Your Guide to Getting Started

Transcription

1 Retirement Savings Plan provided by The Directed Account Plan Invest in your retirement and yourself today, with help from the DAP and Fidelity. Your Guide to Getting Started

2 Get started today. Starting early can have an impact on your account. Your decision to start today could give you quite a bit more at retirement than starting five years from now. Hypothetical example: Potential growth if you contribute $100 of your paycheck monthly Potential account Potential account value in 10 years (2023) value in 20 years (2033) Start today $17,308* $52,093* Wait 5 years to start $7,159 $31,696 $10,149 difference $20,397 difference * Increase your contributions to $200 a month, and your potential account value could be even more $34,617 in 10 years and $104,185 in 20 years. This hypothetical illustration is based on the following assumptions: (1) Hypothetical participant remains employed and contributes as shown at the beginning of each month throughout the periods shown, (2) a hypothetical effective annual rate of return of 7%, (3) reinvestment of all earnings, (4) no withdrawals or loans throughout the indicated periods, and (5) participant is 100% vested. Income taxes, inflation, fees and expenses are not taken into account. If they were, values would be lower. Earnings and pre-tax contributions in a tax-deferred plan are subject to income taxes when withdrawn, and if distributions are taken before age 59½, may also be subject to a 10% penalty. Individual results will vary. Systematic investing does not ensure a profit and does not protect against loss in a declining market. This example is for illustrative purposes only and does not represent the performance of any investment. Contributions are subject to Plan and IRS limits and such limits are indexed and adjusted for cost of living increases. Plan limits may be less than IRS limits. For highly compensated employees, additional limits may apply. This hypothetical illustration is for educational purposes. Actual benefits are provided solely according to the terms of the Plan. A participant s actual account balance at any point in the future will be determined by the contributions that have been made, any plan or account activity, and any investment gains or losses that may occur. The illustrations of future balances should in no way be construed to imply any guarantee of future employment. A PIECE

3 Frequently asked questions about your plan Here are answers to questions you may have about the key features, benefits, and rules of your plan. When can I enroll in the plan? There is no waiting period. You can enroll in the Plan at any time. How do I enroll in the Plan? Log on to Fidelity NetBenefits at or call the Directed Account Plan Benefits Center at Fidelity at to enroll in the Plan. If you have not enrolled in the Plan within 45 days from your date of hire, you will be automatically enrolled in the Plan at a contribution rate of 6% of your pretax eligible earnings. Your contributions will be invested in the Moderate Portfolio. However, we encourage you to take an active role in the Plan and to choose a contribution rate and select the investment options that may be appropriate for you. If you do not wish to contribute to the Plan, you must call Fidelity at or go to and change your contribution rate to 0% during the 45-day eligibility period. It s important to note that you can stop or change your contribution percentage at any time. What is the Roth contribution option? A Roth contribution to your retirement savings plan allows you to make after-tax contributions and take any associated earnings completely tax free at retirement - as long as the distribution is a qualified one. A qualified distribution, in this case, is one that is taken at least five tax years after your first Roth 401(k) contribution and after you have attained age 59½, or become disabled or die. Through automatic payroll deduction, you can contribute between 1% and 75% of your eligible pay as designated Roth contributions, up to the annual IRS dollar limits. For more information please log on to NetBenefits at and select "Tools & Learning" from the home page. Under "Learning" you will see a tab called "About 401(k)s;" select that tab and click on "Roth." How much can I contribute? Through automatic payroll deduction, you can contribute between 1% and 75% of your eligible pay on a pre-tax or Roth basis, up to the annual IRS dollar limits. The Internal Revenue Code provides that the combined annual limit for total plan contributions is 100% of your W2 compensation or $51,000, whichever is less. You can request to change your contribution amount virtually any time by logging on to Fidelity NetBenefits at When is my enrollment effective? Your enrollment becomes effective once you elect a deferral percentage, which initiates deduction of your contributions from your pay. These salary deductions will generally begin with your next pay period after we receive your enrollment information, or as soon as administratively possible. If you have not made a deferral election after 45 days, you will be automatically enrolled in the Plan. Your enrollment will be effective, with deferrals of 6% of compensation, during the first pay period after the 45-day auto enrollment window, unless you elect not to participate or change or stop your contributions. FAQs For more information visit or call

