Fillable CARRIER ELECTION AND ALLOCATION ALTERNATE BENEFITS PROGRAM (ABP) (Hudson County Community College)

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CARRIER ELECTION AND ALLOCATION ALTERNATE BENEFITS PROGRAM (ABP) (Hudson County Community College)

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BROWSE HUDSON COUNTY COMMUNITY COLLEGE FORMS

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State of New Jersey • Department of the Treasury
DIVISION OF PENSIONS & BENEFITS — DEFINED BENEFIT &
DEFINED CONTRIBUTION BUREAU
P. O . Box 295, Trenton, NJ 08625-0295
ALTERNATE BENEFITS PROGRAM (ABP)
CARRIER ELECTION AND ALLOCATION
FP-0777-0319
Name ___________________________________________________________________________________________
Last First MI
Social Security Number ___________________________________ ABP Number ___________________________
if assigned
Address _________________________________________________________________________________________
Street
________________________________________________________________________________________________
City State Zip
Daytime Telephone Number ( ________ ) _________________________
AUTHORIZED INVESTMENT CARRIERS
If you are vested, select any number of investment carriers and allocate the percentage of your contributions to each one,
totaling 100 percent. Percentages must be whole numbers. You must establish a valid account directly with the carrier(s)
you select.
Check One: oInitial Election oSubsequent Election
____ AXA Financial (Equitable) _________ %
____ MassMutual Retirement Services (The Hartford) _________ %
____ ING/VOYA Financial Services _________ %
____ MetLife (formerly Travelers/CitiStreet) _________ %
____ Prudential _________ %
____ TIAA-CREF _________ %
____ VALIC _________ %
100%
I elect to allocate my total employee and employer tax sheltered contributions as indicated above. This allocation becomes
effective within 30 days of receipt of a properly completed form. I have read and understand the information on the back of
this application about my ABP membership.
Employee Signature _______________________________________________ Date _________________________
Certifying Ofcer Signature _________________________________________ Date _________________________
Certifying Ofcer’s Phone Number ( ______ ) ____________________
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ABP
Information For New Applicants
A Carrier Election and Allocation form must be completed to identify the investment carrier(s)
with which you want your contributions invested.
If you are eligible for immediate vesting, the employer contributions become your property imme-
diately upon investment in your account. You may elect any number of investment carriers and
designate the percentage (in whole numbers) of the total contributions they each should receive.
If you are not eligible for immediate vesting, the employer contributions do not become your
property until the beginning of the 13th month of your employment. You may elect only one in-
vestment carrier.
If you do not le a Carrier Election and Allocation form, the ABP Administrator will enroll you with
the investment carrier selected as the default carrier for the current plan.
You must le an application directly with the investment carrier(s) you have elected or with
the default investment carrier if you fail to complete this form. If you fail to do so, you may lose
possible revenue from your contributions. Additionally, the carrier(s) you elected will return your
contributions to your employer and the ABP administrator will enroll you with the default invest-
ment carrier.
Information For Vested ABP Members
ABP members may change their investment carrier election and/or allocation once each quarter
of the calendar year.
FP-0777-0418
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CARRIER ELECTION AND ALLOCATION ALTERNATE BENEFITS PROGRAM (ABP) (Hudson County Community College)

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Completed 29 January 2021

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