Oklahoma County 457 (B) Plan - New Enrollment Participation Election Form
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2OKLAHOMA COUNTY 457 (b) PLAN
NEW ENROLLMENT PARTICIPATION ELECTION FORM
Please Print:
Effective Date:
Social Security #: _________________________________
First Name: ____________________________ Middle Name: ___________________ Last Name: _________________________________
Mailing Address: ___________________________________________________________________________________________________
City: _________________________________________________ State: _________________ Zip Code: _____________________________
Date of Birth: ____________________ Age: ______ Marital Status: ____________ Daytime Phone #: ______________________________
Hire Date: _______________________ Rehired: YES or
NO
If yes, previous employment dates: _____________________________
Department: ___________________________________ E-Mail Address: __________________________________________
Employee Contribution Per Pay Period: $ ______________________
INVESTMENT DIRECTION
*In the event the Trustee does not receive a proper direction for the election of an Investment Option, the Accounts of such Participant shall
be invested in the default investment until the Trustee receives a proper direction which will be effective thereafter.
Method One
Style
Symbol
Percentage
Mellon Stable Value
Stable Value
%
Invesco Treasury Portfolio
Money Market
TRPXX
%
Vanguard Short-Term Treasury
Intermediate Bond
VFIRX
%
Pimco Total Return
Intermediate Bond
PTTDX
%
Vanguard GNMA
Intermediate Bond
VFIJX
%
Vanguard Total Bond Market Index
Bond Index
VBTLX
%
Templeton Global Bond Fund
Intermediate Bond
FBNRX
%
American Funds Grth Fund of Amer R6
Large Growth
RGAGX
%
Harbor Capital Appreciation Instl
Large Growth
HACAX
%
Vanguard 500 Index
S & P Index
VFIAX
%
American Funds American Mutual R6
Large Value
RMFGX
%
T. Rowe Price Equity-Income
Large Value
PRFDX
%
Neuberger Berman Genesis R6
Mid Cap Growth
NRGSX
%
Columbia Acorn Z
Mid Cap Growth
ACRNX
%
Vanguard Mid Capitalization Index
Mid Cap Blend
VIMAX
%
Vanguard Selected Value Fund
Mid Cap Index
VASVX
%
TIAA-CREF Instl Mid-Cap Value Retire
Mid Cap Value
TRVRX
%
MSIF Small Company Growth Fund I
Small Growth
MSSGX
%
American Beacon Stephens Small Cap Growth
Small Growth
STSIX
%
Vanguard Small Cap Index
Small Cap Index
VSMAX
%
Keeley Small Cap Value
Small Blend
KSCIX
%
Royce Opportunity Inv
Small Value
RYPNX
%
Royce Total Return Invt
Small Value
RYTRX
%
Invesco International Growth R5
International Growth
AIEVX
%
Artisan International Adv
International Growth
APDIX
%
Harbor International Instl
International Value
HAINX
%
Dodge & Cox International Stock
International Value
DODFX
%
Method Two
Vanguard Target Retirement Income Inv
Balanced
VTINX
%
Vanguard Target Retirement 2015 Inv
Balanced
VTXVX
%
Vanguard Target Retirement 2025 Inv
Balanced
VTTVX
%
Vanguard Target Retirement 2035 Inv
Balanced
VTTHX
%
Vanguard Target Retirement 2045 Inv
Balanced
VTIVX
%
Vanguard Target Retirement 2055 Inv
Balanced
VFFVX
%
Dodge & Cox Balanced
Balanced
DODBX
%
100%
Signature of Participant: ________________________________________________
Date: ______________________
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