4 In addition, your contribution to the Plan will be automatically increased by 1% of compensation each year until a maximum of 9% of compensation is achieved, unless you make a subsequent contrary election. years of service vested percentage 1 25% 2 50% 3 75% 4 100% FAQs Does the CommunityAmerica Credit Union contribute to my account? The Plan helps your retirement savings grow by matching your contributions. CommunityAmerica Credit Union ("the Company") will match 100% of each pre-tax or Roth dollar you contribute on the first 6% of pay that you defer to your Plan. Your Company contributions may change depending on profitability. The Company matching contribution is made only on your pre-tax contributions. The Company may also make profit-sharing contributions at its discretion which will be allocated among all eligible employees whether or not they make contributions. Employees may be eligible for discretionary contributions if they are actively employed on the last day of the Plan year and have worked 1,000 hours of service during the Plan year. What "catch-up" contribution can I make? If you have reached age 50 or will reach 50 during the calendar year January 1 December 31 and are making the maximum plan or IRS pretax contribution, you may make an additional catch-up contribution each pay period. Going forward, catch-up contribution limits will be subject to cost of living adjustments (COLAs) in $500 increments. When am I vested? You are always 100% vested in your contributions to the DAP, as well as any earnings on them. The Company s matching contributions and any earnings vest according to the following schedule: For the purpose of vesting, a year of service is defined as a calendar year in which you complete 1,000 hours of service. Can I take a loan from my account? Although your plan account is intended for the future, you may borrow from your account for any reason. Generally, the DAP allows you to borrow up to 50% of your vested account balance. The minimum loan amount is $1,000, and a loan must not exceed $50,000. You may have two loans outstanding at a time. You then pay the money back into your account, plus interest, through after-tax payroll deductions. The interest rate on your loan will be the Wall Street Journal Prime Rate plus 1%. Any outstanding loan balances over the previous 12 months may reduce the amount you have available to borrow. The cost to initiate a loan is $35, and there is a quarterly maintenance fee of $3.75. The initiation and maintenance fees will be deducted directly from your individual plan account. If you fail to repay your loan (based on the original terms of the loan), it will be considered in "default" and treated as a distribution, making it subject to income tax and possibly to a 10% early withdrawal penalty. Defaulted loans may also impact your eligibility to request additional loans. To learn more about or request a loan, log on to or call the The Directed Account Plan Service Center at Can I make withdrawals from my account? Withdrawals from the Plan are generally permitted when you terminate your employment, retire, become permanently disabled, or have severe financial hardship as defined by your Plan. Keep in mind that withdrawals are subject to income taxes and possibly to early withdrawal penalties. 2

5 The taxable portion of your withdrawal that is eligible for rollover into an individual retirement account (IRA) or another employer s retirement plan is subject to 20% mandatory federal income tax withholding, unless it is rolled directly over to an IRA or another employer plan. (You may owe more or less when you file your income taxes.) If you are under age 59½, the taxable portion of your withdrawal is also subject to a 10% early withdrawal penalty, unless you qualify for an exception to this rule. To learn more about and/or to request a withdrawal, log on to Fidelity NetBenefits at or call The Directed Account Plan Service Center at The plan document and current tax laws and regulations will govern in case of a discrepancy. Be sure you understand the tax consequences and your plan s rules for distributions before you initiate a distribution. You may want to consult your tax adviser about your situation. When you leave the Company, you can withdraw contributions and any associated earnings or, if your vested account balance is greater than $5,000, you can leave contributions and any associated earnings in the Plan. After you leave the Company, if your vested account balance is equal to or less than $1,000, it will automatically be distributed to you. If the balance is between $1,000 and $5,000, it must be distributed or it will be automatically rolled over to an Individual Retirement Account (IRA). Can I move money from another retirement plan into my account in the DAP? You are permitted to roll over eligible pre-tax or Roth contributions from another 401(k) plan, 403(b) plan or a governmental 457(b) retirement plan account or eligible pre-tax contributions from conduit Individual Retirement Accounts (rollover IRAs) and certain non-conduit individual retirement accounts (traditional IRAs, Simplified Employee Pension plans, and "SIMPLE" IRA distributions made more than two years from the date you first participated in the SIMPLE IRA). A conduit IRA is one that contains only money rolled over from an employer-sponsored retirement plan that has not been mixed with regular IRA contributions. Contact your Fidelity Investments Benefits department for details. You should consult your tax adviser and carefully consider the impact of making a rollover contribution to your employer s plan because it could affect your eligibility for future special tax treatments. You can also roll over eligible after-tax contributions from a 401(a), 401(k) or 403(a) account. How do I access my account? You can access your account online through Fidelity NetBenefits at or call the The Directed Account Plan Service Center at to speak with a representative or use the automated voice response system, virtually 24 hours, 7 days a week. Where can I find information about exchanges and other plan features? You can learn about loans, exchanges, and more, online through Fidelity NetBenefits at In particular, you can access loan modeling tools that illustrate the potential impact of a loan on the long-term growth of your account. You will also find a withdrawal modeling tool, which shows the amount of federal income taxes and early withdrawal penalties you might pay, along with the amount of earnings you could potentially lose by taking a withdrawal. You can also obtain more information about loans, withdrawals, and other plan features, by calling the The Directed Account Plan Service Center at to speak with a representative or use the automated voice response system, virtually 24 hours, 7 days a week. FAQs For more information visit or call

