How to Roll Your Money into the JPMorgan Chase 401(k) Savings Plan In this packet, you will find information to help you roll over your individual retirement account (IRA) or qualified retirement savings account into the JPMorgan Chase 401(k) Savings Plan. It s easy! All you have to do is follow the Rollover Checklist. The checklist items are required to process your rollover. Rollover Checklist Read the JPMorgan Chase 401(k) Savings Plan Important Information About Rollovers flyer. Send the following required items to: Empower Retirement TM, P.O. Box 419784, Kansas City, MO 64141-6784. Rollover Application Complete and sign. Eligible Rollover Distribution Certification Complete and sign. To demonstrate that your rollover distribution comes from an eligible source, you must provide the following documentation with your Rollover Application: For a rollover originating from a prior employer s defined contribution or defined benefit plan, provide a copy of your prior plan s IRS Letter of Determination. Contact your prior plan s administrator to obtain this document. For a rollover originating from your prior employer s 403(b) plan, provide written confirmation from the plan s administrator that the account is in compliance with the applicable requirements of the Internal Revenue Code for a 403(b) plan. If you are rolling over Roth 401(k) or 403(b) contributions from a prior employer s qualified plan, you must include either a copy of your prior plan s Roth 401(k) or 403(b) account distribution statement, or the distribution check stub detail showing the contribution basis and first contribution date for your Roth 401(k) or 403(b) contributions. Contact your prior plan s administrator to obtain this documentation. Rollover check payable to Trustee for JPMorgan Chase 401(k) Savings Plan fbo (your name). Questions? Please contact the 401(k) Savings Plan Call Center at 1-866-JPMC401k (1-866-576-2401). (The TTY number is 1-800-345-1833.) Participant Services Representatives are generally available from 8 a.m. to 9 p.m. Eastern time, Monday through Friday, except New York Stock Exchange holidays. DC-JPC-044 1501 2015 Great-West Life & Annuity Insurance Company. All rights reserved.
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JPMorgan Chase 401(k) Savings Plan Rollover Application 1 Your Personal Information (Please use ink and print in capital letters.) Social Security Number Daytime Phone Number Evening Phone Number Plan-141356 TT/ROLLIN For ER use only Last Name First Name MI Address City State Zip 2Rollover Information Please answer the following questions regarding your rollover contribution: A. Does your rollover contribution meet the requirements for an eligible rollover distribution? (Please see page 2 of this application for the definition of an eligible rollover distribution. ) * Yes * No Note: If No, your rollover contribution cannot be accepted. B. What is the approximate amount of your rollover contribution? $ C. Prior qualified plan name or IRA custodian name: 3Your Investment Funds Indicate below how you want your rollover contribution invested. You can choose one or any combination of the choices below. The percentages must be in whole numbers, not fractions, and total 100. Target Date Funds Core Funds Large Cap Growth Fund (09) Target Date Income Fund (ID) Short-Term Fixed Income Fund (0Z) Mid Cap Value Fund (0L) Target Date 2015 Fund (15) Stable Value Fund (DY) Mid Cap Growth Fund (G5) Target Date 2020 Fund (20) Government Inflation- Protected Bond Fund(WM) Small Cap Index Fund (0F) Target Date 2025 Fund (25) Core Bond Fund (1O) Small Cap Core Fund (0E) Target Date 2030 Fund (30) Intermediate Bond Fund (01) Small Cap Blend Fund (2S) Target Date 2035 Fund (35) High Yield Bond Fund (02) International Large Cap Value Fund (IL) Target Date 2040 Fund (40) Large Cap Value Index Fund (05) International Large Cap Index Fund (08) Target Date 2045 Fund (45) Large Cap Value Fund (04) International Small Cap Index Fund (0H) Target Date 2050 Fund (50) S&P 500 Index Fund (06) Emerging Market Equity Index Fund (EM) Target Date 2055 Fund (55) Large Cap Growth Index Fund (0B) JPMorgan Chase Common Stock Fund (2K) 4Your Signature 1 0 0 TOTAL I certify that the information provided on this application is accurate. I understand that I am permitted to direct the investment of my accounts in the plan, as outlined in Section 404(c) of ERISA. I acknowledge that I have received and reviewed the information in my rollover materials about my investment choices and have had an opportunity to freely choose how my accounts are invested. I understand and agree that, under Section 404(c), my employer and other plan fiduciaries will not be liable for the results of my investment directions. X Signature Date DC-JPC-041 1501 2015 Great-West Life & Annuity Insurance Company. All rights reserved. Page 1 of 2
