Fillable New Baby Match Instructions

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New Baby Match Instructions

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CSNDD_04283C 080720 — Page 1 of 2
1
For questions about New Baby Match, call 1.866.SAVE.529 (866.728.3529) any business day from 8 a.m. to 8 p.m. Eastern time or
visit collegesave4u.com/baby.
DO NOT STAPLE
College SAVE Plan
New Baby Match Instructions
New Baby Match is a program created by Bank of North Dakota ("Bank") that allows every baby residing in North Dakota, twelve months old or
younger, to be considered for a New Baby Match in an amount up to $200. New Baby Match is a component of College SAVE, the State of North
Dakota's 529 College Savings Plan.
In addition to these Instructions, please see the College SAVE
Plan Disclosure Statement and Participation Agreement
and any
supplements distributed from time to time (together, the "Disclosure Statement") for details and rules regarding
New Baby Match.
The
Disclosure Statement is located at collegesave4u.com.
Please note that New Baby Match is dependent upon funding limitations as overseen by Bank and can be modified, reduced or discontinued at
Bank’s discretion at any time.
Eligibility Requirements
The following eligibility requirements must be met to qualify for a New Baby Match:
• The Participant must open a College SAVE account and apply for New Baby Match.
• Residency:
The Designated Beneficiary must be a North Dakota resident at the time of applying for the New Baby Match.
• Designated Beneficiary:
The Designated Beneficiary must be 12 months old or younger at the time of applying for the New Baby Match.
• Participant:
If the Participant completes, signs, and returns the New Baby Match Enrollment Form, the Participant (who must be at
least 18 years of age) must open a College SAVE Account (complete and return a College SAVE Enrollment Form*) and contribute up to
$200 to that College SAVE Account prior to the 1 year enrollment anniversary. If the Participant completes, signs, and returns the College
SAVE Enrollment Form, the Participant must contribute up to $200 to that College SAVE Account prior to the 1 year enrollment anniversary.
• Family Income:
No family income restrictions apply.
How to Apply
There are two ways to apply for New Baby Match:
1) Online - Opt into New Baby Match when opening a College SAVE account online (Note: If the Designated Beneficiary already has a College
SAVE Account, then the Participant cannot apply online and must complete and return a New Baby Match Enrollment Form by mail); and
2) By mail - Complete a New Baby Match Enrollment Form or complete the New Baby Match section of the College SAVE Enrollment Form (if
simultaneously opening a College SAVE Account) and mail it to College SAVE, P.O. Box 219781, Kansas City, MO 64121-9781
The Participant must apply separately for a New Baby Match for each Designated Beneficiary. An eligible Designated Beneficiary may only
receive one New Baby Match. In the event that more than one Participant requests a New Baby Match for the same Designated Beneficiary, the
New Baby Match will be awarded to the Participant named in the first completed application received. In the event that multiple applications
are received on the same day, a New Baby Match will be awarded to the Participant named in the first application processed and approved that
day.
New Baby Match Approval Process and Verication
If the application is approved, the Participant will be notified within one month of College SAVE's receipt of the application.
If the application is not approved (e.g., Participant is deemed ineligible), the Participants will be notified within 60 days from College SAVE's
receipt of the application.
CSNDD_04283C 080720 — Page 2 of 2
2
For questions about New Baby Match, call 1.866.SAVE.529 (866.728.3529) any business day from 8 a.m. to 8 p.m. Eastern time or
visit collegesave4u.com/baby.
DO NOT STAPLE
Acceptance of a New Baby Match by the Participant authorizes for Bank to undertake, at its discretion, an investigation to verify the Participant
meets the program requirements. Bank reserves the right at all times to require evidence of eligibility to receive a New Baby Match and may
conduct investigations to determine eligibility without obtaining additional consent from the Participant. In the event a subsequent investigation
reveals that the New Baby Match was obtained through misrepresentation or fraud, Bank shall revoke the New Baby Match.
Investment/Allocation of New Baby Match
If a Participant qualies for New Baby Match, the award will be deposited into a Match Account and will be invested according to the
allocation instructions on le for the Participant's College SAVE Account. The Match Account will be linked to the College SAVE Account. Bank
retains ownership of the assets in the Match Account until the Participant submits a request in good order for a qualied withdrawal.
New Baby Match Forfeiture
Under certain circumstances, the New Baby Match, and any earnings, may be fully or partially forfeited. These circumstances include:
• Rollover to another state’s 529 plan;
• Change of Designated Beneciary and the new Designated Beneciary has previously received a New Baby Match or is not a Member of the
