NC 529 Plan
North Carolina’s National College Savings Program
Enrollment and Participation Agreement
Please print clearly in capital letters and dark ink.
Check one.
Name of Participant (First, Middle, Last, Suffix)
Check type and enter the number.
Social Security or Taxpayer Identification Number Birth Date (month, day, year)
Address (line 1)
Address (line 2)
City State Zip or Postal Code Country (if not U.S.)
Primary Telephone Number (8:00 a.m. to 5:00 p.m.) Alternate Telephone Number
E-mail Address
Mail to:
NC 529 Plan
P.O. Box 40877
Raleigh, NC 27629-0877
Overnight or
registered
mail:
NC 529 Plan
2917 Highwoods Blvd.
Raleigh, NC 27604
Fax to:
919-835-2304
Email to:
savings@cfnc.org
For questions or forms, contact the Program
Administrator: College Foundation, Inc.
NC529.org 800-600-3453
919-828-4904 (Raleigh)
One of the College Foundation of North Carolina (CFNC) services
helping students and families plan, apply and pay for college.
Use this form to establish a new Account. The terms,
conditions, risks and full description of the Program are
contained in the Program Description for North Carolina’s
National College Savings Program (the “Program
Description”). You should read that document in full before
completing this Enrollment and Participation Agreement (the
“Enrollment Agreement”). Complete a separate Enrollment
Agreement for each Beneficiary for whom you are establishing
an Account.
Make checks payable to: “NC 529 Plan”
1 Type of Account
SSN
TIN
Individual 529 Account
UGMA/UTMA Account. I am opening this Account with assets liquidated from an UGMA/UTMA custodial
account. I understand that the minor named on the UGMA/UTMA custodial account and the Beneficiary named
on this Account must be the same. (See item 7a of Section 9 of this Enrollment Agreement.)
For other types of Accounts, such as Trust, Entity, Scholarship, or Accounts that may involve a business entity, state or local
government agency, 501(c)(3) organization, or certain legal requirements, please download and complete an Enrollment and
Participation Agreement for Entities (Form C420d) or call 800-600-3453 for assistance.
Electronic Delivery: I prefer online notification of quarterly Account statements and other
communication using my e-mail address above instead of receiving paper statements
and notices via standard mail. (Checking “No” indicates preference for paper, which
incurs an automatic deduction of $1.50 per month from your Account for mailing costs.)
Yes No
2 Participant Information (The person who establishes, owns, and controls the Account.)
CFNC.org/NC529 800-600-3453 CFI Form C420 (08/18)
Optional Information
A. Promo Code (if applicable)
B. How did you learn about the Program?
I am a current Participant School Billboard Social Media
Friend/Family Newspaper/Magazine Direct Mail
Employer TV Website
Financial Advisor Radio Presentation
C. What is your relationship to the Account Beneficiary (future student)?
Self Parent Grandparent Other Family/Friend
Successor Participant Information (Optional)
The Successor Participant is the individual you may designate to replace you as Participant in the event of your death or
incapacity; he or she must be at least 18 years old. Until the time that a Successor Participant may take over your Account,
this person does not have any access to the Account or any information related to it.
Name of Successor Participant (First, Middle, Last, Suffix)
Check type and enter the number
Social Security or Taxpayer Identification Number Birth Date (month, day, year)
Telephone Number
If your Beneficiary does not yet have a Social Security or Taxpayer Identification Number, send it to the Program Administrator
as soon as it is available.
Name of Beneficiary (First, Middle, Last, Suffix)
Check type and enter the number
Social Security or Taxpayer Identification Number Birth Date (month, day, year) State of Residence
Enter below anyone you want to receive copies of your Account statements, such as a financial advisor or relative. This person is
not authorized to access or make any changes to your Account.
Name (First, Middle, Last, Suffix)
Address (line 1)
Address (line 2)
City State Zip or Postal Code
SSN
TIN
SSN
TIN
4 Duplicate Statement Request (Optional)
3 Beneficiary Information (The Beneficiary is the future or current college student.)
CFNC.org/NC529 800-600-3453 CFI Form C420 (08/18)
Refer to the Program Description for detailed information on each Investment Option.
Note: Contributions that accompany this form and all future Contributions to your Account will follow the instructions provided
below. Designation of future Contributions may be changed at any time. To change either currently invested or future
Contributions later, complete an Enrollment and Participation Agreement Supplement (Form C421).
Investment Options
You have multiple choices for your Investment Options. You may choose one of the age-based options and/or one or more of
the individual options. Use only whole numbers, not fractions, for your Contribution percentages. Your total investment must
equal 100%.
Vanguard Age-Based Options
The Program will automatically place assets into the appropriate age range and
migrate them based on Beneficiary’s birth date.
