Asset Transfer Kit. Everything you need to consolidate your retirement plan accounts. Brighten Your Outlook

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1 Asset Transfer Kit Everything you need to consolidate your retirement plan accounts Brighten Your Outlook SM Rainy Cloudy Partly Sunny Sunny

2 Let us help you simplify planning for retirement. If you have retirement plan accounts with more than one provider, consider the advantages of consolidating your accounts with Transamerica Retirement Solutions. It s easy... Call: A Transamerica transfer specialist will assist you with the process. Specialists are available Monday Friday, 9:00 a.m. 7:00 p.m. ET. [email protected]

3 Planning for retirement shouldn t be complicated. Consolidating your retirement accounts with Transamerica can make a lot of sense. When your retirement assets all work together under one program you can simplify your life and create a more effective plan. Having one account and one point of contact means more control for you. Combining multiple retirement plan accounts into a single account can also help make it easier and less costly for you to manage your retirement savings and income planning strategies you ll have fewer statements, account updates, and forms. And one retirement account instead of several can give you a better grasp of the value of your overall retirement savings and whether or not you are on course for achieving a rewarding retirement. Here are a few additional advantages of consolidating your retirement accounts with Transamerica. You will have: An easy way to track your progress through a consolidated statement. One convenient website with state-of-the-art technology and investment planning tools. Access to an efficient and professionally staffed call center for personal service whenever you need it. Plus, a comprehensive view of how your retirement portfolio is diversified. In some cases your prior provider may charge a surrender or withdrawal fee for transferring your account. Contact that provider to confirm if any fees or charges apply to you. Review the fees and expenses you pay, including any charges associated with transferring your account, to see if consolidating your accounts could help reduce your costs. Be sure to consider whether such a transfer changes any features or benefits that may be important to you.

4 Transferring your account balance to Transamerica is easy! Here s everything you need to get started to transfer your 403(b) account. Transfer from your Fidelity Investments account: Step One: Complete the Transamerica Incoming Contract Exchange Form On page 1, in Section B, complete the Participant Information section. On page 1, in Section C, provide your Fidelity Investments account number(s). On page 2, in Section D, sign and date the form. If you have questions on your Fidelity Investments account please call Transfer your Lincoln Financial Assets: Step One: Complete the Transamerica Incoming Contract Exchange Form On page 3, in Section B, complete the Personal Information section. On page 3, in Section C, provide your Lincoln Financial account number(s). On page 4, in Section D, sign and date the form. Step Two: Complete the Lincoln Distribution Form On page 5, complete the Personal Information section. On page 6, complete Section 5. On page 8, complete Section 7, if you have an outstanding loan with Lincoln. On page 12, in Section 11, sign and date the form. On page 12, in Section 12, obtain spousal consent. Please note that your spouse s signature must be witnessed by the Plan Administrator or a Notary Public to be valid.

5 Transfer your VALIC Assets: Step One: Complete the Transamerica Incoming Contract Exchange Form On page 15, complete the Client Information section. On page 15, in Section C, provide your provide your VALIC account number(s). On page 16, in Section D, sign and date the form. Step Two: Complete the VALIC Rollover/Transfer Out Form On page 17, complete the Personal Information section. On page 17, in Section 2. On page 18, in Section 8, obtaining spousal consent. Please note that spousal consent must be witnessed by the Plan Administrator or a Notary Public to be valid. On page 19, in Section 8, obtain Plan Administrator signature. On page 17, in Section 9, please sign and date the form. Please note that if your VALIC account balance is greater than $25,000 Section 10 must be completed.

6 How to contact us about your Transamerica Retirement Account For help consolidating your retirement accounts, call A Transamerica transfer specialist will assist you with the process. Representatives are available Monday-Friday, 9:00 a.m. 7:00 p.m. ET. or [email protected] For account management and questions, call You can access your retirement account by calling Transamerica and simply saying the type of information you wish to receive. It s easy to use and available 24/7. Visit the web: my.trsretire.com Visit Transamerica at my.trsretire.com for online access to your retirement account, and retirement planning tools and services. The role of the transfer specialist is to assist you with your savings and investment plan. There are no fees or commissions for meeting with your transfer specialist, who is a registered representatives with Transamerica Retirement Solutions Corporation (TISC). Securities offered through TISC, 440 Mamaroneck Avenue, Harrison, NY Transamerica is affiliated with TISC. When ing, do not include sensitive personal information in the communication.

