Investment Selection

Member Information

*First Name:

*MI:

*Last Name:

*Ministerial/Member File No.:

(Not a minister? Enter: 000)

*Home Address

*City

*State

*Zip Code

*Date of Birth

*Telephone Number

- -

*Social Security Number

- -

*E-mail Address

*Marital Status

*Gender

Important Information

To change your investment allocation, complete the direct allocation chart below. A confirmation e-mail of the Investment Selection changes will be returned to you for your records. This change will be pending until you recieve a confirmation e-mail verifying that your request has been processed. You can also check your account online to verify your funds have been allocated according to your request.

Direct Allocation

You may invest in one or any combination of the four investment options. Please indicate the percentage that you want invested in each fund (must total 100%).

*My investment decision applies to: (Check One)
Both future contributions and all existing accumulations (By choosing this option, ALL current funds in the Trustee Fund and the Stock Funds will be re-allocated according to the percentages on this form, plus all future contributions), or
Future contributions only (Current funds in each investment option will not be affected by this choice. After this form is processed, all new contributions will be invested according to the percentages selected below).


Investment Options


Trustees' Fund (Manager: Benefits Board)

% (Multiple of 5%)

Large Capitalization Stock Fund (Manager: Eagle Capital and Rigel Capital)

% (Multiple of 5%)

Small Capitalization Stock Fund (Manager: Wentworth, Hauser & Violich)

% (Multiple of 5%)

International Stock Fund (Manager: NWQ)

% (Multiple of 5%)

____________

Total: 100%

Certification

*By clicking on Submit, I request that the Benefits Board invest my accumulations/contributions based upon my investment choices above. I have reviewed the information provided by the fund managers and I make this selection based upon my own investment judgment. I also realize that past results are not a guarantee of future performance. If I need additional information, I know that I can contact the Benefits Board.


*Date




* Denotes a Required Field