One Florida Bank Enrollment PDF - Flipbook - Page 22
One Florida Bank 401(k) Plan
Investment Election/Change Form
One Florida Bank
33 W. Pineloch Avenue, Suite A
Orlando, FL 32806
Certified Benefits Corp
1111 Douglas Avenue
Altamonte Springs, FL 32714
SECTION 1: Investment Option Election – this investment election will be applied to all contribution types.
You may select from the following list of Model Investment Portfolios, Target Date Funds or Mutual Funds.
□
Future Contributions
□
Existing account balance
Percentage to be
Allocated
_____.0%
Model Investment Portfolios
Conservative
□
Both Future and Current
Additional Investment Options:
Cohen & Steers Instl Realty Shares – CSRIX
Percentage to
be Allocated
_____.0%
Moderately Conservative
_____.0%
Columbia Small Cap Ind Inst2 - CXXRX
_____.0%
Moderate
_____.0%
Fidelity Advisor Intl Small Cap I - FIXIX
_____.0%
Moderately Aggressive
_____.0%
Fidelity 500 Idx Institutional Prem – FXAIX
_____.0%
Aggressive
_____.0%
Target Date Funds
Vanguard Target Retirement Inc Inv - VTINX
Vanguard Target Retirement 2020 - VTWNX
Vanguard Target Retirement 2025 - VTTVX
Vanguard Target Retirement 2030 - VTHRX
_____.0%
_____.0%
_____.0%
_____.0%
Invesco Stable Value Trust I – QJQKQ
American Funds The Bond Fund of Am - RBFGX
Thornburg Strategic Inc Fund Cl R5 - TSRRX
Vanguard Mid Cap Ind Adm - VIMAX
Vanguard Federal Money Market Inv - VMFXX
Vanguard Devel Mrkt Indx Fnd Adm - VTMGX
_____.0%
_____.0%
_____.0%
_____.0%
_____.0%
_____.0%
Vanguard Target Retirement 2035 - VTTHX
_____.0%
Vanguard Target Retirement 2040 - VFORX
_____.0%
Vanguard Target Retirement 2045 - VTIVX
_____.0%
Vanguard Target Retirement 2050 - VFIFX
_____.0%
Vanguard Target Retirement 2055 - VFFVX
_____.0%
Vanguard Target Retirement 2060 - VTTSX
_____.0%
Vanguard Target Retirement 2065 - VLXVX
_____.0%
TOTAL MUST EQUAL 100%
Automated Investment Strategies – (To be used only if more than one investment option is chosen.) Please choose
one of the following options (if no selection is made and more than one investment option is chosen above, the
account will be rebalanced annually). Please note that rebalancing will occur only if the initial allocation changes
by two percentage points or more.
❑ Do Not Rebalance
❑ Monthly
❑ Quarterly
❑ Semi-Annually
❑ Annually
SECTION 2: Signature – Review to make sure that you have completed each section fully. Please return this form
to your employer.
Employee Name (printed):______________________________________ SSN: ___________________________
Employee Signature: __________________________________________ Date: ___________________________
Employer Signature: __________________________________________ Date: ___________________________
Special 404 (c) Regulations Section and Notice of Limited Liability. This plan intends to comply with ERISA 404 (c) and Title 29 of CFR 2550.404 c-1. Plan Fiduciaries may be relieved of liability for any
losses that may result from participant’s investment instruction.