Slavic Integrated Administration

1075 Broken Sound Parkway. NW, Suite 100

Boca Raton, FL 33487-3540
Phone: (800) 356-3009
Fax: 561-245-5963
Email Address: [email protected]

PLAN DISTRIBUTION REQUEST FORM

PLEASE ALLOW 7-10 BUSINESS DAYS FOR PROCESSING

Consider the following information:

• You are required to read the Special Tax Notice accompanying this form before you decide how to receive your
benefits from the Plan. If your taxable distribution is eligible to be rolled over to an IRA or an employer plan, but it is
paid to you, it will be subject to mandatory 20% income tax withholding on withdrawals over $200. If you receive your
taxable distribution before age 59½ it may be the subject to a 10% additional income tax penalty on early distributions.
You may wish to consult a professional tax advisor before taking a distribution from the plan.

• There is a fee that will be applied to your account. Please refer to your Plan's Fee Disclosure for the fee amount.
• Electronic Funds Transfer is available only for Online Requests at www.slavic401k.com.

Section 1: Participant Information

Participant Name CAMERON WYLDE Social Security Number 560-41-4967

Participant Address 17038 wheatley dr
(Overnight mail cannot be sent to PO Box)

whittier ca 90603
City State Zip

Daytime Telephone 15622170683

- - Date of Birth 04-28-1972 Date of Termination/Retirement 3-23-2025

E-mail [email protected] Worksite Employerviper cabling inc

If you are still making contributions, please wait 30 days AFTER you terminate to submit your request.
Do you have an outstanding 401(k) loan? yes Yes No (An unpaid loan balance is subject to income tax if not repaid
within 60 days)

1 V3.0 - 12.26.2024
Section 2: Distribution Reason (Select one)

Please accept this document as my request for my account balance to be distributed as a result of the following event:
No longer employed by work-site employer or any other Adopting Employer of the Plan.

Full In–service withdrawal (For active participants, age 59½ or older)

Partial In–service Distribution in the amount of $ (For active participants, age 59½ or older)

Disability (Please provide proof of disability)

Full Unrelated source distribution (For active participants if plan allows: Money from an IRA or unrelated employer plan)
Partial Unrelated source distribution in the amount of $ (For active participants if plan allows: Money
from an IRA or unrelated employer plan)

Section 3: Distribution Option (Select one)

Distribution to myself
Rollover of the full amount to an IRA account (Complete Section 5)
Rollover of the full amount to a qualified plan (Complete Section 5)

A distribution to myself in the amount of $ and the remainder payable as a direct rollover
(Complete Section 5)
If you selected a partial distribution payable to yourself, indicate if the amount should be (you may only choose one):

Gross amount (before taxes withheld)

Net amount (after taxes withheld)

Section 4: Federal Tax Withholding Information

The default withholding rate for the taxable portion of your rollover eligible distribution is 20%.

You can choose a rate greater than 20%, but you may not choose a lower rate. If you desire a withholding rate greater than
20%, you must complete line 2 on the enclosed Form W-4R and submit the form to Slavic401k together with your Distribution
Form.

Any changes to your tax withholding, after the initial submission, may cause a delay in processing of your distribution. You
may not change the tax withholding after your distribution has been processed.

Complete Form W-4R ONLY if you desire a withholding rate greater than 20%. Form W-4R is available online on
www.irs.gov/FormW4R

2 V3.0 - 12.26.2024
Section 5: Distribution Method (Select one. A check will be issued unless you provide other instructions)

Check mailed to myself

Rollover check mailed to rollover company
cameron wylde
How should the rollover check be made payable:
Rollover company name (If rolling to an IRA or qualified retirement plan):
Address: 17038 wheatley dr whittier ca 90603
Street City State Zip
To the Attention of:

Account number: Roth Account number:

Additional Mailing Instructions:
I REQUEST OVERNIGHT MAIL SERVICE ($25.00 fee will be deducted from your account, $35.00 for Hawaii/Alaska)

By signing this form, I acknowledge that I have received and read the Special Tax Notice Regarding Plan Payments, which
explains the tax consequences of and the direct rollover option available with respect to my distribution from the Plan. I also
understand that I have the right to consider the information provided in the Special Tax Notice Regarding Plan Payments for at
least 30 days. I hereby waive my right to consider the content of that notice for the full 30-day period and I hereby consent to a
distribution from the Plan as soon as administratively feasible.

