Transfer/Direct Rollover/ Conversion Authorization

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1 1 Prudential Mutual Fund Services LLC (PMFS), a Prudential Financial company Instructions Submit a separate transfer form for each Resigning Custodian and each unique account type. Account Owner Information First name MI Last name Transfer/Direct Rollover/ Conversion Authorization For assistance: Clients: (800) Pruco representatives: (800) Financial professionals: (888) Social Security number PMFS account number (Required for existing accounts only.) 2 Account(s) to be Transferred to PMFS (Please attach copies of your most recent account statements.) Complete all sections for your request to be processed. Note: Prudential Mutual Fund Services LLC cannot accept stock certificates. A. Account types being transferred to PMFS Traditional IRA Roth IRA SEP-IRA 403(b) Plan Governmental 457 Plan Roth 401(k) Plan Roth 403(b) Plan SIMPLE IRA Employer-Sponsored 401(a) Retirement Plan (i.e., 401(k), pension or profit sharing plan, or defined benefit plan) B. Account number(s) to be transferred C. Resigning Custodian information Name of institution/employer-sponsored retirement plan from which the accounts in section B above will be transferred Attention Mailing address City State ZIP code 4-digit ext. Contact telephone number Extension Name of contact person or department 3 4 Transfer Instructions All liquidations are done immediately unless special instructions are provided below. Check with your sending institution about financial penalties, suspensions, signature guarantees, or other restrictions that could affect the transfer of your account to PMFS. A. Liquidate All $ (estimated value) Partial B. Special instructions for CDs and certain annuity contracts Transfer immediately. I am aware of and acknowledge Transfer at maturity (month, day, year): any penalty I may incur from an early withdrawal. (Please submit 4 weeks prior to maturity date.) Transfer-in-Kind Instructions Complete this section only if you have existing Prudential mutual funds and want to change your current Trustee/Custodian. Prudential shares will not be sold. Transfer my funds in kind immediately. Important: Section 3 must be completed for any general securities to be liquidated. Otherwise, only Prudential positions will be transferred. MF1012 Ed. 3/2015 Page 1 of 3

2 PMFS Account Type The transferred proceeds will be invested into the following account type. Traditional IRA, Rollover IRA, or SEP IRA Roth IRA or Roth Conversion IRA Establishment date* 403(b) Plan You must have an existing account at PMFS. New accounts will not be accepted. * The date you originally contributed to a Roth IRA or converted from a traditional IRA to a Roth IRA. This information is required by the IRS for compliance with the 5 tax-year holding period requirement. Mutual Fund Selection and Allocation I am opening a new account and have attached a completed application. Allocation instructions are included in section 4 of my new account application. For this transfer request, invest the amount received into my existing account(s) (indicated in section 1) in the funds and allocations listed below. Please provide investment fund selections and indicate allocations. Refer to the fund s prospectus for the fund minimum and eligibility requirements. Note: All allocations by percentage must total 100%. Share class Fund name Fund number Percent Amount A C Other Fund Holding Years. Indicate the number of years you intend to hold your mutual fund Withholding Election and Roth Conversion Disclosure Federal tax law requires that income tax be withheld at a rate of 10% from the total amount of your IRA distribution/conversion unless you elect not to have tax withheld. Depending on your state of residence, state tax withholding may also apply. If you do not want taxes withheld, proceed to the next section. If you would like to have taxes withheld, please check the box below: I would like federal and applicable state income taxes withheld from my IRA distribution being converted to a Roth IRA. I understand that, as a result, the portion of my IRA distribution that is withheld as income taxes will not be converted to my Roth IRA and may result in adverse tax consequences. (Please consult with your tax adviser.) If you would like more than 10% withheld, please indicate below: Federal taxes Mailing Instructions for Resigning Custodian State taxes* (Percentage or Dollars) Percentage: % (minimum 10% distribution), or Percentage: %, or Dollar amount $ (Amount cannot be less than 10% of distribution.) Dollar amount $ *Percentage/dollar amount cannot be less than the minimum required for your state. Checks should be made payable to PMFS for the benefit of (account owner). Checks should be sent to: Standard Prudential Mutual Fund Services LLC mail to: PO Box 9658 Providence, RI Overnight mail to: Total Prudential Mutual Fund Services LLC 4400 Computer Drive Westborough, MA If you have any questions, please call PMFS at (800) , Monday through Friday between 8 a.m. to 6 p.m. Eastern time. MF1012 Ed. 3/2015 Page 2 of 3

