NPERS2502 Rev. 09/2013 Page 1 of 1
BAR CODE
Last First Middle
Name
Date of Birth - -
Plan Type
Social Security Number - - Retirement Number
Patrol –
DROP
Address City State Zip
Home Phone
Work Phone Employer
INVESTMENT ELECTION (FUTURE CONTRIBUTIONS ONLY)
You must make your selection in whole increments. The total must equal 100%. This election will change the allocation of future DROP Plan
contributions only. See transfer section below for transfer of existing balances. Funds are not guaranteed as to rate of return or principal stability.
Your employer and NPERS are held harmless against any losses in these funds.
% Stable Value (10) % Conservative Premixed (21) % S & P 500 Stock Index (15) % Small Company Stock (16)
% Money Market (13) % Moderate Premixed (23) % Lg. Co. Gro. Stock Index (19) % International Stock (17)
% Bond Market Index (18) % Aggressive Premixed (22) % Lg. Co. Value Stock Index (20) % Investor Select (24)
% Age-Based: Age 0-39 (26) % Age-Based: Age 40-59 (27) % Age-Based: Age 60 & Up (25)
TRANSFER OF EXISTING BALANCES/ELECTED DEFERRALS
A transfer will move a dollar amount or % of your existing funds from one investment fund to another. A transfer between the Stable Value Fund
and the Money Market Fund, which is a “competing fund,” is not allowed.
TRANSFER $ OR % from the FUND, into the FUND.
TRANSFER $ OR % from the FUND, into the FUND.
TRANSFER $ OR % from the FUND, into the FUND.
The above changes will be effective the same business day if received by NPERS before the close of market, generally 3:00 p.m. Central Time Monday – Friday.
I understand that my DROP contributions may not be withdrawn from the plan except in the event of termination, retirement, death, or disability.
I authorize the above changes, and certify that the above information is accurate.
Member Signature: Date:
Investment Election Change Form – DROP
COMPLETE ONLY THOSE SECTIONS BELOW THAT APPLY TO CHANGES YOU WISH TO MAKE.