6 FAQs What are my rights with respect to mutual fund pass-through voting? As a Plan participant, you have the ability to exercise voting, tender, and other similar rights for mutual funds in which you are invested through the Plan. Materials related to the exercise of these rights will be sent at the time of any proxy meeting, tender offer or similar rights relating to the particular mutual funds held in your account. What are my investment options? You give investment directions for your Plan account from a broad selection of investment choices. See your Investment Overview booklet or log on to Fidelity NetBenefits at If you do not choose any investment options, your contributions will be invested in the Moderate Model Portfolio. You may change this selection at any time by logging on to Fidelity NetBenefits. For those desiring the most investment flexibility and choice, the Plan offers a selfdirected brokerage option, which gives you access to many mutual funds. A complete description of the Plan s investment options and their performance, as well as planning tools to help you choose an appropriate mix, are available online at Fidelity NetBenefits. How do I obtain additional investment option and account information? The Employer has appointed Fidelity to provide additional information on the investment options available through the Plan. Also, a statement of your account may be requested by phone at or reviewed online at 4

7 What is the Roth 401(k) Contribution Option? A Roth contribution is available to employees who participate in the 401(k) plan. For payroll purposes Roth contributions are treated as after tax. This feature will allow participants to make Roth contributions to their plan while taking their earnings completely tax free at retirement as long as the withdrawal is a qualified one. A qualified withdrawal is one that can be taken five tax years after the year of the first Roth contribution and after the participant has attained age 59½, has become disabled, or has died. If you qualify to make traditional 401(k) contributions, you are eligible for a Roth 401(k) contribution. How does a Roth 401(k) contribution option work? You elect a percentage (or dollar amount) of your salary that you wish to contribute to the Roth source, just as you would for your traditional 401(k). The contribution is based on your eligible compensation, not on your net pay for example, if your total annual eligible compensation is $40,000 per year and you elect a 6% deferral amount, then $2,400 per year would go into your Roth 401(k) account. Unlike your traditional 401(k) pretax contribution, with a Roth 401(k) contribution, you pay the taxes now on the contributions you make but later your earnings are all tax free, if you meet certain criteria. Example: Sally earns $40,000 and has elected to put 6% toward her Roth 401(k) contributions and 6% toward her traditional 401(k) pretax contributions on a monthly basis. Sally s monthly contribution into each account Sally s reduction in take-home pay ROTH 401(k)* TRADITIONAL 401(k)* $200 $200 $200 $150 Would a Roth 401(k) contribution option benefit me? The potential benefits of Roth 401(k) contributions really depend on your personal situation, but are mainly focused on your existing tax rate and your anticipated tax rate at the time of retirement. If you are contributing to a Roth, you are giving up a tax break today for a tax break in the future. Therefore, a Roth contribution might benefit you if your tax rate in retirement were higher than it had been during the years you contributed. If your tax rate were lower in retirement, then a traditional 401(k) might be more beneficial to you than the Roth option. Talk with a tax professional for more information on how to determine if Roth 401(k) contributions are right for you. Is a traditional pretax 401(k) still beneficial? Yes. For many participants a traditional pretax 401(k) will still be the most beneficial type of retirement savings plan. We do not know what the future holds regarding tax rates. Therefore, it is not possible to predict with certainty which type of 401(k) savings will be most beneficial to a participant. Remember, because Roth 401(k) contributions are made after tax, you may take home less money in your paycheck than you would if you contributed to a traditional pretax 401(k). For more information, please log on to and select Tools & Learning from the homepage. Under Learning you will see a tab called About 401(k)s. Select that tab and click on Roth 401k. Investment Roth Options Options For more information visit or call * This hypothetical example is based solely on an assumed federal income tax rate of 25%. No other payroll deductions are taken into account. Your own results will be based on your individual tax situation. Your combined Roth and traditional pretax 401(k) contributions cannot exceed the IRS limits for the year. 75