3 9 Authorization For Traditional IRAs, Roth IRAs, SEP-IRAs, and 403(b) accounts. It is my intention to effect a transfer, without inclusion of the amount to be transferred in my gross income. You are directed to transfer all or a portion of the redemption value of the account as identified in section 2 to an account established for me with Prudential Trust Company (PTC) as custodian. Accordingly, you are hereby directed to request on my behalf the transfer of my interest in the account referenced in section 2 for subsequent investment in Prudential Mutual Funds for investment in the custodial account(s) maintained for me. I hereby agree to the terms and conditions set forth in this Transfer/Direct Rollover/Conversion Authorization. For direct rollover. This authorizes the employer-sponsored retirement plan designated in section 2 to distribute my eligible rollover distribution directly from my retirement plan to PTC in accordance with the instructions in section 3. I have received and considered a copy of The Should You Rollover Your Retirement Plan? Challange for applicable IRA rollovers. I understand that the conversion of a traditional IRA to a Roth IRA will result in a taxable event which will be reported to the IRS. If the account owner has attained the age of 70½ or older in the year of this transfer request, the required minimum distribution must be removed prior to the transfer being made. I understand that the Resigning Custodian may charge a closeout fee for IRA accounts. The default election is for the Resigning Custodian to redeem shares to cover charges. I authorize the Resigning Custodian to redeem shares to cover those charges. Owner s signature X I will arrange to cover those charges by other means. Important: If elected, any fees must be paid to the resigning custodian, prior to submitting this form, or they may deny the request. Date Signature Guarantee (If applicable, may be required by Resigning Custodian.) Prudential Trust Company s Acceptance (To be completed by PMFS.) Prudential Mutual Fund Services LLC, as agent for the Prudential Trust Company (PTC) which is custodian of the traditional IRA, Roth IRA, SEP IRA or 403(b) plan, hereby confirms its acceptance of the above mentioned transfer or rollover. Authorized signature of Prudential Mutual Fund Services LLC (as agent for PTC) X Financial Professional Identification and Signature (if applicable) Financial professional s name (first name, MI, last name) (Please print.) Financial professional s signature X Broker/Dealer s name (Please print.) Broker/Dealer number Branch/Agency number Rep./Contract number Branch telephone number Alternate telephone number MF1012 Ed. 3/2015 Page 3 of 3

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5 The Should You Rollover Your Retirement Plan? Challenge PRUDENTIAL INVESTMENTS If you are retiring or have changed jobs, it may be challenging to decide what to do with the assets in your company s pension and 401(k) plans. Here are the options available to you: 1. Roll over the assets into a Traditional IRA or roll over the assets into a Roth IRA 1 ; 2. Roll over the assets into your new employer s retirement plan; 3. Leave the assets in your old employer s retirement plan, if greater than plan minimum; or 4. Take a lump-sum distribution. DETERMINING WHICH OPTION IS RIGHT FOR YOU depends on your specific situation and financial needs. Benefits of rolling over your plan funds directly to an IRA (Traditional or Roth) may include: IRAs generally offer a wider range of investment choices than employer-sponsored retirement plans. Consolidating your retirement assets from multiple sources allows for easier account management and control of asset allocation. IRAs allow a higher degree of control of investment fees associated with your assets. Assets are typically more easily accessible in an IRA than an employer-sponsored plan. (Keep in mind that distributions from a Traditional IRA are subject to current taxes, and a 10% early withdrawal penalty may apply if you are under age 59½.) Benefits of an employer-sponsored retirement plan may include: Employer-sponsored plans typically allow loans which are not an option with IRAs. Company or Employer stock gets special tax treatment when it s distributed directly. Taxes are paid on original purchase price; earnings are taxed when liquidated at long-term capital gain rates. If rolled over to an IRA it would be taxed upon distribution at current income tax levels. Depending on your state of residence, different creditor protection laws apply to employer plan assets than IRAs. If you separate from service after you turn 55, you can make penalty-free withdrawals before the age of 59½. Required Minimum Distributions (RMD) may not be required if you are still working for that employer over the age of 70½. In order to determine what is right for you, you should review all fees and expenses associated with the different options available. An IRA rollover may have certain tax consequences. You may want to speak with a tax advisor about any specific tax-related questions. There are portability rules that allow you to consolidate various retirement plan balances. They are: Your 401(k) (and other qualified plans), 403(b), and 457(b) state or local government plan balances can be rolled into an IRA or they can be rolled into each other (as long as the plan permits such rollovers and is able to separately account for the plan assets). 2 After-tax employee contributions can be included in rollovers into an IRA, but once rolled over into an IRA they may not be rolled over again into an employer-sponsored plan. In addition, pre-tax Traditional IRA balances can be rolled into a qualified plan, if the plan allows it Ed. 12/2014

