Death Benefit Claim (Page 8 of 13) in pdf

Estate Claimants

— Payments may be made to a personal representative appointed by an appropriate final judicial order. Personal representatives must

provide a tax identification number (TIN) for the decedent’s estate. A TIN is obtained by filing Form SS-4 with the Social Security Administration. If a

personal representative has not been appointed by an appropriate court because the value of the estate is small, certain states will allow certain successors

of the decedent to submit a small estate affidavit allowing them to receive payment. In such cases, only one affidavit containing the notarized signatures

of all successors should be submitted to the Service Provider. If appropriate documentation is not submitted, the Service Provider may be unable to make

payment. However, the rules specified above still apply and Claimants should obtain and submit appropriate documentation to the Service Provider on a

timely basis to avoid penalties and taxes.

Leave Funds in the Account

— If the Claimant is the decedent’s surviving spouse and sole beneficiary and the decedent died prior to reaching age

, the Claimant can elect to leave the funds in the Plan until distributions are required to begin. Distributions must begin from the account by the later

of (a) December 31 of the calendar year in which the decedent would have attained age 70

or (b) December 31 of the calendar year following the

calendar year of the decedent’s death. Distributions must be made over a period not exceeding the Claimant’s life or life expectancy.

All existing monies will remain in the same investment option(s) in effect on the date of the decedent’s death. The Claimant will have the option of

transferring the monies to other investment options by visiting the Web site at or by calling a Participant Service Representative at

1-VRS-DC-PLAN1 (1-877-327-5261). However, some investment options may not be available for transfer. The Claimant may not make any additional

deposits to this account.

The account will remain in the decedent’s name until such time as the Claimant initiates a distribution from the account.

Full Distribution of My Share

— Check this box if the Claimant wants a full distribution of his or her share of the account. The full vested value of

each investment option will be distributed based on the instructions on the Form. The Service Provider will liquidate the funds pro-rata from all available

investment options with a balance.

Periodic Payment of My Share

— The Claimant must select a frequency, pay date and either specific dollar amount or specific number of years. The

payment start date is the date the funds will be distributed from the account. Installments will begin as soon as administratively possible and are processed

on the 1st and 15th of each month. The Claimant must also select the frequency of payment — monthly, quarterly, semi-annually, or annually. Allow

approximately 5 – 10 business days from the payment start date to receive the distribution. It is solely the responsibility of the Claimant to ensure that the

payment option elected satisfies the minimum distribution requirements.

The Periodic Payment Options are as follows:

1. Payment of an Amount Certain

— Designate the dollar amount the Claimant wishes to receive on a regular installment basis (monthly, quarterly,

semi-annually or annually). The payments will continue until the account balance is depleted. The number of payments the Claimant receives will vary

depending on the performance of the investments. The payments must be structured so that the account balance will be approximately depleted over a

time period not to exceed the Claimant’s life expectancy.

2. Payment of a Period Certain (Years)

— The Claimant will receive payments on a regular installment basis (monthly, quarterly, semi-annually or

annually). Payment amounts will depend on the length of time in years during which the Claimant elected to receive payments, the periodic basis that

the Claimant chooses, and the performance of the investment options.

The payment amount will be calculated by dividing the current account balance by the number of remaining payments. For example, if the payout is to

be monthly for 4 years, the initial payout amount will be equal to of the account balance. The second payment will be

of your balance, the third will

be and so on.

The payment is recalculated each time a payment is distributed; therefore, the amount of each payment will never be the same. The payment amount

will depend on the account value, which may fluctuate depending upon the chosen investment’s performance. The balance will be depleted by the end

of the term selected. The payment plan must be structured so that it will approximately deplete the account over a time period not to exceed the

Claimant’s life expectancy.

Fixed Annuity of My Share

— An annuity is a payment option that can guarantee the Claimant a retirement income for life or a limited, defined period.

The Claimant will receive payments on a regular basis. Payments made under a fixed annuity option will not change for as long as the annuity period

continues. To request an annuity quote, review the annuity options that follow and call the Service Provider. The insurance company issuing the annuity

makes annuity payments and will deduct the applicable tax withholding. Once an annuity option is selected, the Claimant may not select a different claim

method or change to another fixed annuity option. To elect this method, the minimum annuity purchase amount is $2,000.00, and each payment must be

at least $50.00. If the Claimant chooses a fixed annuity payment option, the Claimant will need to choose a Fixed Annuity Option.

Purchase Date

— The purchase date is the date the funds are withdrawn from the existing account and placed into a fixed annuity. The purchase date

may vary depending on the underlying investment options. If the purchase date is not a business day, the purchase date will default to the next business

day. The selected purchase date must be prior to the payment start date. The interest rate applied will be the annuity rate in effect on the actual purchase

date. If a purchase date is not selected, the purchase date will automatically be the date a properly completed Form is received by the Service Provider.

The purchase date cannot be more than 12 months from the date the Claimant completes the Form.

Payment Start Date

— The payment start date is the date the first check is to be received. The Claimant’s first electronic transfer or check may be delayed

5–10 business days as the annuity account is established. The payment start date for fixed annuities cannot be more than 90 days after the purchase date.

The Claimant is responsible for ensuring that the Fixed Annuity Option as elected meets the minimum distribution requirements, if applicable.

ING_VRS_Death

Page 3 of 8 Guide

Benefit Claim_12.30.10