8 Fidelity BrokerageLink Fidelity BrokerageLink Fidelity BrokerageLink combines the convenience of your workplace retirement plan with the additional flexibility of a brokerage account. It gives you expanded investment choices and the opportunity to more actively manage your retirement contributions. A self-directed brokerage account is not for everyone. If you are an investor who is willing to take on the potential for more risk and you are prepared to assume the responsibility of more closely monitoring this portion of your portfolio, it could be appropriate for you. However, if you do not feel comfortable actively managing a portfolio of options beyond those offered through your plan s standard investment options, then a self-directed brokerage account may not be appropriate for you. Additional fees apply to a brokerage account; please refer to the fact sheet and commission schedule for a complete listing of brokerage fees. Remember, it is always your responsibility to ensure that the options you select are consistent with your particular situation, including your goals, time horizon, and risk tolerance. 6

9 Roth Options Investment Options For more information visit or call

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11 Incoming Rollover Instructions Directed Account Plan #21622 If you are a current Directed Account Plan (DAP) participant or a former DAP participant, you may roll over assets from other accounts into the DAP based on the following guidelines: 1) Traditional IRA assets can be rolled into the DAP. 2) Assets that were rolled out of the DAP into a Traditional IRA can be rolled back into the DAP. 3) Roth IRA assets cannot be rolled into the DAP. However, Roth 401(k)/403(b) assets can be rolled into the DAP. 4) Nondeductible IRA contributions cannot be rolled into the DAP. 5) The earnings attributable to nondeductible IRA contributions can be rolled into the DAP. If you have a balance in a former employer s retirement plan or Individual Retirement Account (IRA), you may want to consider consolidating your assets in the Directed Account Plan. Keeping your retirement savings in a single plan can help simplify performance tracking, provide greater convenience in making investment changes, and minimize paperwork. Rolling money into the Directed Account Plan is a three-step process. Please follow these instructions to ensure that your rollover is completed in a timely and accurate manner. Please note that failure to follow these instructions may result in a delay in the processing of your request and may jeopardize your ability to roll over your distribution. 1. Complete Your Rollover Application Please complete the attached Incoming Rollover Contribution Application, and attach any supporting documents. 2. Mail the Information Mail the Incoming Rollover Contribution Application along The Directed Account Plan with a copy of your latest statement from the financial 3221 McKelvey Road institution currently holding the funds to: Suite 105 Bridgeton, Missouri Please include all the information requested. Incomplete forms may be returned and may jeopardize your ability to roll over your distribution. 3. Request Your Distribution from Your Previous Employer-Sponsored Plan or Eligible IRA There are two distribution check payment options: 1. Direct Rollover: The check can be made payable directly to Fidelity Investments Institutional Operations Company, Inc. (or FIIOC) for the benefit of [YOUR NAME]. The check must be from the distributing trustee or custodian. (Personal checks are not acceptable.) Do not endorse the check. Important: This type of rollover avoids automatic federal income tax withholding. It also avoids the possible 10% early withdrawal penalty if you are under age 59½. 2. Indirect Rollover: If the distribution was originally made payable directly to you, you must send your rollover contribution via a certified check or money order only for the amount you are rolling over. (Personal checks are not acceptable.) Important: If your distribution is initially received as a check made payable to you, your rollover must be completed within 60 days of the date of the distribution. Your previous administrator will be required to withhold federal income taxes and possibly state taxes. As a result, you will not be able to roll over 100% of your eligible distribution unless you have extra savings available to make up the amount withheld. You must also roll over that amount within 60 days of receipt of your distribution. If you do not make up the amount withheld, that amount will be considered a withdrawal from the previous program and will be subject to ordinary income taxes and possibly to a 10% early withdrawal penalty. Once your application is received by the Directed Account Plan, and your rollover check is processed, you can log on to Fidelity NetBenefits at to view your rollover contribution and investment elections. If you have any questions about rollover contributions, call the Plan Office at Please allow time for your check to reach Fidelity. Please be sure you have beneficiary information for the Plan on file. To select or change your beneficiary designation for the Directed Account Plan, you can log on to Fidelity NetBenefits at and click Beneficiaries in the My Profile section. If you do not have Internet access, call the Directed Account Plan Service Center toll free at TWADAP ( ) and request a Beneficiary Designation Form. Page 1 of 6 3.DI-C-740A.115

