Free 48970.pdf - Indiana

INVESTMENT DIRECTION
State Form 48970 (R4 / 8-08)

Reset Form

* PRIVACY NOTICE All Social Security Numbers are requested by this agency in accordance with the requirements of the Internal Revenue Code. Disclosure is mandatory; this form will not be processed without the information

Name of member (first, middle initial, last)

Member's Social Security Number *


Address (number and street) City State Zip code

You have the right to change your investment direction at any time while you maintain a balance in your Annuity Savings Account. However, your change will not take effect until the first day of the next calendar quarter: January 1, April 1, July 1, or October 1. This form must be received at least thirty (30) days prior to the date it is to take effect. If you leave PERF-covered employment and leave your money with the fund, you still retain the right to direct the investment of your account. This form revokes and replaces all previously selected investment directions. In choosing your investment directions, please make sure the percentages total 100%, or it will be returned. Investments may only be made in increments of 10%. This form must be correctly completed and signed in order to take effect. Please return this form to PERF at the following address: Public Employees' Retirement Fund 143 West Market Street Indianapolis, IN 46204 Fax: (317) 234-5922 If you have not received a confirmation notice within three (3) weeks of mailing this form, please call the Public Employees' Retirement Fund TOLL-FREE at 888-526-1687.
10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Guaranteed Fund Money Market Fund Bond Fund S&P 500 Index Fund US Small Companies Stock Fund International Equity Index Fund

The total of all selections must equal 100%.
I revoke any previous investment directions and hereby direct the above investments, effective this date.
Signature of member Date (month, day, year)