Brewer Enrollment - Web Book - 2024 - Flipbook - Page 23
BREWER ORTHODONTICS, PLLC
401(K) PROFIT SHARING PLAN
Investment Election/Change Form
Brewer Orthodontics, PLLC
1291 Blackwood Avenue
Ocoee, FL 34761
Certified Benefits Corp
1111 Douglas Avenue
Altamonte Springs, FL 32714
SECTION 1: Investment Option Election 3 this investment election will be applied to all contribution types.
You may select from the following list of Model Investment Portfolios, Target Date Funds or Mutual Funds.
¥
Future Contributions
¥
Existing account balance
Percentage to be
Allocated
_____.0%
Model Investment Portfolios
Conservative
¥
Both Future and Current
Additional Investment Options:
American Century Small Cap Gr R6 3 ANODX
Percentage to
be Allocated
_____.0%
Moderately Conservative
_____.0%
AB Large Cap Growth Z - APGZX
_____.0%
Moderate
_____.0%
Cohen & Steers Instl Realty Shares 3 CSRIX
_____.0%
Moderately Aggressive
_____.0%
DFA International Small Company I 3 DFISX
_____.0%
Aggressive
_____.0%
Target Date Funds
Vanguard Target Retirement Inc Inv - VTINX
Vanguard Target Retirement 2020 - VTWNX
Vanguard Target Retirement 2025 - VTTVX
_____.0%
_____.0%
_____.0%
Dodge & Cox Global Bond 3 DODLX
Fidelity Advisor Intl Cap App Z 3 FIDZX
Fidelity Advisor® Intl Sm Cap Opps Z - FIQJX
Fidelity 500 Idx Institutional Prem 3 FXAIX
JPMorgan Mid Cap Growth Fnd Cl R6 - JMGMX
Prudential High-Yield Q 3 PHYQX
PIMCO Income Instl 3 PIMIX
_____.0%
_____.0%
_____.0%
_____.0%
_____.0%
_____.0%
_____.0%
Vanguard Target Retirement 2030 - VTHRX
_____.0%
Invesco Stable Value Trust I 3 QJQKQ
_____.0%
Vanguard Target Retirement 2035 - VTTHX
_____.0%
American Funds Bond Fnd of Amer R6 - RBFGX
_____.0%
Vanguard Target Retirement 2040 - VFORX
_____.0%
Columbia Floating Rate R5 3 RFRFX
_____.0%
Vanguard Target Retirement 2045 - VTIVX
_____.0%
American Funds New Persp R6 3 RNPGX
_____.0%
Vanguard Target Retirement 2050 - VFIFX
_____.0%
Schwab Fdmtl Intl Lg Co Idx - SFNNX
_____.0%
Vanguard Target Retirement 2055 - VFFVX
_____.0%
Vanguard Inflation-Prot Secs Adm 3 VAIPX
_____.0%
Vanguard Target Retirement 2060 - VTTSX
_____.0%
Vanguard Equity Income Admiral 3 VEIRX
_____.0%
Vanguard Target Retirement 2065 - VLXVX
_____.0%
Vanguard Federal Money Market Fund - VMFXX
_____.0%
Vanguard Short-Trm Treasury Indx Fnd - VSBSX
_____.0%
Vanguard Small Cap Val Idx Adm 3 VSIAX
_____.0%
Allspring Special Mid Cap Value R6 - WFPRX
_____.0%
TOTAL MUST EQUAL 100%
Automated Investment Strategies 3 (To be used only if more than one investment option is chosen.) Please choose
one of the following options (if no selection is made and more than one investment option is chosen above, the
account will be rebalanced annually). Please note that rebalancing will occur only if the initial allocation changes
by two percentage points or more.
w Do Not Rebalance
w Monthly
w Quarterly
w Semi-Annually
w Annually
SECTION 2: Signature 3 Review to make sure that you have completed each section fully. Please return this form
to your employer.
Employee Name (printed):______________________________________ SSN: ___________________________
Employee Signature: __________________________________________ Date: ___________________________
Employer Signature: __________________________________________ Date: ___________________________
Special 404 (c) Regulations Section and Notice of Limited Liability. This plan intends to comply with ERISA 404 (c) and Title 29 of CFR 2550.404 c-1. Plan Fiduciaries may be relieved of liability for any
losses that may result from participant9s investment instruction.