Rollover Application Information To make a rollover contribution to the JPMorgan Chase 401(k) Savings Plan, you must complete this application and mail it back to Empower Retirement TM. Eligible Rollover Distribution Information To be eligible for a rollover, your distribution must qualify as an eligible rollover distribution. An eligible rollover distribution is generally any distribution from an IRA or a qualified retirement plan of all or any portion of the balance of your account. However, the following types of distributions are NOT considered eligible rollover distributions: A payment that is part of a series of equal (or almost equal) payments that are made at least once a year and that are based on: your life expectancy, the joint life expectancy of you and your beneficiary, or a period of 10 years or more. After-tax money that is not applicable to Roth 401(k) contributions. The portion of a distribution that is required to be made because of your attainment of your Required Beginning Date [Internal Revenue Code Section 401(a)(9)]. A return of contributions resulting from a failed discrimination test [Internal Revenue Code Sections 401(k) and 401(m)]. A return of contributions resulting from exceeding contribution limitation amounts [Internal Revenue Code Sections 402(g) and 415]. Dividends on employer securities in an Employee Stock Ownership Plan paid in cash directly to you. P.S. 58 costs representing the taxable portion of any life insurance held by the plan. Defaulted loans declared as a distribution prior to your termination of employment. IMPORTANT You cannot roll over securities or outstanding loan balances into the JPMorgan Chase 401(k) Savings Plan. Only distributions of before-tax and Roth 401(k) contributions and associated investment earnings are eligible for rollover into the JPMorgan Chase 401(k) Savings Plan. To demonstrate that your rollover comes from a qualified plan, please include with your application a copy of the plan s IRS Letter of Determination indicating that the plan is qualified under section 401(a) of the Internal Revenue Code. For a 403(b) account, please include written confirmation from your prior employer that the account is currently designed and being operated in compliance with the applicable requirements of the Internal Revenue Code. If you are rolling over Roth 401(k) contributions, you will need to request a Roth 401(k) account distribution statement from your prior plan administrator or the distribution check stub detail showing basis and first contribution date for Roth 401(k) contributions, and include it with your other paperwork. All rollover requests are generally processed within three business days of receipt of all completed paperwork and appropriate documentation. For specific questions concerning whether or not your distribution qualifies as an eligible rollover distribution, please contact your former plan administrator before completing any paperwork. Investment Choices The JPMorgan Chase 401(k) Savings Plan offers you a number of different ways to invest your rollover contribution. Your investment choices should reflect your own investment goals and the amount of risk you are willing to incur. It is the plan sponsor's intention for the plan to meet the conditions of ERISA Section 404(c). Consequently, JPMorgan Chase and the plan s trustee are not responsible for investment gains or losses that occur as a result of following your investment instructions. Please see your enrollment or rollover kit for more information about your investment alternatives. You are encouraged to carefully read all materials in your JPMorgan Chase 401(k) Savings Plan Enrollment Kit, or this Rollover Kit, or on the 401(k) Savings Plan Web Center before making any investment elections. An investment prospectus for each of the plan s mutual fund investment choices is available on request from the Call Center. Remember that investment is not without risk and could result in a loss of principal depending on which investment choices you elect. You may wish to consult with a personal financial planner and/or tax advisor before making any decisions regarding your investments in the plan. Check Instructions The check for your rollover must be a certified check or cashier s check, or a check from a financial institution. It should be made payable as follows: Trustee for the JPMorgan Chase 401(k) Savings Plan fbo (your name) You may return your check to Empower Retirement by mail to the following address: Empower Retirement P.O. Box 419784 Kansas City, Missouri 64141-6784 If you have any questions about this process, please contact the 401(k) Savings Plan Call Center at 1-866-JPMC401k (1-866-576-2401). (The TTY number is 1-800-345-1833.) Participant Services Representatives are generally available between 8 a.m. and 9 p.m. Eastern time, Monday through Friday, except New York Stock Exchange holidays. For more complete information about the underlying mutual funds available within the JPMorgan Chase 401(k) Savings Plan, please call 1-866-JPMC401k (1-866-576-2401). Investors should carefully consider the investment objectives, risks, charges, and expenses of the fund. Please carefully read the prospectus that contains this and other important information before you invest. Core securities, when offered, are offered through GWFS Equities, Inc. and/or other broker dealers. GWFS Equities, Inc., Member FINRA/SIPC, is a wholly owned subsidiary of Great-West Life & Annuity Insurance Company. Page 2 of 2