7 I. Incoming 403(b) Contract Exchange Request Transfer Requirements Under the existing IRS Contract Exchange rules, your 403(b) account or annuity may be transferred to another investment provider for the same 403(b) plan, provided certain requirements are met. (1) The 403(b) plan sponsored by your employer must permit such contract exchanges and (2) the investment provider receiving the transfer must be an approved investment provider under your employer s 403(b) plan or such provider must have entered into an information-sharing agreement with your employer. Any 403(b) funds transferred to Transamerica from another 403(b) investment provider for your employer s 403(b) plan must continue to be subject to distribution restrictions that are not less stringent than those imposed on the contract being exchanged. Any 403(b) funds transferred to Transamerica under a 403(b) Contract Exchange will retain their December 31, 1986 and/or December 31, 1988 grandfathered status, (if applicable) provided the necessary information is timely provided to Transamerica by your present investment provider in the section provided on Transamerica s Incoming Contract Exchange (within the Same Plan), in accordance with the instructions on that form. II. Incoming 403(b) Plan-to-Plan-Transfer Request to Transamerica from Another 403(b) Plan If your current 403(b) account or annuity is under a different 403(b) plan than the 403(b) plan of your present employer (or former employer), and the receiving plan is serviced by Transamerica, please complete the Incoming 403(b) Plan-to-Plan Transfer (from another 403(b) Plan) in accordance with the instructions on that form. In order to allow for a Plan-to-Plan Transfer to occur, both the 403(b) transferor plan and the receiving plan that is serviced by Transamerica must provide for a Plan-to-Plan Transfer. In order to allow for a Plan-to-Plan Transfer to occur, the funds transferred to Transamerica from another 403(b) plan must continue to be subject to distribution restrictions that are not less stringent than those imposed under the transferor 403(b) plan. Any 403(b) funds transferred to Transamerica under a 403(b) Plan-to-Plan Transfer will retain their December 31, 1986 and/or December 31, 1988 grandfathered status, (if applicable) provided the necessary information is timely provided to Transamerica by your present investment provider in the section provided on Transamerica s Incoming Plan-to-Plan Transfer (from another 403(b) Plan), in accordance with the instructions on that form. Important Note: Some 403(b) plans are subject to the requirements of the Employee Retirement Income Security Act of 1974 ( ERISA ). You cannot transfer 403(b) assets from an ERISA-covered 403(b) plan to a non-erisa 403(b) plan except by a direct rollover, which requires a distributable event (e.g., termination of employment). If you transfer 403(b) assets from a non-erisa 403(b) plan to an ERISA-covered 403(b) plan, the transferred assets will automatically become subject to the requirements of ERISA. Please contact the Plan Administrator of the ERISA covered 403(b) plan or us for further information. III. Incoming 401(a) Plan-to-Plan Transfer Request to Transamerica from Another 401(a) Plan If your current 401(a) account is under a different 401(a) plan than the 401(a) plan of your present employer (or former employer), and the receiving plan is serviced by Transamerica, please complete the Incoming 401(a) Plan-to-Plan Transfer (from another 401(a) Plan), in accordance with the instructions on that form. In order to allow for a Plan-to-Plan Transfer to occur, both the 401(a) transferor plan and the receiving plan that is serviced by Transamerica must provide for a Plan-to-Plan transfer. In order to allow for a Plan-to-Plan Transfer to occur, the funds transferred to Transamerica from another 401(a) plan must continue to be subject to distribution restrictions that are not less stringent than those imposed under the transferor 401(a) plan. In order to allow for a Plan-to-Plan Transfer to occur, the funds transferred to Transamerica from another 401(a) plan must provide that the participant is entitled to receive any distribution from the receiving plan in a single sum distribution. Please contact your Plan Administrator or us for further information TRS (rev. 4/13) (Page 1 of 2) NFP ERISA/NFP Non-ERISA/Governmental 457(b)/Tax-Exempt 457(b)

