Deposit into an existing non-qualified Thrivent Mutual Fund account Fund/account number - Deposit into an existing non-qualified Thrivent annuity Contract number - Deposit into a new non-qualified Thrivent Mutual Fund account Complete a new business application. MF14643 Page 1 of 4 N2-16

15 For Direct Deposit only, complete bank information below. Name of account owner Account number Name of joint account owner Name of financial institution Financial institution phone Address Routing number City State ZIP code Type of account: Checking Savings Section 4 - Notification for Federal and State Income Tax Withholding Federal Tax Withholding (must be at least 10%): Do not withhold federal income tax Withhold federal income tax amount of or %. If no box is checked, IRS regulations require us to withhold the minimum federal income tax (10%) from your distribution. State Tax Withholding: Do not withhold state income tax* Withhold the applicable state income tax amount of or %. *If your state requires withholding, we will withhold at your state's minimum rate unless you indicate a higher rate. Any tax withholding will be subtracted from the taxable amount (gross). Section 5 - Additional Information Section 6 - Employer Certification (complete for 403(b) Required Minimum Distributions only) By signing below, I certify that the participant/owner named in Section 1 is requesting the commencement of required minimum distributions in accordance with the terms and conditions of the 403(b) plan sponsored by the employer named below. In addition, I certify that I am an authorized representative of the employer. Name of employer Name of authorized representative of employer Title of authorized representative of employer Signature of authorized representative of employer and date signed X MF14643 Page 2 of 4 N2-16

16 Section 7 - Validation Medallion Signature Guarantee Seal or Notary Seal Section 8 - Agreements and Signature I certify that I have received, read, and agree to the Disclosures (page 4 of this form) and any other disclosures contained in this form. Signature of owner and date signed X Title (if applicable) Mail completed form to: Regular Mail: Thrivent Mutual Funds PO Box Kansas City, MO Express Mail: Thrivent Mutual Funds 330 W 9th St Kansas City, MO Fax: MF14643 Page 3 of 4 N2-16

17 Disclosures The RMD will be made proportionately from each fund/account. Specific fund/accounts cannot be selected for the distribution. If you choose to aggregate your RMD with other fund/accounts, you will be responsible for calculating and distributing your aggregated amount each year. Inherited fund/accounts cannot be aggregated with non-inherited fund/accounts. Any payouts that occur on a weekend or nonbusiness day will be processed using the following business day's unit/share price. Distributions will be adjusted so the annual required amount is distributed by December 31. RMD will be calculated using your prior year end account balance. The value will be divided by the applicable divisor from the Internal Revenue Service (IRS) Uniform Distribution Table, unless your spouse is your sole beneficiary and is more than 10 years younger than you. Inherited fund/accounts use the IRS Single Table. The applicable divisor from the IRS Joint Life Expectancy Table will be used. If I change my beneficiary in the future so my spouse is no longer the sole primary beneficiary, I understand that I need to separately request to have my RMD calculation changed to use the IRS Uniform Distribution Table. I authorize Thrivent Financial Investor Services, Inc. to: (1) make this electronic deposits, withdrawals and corrections to my bank account that comply with U.S.law; (2) act on this authorization until I revoke it by contacting us; (3) apply this authorization to any future bank accounts I man designate; (4) make administrative changes to this authorization which I request such as date or amount changes' (5) release any and all information related to this authorization to the third party account owner, and (6) act upon electronic deposit instructions I provide to Thrivent Mutual Funds. You are liable for federal and state income tax, where applicable, on the taxable portion of your distribution even if you elect no withholding. Except where prohibited by federal and/or state law, you can elect: 1) no withholding; 2) withholding at the minimum federal and state rates; or 3) withholding at a rate higher than the minimum rates. You may be subject to tax penalties under the estimated tax payment rules if your payments of estimated tax and withholding, if any, are not adequate. Check with your tax advisor to determine if withholding is necessary. If we receive this form in good order after your selected start date, the start date shall be deemed the first business day that occurs on or after the date of receipt. Subsequent transactions requested pursuant to this form shall be based upon your selected start date. I understand that this distribution represents only the minimum amount which must be distributed annually and I can receive more than the minimum either now or in the future. I acknowledge that distributions made under the above requested RMD will result in the reporting of a taxable amount to the IRS and it cannot be reversed. Such taxable amount will be subject to income tax withholding unless the Notification for Federal and State Income Tax Withholding is completed. MF14643 Page 4 of 4 N2-16