JPMorgan Chase 401(k) Savings Plan Eligible Rollover Distribution Certification Plan-141356 TT/ROLLIN For ER use only Complete section 1. Include appropriate documentation as outlined in Section 2. Complete and sign section 3, 4 or 5, depending on the source of the funds to be rolled over. See the specific section for details. 1 Your Personal Information (Please use ink and print in capital letters.) Social Security Number Daytime Phone Number Last Name First Name MI Required Documentation 2 To demonstrate that your rollover distribution comes from an eligible source, please enclose with this application the following documentation, as applicable: 3 For a rollover originating from a prior employer s qualified defined contribution or defined benefit plan, please enclose a copy of the plan s IRS Letter of Determination. Contact your prior plan s administrator to obtain this documentation. For a rollover originating from a prior employer s 403(b) plan, please enclose written confirmation from the plan s administrator that the account is in compliance with the applicable requirements of the Internal Revenue Code for a 403(b) plan. In addition, if this is a rollover from a Roth 401(k) or 403(b) account, please enclose your prior employer s Roth 401(k) or 403(b) account distribution statement or your distribution check stub showing basis and first contribution date for your Roth 401(k) or 403(b) contributions. Please Note: Non-taxable amounts (such as Roth 401(k) or 403(b) contributions or any portion of a qualified distribution) distributed from a Roth 401(k) or 403(b) account in another employer s plan may only be rolled over to this plan in a direct trustee-to-trustee rollover. Certification of Rollover From Prior Employer Direct Rollover A direct rollover is a trustee-to-trustee transfer and your check is made payable to Trustee for JPMorgan Chase 401(k) Savings Plan fbo (your name). No federal income taxes are withheld from the distribution. Name of prior employer Plan name of prior employer A. Indicate the type of plan you are rolling over from: 401(a)/401(k) 403(b) 457(b) of a governmental entity B. Is this a rollover from a Roth 401(k) or 403(b) account? Yes No (If yes, please see Section 2 for required documentation.) C. I certify that all funds this plan will receive are eligible for rollover to this plan in accordance with the definition of an eligible rollover distribution provided in the Rollover Application. X Participant s signature Date DC-JPC-042 1501 2015 Great-West Life & Annuity Insurance Company. All rights reserved. Page 1 of 2
4 In an indirect rollover, the check is made payable to you and the mandatory 20 federal income tax is withheld from the distribution. Certification of Rollover From Another Plan within 60 Days of Distribution Indirect Rollover Name of prior employer Plan name of prior employer A. Indicate the type of plan you are rolling over from: 401(a)/401(k) 403(b) 457(b) of a governmental entity B. Is this a rollover of earnings from a Roth 401(k) or 403(b) account? Yes No (If yes, please see Section 2 for required documentation.) C. Please Note: You may only make an indirect rollover of the earnings related to a nonqualified distribution from a Roth 401(k) or 403(b) account within 60 days of receipt of the distribution. I certify that all funds this plan will receive are eligible for rollover to this plan in accordance with the definition of an eligible rollover distribution provided in the Rollover Application. X Participant s signature Date 5Certification of Rollover from an Individual Retirement Account (IRA) I certify that all funds this plan will receive are from an individual retirement account (IRA) account and are eligible for rollover to this plan. I specifically certify that: The only contributions made to my IRA are either eligible rollover contributions from my prior employer s retirement plan or deductible IRA contributions and earnings thereon. No non-deductible contributions or amounts attributable to Roth IRAs are included. Any rollover into my IRA was an eligible rollover contribution from a retirement plan maintained by my prior employer and qualified under Section 401(a) of the Internal Revenue Code. To the best of my knowledge, my IRA is qualified under Section 408 of the Internal Revenue Code. I have documentation that can prove each of these statements and agree to provide this documentation to the plan upon request. I understand that the plan will rely on the truth of these certifications and that, if any of these certifications are false, there may be severe financial consequences to me and to the plan. In consideration for the acceptance of my rollover contribution from my IRA, I agree to be financially responsible for these consequences. X Participant s signature Date Page 2 of 2
JPMorgan Chase 401(k) Savings Plan Important Information About Rollovers This flyer is designed to help you better understand rollover contributions to your JPMorgan Chase 401(k) Savings Plan account. If you have questions, please contact the 401(k) Savings Plan Call Center at 1-866-JPMC401k (1-866-576-2401). (The TTY number is 1-800-345-1833.) Participant Services Representatives are generally available from 8 a.m. to 9 p.m. Eastern time, Monday through Friday, except New York Stock Exchange holidays. What is a rollover? A rollover is a contribution you make to the JPMorgan Chase 401(k) Savings Plan from a previous employer s tax-qualified plan (like another 401(k) plan), a conduit or contributory individual retirement account (IRA), the JPMorgan Chase Retirement Plan (after you terminate your employment with the firm), a governmental 457 plan, or a 403(b) annuity plan. What is the advantage