Contribution Percentages
%
Select only one age-based track:
Individual Options
Federally-Insured Deposit Account (Provided by State Employees’ Credit Union)
%
Vanguard Aggressive Growth Portfolio
%
Vanguard Growth Portfolio
%
Vanguard Moderate Growth Portfolio
%
Vanguard Conservative Growth Portfolio
%
Vanguard Income Portfolio
%
Vanguard Interest Accumulation Portfolio
%
Vanguard Total Stock Market Index Portfolio
%
Vanguard Total International Stock Index Portfolio
%
Vanguard Total Bond Market Index Portfolio
%
TOTAL %
5 Investment Options
Aggressive Track
Moderate Track
Conservative Track
1
0 0
0
CFNC.org/NC529 800-600-3453 CFI Form C420 (08/18)
Source of Funds (Check and complete all that apply.)
For information on wire transfers, please call us at 800-600-3453.
A. Lump Sum
1. Personal Check or Money Order (Make payable to NC 529 Plan.)
Amount ($25 minimum) $
, .
2.
Electronic Funds Transfer (EFT)
(To make a one-time transfer from your account with a financial institution to your NC 529 Account.)
Note: To set up this option, provide account information in Section 7. If a Contribution is not honored by your
financial institution, you will be assessed a transaction fee.
Amount ($25 minimum) $ , .
B. Transfer or Rollover
1. Assets from another State’s Section 529 Qualified Tuition Program.
(Complete and send Incoming Rollover (Form C427) to that program’s manager, not to the NC 529 Plan.)
2. Coverdell Education Savings Account, a Qualified Savings Bond (Series EE or I, issued after 1989) or an
existing NC 529 Account.
(Complete and return Rollover and Transfer (Form C445) to the NC 529 Plan with your enrollment form.)
C. Automatic Investment Plan
1. Automatic Draft
(To transfer funds electronically on a regular basis from your account with a financial institution to
your NC 529 Account.)
You may change the Contribution amount and frequency by going online to CFNC.org/NC529 or by completing
an Enrollment and Participation Agreement Supplement (Form C421). It may take up to 5 days to set up an
automatic draft with your financial institution.
Note: To set up this option, provide account information in Section 7. If a Contribution is not honored by your
financial institution, you will be assessed a transaction fee.
Amount ($25 minimum) $
, .
Frequency
Check one and include the day(s) on which you want funds debited.
Note: Unless you select a different schedule below, your account will be debited on the 20th of each
month. If a debit date is scheduled for a weekend or holiday, the debit will occur on the next business day.
You must select a debit date that falls within the first 28 days of the month.
Once a month on the day of the month.
Twice a month on the and days of the month.
2.
Payroll Deduction
Please confirm with your employer that your company will support payroll deduction Contributions to North
Carolina’s National College Savings Program (NC 529 Plan). If your company does not currently support,
please call 800-600-3453 for more information.
Minimum Contribution amount per pay period must be $25.
Note: To begin payroll deduction, also complete and return the Payroll Deduction Authorization Agreement
(Form C426).
Employer Name Employer Code (if known)
6 Contribution Methods (The minimum amount required for all Contribution methods is $25.)
CFNC.org/NC529 800-600-3453 CFI Form C420 (08/18)
Note: Electronic Funds Transfer or Automatic Draft options are available only from a U.S. bank, savings and loan association, or
credit union that is a member of the Automated Clearing House (ACH) network.
Provide account information below. During the initial enrollment process for your new 529 Account, please provide information for
only one financial institution. To add another or change financial institution account information, complete an
Enrollment and Participation Agreement Supplement (Form C421), or go online to CFNC.org/NC529.
Account Type
Check one.
Financial Institution Name
Telephone Number
Routing Number Account Number
Note: This check image is an example of a format many financial institutions use; however, you should confirm your routing and
account number for electronic drafts with your financial institution before submitting this information.
I understand that by signing this Enrollment and Participation Agreement and submitting it to College Foundation, Inc., the
Program Administrator, I hereby certify that all of the information contained in this Enrollment and Participation Agreement
or that will be provided in the future is true, complete and correct, and I authorize College Foundation, Inc. to establish an
Account based upon this completed Enrollment and Participation Agreement. I further certify that I have received and read
the Program Description for North Carolina’s National College Savings Program, which I understand may be amended from
time to time, and I agree to be bound by the Agreements, Representations, and Warranties contained in Section 9 of this
Enrollment and Participation Agreement.
_________________________________________________________
Signature of Participant Date (month, day, year)
Please print, sign, and mail to the NC 529 Plan to complete your enrollment.