8 IV. Incoming Tax Exempt Employer 457(b) Plan-to-Plan Transfer Request to Transamerica from Another Tax Exempt Employer 457(b) Plan If your current Tax Exempt 457(b) account is under a different Tax Exempt 457(b) plan than the Tax Exempt 457(b) plan of your present employer or former employer, and the receiving plan is serviced by Transamerica, please complete the Tax Exempt Employer 457(b) Transfer Deposit in accordance with the instructions on that form. In order to allow for a Plan-to-Plan Transfer to occur, both the Tax Exempt Employer 457(b) transferor plan and the receiving plan that is serviced by Transamerica must provide for a Plan-to-Plan Transfer. Important Note: If you transfer from one Tax Exempt Employer 457(b) Plan to another Tax Exempt Employer 457(b) Plan, your transferred amount is an unsecured obligation of the receiving plan s employer and is subject to the payment of claims of the employer s general creditors in the event of the employer s insolvency. Please contact your Plan Administrator or us for further information. V. Incoming Governmental 457(b) Plan-to-Plan Transfer Request to Transamerica from Another Governmental 457(b) Plan If your current Government 457(b) account is under a different Governmental 457(b) plan than the Governmental 457(b) plan of your present employer or former employer, and the receiving plan is serviced by Transamerica, please complete the Governmental 457(b) Transfer Deposit in accordance with the instructions on that form. In order to allow for a Plan-to-Plan Transfer to occur, both the Governmental 457(b) transferor plan and the receiving plan that is serviced by Transamerica must provide for a Plan-to-Plan Transfer. Important Note: Instead of a plan-to-plan transfer from one Governmental 457(b) plan to another Governmental 457(b) Plan, you may also do a rollover by requesting an eligible rollover distribution. Please contact your Plan Administrator or us for further information. VI. Mailing and Wiring Instructions Checks If sending a check, mail the check and the Incoming Transfer/Rollover/Exchange Form to one of the following addresses, as applicable: Regular Mail Overnight Mail Transamerica JPMorgan Chase - Lockbox Processing Remittance Processing Center Lockbox No PO Box Chase Metrotech Center Newark, NJ Ground Level Courier on Willoughby Street Brooklyn, NY Phone Number: (718) (must be indicated on overnight air bill) Wire Transfers If sending a wire transfer, mail the Incoming Transfer/Rollover/Exchange Form to the address below: Form Wire Instructions Transamerica State Street Bank and Trust Company 4333 Edgewood Road NE 200 Clarendon Street Cedar Rapids, IA Boston, MA Bank ABA # Receiving Account # Receiving Account name: Transamerica Contract Name 3484-TRS (rev. 4/13) (Page 2 of 2) NFP ERISA/NFP Non-ERISA/Governmental 457(b)/Tax-Exempt 457(b)

9 Instructions Incoming Contract Exchange (within the Same Plan) To request an exchange of investments to Transamerica from another 403(b) account or annuity with your current employer, complete all applicable sections of this form and return the form to Transamerica at the address indicated on the enclosed mailing and wiring instructions. For exchanges Application if you are not currently enrolled. This form should not be used if the exchange involves Roth 403(b) account monies. The exchange may not be initiated until receipt of all required paperwork and information. For further information, please refer to your Summary Plan Description, contact your Plan Administrator, or call us at Also, if you have an outstanding loan, please contact your current service provider to make arrangements for the handling of your loan prior to transferring your account to Transamerica. Note: If you are terminated from employment, please call us and request a form to roll over your account to Transamerica. Section A. Employer Information Company/Employer Name Hospital Sisters Health System Contract/Account No. TA Division No. Section B. Personal Information Social Security No. First Name/Middle Initial Date of Birth (mm/dd/yyyy) Last Name Mailing Address City Phone No. Address Date of Hire mm/dd/yyyy) State Ext. Zip Code Section C. Present 403(b) Investment Provider Information (include all present contract/account numbers) Provider Name Fidelity Investments Present Contract/Account Number(s) Insert account number(s) Provider Mailing Address City PO Box Cincinnati State OH Zip Code Phone No Ext. Amount to be transferred from present provider: 100% of account Partial transfer of $ 3479-TRS (rev. 4/13) (Page 1 of 2) NFP ERISA/Non-ERISA Page 1

