alger family of funds simple ira application

Transcription

1 please print alger family of funds simple ira application To open an Alger SIMPLE IRA, please complete this application. If you would like to transfer funds from another SIMPLE IRA to your Alger SIMPLE IRA, please also complete the SIMPLE IRA Transfer Request Form. Items marked with an * must be completed. Mail completed application to: Alger Family of Funds, P. O. Box 8480, Boston, MA employee information Name (First, M.I., Last)* Social Security Number* of Birth* Street Address (no P.O. boxes)* City* State* Zip* Mailing Address (if different from above) Daytime Phone Evening Phone Address Citizenship:* U.S. Resident Alien Non-Resident Alien (specify country): 2 employer information Name of Employer Mailing Address Payroll Contact Phone 3 investment instructions A $500 minimum investment per Fund is required to set up an account. Please select the Alger Fund(s) you want for your SIMPLE IRA investment(s) and indicate the amount to be invested in each Alger Fund. If you plan to transfer assets from an existing SIMPLE IRA to your Alger SIMPLE IRA, please provide your investment instructions for those assets on the SIMPLE IRA Transfer Request Form. We will allocate those assets as you have indicated on that form. Class A Class B Class C Alger Analyst Fund $ (2170) N/A $ (2174) Alger Capital Appreciation Focus Fund (2167) N/A (2177) Alger Capital Appreciation Fund (2066) (2016) (2076) Alger Dynamic Opportunities Fund (2162) N/A (2175) Alger Emerging Markets Fund (2166) N/A (2176) Alger Global Growth Fund (2135) N/A (2137) Alger Green Fund (2140) N/A (2172) Alger Growth & Income Fund (2064) N/A (2074) Alger Growth Opportunities Fund (2068) N/A (2078) Alger Health Sciences Fund (2067) N/A (2077) Alger International Growth Fund (2062) (2012) (2072) Alger Mid Cap Growth Fund (2065) (2015) (2075) Alger Small Cap Growth Fund (2061) (2011) (2071) Alger SMid Cap Growth Fund (2069) N/A (2079) Alger Spectra Fund (2130) N/A (2171) TOTAL $ $ $ learn more about alger. call or visit Please proceed to next page }

2 4 amount and frequency of deferrals The parties named on previous page hereby agree to the following salary reduction agreement: The salary or wages of the employee will be reduced by ($50 minimum investment) $ or % per pay period and the employer will contribute the amount to the employee s custodial account. The amount above will be sent: Weekly Bi-weekly Monthly Bi-monthly 5 telephone privileges Shareholders automatically have the ability to make exchanges and redemptions by telephone. Exchanges can be made among funds of the same class of shares for identically registered accounts. Redemption proceeds are mailed to the address of record. Please note: if your address was changed within the last 30 days or if the proceeds are not being sent to the current address of record, your redemption request must be in writing and the signature(s) must be guaranteed by a financial institution. Check here if you do not want the ability to make exchanges and redemptions by telephone. 6 beneficiary designation I hereby designate the following persons as primary and contingent beneficiaries to receive my holdings in this SIMPLE IRA according to the terms of the Custodial Account Agreement in the proportions specified below (or in equal proportions if none specified), hereby revoking any such prior designations made by me (attach additional sheets if necessary): Primary Beneficiary: Name Relationship of Birth* Social Security Number* % Allocation Name Relationship of Birth* Social Security Number* % Allocation Contingent Beneficiary: Name Relationship of Birth* Social Security Number* % Allocation Name Relationship of Birth* Social Security Number* % Allocation Spousal Consent: If the participant resides or has ever resided in a community or marital property state and wishes to name someone other than or in addition to the participant s spouse as primary beneficiary, the participant is advised to seek competent professional advice. The designation of a non-spouse beneficiary may be ineffective unless the participant s spouse has consented to the designation. The participant is solely responsible for the effectiveness of the participant s beneficiary designation. I hereby certify that I am the spouse of the above named participant. I acknowledge that I have received a fair and reasonable disclosure of my spouse's property and financial obligations. Due to the important tax consequences of giving up my interest in this account, I have been advised to see a tax professional. I hereby give the account holder any interest I have in the funds or property deposited in this account and consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequences that may result. No tax or legal advice was given to me by the Custodian or Plan Sponsor. X Spouse s Signature The signature of the spouse must be witnessed by a notary public. Subscribed and sworn to before me on this day of, Signature 7 annual custodial fees This account is effective on the date State Street Bank and Trust Company, or its Agent, accepts this application by issuing a confirmation to the participant. The annual fee for each SIMPLE IRA Plan is $ The $10.00 fee will be deducted from your account in December if not paid by a separate check. learn more about alger. call or visit Please proceed to next page }