7 Financial Institution Information (Required to establish EFT and/or Automatic Draft services.)
Checking Savings
Routing Number
Account Number Check Number (do not enter)
8 Authorization – You Must Sign Below
CFNC.org/NC529 800-600-3453 CFI Form C420 (08/18)
Please read this carefully before you sign and submit your Enrollment Agreement.
A. DEFINED TERMS. Capitalized terms appearing but not defined in this
Enrollment Agreement have the meanings assigned to them in the Program
Description.
B. CERTAIN AGREEMENTS, REPRESENTATIONS AND WARRANTIES. I
hereby represent and warrant to the Program Administrator and agree as follows:
1. Program Description. I have received, read and understand the Program
Description for North Carolina’s National College Savings Program as currently in
effect, and as may be amended from time to time (the “Program Description”). In
making a decision to open an Account and enter into this Enrollment Agreement, I
have not relied on any representations or other information, whether oral or written,
other than as set forth in the Program Description and this Enrollment Agreement. I
agree to be bound by the terms and conditions set forth in the Program Description.
2. Full Authority and Legal Capacity. I have full authority and legal capacity to
establish an Account in North Carolina’s National College Savings Program.
3. Limit on Contributions. I certify that I intend that this Account fund the Qualified
Higher Education Expenses of the Beneficiary of the Account, that each
Contribution to the Account will be for that purpose, and that I will not make any
Contribution to the Account if, to the best of my knowledge, the total value of the
Account combined with the total value of all other accounts established for the
Beneficiary in other qualified tuition programs under Section 529 of the Internal
Revenue Code exceeds the amount necessary to provide for the Qualified Higher
Education Expenses of the Beneficiary.
4. Risks. I recognize that the investment of my Account involves risks, including the
risk of loss of my investment, as described in the Program Description. I understand
that the returns on Contributions are not guaranteed by the State of North Carolina,
the Authority, the Program Administrator, or any other governmental authority, or by
any current or successor investment manager or any of their affiliates, directors,
officers or employees. Not withstanding the foregoing, contributions and interest
thereon allocated to the Federally-Insured Deposit Account are guaranteed by
SECU and insured by the National Credit Union Administration (“NCUA”), which is
backed by the full faith and credit of the United States Government. I understand
the value of my Account may fluctuate depending on market conditions and the
performance of the Investment Options selected and that I could lose money by
investing in the Program.
5. Electronic Funds Transfers and Automatic Drafts. If I have elected to make
Contributions by electronic funds transfers (EFT) or automatic draft, I authorize the
Authority and the Program Administrator to initiate debit and/or credit entries in
accordance with my instructions designated in the Enrollment Agreement or any
future instructions against my account designated in this Enrollment Agreement or
later designated by me. I authorize the financial institution to accept any such debits
or credits to my account. I understand that my authorization for any such credit or
debit must comply with applicable law, and I agree to hold harmless the Authority
and Program Administrator for any credits or debits related to my Account that
result in any losses, damage, liability, cost, or expenses. This authorization will
remain in effect until I notify the Program Administrator in writing of its termination
and until the Program Administrator has reasonable time to act on that termination.
I further agree to maintain the balance in my designated account at a level sufficient
to satisfy each debit transaction, and I understand that if the balance is insufficient,
the Program Administrator may assess a fee in accordance with this Enrollment
Agreement and the Program Description.
6. Payroll Deduction. If enrolling through a payroll deduction plan, I understand
that the payroll deduction plan is being made available to me by my employer, and
that my employer is responsible for collecting and forwarding my Contributions to
the Program Administrator. I understand and agree that none of the Authority, the
Program Administrator, each investment manager or any successor investment
manager or any third party payroll service provider of my employer, or any of their
affiliates, directors, officers, employees, or agents (collectively the “Program
Parties”) is liable for any act, omission or error by the Program Parties in connection
with my Account, except to the extent of any liability imposed by federal law or other
applicable law that cannot be waived.
7. Transfers and Rollovers.
a. Transfers from an Existing UGMA/UTMA Custodial Account.
If I am funding my Account through a transfer of assets from an existing Uniform
Gifts to Minors Act/Uniform Transfers to Minors Act (UGMA/UTMA) custodial
account, I recognize that there may be certain adverse tax consequences. I
understand that I will not be able to change the Beneficiary of the Account or
authorize any Withdrawals from the Account unless the Withdrawal is for a use
permitted under the law governing the UGMA/UTMA custodial account and any
relevant terms and conditions for the UGMA/UTMA custodial account. I further
understand that any additional Contributions made to the UGMA/UTMA Account
established by this Enrollment Agreement will be subject to the terms and
conditions of the UGMA/UTMA custodial account and the state law that governs the
UGMA/UTMA custodial account.
b. Rollovers and Other Transfers.