of making a rollover contribution to my plan account? Rolling over a distribution can mean considerable tax savings for you, since funds that are rolled over are not currently taxable. By rolling over your distribution, you can defer payment of federal and state income taxes, and avoid any premature distribution penalties associated with a taxable retirement plan distribution if you are under age 59½. What type of distributions can I roll over? To be eligible for a rollover, your distribution must qualify as an eligible rollover distribution. An eligible rollover distribution is generally any distribution from an IRA or a qualified retirement plan of all or any portion of the balance of your account. Please see page 2 of the Rollover Application for a list of distributions that are not eligible for rollover. Refer to the Rollover Checklist included in this kit for any documentation you may need to show that your rollover is from a qualified source. If you have specific questions concerning your distribution from a previous employer s plan, please contact the administrator of that plan before completing any paperwork. How long do I have to roll over my distribution from my former employer s plan? You have 60 days from the date of distribution to make your rollover contribution. What type of distributions can be rolled over from an IRA? Only a distribution from an IRA that contains before-tax and/or Roth 401(k) contributions can be rolled over to your plan account. Non-Roth 401(k) after-tax money is not eligible for rollover into the plan. Do I have to roll over the entire amount of the distribution I receive? You can elect to have all or a portion of your eligible rollover distribution directly transferred to the JPMorgan Chase 401(k) Savings Plan. However, any taxable portion of your distribution that is not rolled over will be subject to a mandatory 20 federal income tax that will be withheld by your prior plan before the check is sent to you. If you are under age 59½, an additional 10 penalty tax is also assessed by the IRS on most taxable distributions that are paid to you and not rolled over. How do I make a rollover contribution to my plan account? In addition to submitting a check payable to Trustee for JPMorgan Chase 401(k) Savings Plan fbo (your name), you must complete a Rollover Application to request that the plan accept your rollover contribution. You must also submit an Eligible Rollover Distribution Certification form, which is included in your rollover kit, and documentation to show that your rollover represents only before-tax and/or Roth 401(k) contributions from a qualified retirement plan or IRA. Please see the Rollover Checklist for more detail about the documentation you must provide. Does the JPMorgan Chase 401(k) Savings Plan have to accept my rollover contribution? No. Empower Retirement TM will review your application to determine if your contribution will be accepted as a rollover under the terms of the plan and governing law. The plan also retains the discretion to accept only qualifying rollover contributions that meet the administrative policies established by the plan. DC-JPC-048 1501 2015 Great-West Life & Annuity Insurance Company. All rights reserved. Page 1 of 2
If my distribution includes property other than cash, (for example, company stock), can I sell the property and roll over the proceeds? Yes, you can roll over the proceeds from the sale of such property. If you roll over the entire proceeds, no taxes will be currently due on any gains from the sale. Any portion of your proceeds that is not rolled over will be considered taxable income. Consult your attorney or tax advisor regarding all of the options available to you. Can I roll over a distribution from a 403(b) account into my JPMorgan chase 401(k) Savings Plan account? Yes. The JPMorgan Chase 401(k) Savings Plan does accept rollovers from a 403(b) account. To demonstrate that your rollover comes from a qualified 403(b) account, please include written confirmation from your prior employer that the account is currently designed and being operated in compliance with the applicable requirements of the Internal Revenue Code. Can I roll over a death benefit I receive as a beneficiary from a qualified retirement plan? If you are the deceased participant s surviving spouse, you can roll over the distribution into the JPMorgan Chase 401(k) Savings Plan. A distribution from a qualified plan paid to a beneficiary other than the employee s surviving spouse is not eligible for rollover to the JPMorgan Chase 401(k) Savings Plan. Can I roll over a distribution I receive from a qualified retirement plan as an alternate payee under a qualified domestic relations order (QDRO)? As long as you are a former spouse alternate payee, you may roll over your QDRO distribution to the JPMorgan Chase 401(k) Savings Plan. If you have questions, please contact the 401(k) Savings Plan Call Center at 1-866-JPMC401k (1-866-576-2401). (The TTY number is 1-800-345-1833.) Participant Services Representatives are generally available from 8 a.m. to 9 p.m. Eastern time, Monday through Friday, except New York Stock Exchange holidays. NOTE: The law concerning rollover contributions is complicated. Please consult your attorney or tax advisor to determine if a rollover contribution to the plan is in your best interest. Page 2 of 2