Family as dened by Section 529 of the Internal Revenue Code and as described in the Disclosure Statement;
• The Designated Beneciary dies or becomes disabled and cannot attend school, unless the Participant changes the Designated Beneciary
to a Member of the Family;
• Non-qualied withdrawal from your New Baby Match Account;
• The Participant’s College SAVE Account is closed and the New Baby Match is not used within 18 months for a qualied withdrawal to an
Eligible Higher Educational Institution; and
• If you provide false information when applying for New Baby Match.
Tax Considerations
The New Baby Match Program is designed so that the New Baby Match, together with any earnings, used for certain qualied higher education
expenses will not be subject to federal or North Dakota state income tax. It is possible that future changes in law may cause a New Baby
Match to be taxable, or that the Internal Revenue Service may take the position that a New Baby Match is taxable, in the year the New Baby
Match is awarded or distributed. You should consult your tax advisor for more information.
Use of Personal Information
The information provided on this
New Baby Match Enrollment Form
or the
College SAVE Enrollment Form
is personal information.
The personal information provided, or which must be reviewed in connection with this
New Baby Match Enrollment Form
or the
College
SAVE Enrollment Form
, includes social security number or taxpayer identication number.
Bank will use or review the information according to state law to determine eligibility for a New Baby Match. Your social security number
or taxpayer identication number is required to verify your identity as the Participant and is used as an identier for the New Baby Match to
ensure all necessary data are accurately recorded. Social security numbers or taxpayer identication numbers are also used for federal and
state tax administration purposes.
Personal information will not be disclosed to third parties without your informed consent or the consent of the person to whom it pertains,
unless required by law.
CSNDD_01728 080720 — Page 1 of 2
1
DO NOT STAPLE
College SAVE Plan
New Baby Match Enrollment Form
Before completing this New Baby Match Enrollment Form, please read the College SAVE Plan Disclosure Statement and Participation
Agreement and any supplements distributed from time to time (the "Disclosure Statement").
IMPORTANT INFORMATION ABOUT OPENING A NEW ACCOUNT. We are required by federal law to obtain from each person who applies
for a New Baby Match certain personal information — including name, street address, and date of birth, among other information — that will be
used to verify their identity. If you do not provide us with this information, we will not be able to verify your identity.
• Sections 1-2 must be completed by the Participant, who must sign and date this New Baby Match Enrollment Form.
• You must complete and submit a separate New Baby Match Enrollment Form for each Designated Beneficiary on whose behalf you are
requesting a New Baby Match.
• Type in your information and print out the completed form, or print clearly, preferably in capital letters and black ink. Mail the form to the
address below. Do not staple.
Forms can be downloaded from our website at www.collegesave4u.com, or you can call us to order any form — or request assistance in
completing this form — at 1.866.SAVE.529 (866.728.3529) any business day from 8 a.m. to 8 p.m. Eastern time.
Return this form and any other required documents to:
College SAVE
P.O. Box 219781
Kansas City, MO 64121-9781
For overnight delivery or registered mail, send to:
College SAVE
920 Main Street, Suite 900
Kansas City, Missouri 64105
1. Account information
• The Designated Beneciary’s social security number or taxpayer identication number on your College SAVE Account must match
your Designated Beneciary’s social security number or taxpayer identication number you submit on this New Baby Match
Enrollment Form.
Account Number (If you have not established an Account, please complete an Enrollment form.)
Participant Name (rst, middle initial, last)
Participant Social Security Number or Taxpayer Identication Number (Required)
Designated Beneciary Name (rst, middle initial, last)
Designated Beneciary Social Security Number or Taxpayer Identication Number (Required) Designated Beneciary Birth Date
CSNDD_01728 080720 — Page 2 of 2
2
DO NOT STAPLE
2. SIGNATURE — YOU MUST SIGN BELOW
By signing below, I hereby apply for a New Baby Match and I certify that:
• I have read and agree to the terms regarding the New Baby Match program as described in the New Baby Match Instructions and
the Plan Disclosure Statement and Participation Agreement.
• I certify that the information provided on this New Baby Match Enrollment Form is true, complete, and accurate, and that I
consent to and authorize the use of my private data as described in the New Baby Match Instructions.
SIGNATURE
Signature of Participant Date (mm/dd/yyyy)
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New Baby Match Instructions

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Completed 29 October 2020

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