Free A BREAKDOWN OF YOUR ROLLOVER INVESTMENT OPTIONS - Indiana

Request to Allocate Rollover Account
State Form 52178 (6-05) Approved by the State Board of Accounts 2005

Indiana State Teachers' Retirement Fund 150 West Market St., Suite 300 Indianapolis, IN 46204-2809 Telephone: (317) 232-3860 / (888) 286-3544 Fax Number: (317) 232-3882 Home page: http://www.in.gov/trf

Teachers' Retirement Fund (TRF) number:

MEMBER INFORMATION Date:

First name (printed):

Middle initial:

Last name (printed):

Address:

Home phone number:

New address (if new, please check the box): City: State:

Other phone number: Zip code:

INSTRUCTIONS 1. Non-retired members may allocate their Rollover Account monies among five approved Funds by using this form. For security purposes, we must receive the original form with an original signature. We cannot accept allocation forms submitted by facsimile. 2. Members may select one or all of the Rollover Account Investment Option Elections. 3. Allocations must be in 10% increments and must total 100%. 4. In order to take effect, this form must be signed and dated. This form revokes all previously selected options. 5. This form must be received by the designated cut-off date published on the back of this form. 6. Please read the information posted on the back of this form carefully. 7. New deposits and the previous Rollover Account balance will be allocated as prescribed on this form. Any variation from the allocation method prescribed on this form may not be processed. The Indiana State Teachers' Retirement Fund (TRF) may not change asset allocation request unless all terms and conditions contained herein are met. Accordingly, TRF is not responsible for missed investment opportunities due to improper completion. As a member, it is your responsibility to verify requested changes to your account. Please be advised gains and loses hinge upon performance.
T PAYMENT PLANS MONTHLY OPTIOL BENEFIT PAYMENT PLANS

ROLLOVER ACCOUNT INVESTMENT OPTION ELECTION Please circle the percentage you wish to allocate to each investment fund. Allocations must be made in 10% increments and must total 100% or this form may not be processed. Money Market Fund S & P 500 Index Equity Fund Bond Fund International Fund Small Cap Equity Fund 10% 10% 10% 10% 10% 20% 20% 20% 20% 20% 30% 30% 30% 30% 30% 40% 40% 40% 40% 40% 50% 50% 50% 50% 50% 60% 60% 60% 60% 60% 70% 70% 70% 70% 70% 80% 80% 80% 80% 80% 90% 90% 90% 90% 90% 100% 100% 100% 100% 100%

SIGNATURE As of this date, I revoke all previous investment selection options. I understand these investment directions pertain to my Rollover Account and will not affect my Annuity Savings Account.
Signature: Date:

FOR OFFICE USE ONLY Date received:

Processed by:

Date processed:

Audited by:

Date audited:

Indiana State Teachers' Retirement Fund

Indiana State Teachers' Retirement Fund
In order for changes to be effective, a "Request to Allocate Rollover Account" form must be submitted according to the following schedule: TO BE EFFECTIVE BY: January 1 April 1 July 1 October 1 THIS FORM MUST BE RECEIVED ON OR BEFORE: December 2 March 2 June 1 September 1

In addition, please note the following "Investment" Models for Rollover Account Participants: Asset Type S & P 500 Index Equity Fund Small Cap Equity Fund International Equity Fund Bond Fund Money Market fund Total Portfolio More Aggressive ================ More Conservative 50% 60% 40% 20% 0% 20% 10% 10% 0% 0% 20% 10% 10% 10% 0% 10% 10% 20% 30% 0% 0% 10% 20% 40% 100% 100% 100% 100% 100% 100%

Special Note Specific options should be based on risk tolerance and length of investment. After careful consideration, you may also wish to consult a professional financial advisor.

Current Rollover Account Investment Options: 1. S & P INDEX FUND - Closely tracks returns on the S & P 500 index by employing and indexing strategy that invests in the stocks of S & P 500 index companies (500 largest public companies on major stock exchanges). SMALL CAP EQUITY FUND - Consists of stocks with a market capitalization of less than $1.5 billion. The Fund's objective is to provide total returns in excess of the Russell 2000 index (2000 selected small-capitalized public companies) over the long term. INTERNATIONAL EQUITY FUND - Consists of securities of developed non-US countries. The Fund's objective is to provide returns in excess of a broad international market index (EAFE Companies from Europe, Australia and the Far East) over the long term. BOND FUND - Consists of a broad range of corporate, government and agency instruments, which may have up to 10% in high yield bonds and 10% in non-US fixed income instruments. The objective of the Fund is to outperform the Lehman Brothers Aggregate Bond index over the long term. MONEY MARKET FUND - Consists of high-grade money market securities with short-term maturities. The objective of the Fund is to preserve the principle while providing a competitive short-term rate of return.

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