6 THE SHOULD YOU ROLLOVER YOUR RETIREMENT PLAN? CHALLENGE There are two ways to roll over your retirement plan assets into an IRA: a direct rollover or an indirect rollover. The following is an overview of each: DIRECT ROLLOVERS The easiest way to roll over your retirement plan assets into a Traditional IRA is a direct rollover, which allows you to transfer eligible assets from your company s retirement plan directly into a Traditional IRA. In doing so, you are not subject to current taxes and potential penalties, and your savings can continue to grow tax-deferred. In addition, you will not be subject to the mandatory 20% federal income tax withholding on retirement plan distributions. You can choose from several methods to transfer your retirement plan assets into your Rollover Traditional IRA. For example, your employer can send a check for your eligible retirement plan distribution directly to the financial institution where you maintain your Traditional IRA. Or your employer can make out the check to the custodian of the Traditional IRA and send it to you for immediate deposit with the custodian. You may also be able to directly transfer mutual fund shares or other securities into your Traditional IRA. 3 INDIRECT ROLLOVERS Another option is to use an indirect rollover. In this case, you receive a distribution in your name and roll all or part of it into a Traditional IRA at a later date. To avoid being subject to tax, and possibly the 10% early withdrawal penalty, you must complete the rollover within 60 days of receiving the distribution. You should also note that 20% of the distribution will be withheld for federal income tax if you receive a distribution check or securities made out in your name. In order to have no current tax liability, you would then need to make up the 20% from other sources to complete the rollover within the 60-day period. *Note: There are often times when an employee must complete paperwork with a previous employer to initiate a rollover. 1 Rollovers into the Roth IRA are subject to ordinary income tax, but the rollover is not subject to early distribution penalties. You may find it beneficial to roll over to a Roth IRA, since after paying the initial tax on the rollover, distributions from the Roth IRA are free of federal income and penalty taxes if taken after you have reached age 59½ and at least five tax years after opening a Roth account. 2 After-tax contributions may be rolled over from one qualified plan to another, but never from an IRA to a qualified plan. In addition, after-tax contributions to a 457(b) state or local government plan may never be rolled over. 3 Because the portability rules may be applied differently by each plan, you should review the options a plan provides before making your rollover decision. Neither Prudential Financial, its affiliates, nor its financial professionals, render tax or legal advice. Clients and prospects should consult with an attorney, accountant, and/or tax advisor for advice concerning their particular circumstances. NOTE: Mutual fund investing involves risk. Some mutual funds have more risk than others. The investment return and principal value will fluctuate and shares when sold may be worth more or less than the original cost and it is possible to lose money. There is no guarantee a Fund s objectives will be achieved. The risks associated with each fund are explained more fully in each fund s respective prospectus. Consider a fund s investment objectives, risks, charges, and expenses carefully before investing. The prospectus and summary prospectus contain this and other information about the fund. Contact your financial professional for a prospectus and summary prospectus. Read them carefully before investing. Mutual funds are distributed by Prudential Investment Management Services LLC, a Prudential Financial company and member SIPC Prudential Financial, Inc. and its related entities. Prudential Investments LLC, Prudential, the Prudential logo, the Rock symbol, and Bring Your Challenges are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide Prudential Financial, Inc. and its related entities Ed. 12/2014 Securities and Insurance Products: Not Insured by FDIC or Any Federal Government Agency. May Lose Value. Not a Deposit of or Guaranteed by Any Bank or Bank Affiliate.