State Of Tennessee Participant Enrollment Form 401(K) And 457 Plans

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What is 401k Enrollment Form and Instructions on filling it out

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State of Tennessee Participant Enrollment Form
401(k) and 457 Plans
Participant Information
Last Name
MI
First Name
Social Security Number
Address - Number & Street
E- Mail Address
TBR____ UT ___ State ___
City
State
Zip Code
Employer
Home Phone
Work Phone
Date of Birth
Female
Male
Plan and Deferral Election
I elect to enroll and participate in the following plan(s) and authorize the state to deduct and defer the amounts shown.
Effective date must be a least 30 days after completion of the agreement. Deferral amount minimum is $20.00 per plan, per month.
401(k) plan
Deduct $____________ 401(k) pre-tax from my gross per pay period salary.
Effective___ /___ / 20____Deduct $____________ 401(k) post-tax from my gross per pay period salary.
457 plan
Deduct $____________ 457 pre-tax from my gross per pay period salary.
Effective___ /___ / 20____ Total: $ __________ Dept Name_________________ Paid:
Monthly
Semi-Monthly
Note: Your annual deferral cannot exceed the lesser of 100% of your eligible compensation or $15,500 per plan for the 2008 calendar year. State and
Higher Education employees may enroll in both plans. 401(k) Plan deferral may be eligible for employer match, subject to annual appropriation.
Investment Option Information-
Please refer to your marketing communication materials for investment option descriptions.
Select Investment Options
401(k)
457
Code
%
%
INGALG
Allianz NFJ Large Cap Institutional *………………
%
%
Calvert Income………………………….………………CINCX
%
%
Columbia Acorn Z *…………………………….....….. INGCAC
%
%
Columbia Midcap Value Z *…………………………. INGCMC
%
%
DFA International Value…………………………….
DFIVX
%
%
Fidelity Contra Fund………………………………… FCNTX
%
%
Fidelity International Discovery………………………… FIGRX
%
%
Fidelity Magellan Fund…………………………………FMAGX
%
%
Fidelity OTC Portfolio………………………………… FOCPX
%
%
Fidelity Puritan Fund……………………………………FPURX
%
%
Fidelity Retirement Government Money Market…….. FGMXX
%
%
Fidelity Small Cap Independence………………………FDSCX
%
%
ING Fixed Plus Account…………………….………. AEF-FX
%
%
Morgan Stanley Inst US Small Cap Value Inst *…….. INGMSC
%
%
State Street S&P 500 Flagship Series C………………… SV-SPC
%
%
Regions Bank………………………………………...…UP-UPB
%
%
Vanguard Total Bond Market Index……………………VBTSX
Vanguard Target Date Funds
%
%
Vanguard Target Retirement Income…………………… VTINX
%
%
Vanguard Target Retirement 2010……………………… VTENX
%
%
Vanguard Target Retirement 2015……………………… VTXVX
%
%
Vanguard Target Retirement 2020……………………… VTWNX
%
%
Vanguard Target Retirement 2025……………………… VTTVX
%
%
Vanguard Target Retirement 2030……………………… VTHRX
%
%
Vanguard Target Retirement 2035……………………… VTTHX
%
%
Vanguard Target Retirement 2040……………………… VFORX
%
%
Vanguard Target Retirement 2045……………………… VTIVX
%
%
Vanguard Target Retirement 2050……………………… VFIFX
* Indicates separate account funds offered through ING
Total
100%
100%
Percentages must be whole numbers and columns must add up to 100%

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