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13 Incoming Rollover Contribution Application Directed Account Plan #21622 Section 1 Participant Information Please Print Participant s Name (First, Middle Initial, Last) Social Security Number ( ) Street Number Street Name Daytime Phone Number City State ZIP Country / / / / Birth Date Hire Date Address Section 2 Rollover Contribution Information Please complete the boxes at the end of this section. If you are not sure of the plan type, please contact your prior Plan Sponsor for verification. An incorrect plan type could invalidate your rollover. ACCEPTABLE ROLLOVER FUNDS The Plan will accept taxable and non-taxable money from the following types of employer-sponsored plans: Qualified plans (such as 401(k), Roth 401(k)/403(b), profit-sharing, and money purchase pension plans) Individual Retirement Accounts (IRAs) UNACCEPTABLE ROLLOVER FUNDS The Plan cannot accept distributions from the following types of plans or accounts: Governmental 457(b) plans Coverdell Education IRAs Roth IRAs SIMPLE IRAs Simplified Employee Pension Plans (or SEP IRAs) IRAs in which you have made non-deductible IRA contributions In addition, distributions to a beneficiary (other than a spousal beneficiary), distributions to a former spouse under a qualified domestic relations order (QDRO), distributions made over life expectancy or a period of ten years or more, hardship distributions, and mandatory age 70½ distributions are not eligible for rollover into the Plan. Non-taxable (or after-tax) distributions other than from a qualified plan may not be rolled into the Plan. In-kind distributions of employer stock will not be accepted. If you hold employer stock in your prior employer s plan, the stock must be sold and the proceeds rolled over in cash. PLEASE COMPLETE BOTH BOXES BELOW: 1. Your Estimated Contribution Amount: Pre-tax dollars $ After-tax dollars $ Roth 401(k)/403(b) dollars $ Total $ 2. Plan type of the origin of this rollover (please check one). If you are not sure of the plan type, please contact your prior Plan Sponsor for verification. An incorrect plan type could invalidate your rollover. Qualified plan (such as 401(k), Roth 401(k)/403(b), profit-sharing, and money purchase pension plan) Individual Retirement Account (IRA) Page 3 of 6 For Fidelity Use Only: NIGO DC

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15 Section 3 Investment Elections You may choose as many investment options as you wish from the options in the Plan. The quantity and selection of available investment options are determined by the Plan Sponsor. Please indicate your investment elections in whole percentages among the investment options shown below (the total percentage must equal 100%). Your investment elections below will apply only to this rollover contribution. If your investment elections do not total 100%, your documentation and check will be returned to you. Please be sure to read the mutual fund prospectuses before choosing your investment options. Prospectuses for the funds are available from the Directed Account Plan Service Center by calling TWADAP ( ). Investment Option Fund Fund Code Percentage Investment Option Fund Fund Code Percentage Level One: The Model Portfolios Level Three: Fidelity Mutual Funds cont d Retirement Model Portfolio OOLS % Fidelity Equity-Income Fund Class K 2085 % Conservative Model Portfolio OJQT % Fidelity Europe Capital Appreciation Fund* 0341 % Moderate Model Portfolio OJQU % Fidelity Europe Fund* 0301 % Aggressive Model Portfolio OJQV % Fidelity Export and Multinational Fund Class K* 2087 % Level Two: The Core Options Fidelity Fifty 0500 % Stable Value Option OJQW % Fidelity Focused Stock Fund 0333 % Value Stock Option OJQX % Fidelity Four-in-One Index Fund 0355 % Equity Index Option OJQY % Fidelity Fund Class K 2088 % Growth Stock Option OJQZ % Fidelity Global Balanced Fund* 0334 % International Stock Option* OJRA % Fidelity Government Income Fund 0054 % Diversified Small Company Stock Option OJRB % Fidelity Growth & Income Portfolio Class K 2089 % Level Three: Fidelity Mutual Funds Fidelity Growth Company Fund Class K 2090 % Fidelity Balanced Fund Class K 2077 % Fidelity Growth Discovery Fund Class K 2091 Fidelity Blue Chip Growth Fund Class K 2078 % Fidelity Growth Strategies Fund Class K* 2076 % Fidelity Blue Chip Value Fund 1271 % Fidelity High Income Fund* 0455 % Fidelity Canada Fund* 0309 % Fidelity Independence Fund Class K 2092 % Fidelity Capital & Income Fund* 0038 % Fidelity Inflation-Protected Bond Fund 0794 % Fidelity Capital Appreciation Fund Class K 2079 % Fidelity International Capital Appreciation 0335 % Fund* Fidelity China Region Fund* 0352 % Fidelity International Discovery Fund 2093 % Class K* Fidelity Contrafund Class K 2080 % Fidelity International Small Cap Fund* 0818 % Fidelity Convertible Securities Fund 0308 % Fidelity Investment Grade Bond Fund 0026 % Fidelity Disciplined Equity Fund Class K 2081 % Fidelity Japan Fund* 0350 % Fidelity Diversified International Fund 2082 % Fidelity Japan Smaller Companies Fund* 0360 % Class K* Fidelity Dividend Growth Fund Class K 2083 % Fidelity Large Cap Stock Fund 0338 % Fidelity Emerging Asia Fund* 0351 % Fidelity Latin America Fund* 0349 % Fidelity Emerging Markets Fund Class K* 2084 % Fidelity Leveraged Company Stock Fund Class K* 2094 % Fidelity Equity Dividend Income Fund Class K 2086 % Fidelity Low-Priced Stock Fund Class K* 2095 % *Shareholders may be subject to certain short-term trading fees. Please consult the prospectus for further information. Page 5 of 6 3.DI-C-740A DC

