Allocation Programs Change Request Some requests available on this form may be made over the phone by contacting our Service Center at 1-800-272-2216. Complete this form only if you are currently participating in a MassMutual Evolution, MassMutual Transitions Select or MassMutual RetireEase Select Allocation Program. 1. Owner Information Contract Number Owner Name Joint Owner Name (if applicable) Daytime Phone Number Email Directions & Disclosures Evolution and Transitions Select contracts- Complete one of the following sections: 2, 3, 4, OR 5. Also complete section 7. o Section 2- MML Allocation : Only available if you are currently participating in GMAB, GMIB, MassMutual Lifetime Payment Plus SM, or MassMutual Lifetime Income Protector SM. o Section 3- Directed Allocation Models: Only available to you if you have been participating in them since January 18, 2008. o Section 4- Custom Allocation Choice Select: Only available if you are currently participating in GMAB or MassMutual Lifetime Income Protector SM. o Section 5- Custom Allocation Choice: Only available if your contract was issued before May 1, 2010. Not available if you are participating in the MassMutual Lifetime Income Protector SM. RetireEase Select contracts- Complete one of the following sections: 3 OR 6. Also complete section 7. We reserve the right to restrict or reject any transfer. Refer to your prospectus or contact the Service Center at the number above for additional information regarding transfer restrictions and investment choices. Changing allocations on this form will affect funds currently held in investment options in addition to future contributions. 2. MML Allocation This section is only available if you are currently participating in GMAB, GMIB, MassMutual Lifetime Payment Plus SM, or MassMutual Lifetime Income Protector SM. Select one of the following: See the Product Brochure on www.massmutual.com or call the Service Center for more details. MML Conservative Allocation (G) MML Balanced Allocation (H) MML Moderate Allocation (I) MML Growth Allocation (J) - Only available for contracts issued prior to May 1, 2010. Not available if MassMutual Lifetime Income Protector SM is elected. MML Aggressive Allocation (K) - Not available if 6% GMIB, MassMutual Lifetime Payment Plus SM, or MassMutual Lifetime Income Protector SM is elected. Not available with GMAB or 5% GMIB5 for contracts issued on or after 4/15/09. MML American Core Allocation (L) Page 1 of 5
3. Directed Allocation Models If you transfer out of a Directed Allocation Model, it cannot be reelected. Rules for Evolution and Transitions Select Direct Allocation Models: The Directed Allocation Models are only available to you if you were participating in them on January 18, 2008. If you were participating in the Directed Allocation Models on January 18, 2008, but subsequently cancelled participation, you cannot reelect participation in the Directed Allocation Models. If participating in a Directed Allocation Model, the Contract Value will automatically be rebalanced to the chosen Allocation Model each calendar quarter. Rules for RetireEase Select Allocation Models: In order to execute a fund transfer out of or into any individual fund(s) in an asset allocation model, the client will need to cancel their current asset allocation model. Your Automatic Rebalance program funds will be based on your Model selection. Rebalancing Frequency (Select one): Monthly Quarterly (default) Semi-Annually Annually Directed Allocation Models (Listed in order from low risk to high risk with Model A being the lowest risk; Select one): Model A Model B Model C Model D Model E Not available if 6% GMIB is elected. 4. Custom Allocation Choice Select Only available if you are currently participating in GMAB or MassMutual Lifetime Income Protector SM. You must allocate purchase payments within the minimum and maximum parameters listed for the asset classes below. Rebalancing Frequency (Select one): Quarterly (Default option if no selection is made.) Semi-Annually Annually Investment Options: Fund numbers shown as (Transitions Select/Evolution) Fixed Income: (40% to 60%) Mid Cap Value & Growth: (0% to 10%) % MML Managed Bond (543/632) % MML Mid Cap Growth (558/655) (40% to 60%) % MML Mid Cap Value (522/611) Large Cap Value: (20% to 25%) (0% to 10%) % MML Equity (539/629) International/Global: (0% to 10%) % MML Equity Income (557/647) % MML American International (588/664) % MML Managed Volatility (542/652) % MML Global (533/624) (20% to 25%) % Oppenheimer Global (549/637) Large Cap Blend & Growth: (20% to 25%) (0% to 10%) % MML American Growth (586/662) % MML Equity Index (540/630) (20% to 25%) Total 100% Page 2 of 5