18 New Account and Suitability Information Section 1 - Account Information Name of primary owner/custodian/trust/business Name of trustee/authorized person (if applicable) Street/Residential address Mailing address (if different) City State ZIP code City State ZIP code Date of birth Social Security number/tin Primary phone Phone type (cell, home, work) Number of dependents Name of employer Marital status Single Married Divorced Widowed Employment status/occupation: Labor/Trades Office/Retail Manager/Sales Professional Retired Student Unemployed Other - Yes No Do you own a business? Number of employees: Full-time - Part-time - Yes No Are you employed by or associated with a securities firm, FINRA, or AMEX? If yes, name of firm - Thrivent Investment Management Inc. may be required to send duplicate statements directly to the firm you are associated with. Yes No Are you or an immediate family member a director, 10% or greater shareholder, and/or policy-making executive officer of a publicly traded company? If yes, name of company - Name of joint owner/custodian/trustee/authorized person Street/Residential address Mailing address (if different) City State ZIP code City State ZIP code Date of birth Social Security number/tin Primary phone Phone type (cell, home, work) Number of dependents Name of employer Marital status Single Married Divorced Widowed MF20680 Page 1 of 6 N2-16

19 Employment status/occupation: Labor/Trades Office/Retail Manager/Sales Professional Retired Student Unemployed Other - Yes No Do you own a business? Number of employees: Full-time - Part-time - Yes No Are you employed by or associated with a securities firm, FINRA, or AMEX? If yes, name of firm - Thrivent Investment Management Inc. may be required to send duplicate statements directly to the firm you are associated with. Yes No Are you or an immediate family member a director, 10% or greater shareholder, and/or If yes, name of company - Section 2 - Risk Tolerance (select one) policy-making executive officer of a publicly traded company? Aggressive - Able to accept prolonged negative returns during difficult phases in a market cycle. Moderately Aggressive - Able to accept negative annual returns during difficult phases in a market cycle. Moderate - Able to accept only two or three quarters of negative returns during difficult phases in a market cycle. Moderately Conservative - Able to accept infrequent and very modest losses during difficult phases in a market cycle. Conservative - To minimize the chance for loss, willing to accept the lower long-term returns provided by conservative investments. Section 3 - Investment Objective (select one) Aggressive Growth - Focus is on generating growth and/or income with a willingness to assume a high level of risk. Growth - Focus is on generating long-term growth of capital, offset by a low level of income. Balanced/Conservative Growth - Focus is on generating current income and/or long-term growth. Preservation of Principal - Focus is on preservation of principal and/or income. Section 4 - Additional Account Information Aggregated Net Worth (not including primary residence): Under 50,000 50,000-99, , , , , , ,999 1,000,000-2,999,999 3,000,000 + Liquid Net Worth (Assets easily converted to cash. Do not include residence or business.): Under 20,000 20,000-49,999 50,000-99, , , , , , ,999 1,000,000-2,999,999 3,000,000 + Annual Income: Under 20,000 20,000-49,999 50,000-99, , , , , , , ,000 + Household annual income - Source of Income (select all that apply): Earned income IRA/SEP/SIMPLE/Roth Qualified plan Social Security Investment Reverse mortgage None Other - Federal Tax Bracket: 0-10% 11-15% 16-25% 26-28% 29-33% 34% + MF20680 Page 2 of 6 N2-16

20 Prior Investment Experience: None < 5 Years 5 + Years Bank Savings, CDs, Money Market Funds Stocks Bonds Mutual Funds Variable Annuities Fixed Annuities Life Insurance (Cash Value) Other - Approximate Current Value of Assets (exclude this purchase): Yes No Does your current income cover your expected day to day living expenses? If no, explain: Yes No Do you have cash and/or other liquid assets available to you that may be used in the event of a financial emergency? What are your needs for liquidity in the next several years? Yes No Do you anticipate any decrease in income or increase in living expenses in the next several years? If yes, due to (select all that apply): Health care Housing Change in Social Security Other - Change in pension Change in employment status/occupation An income stream that will cease When are the changes anticipated and how will they be addressed? Section 5 - Individual Product Information Purpose (select all that apply): Retirement Home purchase Emergency fund Supplemental source of income Tax free income College funding Time Horizon: 0-3 years* 4-7 years* More than 7 years *Give specific time horizon and explain: Bequeath assets to heirs Other - MF20680 Page 3 of 6 N2-16

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