Florida Municipal Pension Trust Fund 457(B) Deferred Compensation Plan Participation Agreement (Page 2 of 2) in pdf

PARTICIPANT AGREEMENT

Investment Options – log into your account online to make your selections or contact FMPTF for help

Asset Class

Fund Name

Symbol

Expense Ratio

Cash

Vanguard Prime Money Market

VMRXX

0.09%

Bonds

Vanguard Intermediate Bond Index

VIBSX

0.12%

Vanguard Total Bond Market Index

VBTIX

0.07%

Vanguard Long‐term Treasury

VUSUX

0.12%

Vanguard Inflation Protected Securities

VAIPX

0.12%

Balanced

Vanguard Wellington Fund

VWENX

0.23%

Stock

Vanguard Windsor II

VWNAX

0.27%

Vanguard Institutional Index

VINIX

0.05%

Vanguard PrimeCap

VPMAX

0.36%

Vanguard Small‐cap Index Signal

VSISX

0.14%

EV Atlanta Capital SMID‐Cap I

EISMX

0.95%

International

Vanguard Total International Stock Index

VTSGX

0.20%

Artio International Equity II

JETIX

0.96%

Real Estate

Vanguard REIT

VGRSX

0.14%

Target Retirement

Vanguard Target Retirement Income

VTINX

0.17%

Vanguard Target Retirement 2010

VTENX

0.17%

Vanguard Target Retirement 2015

VTXVX

0.17%

Vanguard Target Retirement 2020

VTWNX

0.17%

Vanguard Target Retirement 2025

VTTVX

0.18%

Vanguard Target Retirement 2030

VTHRX

0.19%

Vanguard Target Retirement 2035

VTTHX

0.19%

Vanguard Target Retirement 2040

VFORX

0.19%

Vanguard Target Retirement 2045

VTIVX

0.19%

Vanguard Target Retirement 2050

VFIFX

0.19%

Vanguard Target Retirement 2055

VFFVX

0.22%

* Investment options and expenses as of 3/15/2011

I hereby request to participate in the FMPTF 457(b) Retirement Plan and I agree to all provisions of the Plan and this agreement. I certify that

everything I said on this form is true, correct, and complete. I certify, under penalties of perjury, that my Social Security Number shown above is correct.

I am not domiciled in or a resident of any place other than the address shown above. I understand that I may be subject to civil and criminal penalties

and punishment for any knowingly false statement on this form. If the Plan pays or fails to pay any benefit in reliance on my false statement, I will be

liable for the Plan’s damages, including (but not limited to) investigation expenses, legal fees and costs.

By signing below, I acknowledge:

1. Representatives of the Florida Municipal Pension Trust Fund or the Florida League of Cities, Inc. cannot provide me

with investment advice and they have not provided me with any investment advice.

2. I am responsible for my decisions on investing in one or more of the investment options.

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Participant’s Signature

Date

Please submit completed, signed forms to Your Human Resources Department

EMPLOYER’S INSTRUCTION AND APPROVAL

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