Unless I return the Rollover and Transfer Form with this Agreement, I certify that no
part of any Contribution that I make to an Account established pursuant to this
Enrollment Agreement consists of proceeds derived from a Rollover of amounts
from another qualified tuition program or transfer of proceeds from a Coverdell
Education Savings Account or a Qualified Savings Bond (Series EE or Series I,
issued after 1989). I further certify that if any part of a future Contribution consists of
such amounts or proceeds, I will so inform the Program Administrator and agree to
provide documentation as requested by the Program Administrator regarding the
earnings associated with the other qualified tuition program, Coverdell Education
Savings Account, or Qualified Savings Bond (Series EE or Series I, issued after
1989). I recognize that if I fail to provide acceptable documentation, the Program
Administrator will treat such Contributions entirely as earnings as required by
applicable rules, regulation, or guidance from the Internal Revenue Service.
8. Account Changes. If I use telephone services or other electronic means for
Account changes: (a) I recognize that I may use the services only to update or
change certain information contained in the Enrollment Agreement, as explained in
the Program Description; (b) I authorize the Program Administrator and its agents to
act on my instructions, and I agree to hold harmless the Program Administrator and
its agents for any loss, damage, liability, cost, or expenses including reasonable
attorne
y
’s fees resulting from such instructions reasonably believed to be genuine;
and (c) I understand that the Program Administrator or its agents will employ
reasonable procedures such as requesting personal information to verify that the
caller or user of electronic means is the Participant. In addition, telephone calls may
be recorded as documentation, and I consent to such recording.
9. Taxes. I understand my Contributions per Beneficiary in a calendar year
generally may not exceed the applicable annual federal exclusion without incurring
federal and North Carolina gift taxes. I further understand that certain transactions
with my Account including but not limited to certain Rollovers, Non-Qualified
Withdrawals, or Withdrawals on account of Beneficiary’s death, Permanent
Disability, or receipt of a Scholarship, may result in regular federal and/or state
income taxes and an additional 10% federal income tax on earnings. Please refer to
the Program Description for details on any tax consequences related to
Contributions or other transactions with my Account.
10. Fees and Charges. I understand that my Account and certain transactions to or
from my Account are subject to the fees and charges set forth in the Program
Description. I understand further that these fees and charges may change in the
future. I agree that the payment of the administrative fees, asset-based charges,
and any other fees set forth in the Program Description are an unconditional
obligation of mine and the Account and shall be payable on my behalf by the
Program Administrator from Contributions or transfers of funds to my Account or
from assets in my Account as provided in the Program Description.
11. Finality of Decisions and Interpretations. All decisions and interpretations by
the Authority and the Program Administrator in connection with the operation of the
Program shall be final and binding on each Participant, Beneficiary and any other
person affected thereby.
12. Indemnity. I understand that the establishment of my Account is based on my
agreements, representations and warranties set forth in this Enrollment Agreement.
I will indemnify and hold harmless Program Parties, from and against any loss,
damage, liability or expense, including reasonable attorney’s fees, that any of them
may incur by reason of, or in connection with, any misstatement or
misrepresentation by me herein or otherwise with respect to my Account, and any
breach by me of any of the agreements, representations or warranties contained in
this Enrollment Agreement. I agree to hold harmless the Program Parties for any
loss, cost, or expense resulting from my instructions reasonably believed to be
genuine. This provision, and all of my agreements, representations or warranties
will survive termination of this Enrollment Agreement.
13. Use of Tax Identification Numbers. I understand that the Program
Administrator may collect and use the Social Security Numbers or Taxpayer
Identification Numbers provided in this Enrollment Agreement for certain federal
and state tax reporting requirements and for verifying identity for Account access by
telephone or other electronic means, and I consent to such use.
14. Effectiveness of Enrollment Agreement. This Enrollment Agreement will
become effective upon the opening of the Account by the Program Administrator.
15. Binding Nature, Third-Party Beneficiaries. This Agreement will survive my
death and will be binding on my personal representatives, heirs, successors, and
assigns. The Program Administrator is a third-party beneficiary of my agreements,
representations, and warranties in this Enrollment Agreement.
16. Amendment and Termination. At any time, and from time to time, the
Authority and the Program Administrator may amend this Enrollment Agreement or
the Program Description, or may suspend or terminate the Program.
17. Governing Law. The Program and this Enrollment Agreement are governed by
North Carolina law, and I submit to the exclusive jurisdiction of courts in North
Carolina for all legal proceedings arising out of or relating to the Program or this
Enrollment Agreement.
9 Agreements, Representations, and Warranties of the Participant