16 Section 3 Investment Elections Continued Investment Option Fund Fund Code Percentage Investment Option Fund Fund Code Percentage Level Three: Fidelity Mutual Funds cont d Fidelity Stock Selector Large Cap Value Fund 0708 % Fidelity Magellan Fund Class K 2096 % Fidelity Stock Selector Mid Cap Fund 2412 % Fidelity Mega Cap Stock Fund 0361 % Fidelity Stock Selector Small Cap Fund* 0336 Fidelity Mid-Cap Stock Fund Class K* 2097 % Fidelity Strategic Dividend & Income Fund 1329 % Fidelity Mid Cap Value Fund* 0762 % Fidelity Strategic Income Fund 0368 % Fidelity Money Market Trust Retirement 0631 % Fidelity Telecom and Utilities Fund 0311 % Government Money Market Portfolio Fidelity Nasdaq Composite Index Fund* 1282 % Fidelity Total Bond Fund 0820 % Fidelity New Markets Income Fund* 0331 % Fidelity Trend Fund 0820 % Fidelity New Millennium Fund 0300 % Fidelity Value Discovery Fund Class K 2103 % Fidelity Nordic Fund* 0342 % Fidelity Value Fund Class K 2102 % Fidelity OTC Portfolio Class K 2098 % Fidelity Value Strategies Fund Class K 2104 % Fidelity Overseas Fund Class K* 2099 % Fidelity Worldwide Fund* 0318 % Fidelity Pacific Basin Fund* 0302 % Spartan 500 Index Fund Investor Class 0650 Fidelity Puritan Fund Class K 2100 % Spartan Extended Market Index Fund 0398 % Investor Class* Fidelity Real Estate Income Fund* 0833 % Spartan International Index Fund 0399 % Investor Class* Fidelity Real Estate Investment Portfolio* 0303 % Spartan Total Market Index Fund 0397 % Investor Class* Fidelity Small Cap Discovery Fund* 0384 % Spartan U.S. Bond Index Fund 0651 % Investor Class Fidelity Small Cap Growth Fund* 1388 % Level Four: Fidelity BrokerageLink Fidelity Small Cap Stock Fund* 0340 % Fidelity BrokerageLink BLNK % Fidelity Small Cap Value Fund* 1389 % TOTAL 100% Fidelity Stock Selector All Cap Fund Class K 2101 % Note: Any investment elections chosen on this form will take precedence over any other investment election that Fidelity Investments may have on its system for a rollover contribution. *Shareholders may be subject to certain short-term trading fees. Please consult the prospectus for further information. Section 4 Participant Certification I authorize the investment elections for this rollover and acknowledge that I have received information detailing my available investment options. I certify that this rollover amount is composed only of money from acceptable sources listed under Section 2 above, and I have completed the information regarding the source of this money to the best of my knowledge. Also, if the distribution check was made payable to me, I understand that this rollover must be received and deposited to my account within 60 days of my receipt of the distribution. I understand that once invested, these monies will be subject to the terms that govern the Directed Account Plan. Signature of Participant Fidelity Investments Institutional Operations Company, Inc. Page 6 of 6 Date 3.DI-C-740A.115

17 Use this envelope only for the rollover contribution application. Please remove envelope from book here. RP-BRE BUSINESS REPLY MAIL FIRST-CLASS MAIL PERMIT NO CINCINNATI OH POSTAGE WILL BE PAID BY ADDRESSEE FIDELITY INVESTMENTS P.O. BOX 5000 CINCINNATI, OH NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES

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19 Plan Name: Retirement Savings Plan provided by Plan #: The Directed Account Plan Beneficiary Designation Instructions A beneficiary is a person, institution, charitable organization, or Trust named by you, the participant, to receive payment of benefits provided under the DAP in the event of your death. You may designate more than one primary beneficiary who will share the benefit. You may also designate one or more contingent beneficiaries. A contingent beneficiary would receive payment only if the primary beneficiary or all the primary beneficiaries you named died before you or disclaimed the right to receive payment at the time that payment was to be made. All information must be typed or printed neatly, using uppercase letters and black ink. If it is necessary to make corrections to the beneficiary section, you must place your initials next to the corrected or crossed-out words. Do not use Wite-Out or other correction fluid to make a correction. The form is not acceptable if correction fluid is used, and the form will be returned to you. If you have any questions about making a beneficiary designation, call Fidelity Investments toll-free at and speak with a Participant Services Representative. You can obtain additional Designation of Beneficiary Forms by logging on to Fidelity NetBenefits at or by calling Fidelity Investments at Please make a copy of it for your files, and return the original in the enclosed envelope or mail to: Fidelity Investments P.O. Box 5000 Cincinnati, OH A. Participant Information Complete all applicable information. You must check either single or married. If you are married at the time of your death, the provision of your retirement plan generally requires that all benefits from the retirement plans be paid to your spouse, unless your spouse consents in writing to another beneficiary designation and a Plan Representative or Notary Public witnesses this consent. B. and C. Primary and Contingent Beneficiary(ies) Information Complete all applicable information for those whom you are naming as beneficiary(ies). Please note: Some retirement plans restrict whom you can elect as a beneficiary for specific benefits and when you can change your election. If you designate one beneficiary for all plans in which you are enrolled, you will be subject to these restrictions across all plans. If section B is not filled out completely, the form will be returned to you. 1. The beneficiary designation should not include wording such as either/or or and/or. You cannot designate unborn children as beneficiaries. You can designate charitable organizations. 2. Use only whole-number percentages equaling 100%. For example, designations such as 33 1/3 or 33.3 are not acceptable. 3. Naming an estate: Letters of appointment issued by the court following your death, naming the executor or administrator of the estate must be provided when a claim is filed. Please consult your attorney for advice on the effect of this designation. No additional legal documentation is required at this time. 4. Naming a Trust: Provide the Trust s name and address, name of one Trustee, the date of the Trust and the Trust s tax ID number. Do not send a copy of the trust agreement. If you would like to name more than two primary and two contingent beneficiaries, you may attach a separate sheet of paper to the Designation of Beneficiary Form with the applicable information. D. Signature and Date By signing and dating this section, you officially designate the person(s) listed on the form as your primary beneficiary(ies) and, if applicable, your contingent beneficiary(ies) for this Plan. Your beneficiary designation(s) will not be valid unless this form is on file with the record keeper for this Plan. E. Spousal Consent For the DAP, if you name someone other than, or in addition to, your spouse as your primary beneficiary(ies), your spouse must sign and date the form and have his/her signature witnessed by a Plan Representative or Notary Public. A bank, law office or local government office usually has a Notary Public on staff. (c)2011 FMR Corp. All rights reserved. Please do not return this page. Fidelity Investments Institutional Operations Company, Inc.

20 (c)2011 FMR Corp. All rights reserved. This page intentionally blank.