3 8 for broker use only Broker/Dealer Name Branch Office Address Rep Name Phone Broker/Dealer Number Branch Office Number Rep Number 9 signature and certification* Your signature is required to open an account. By signing this application, I certify that: 1. I hereby apply to establish an Alger SIMPLE IRA. I have received, read and understood the State Street Bank and Trust Company Custodial Agreement and Disclosure Statement, which is incorporated by reference in this application, and agree to be bound by its terms. I have received and read the current Alger prospectus and agree to be bound by its terms. 2. I have the authority and legal capacity, and am of legal age in my state of residence to purchase shares of the fund in which I am investing (the Fund ). 3. I have provided true and correct information in my account application and understand that any information I have provided is subject to verification. I certify under penalty of perjury that the social security number provided in this application is correct. 4. I understand that I am responsible for the monitoring of my account. I understand that all transactions made through the transfer agent (the Transfer Agent ) will be confirmed on separate written transaction confirmations and on periodic account statements. I understand that I should promptly and carefully review the transaction confirmations and periodic statements provided to me and notify the Transfer Agent in writing of any discrepancy or unauthorized account activity, within ten (10) business days after the information is transmitted to me. I understand that any information contained on transaction confirmations and account statements is conclusive unless I notify the Transfer Agent within the time period specified above. I understand that due to the volatile nature of the financial markets, I am fully responsible for any loss that results from my failure to notify the Transfer Agent of any discrepancy or unauthorized account activity, within the time period specified above. 5. I understand that the Fund and the Transfer Agent are required by the USA Patriot Act of 2001 to undertake a due diligence review of each customer and comply with their Anti-Money Laundering Policies and Procedures. I certify that the monies or assets I intend to use to execute my transaction, to the best of my knowledge and belief, are not derived from any criminal enterprise or activity. Important information about procedures for opening a new account: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial organizations to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, you are required to provide your name, residential address, date of birth, and taxpayer identification number. We may require other information that will allow us to identify you. X Participant s Signature learn more about alger. call or visit

4 please print alger family of funds simple ira transfer request form Complete this form if you wish to transfer all or a portion of an existing SIMPLE IRA to an Alger SIMPLE IRA. If you are opening a new account, please complete and return the Alger Family of Funds SIMPLE IRA Application. 1 participant information When completed, mail this form (along with your Application if establishing a new account) to: Alger Family of Funds, P. O. Box 8480, Boston, MA Name (First, M.I., Last) Social Security Number of Birth Mailing Address Daytime Phone Evening Phone Address 2 current custodian information Name of Custodian Mailing Address Phone Account Number (attach a copy of statement) Contact Person 3 transfer instructions to resigning custodian trustee Please transfer my SIMPLE IRA as indicated below: Please liquidate all of the assets of my present account and transfer proceeds to my Alger SIMPLE IRA. Please liquidate/surrender a portion of my present account: $ and transfer proceeds to my Alger SIMPLE IRA. Transfer of shares-in-kind. This will authorize a transfer of Alger Fund shares from your existing Trustee / Custodian to State Street Bank and Trust Company as custodian. If you are requesting a partial transfer, please list assets to be liquidated. Asset description: Quantity: Please Transfer a Certificate of Deposit (CD): Transfer prior to maturity date (I am aware that I may incur a penalty for early withdrawal). Transfer at maturity. Send this form at least two weeks, but not more than four weeks, prior to CD maturity date. CD Maturity : Please draw a check or send authorization to transfer in kind as follows: State Street Bank and Trust Company FBO: Participant s Name P. O. Box 8480, Boston, MA learn more about alger. call or visit Please proceed to next page }

5 4 investment instructions Alger SIMPLE IRA Account Number (if existing account): If this is a new account, please complete the Alger Family of Funds SIMPLE IRA Application. A $500 minimum investment per Fund is required to set up an account. Please deposit the assets transferred from prior custodian in the Alger Fund(s) listed below: Class A Class B Class C Alger Analyst Fund $ (2170) N/A $ (2174) Alger Capital Appreciation Focus Fund (2167) N/A (2177) Alger Capital Appreciation Fund (2066) (2016) (2076) Alger Dynamic Opportunities Fund (2162) N/A (2175) Alger Emerging Markets Fund (2166) N/A (2176) Alger Global Growth Fund (2135) N/A (2137) Alger Green Fund (2140) N/A (2172) Alger Growth & Income Fund (2064) N/A (2074) Alger Growth Opportunities Fund (2068) N/A (2078) Alger Health Sciences Fund (2067) N/A (2077) Alger International Growth Fund Alger Mid Cap Growth Fund (2062) (2065) (2012) (2015) (2072) (2075) Alger Small Cap Growth Fund (2061) (2011) (2071) Alger SMid Cap Growth Fund (2069) N/A (2079) Alger Spectra Fund (2130) N/A (2171) TOTAL $ $ $ 5 participant authorization The current custodian/trustee as named above is hereby removed as custodian/trustee for that portion of my SIMPLE IRA specified above. I have adopted the Alger SIMPLE IRA and have designated State Street Bank and Trust Company as my successor custodian. X Participant s Signature Please ask your current custodian if a Medallion Signature Guarantee is required to transfer. If so, it is available at commercial banks or brokerage offices. Lack of a required Medallion Signature Guarantee could delay the processing of your transfer. place signature guarantee stamp here We only accept STAMP 2000 Medallion Guarantee stamps. Name of Bank or Firm Providing Signature Guarantee Signature / Title of Officer 6 for internal use only - acceptance of appointment State Street Bank and Trust Company (the Custodian ) hereby accepts this transfer/direct rollover from the above plan and accepts its appointment as successor custodian. Authorized Signature learn more about alger. call or visit

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