Peninsula Enrollment - Web Book Ready - Flipbook - Page 20
PENINSULA TRUCKING, INC.
401(k) PROFIT SHARING PLAN AND TRUST
Enrollment / Information Change Form
Certified Benefits Corp
1111 Douglas Avenue
Altamonte Springs, FL 32714
Peninsula Trucking, Inc.
31545 CR 437
Sorrento, FL 32776
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:
AB Large Cap Growth I - ALLIX
Percentage to
be Allocated
_____.0%
Moderately Conservative
_____.0%
American Century Sm Cap Growth Fund- ANODX
_____.0%
Moderate
_____.0%
Cohen & Steers Instl Realty Shares - CSRIX
_____.0%
Moderately Aggressive
Aggressive
_____.0%
_____.0%
Target Date Funds
Vanguard Target Retirement Inc Inv - VTINX
Vanguard Target Retirement 2020 - VTWNX
DFA Intl Sm Company I - DFISX
Dodge & Cox Global Bond Fund- DODLX
Fidelity Adv Intl Cap Apprec Fund- FIDZX
Fidelity Advisor Intl Sm Cp Opps I - FOPIX
_____.0%
_____.0%
_____.0%
_____.0%
_____.0%
_____.0%
_____.0%
_____.0%
Vanguard Target Retirement 2025 - VTTVX
_____.0%
Fidelity 500 Idx Institutional Prem - FXAIX
JPMorgan Mid Cap Growth R6 - JMGMX
PGIM High Yield R6 - PHYQX
Vanguard Target Retirement 2030 - VTHRX
_____.0%
PIMCO Income Instl - PIMIX
_____.0%
Vanguard Target Retirement 2035 - VTTHX
Invesco Stable Value Trust I - QJQKQ
_____.0%
Vanguard Target Retirement 2040 - VFORX
_____.0%
_____.0%
American Funds Bond Fund - RBFGX
_____.0%
Vanguard Target Retirement 2045 - VTIVX
_____.0%
Columbia Floating Rate Inst2 - RFRFX
_____.0%
Vanguard Target Retirement 2050 - VFIFX
_____.0%
Vanguard Target Retirement 2055 - VFFVX
_____.0%
American Fds New Perspective R6 - RNPGX
Vanguard Equity-Income Adm - VEIRX
_____.0%
Vanguard Target Retirement 2060 - VTTSX
_____.0%
Vanguard Target Retirement 2065 - VLXVX
_____.0%
_____.0%
_____.0%
Vanguard Fed Money Market - VMFXX
Vanguard Mid-Cap Val Idx Adm - VMVAX
_____.0%
Vanguard Sh Term Treasury Idx Adm – VSBSX
_____.0%
Vanguard Sm Cap Val Index Fund- VSIAX
_____.0%
Vanguard International Value Fund– VTRIX
_____.0%
_____.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.