5. Custom Allocation Choice- Evolution & Transitions Select For Evolution and Transitions Select contracts, Custom Allocation Choice is only available if your contract was issued before May 1, 2010. Not available if you are participating in the MassMutual Lifetime Income Protector SM. Rebalancing frequency (Select one): Quarterly (default) Semi-Annually Annually Select funds according to the following asset class minimums and maximums: No more than 25% may be allocated to any one fund. Evolution and Transitions Select Minimums and Maximums: Class Balanced & Large Cap Value Large Cap Blend & Growth Mid Cap Value Mid Cap Blend & Growth International/ Global Specialty A Range 15% to 25% 15% to 25% 0% to 10% 0% to 10% 5% to 20% 0% to 5% 0% to 5% Fixed Income Contracts Issued ON or BEFORE March 31, 2009 Fixed Income Contracts Issued ON or AFTER April 1, 2009 Class If 6% GMIB, GMWB or GMAB is elected. If 6% GMIB, GMWB or GMAB is NOT elected. If GMAB, GMIB, or GMWB is elected. If GMAB, GMIB, or GMWB is NOT elected. Range 20% to 65% 0% to 65% 35% to 65% 0% to 65% Investment Options: Investment Options: Fund numbers shown as (Transitions Select/Evolution). Fixed Income Mid Cap Blend & Growth % MML Inflation-Protected and Income (563/631) % MML Mid Cap Growth (558/655) % MML Managed Bond (543/632) % MML Small Cap Equity (545/633) % MML U.S. Government Money Market 1 (580/656) % MML Small Cap Growth Equity (544/650) % Oppenheimer Global Strategic Income (555/642) % Oppenheimer Discovery Mid Cap Growth (547/635) Balanced & Large Cap Value International/Global % MML Blend (536/627) % MML American International (588/664) % MML Equity (539/629) % MML Foreign (559/618) % MML Equity Income (557/647) % MML Global (533/624) % MML Income & Growth (BlackRock) (521/610) % Oppenheimer Global (549/637) % MML Managed Volatility (542/652) % Oppenheimer International Growth (551/643) Large Cap Blend & Growth % Fidelity VIP Contrafund (527/615) Specialty A % MML American Growth (586/662) % Invesco V.I. Global Health Care (529/620) % MML Blue Chip Growth (556/646) % Invesco V.I. Technology (530/621) % MML Equity Index (540/630) % MML Strategic Emerging Markets (590/666) % MML Growth & Income (561/613) % PIMCO CommodityRealReturn Strategy (579/654) % MML Large Cap Growth (526/616) % Oppenheimer Capital Appreciation (548/636) % Oppenheimer Main Street (552/639) % Invesco V.I. Diversified Dividend (528/619) % VY Clarion Global Real Estate (578/653) Mid Cap Value % MML Mid Cap Value (522/611) Total 100% % MML Small Company Value (595/667) % MML Mid Cap Value (562/617) 1 Formerly known as MML Money Market Page 3 of 5
6. Custom Allocation Choice- RetireEase Select Rebalancing frequency (Select one): Quarterly (default) Semi-Annually Annually Select funds according to the following asset class minimums and maximums: No more than 25% may be allocated to any one fund. RetireEase Select Minimums and Maximums: Class Allocation/ Balanced & Large Cap Large Cap Blend & Mid Cap Value Mid Cap Blend & Growth International/ Specialty A Fixed Income Value Growth Global Range 0-60% 15% to 25% 15% to 25% 5% to 10% 0% to 10% 5% to 20% 0% to 5% 0% to 5% Investment Options: Investment Options: Fixed Income Mid Cap Blend % MML Inflation- Protected and Income (810) % MML Small Cap Equity (812) % MML Managed Bond (811) % MML U.S. Government Money Market 1 (722) Mid Cap Growth % Oppenheimer Global Strategic Income (839) % MML Mid Cap Growth (829) % MML Small Cap Growth Equity (831) Allocation/Balanced % Oppenheimer Discovery Mid Cap Growth (832) % MML Blend (808) International/Global Large Cap Value % MML Foreign (830) % MML Equity (814) % MML Global (823) % MML Equity Income (828) % Oppenheimer Global (835) % MML Income & Growth (BlackRock) (806) % Oppenheimer International Growth (837) % MML Managed Volatility (817) Specialty A Large Cap Blend % Invesco V.I. Global Health Care (801) % Fidelity VIP Contrafund (803) % Invesco V.I. Technology (802) % MML Equity Index (818) % PIMCO CommodityRealReturn Strategy (840) % MML Growth & Income (816) % Oppenheimer Main Street (838) % Invesco V.I. Diviersified Dividend (800) Large Cap Growth % VY Clarion Global Real Estate (804) % MML Blue Chip Growth (827) % MML Large Cap Growth (805) Total 100% % Oppenheimer Capital Appreciation (834) Mid Cap Value % MML Mid Cap Value (807) % MML Mid Cap Value (820) 1 Formerly known as MML Money Market Page 4 of 5
7. Signature(s) The requested transaction(s) will take effect on the business day this form, properly executed and completed, is received at the Service Center provided it is received prior to the close of the New York Stock Exchange. Printed Name of Owner, Employer, Trustee or Plan Administrator Signature of Owner, Employer, Trustee or Plan Administrator (Must sign in capacity if Owner is Trustee, POA, Guardian) Date Printed Name of Joint Owner (If applicable) Signature of Joint Owner (If applicable) Date MassMutual Contact Information (We will only accept responsibility for forms that are submitted as indicated below) Service Center (800) 272-2216 Fax (toll free) (866) 329-4272 Mailing Address MassMutual Financial Group PO Box 9067 Springfield MA 01102-9067 Email Address ANNfax@massmutual.com MassMutual Financial Group is a marketing name for Massachusetts Mutual Life Insurance Company (MassMutual)and its affiliated companies and sales representatives. Page 5 of 5