Please be advised that this document requires a wet signature. Electronic signatures will not be accepted.

Signature (required) Date Print Name

Enclosure: Form W-4R, Special Tax Notice 3 V3.0 - 12.26.2024

Form W-4R Withholding Certificate for Nonperiodic Payments and
Eligible Rollover Distributions
OMB No. 1545-0074

Department of the Treasury

Internal Revenue Service
Give Form W-4R to the payer of your retirement payments. 2024
1a First name and middle initial Last name 1b Social security number

Address

City or town, state, and ZIP code

Your withholding rate is determined by the type of payment you will receive.
• For nonperiodic payments, the default withholding rate is 10%. You can choose to have a different rate by entering a rate between
0% and 100% on line 2. Generally, you can’t choose less than 10% for payments to be delivered outside the United States and its
territories.
• For an eligible rollover distribution, the default withholding rate is 20%. You can choose a rate greater than 20% by entering the rate
on line 2. You may not choose a rate less than 20%.
See page 2 for more information.
2 Complete this line if you would like a rate of withholding that is different from the default withholding
rate. See the instructions on page 2 and the Marginal Rate Tables below for additional information.
Enter the rate as a whole number (no decimals) . . . . . . . . . . . . . . . . . . 2 %

Sign
Here
Your signature (This form is not valid unless you sign it.) Date

General Instructions intervals over a period of more than 1 year) from these plans
or arrangements. Instead, use Form W-4P, Withholding
Section references are to the Internal Revenue Code. Certificate for Periodic Pension or Annuity Payments. For
Future developments. For the latest information about any more information on withholding, see Pub. 505, Tax
future developments related to Form W-4R, such as Withholding and Estimated Tax.
legislation enacted after it was published, go to Caution: If you have too little tax withheld, you will generally
www.irs.gov/FormW4R. owe tax when you file your tax return and may owe a penalty
Purpose of form. Complete Form W-4R to have payers unless you make timely payments of estimated tax. If too
withhold the correct amount of federal income tax from your much tax is withheld, you will generally be due a refund
nonperiodic payment or eligible rollover distribution from an when you file your tax return. Your withholding choice (or an
employer retirement plan, annuity (including a commercial election not to have withholding on a nonperiodic payment)
annuity), or individual retirement arrangement (IRA). See will generally apply to any future payment from the same
page 2 for the rules and options that are available for each plan or IRA. Submit a new Form W-4R if you want to change
type of payment. Don’t use Form W-4R for periodic your election.
payments (payments made in installments at regular

2024 Marginal Rate Tables

You may use these tables to help you select the appropriate withholding rate for this payment or distribution. Add your income
from all sources and use the column that matches your filing status to find the corresponding rate of withholding. See page 2
for more information on how to use this table.
Single Married filing jointly
or or Head of household
Married filing separately Qualifying surviving spouse
Total income Tax rate for every Total income Tax rate for every Total income Tax rate for every
over— dollarhmore over— dollar more over— dollar more
$0 0% $0 0% $0 0%
14,600 10% 29,200 10% 21,900 10%
26,200 12% 52,400 12% 38,450 12%
61,750 22% 123,500 22% 85,000 22%
115,125 24% 230,250 24% 122,400 24%
206,550
t 32% 413,100 32% 213,850 32%
258,325 35% 516,650 35% 265,600 35%
623,950* 37% 760,400 37% 631,250 37%
* If married filing separately, use $380,200 instead for this 37% rate.
For Privacy Act and Paperwork Reduction Act Notice, see page 3. Cat. No. 75085T Form W-4R (2024)
Form W-4R (2024) Page 2