10 Section D. Participant Signature I request the immediate transfer of funds from my present 403(b) account referenced in Section C above, to my Transamerica 403(b) account. I understand that my transfer deposit will be invested according to the existing investment allocation on my account. I agree that if I have an outstanding loan in my present 403(b) account with the current provider, I will contact the provider in order to make arrangements for the handling of my loan prior to the transfer of my account to Transamerica. I agree that Transamerica is released from any responsibility regarding the accuracy of my representations or any tax consequences resulting from the incoming contract exchange of my funds into my Transamerica 403(b) account. X Participant Signature X Date X Print Name X Social Security Number Section E. Contribution Types (to be completed by present provider) To present provider: Please complete the applicable contribution account information for this transfer, and see attached mailing instructions. Please also read explanatory footnotes below. Any checks should be made payable to Transamerica, FBO/Participant Name. Employer Employee 403(b)(1) Employee 403(b)(7) Contribution (pre-tax salary reduction) (pre-tax salary reduction) Account Contribution Account Contribution Account $ $ $ 12/31/86 account balance $ (1) $ (2) 12/31/88 account balance $ (3) $ (3) Post-1988 salary reduction contributions $ (3) 403(b)(1) employer annuity contract contributions Important explanatory footnotes to be read by present investment provider: (1) include only amounts originally contributed to a 403(b)(1) annuity contract and earnings thereon. (2) include only amounts originally contributed to a 403(b)(7) custodial account and earnings thereon. (3) exclude any earnings. (Non-Roth) After-tax Contribution Account (if applicable) $ Total After-tax Cost Basis (cost basis is the amount of contributions made, not including earnings) Total amount of transfer $ 3479-TRS (rev. 4/13) (Page 2 of 2) NFP ERISA/Non-ERISA Page 2

11 Instructions Incoming Contract Exchange (within the Same Plan) To request an exchange of investments to Transamerica from another 403(b) account or annuity with your current employer, complete all applicable sections of this form and return the form to Transamerica at the address indicated on the enclosed mailing and wiring instructions. For exchanges Application if you are not currently enrolled. This form should not be used if the exchange involves Roth 403(b) account monies. The exchange may not be initiated until receipt of all required paperwork and information. For further information, please refer to your Summary Plan Description, contact your Plan Administrator, or call us at Also, if you have an outstanding loan, please contact your current service provider to make arrangements for the handling of your loan prior to transferring your account to Transamerica. Note: If you are terminated from employment, please call us and request a form to roll over your account to Transamerica. Section A. Employer Information Company/Employer Name Hospital Sisters Health System Contract/Account No. TA Division No. Section B. Personal Information Social Security No. First Name/Middle Initial Date of Birth (mm/dd/yyyy) Last Name Mailing Address City Phone No. Address Date of Hire mm/dd/yyyy) State Ext. Zip Code Section C. Present 403(b) Investment Provider Information (include all present contract/account numbers) Provider Name The Lincoln National Life Insurance Company Present Contract/Account Number(s) Insert account number(s) Provider Mailing Address City Servicing Office - PO Box 2340 Fort Wayne State IN Zip Code Phone No Ext. Amount to be transferred from present provider: 100% of account Partial transfer of $ 3479-TRS (rev. 4/13) (Page 1 of 2) NFP ERISA/Non-ERISA Page 3