21 Plan Name: Retirement Savings Plan provided by Plan #: The Directed Account Plan Designation of Beneficiary Form A. Participant Information Note: The instructions for this form are an integral part of the form. You should use them to assist you. Also, if it is necessary to make corrections to any part of this form, please do not use whiteout; you must place your initials next to the corrected or crossed-out words. Participant Name (First, MI, Last): Social Security #: Participant Address: City: State: ZIP: Phone (day): Marital Status: (select one) Single Married B. Primary Beneficiary(ies) I understand that if I am married, my spouse shall automatically be my designated beneficiary unless I elect otherwise and my spouse consents to such election as well as to the designation of the other beneficiary(ies). I hereby designate the following person or persons as primary beneficiary(ies) of my account under the Plan(s) payable by reason of my death. If any primary beneficiary does not survive me, the share of that beneficiary shall be divided between the remaining beneficiaries in proportion with their stated percentage of interest. If no primary beneficiary survives me, then my account shall go to my contingent beneficiary(ies). (If additional space is needed for beneficiary information, attach a separate sheet of paper to the Designation of Beneficiary F orm with the information noted below.) 1. Beneficiary s Name: (First, MI, Last) Share %: Date of Birth: / / Sex (M/F) Social Security Number/Tax ID: Relationship to Participant: Spouse Trust Other: Address: City: State: ZIP: 2. Beneficiary s Name: (First, MI, Last) Share %: Date of Birth: / / Sex (M/F) Social Security Number/Tax ID: Relationship to Participant: Spouse Trust Other: Total 100% Address: City: State: ZIP: C. Contingent Beneficiary(ies) In the event that no primary beneficiary survives me, I hereby designate the following person or persons as contingent beneficiary(ies) of my account. If any contingent beneficiary does not survive me, then the share of that beneficiary shall be divided between the remaining contingent beneficiaries in proportion with their stated percentage of interest. 1. Contingent Beneficiary s Name: (First, MI, Last) Share %: Date of Birth: / / Sex (M/F) Social Security Number/Tax ID: Relationship to Participant: Spouse Trust Other: Address: City: State: ZIP: 2. Contingent Beneficiary s Name: (First, MI, Last) Share %: Date of Birth: / / Sex (M/F) Social Security Number/Tax ID: Relationship to Participant: Spouse Trust Other: Total 100% Address: City: State: ZIP: DC IBS (c)2011 FMR Corp. All rights reserved.

22 D. Signature and Date I reserve the right to revoke or change my beneficiary designation in the future. I hereby revoke all my previous designations (if any) of primary and contingent beneficiaries. Note: If you are married, see the next section for applicable spousal consent requirements. I understand that if this beneficiary designation is executed prior to the first day of the plan year in which I attain age 35 that my spouse will become the beneficiary on the earlier of (1) the first day of the plan year in which I attain age 35, or (2) the date that I separate from service with the employer sponsoring the retirement plan. I understand that if I do not wish for my spouse to be my beneficiary at that time I need to complete a new Beneficiary Designation Form. X SIGNATURE OF EMPLOYEE Note: If your spouse is not your designated primary beneficiary, this Designation of Beneficiary Form is invalid without the consent of your spouse. If you are currently single [and marry] or re-marry you will need to complete a new Beneficiary Designation Form if you do not wish for your new spouse to be your primary beneficiary. DATE E. Spousal Consent (Signature must be witnessed by a Plan Representative or Notary Public) If you, the Participant, are married and your spouse is not designated as your primary beneficiary, your beneficiary designation is invalid without the consent of your spouse. Your spouse's consent must be witnessed by a Plan Representative or Notary Public. I am the spouse of the Participant named above. By signing below, I hereby acknowledge that I understand: (1) that the effect of my consent may result in the forfeiture of benefits I would otherwise be entitled to receive upon my spouse s death; (2) that my waiver is not valid unless I consent to it; (3) that my consent is voluntary, (4) that my consent is irrevocable unless my spouse completes a new Beneficiary Designation ; and (5) that my consent (signature) must be witnessed by a notary public [or a plan representative]. I understand that if this beneficiary designation is executed prior to the first day of the plan year in which the participant attains age 35, then my rights to receive the death benefit as determined by the retirement plan provisions will be restored to me on the earlier of (1) the first day of the plan year in which the participant attains age 35, or (2) the date the participant separates from service with the employer sponsoring the retirement plan. X SIGNATURE OF SPOUSE DATE (Must be witnessed by a Plan Representative or Notary Public) Signature of spouse witnessed this on this date, in the presence of: Plan Representative Signature: Plan Representative Print Name (Last, First, MI): OR STATE OF (ss.) COUNTY OF On this date, before me appeared Print Name: (Last, First, MI) who acknowledged herself or himself to be the person who executed the consent set forth above and acknowledged the consent to be his or her free act and deed. Notary Public Signature: Please make a copy of it for your files, and return the original in the enclosed envelope or mail to: Fidelity Investments P.O. Box 5000 Cincinnati, OH Fidelity Investments Institutional Operations Company, Inc (c)2011 FMR Corp. All rights reserved.

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24 _E_000001_ABC

25 This document provides only a summary of the main features of the DAP and the Plan Document will govern in the event of discrepancies. The Plan is intended to be a participant-directed plan as described in Section 404(c) of ERISA, which means that fiduciaries of the Plan are ordinarily relieved of liability for any losses that are the direct and necessary result of investment instructions given by a participant or beneficiary FMR LLC

26 Fidelity Investments P. O. Box Cincinnati, OH Fidelity Brokerage Services LLC, Member NYSE, SIPC, 900 Salem Street, Smithfield, RI NVCP _C _E_000001_ABC123