153 / 499
a.
If
Loans
are to be included under the
Distribution Eligibility Certificate
service, please complete the following by plan:
Plan Name
$10,000 Loan
Rule Applies?
*
(yes/no)
*$10,000 Loan Rule: The plan provides that a participant may borrow
the lesser of (1) the greater of $10,000 or 50% of his account balance or
(2) $50,000.
b.
If
Hardship Withdrawals
are to be included under the
Distribution
Eligibility Certificate
service, please complete the following by plan (check
only one
Loan Gateway column per plan):
Plan Name
No Loan
Gateway
Applies
Standard
Loan
Gateway
Applies
Forced
Loan
Gateway
Applies
No Loan Gateway
: The plan procedures do not require a participant to
take available loans before a hardship withdrawal is allowed.
Standard Loan Gateway
: The plan procedures allow participants to
proceed with a hardship withdrawal by indicating that repayment of a
loan would itself create a financial hardship.
Forced Loan Gateway
: The plan procedures require the participant to
exhaust all available loans prior to taking a hardship withdrawal.
________ 5. Please verify
Employer Retirement Plan
information on
Attachment 1
,
including Plan Name, Plan Type and IRC Contribution Limits Monitored (Page
42).
Employer Signature
I affirm that the information provided in this Checklist for purposes of this Agreement is correct
to the best of my knowledge. I understand that implementation of Retirement Manager will
proceed based on the information provided in this form and if any changes are made the
implementation will be adjusted accordingly.
By: __________________________________
Signature
Date: _____________________, 20____
Print Name: ___________________________
Title: _________________________________
2