HomeMy WebLinkAbout1998 PURCHASE PLAN INVESTMENT OPTION ADDITION REQUEST RETIREMENT ADVISOR AND RETIREMENT MANAGER
Augusta Richmond GA
DOCUMENT NAME: -r r\I VeS,l'IeN r bp-n ON .11 .1& 1:"- i" N iCe~ u lES, ~ DrRe- /h6'J'T
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DOCUMENT TYPE:
YEAR: :;(DO '3
BOX NUMBER: ) <r
~ILE NUMBER: J 1.p S- Dt 3
NUMBER OF PAGES: ~
Investment Option Addition R~que~t
Retirement Advisor and Retirement Manage
Pension Operations :."':~ ~
Phone: 1-800-548-6436 ./ Fax: (614) 44 ~5'5~
Date: Case Number: d- '7 -' 000 ,.Y ~~ i~ S~~
(ObtaIn thIs number from your pens/on p18n nlstrator) J ~
The Ian Trustee or Plan Representative (if Nationwi e~is serving as Trustee) of ::' ~ y '\l
() Ie. y .J, S e. '\'
agel P an Nama as stated on the Contract Face Page) '\
wish to add the followinQ fund(s) as investment optlon(s) to our Rlan:
Primary Plus Primary P s
American Century Investments Gartmore Family of Funds (continu
o Growth Fund-Advisor Class ACGD)iI" Gartmore Large Cap Value Fund-Class A PLVD
o Income & Growth Fund-Advisor Class ACID 0 Gartmore Money Market Fund-Institutional Class GMZD
o International Growth Fund-Advisor Class TCGD 0 Gartmore Total Retum Fund-Class D NFZD
o Short-Term Govemment Fund-Advisor Class ABGD 0 Gartmore U,S, Growth Leaders Fund-Class A GGTD
o Small Cap Quantitative Fund-Advisor Class ACQD 0 Gartmore Value Opportunities Fund-Class A NNOD
o Small Cap Value Fund-Advisor Class ASCD 0 Gartmore Worldwide Leaders Fund-Class A GGLD
o Ultra Fund-Advisor Class ACAD 0 Nationwide Bond Index Fund-Class A NBID
o Value Fund-Advisor Class ACVD 0 Nationwide Intemationallndex Fund-Class A NIID
The Dreyfus Funds 0 Nationwide Mid Cap Market Index Fund-ClassA I\MX)
o Appreciation Fund DAFD 0 Nationwide S&P 500 Index Fund-Service Class NSPD
o Balanced Fund DBFD 0 Nationwide Small Cap Index Fund-Class A NSCD
o Intemational Value Fund DIVD INVESCO Family of Funds
The Dreyfus Premier Family of Funds 0 Dynamics Fund-Investor Shares VDYD
o Premier Core Value Fund-Class A DPCD la Small Company Growth Fund-Investor Shares VSGD
o Premier Third Century Fund-Class Z DTZD Janus Adviser Series
Federated Investors 0 Balanced Portfolio
o High Yield Trust FHYD 0 Capital Appreciation Portfolio
o Intennediate lnoome Fund -Institutional Service SharesFIID 0 Growth Portfolio
Fidelity Advisor Investments 0 Intemational Portfolio
o Equity Growth Fund-Class A FEGD 0 Worldwide Portfolio
o Equity Income Fund-Class A FEID Neuberger Berman
o Overseas Fund-Class A FOVD 0 Guardian Fund-Trust Shares
o Value Strategies Fund-Class A FSOD Oppenheimer Funds
Franklin Templeton Investments 0 Capital Appreciation Fund-Class A
o Franklin Balance Sheet Investment Fund-Class A TBSD 0 Champion Income Fund-Class A
o Franklin Mutual Shares Fund-Class A TMSD 0 Global Fund-Class A
o Franklin Smail-Mid Cap Growth Fund - Class A TSGD 0 Strategic Income Fund-Class A
o Templeton Foreign Fund-Class A TFFD PIMCO Funds
The Gartmore Group 0 Total Retum Fund-Class A
o Gartmore Bond Fund-Class A NBDD Strong Investments
o Gartmore Emerging Markets Fund-Class A GEKD 1iIf Advisor Common Stock Fund-Class A
o Gartmore Global Health Sciences Fund-Class A NLSD 0 Advisor Mid Cap Growth Fund-Class Z
o Gartmore Global Technology & GTCD 0 Advisor Small Cap Value Fund-Class Z
Communications Fund-Class A 0 Growth & Income Fund-Investor Class
o Gartmore Govemment Bond Fund-Class D NGID Van Kampen Investments
o Gartmore Growth Fund-Class D NGZD 0 Comstock Fund-Class A
o Gartmore GVIT Small Company Fund-Class I SCFX 0 Growth and Income Fund-Class A
o Gartmore High Yield Bond Fund-Class A NHYD 0 Real Estate Securities Fund-Class A
o Gartmore International Growth Fund-Class A GIGO
o Gartmore International Small Cap Growth NISD
Fund-Class A
o Gartmore Investor Destinations Aggressive
Fund-Service Class
o Gartmore Investor Destinations Conservative
Fund-8ervice Class
o Gartmore Investor Destinations Moderate
Fund-Service Class
o Gartmore Investor Destinations Moderately
Aggressive Fund-Service Class
o Gartmore Investor Destinations Moderately
Conservative Fund -Service Class
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63
JABD
JACD
JAGD
JAID
JAWD
NGTD
PCAD
PCID
PGZD
PSID
PCTD
SCCD
SMCD
SMVD
SGID
..'
VCAD
VKWD
VRED
DAGD
Special Instructions Symbol
o Block as an Investment option on INQUIRE/Internet: _
o Use to fund the retainer/forfeiture account:
DCFD
DMFD
*If you plan to use a fund other than the money market
for a retainer/forfeiture account, call your account
manager for guidelines,
[Ml)
DMAD
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I (we) understand if there is any problem with the fund(s} requested or the current fund classifications listed on this form, the
fund(s} will not be added at this time and I (we) will be notified of necessary corrections,
01 PI""~sentat ~
r>,~ [, ~ ~ C4~'
Printed Name of Plan Trustee/Plan Representative
The Plan Trustee or Plan Representative (if Nationwide~ is serving as Trustee) must sign this request. If the current Plan Trustee or
Plan Representative is not the individual who signed the original application and/or Trust Agreement, please provide written
evidence that he/she is Plan Trustee or Plan Representative, This may include a Board of Director's Resolution or the signature
page from the plan document.
AP0-3207-R Web Only 10/02
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