12 Section D. Participant Signature I request the immediate transfer of funds from my present 403(b) account referenced in Section C above, to my Transamerica 403(b) account. I understand that my transfer deposit will be invested according to the existing investment allocation on my account. I agree that if I have an outstanding loan in my present 403(b) account with the current provider, I will contact the provider in order to make arrangements for the handling of my loan prior to the transfer of my account to Transamerica. I agree that Transamerica is released from any responsibility regarding the accuracy of my representations or any tax consequences resulting from the incoming contract exchange of my funds into my Transamerica 403(b) account. X Participant Signature X Date X Print Name X Social Security Number Section E. Contribution Types (to be completed by present provider) To present provider: Please complete the applicable contribution account information for this transfer, and see attached mailing instructions. Please also read explanatory footnotes below. Any checks should be made payable to Transamerica, FBO/Participant Name. Employer Employee 403(b)(1) Employee 403(b)(7) Contribution (pre-tax salary reduction) (pre-tax salary reduction) Account Contribution Account Contribution Account $ $ $ 12/31/86 account balance $ (1) $ (2) 12/31/88 account balance $ (3) $ (3) Post-1988 salary reduction contributions $ (3) 403(b)(1) employer annuity contract contributions Important explanatory footnotes to be read by present investment provider: (1) include only amounts originally contributed to a 403(b)(1) annuity contract and earnings thereon. (2) include only amounts originally contributed to a 403(b)(7) custodial account and earnings thereon. (3) exclude any earnings. (Non-Roth) After-tax Contribution Account (if applicable) $ Total After-tax Cost Basis (cost basis is the amount of contributions made, not including earnings) Total amount of transfer $ 3479-TRS (rev. 4/13) (Page 2 of 2) NFP ERISA/Non-ERISA Page 4

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23 Instructions Incoming Contract Exchange (within the Same Plan) To request an exchange of investments to Transamerica from another 403(b) account or annuity with your current employer, complete all applicable sections of this form and return the form to Transamerica at the address indicated on the enclosed mailing and wiring instructions. For exchanges Application if you are not currently enrolled. This form should not be used if the exchange involves Roth 403(b) account monies. The exchange may not be initiated until receipt of all required paperwork and information. For further information, please refer to your Summary Plan Description, contact your Plan Administrator, or call us at Also, if you have an outstanding loan, please contact your current service provider to make arrangements for the handling of your loan prior to transferring your account to Transamerica. Note: If you are terminated from employment, please call us and request a form to roll over your account to Transamerica. Section A. Employer Information Company/Employer Name Hospital Sisters Health System Contract/Account No. TA Division No. Section B. Personal Information Social Security No. First Name/Middle Initial Date of Birth (mm/dd/yyyy) Last Name Mailing Address City Phone No. Address Date of Hire mm/dd/yyyy) State Ext. Zip Code Section C. Present 403(b) Investment Provider Information (include all present contract/account numbers) Provider Name VALIC Present Contract/Account Number(s) Insert account number(s) Provider Mailing Address City VALIC Document Control - PO Box Amarillo State TX Zip Code Phone No Ext. Amount to be transferred from present provider: 100% of account Partial transfer of $ 3479-TRS (rev. 4/13) (Page 1 of 2) NFP ERISA/Non-ERISA Page 15

24 Section D. Participant Signature I request the immediate transfer of funds from my present 403(b) account referenced in Section C above, to my Transamerica 403(b) account. I understand that my transfer deposit will be invested according to the existing investment allocation on my account. I agree that if I have an outstanding loan in my present 403(b) account with the current provider, I will contact the provider in order to make arrangements for the handling of my loan prior to the transfer of my account to Transamerica. I agree that Transamerica is released from any responsibility regarding the accuracy of my representations or any tax consequences resulting from the incoming contract exchange of my funds into my Transamerica 403(b) account. X Participant Signature X Date X Print Name X Social Security Number Section E. Contribution Types (to be completed by present provider) To present provider: Please complete the applicable contribution account information for this transfer, and see attached mailing instructions. Please also read explanatory footnotes below. Any checks should be made payable to Transamerica, FBO/Participant Name. Employer Employee 403(b)(1) Employee 403(b)(7) Contribution (pre-tax salary reduction) (pre-tax salary reduction) Account Contribution Account Contribution Account $ $ $ 12/31/86 account balance $ (1) $ (2) 12/31/88 account balance $ (3) $ (3) Post-1988 salary reduction contributions $ (3) 403(b)(1) employer annuity contract contributions Important explanatory footnotes to be read by present investment provider: (1) include only amounts originally contributed to a 403(b)(1) annuity contract and earnings thereon. (2) include only amounts originally contributed to a 403(b)(7) custodial account and earnings thereon. (3) exclude any earnings. (Non-Roth) After-tax Contribution Account (if applicable) $ Total After-tax Cost Basis (cost basis is the amount of contributions made, not including earnings) Total amount of transfer $ 3479-TRS (rev. 4/13) (Page 2 of 2) NFP ERISA/Non-ERISA Page 16

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