General Instructions (continued) Line 2

Nonperiodic payments—10% withholding. Your payer More withholding. If you want more than the default rate
must withhold at a default 10% rate from the taxable amount withheld from your payment, you may enter a higher rate on
of nonperiodic payments unless you enter a different rate on line 2.
line 2. Distributions from an IRA that are payable on demand Less withholding (nonperiodic payments only). If
are treated as nonperiodic payments. Note that the default permitted, you may enter a lower rate on line 2 (including
rate of withholding may not be appropriate for your tax “-0-”) if you want less than the 10% default rate withheld
situation. You may choose to have no federal income tax from your payment. If you have already paid, or plan to pay,
withheld by entering “-0-” on line 2. See the specific your tax on this payment through other withholding or
instructions below for more information. Generally, you are estimated tax payments, you may want to enter “-0-”.
not permitted to elect to have federal income tax withheld at
Suggestion for determining withholding. Consider using
a rate of less than 10% (including “-0-”) on any payments to
the Marginal Rate Tables on page 1 to help you select the
be delivered outside the United States and its territories.
appropriate withholding rate for this payment or distribution.
Note: If you don’t give Form W-4R to your payer, you The tables are most accurate if the appropriate amount of
don’t provide an SSN, or the IRS notifies the payer that you tax on all other sources of income, deductions, and credits
gave an incorrect SSN, then the payer must withhold 10% of has been paid through other withholding or estimated tax
the payment for federal income tax and can’t honor requests payments. If the appropriate amount of tax on those sources
to have a lower (or no) amount withheld. Generally, for of income has not been paid through other withholding or
payments that began before 2024, your current withholding estimated tax payments, you can pay that tax through
election (or your default rate) remains in effect unless you withholding on this payment by entering a rate that is greater
submit a Form W-4R. than the rate in the Marginal Rate Tables.
Eligible rollover distributions—20% withholding. The marginal tax rate is the rate of tax on each additional
Distributions you receive from qualified retirement plans (for dollar of income you receive above a particular amount of
example, 401(k) plans and section 457(b) plans maintained income. You can use the table for your filing status as a
by a governmental employer) or tax-sheltered annuities that guide to find a rate of withholding for amounts above the
are eligible to be rolled over to an IRA or qualified plan are total income level in the table.
subject to a 20% default rate of withholding on the taxable
To determine the appropriate rate of withholding from the
amount of the distribution. You can’t choose withholding at a
table, do the following. Step 1: Find the rate that
rate of less than 20% (including “-0-”). Note that the default
corresponds with your total income not including the
rate of withholding may be too low for your tax situation. You
payment. Step 2: Add your total income and the taxable
may choose to enter a rate higher than 20% on line 2. Don’t
amount of the payment and find the corresponding rate.
give Form W-4R to your payer unless you want more than
20% withheld. If these two rates are the same, enter that rate on line 2.
(See Example 1 below.)
Note that the following payments are not eligible rollover
distributions for purposes of these withholding rules: If the two rates differ, multiply (a) the amount in the lower
rate bracket by the rate for that bracket, and (b) the amount
• Qualifying “hardship” distributions;
in the higher rate bracket by the rate for that bracket. Add
• Distributions required by federal law, such as required these two numbers; this is the expected tax for this
minimum distributions; payment. To get the rate to have withheld, divide this
• Generally, distributions from a pension-linked emergency amount by the taxable amount of the payment. Round up to
savings account; the next whole number and enter that rate on line 2. (See
Example 2 below.)
• Eligible distributions to a domestic abuse victim;
If you prefer a simpler approach (but one that may lead to
• Qualified disaster recovery distributions;
overwithholding), find the rate that corresponds to your total
• Qualified birth or adoption distributions; and income including the payment and enter that rate on line 2.
• Emergency personal expense distributions. Examples. Assume the following facts for Examples 1 and 2.
See Pub. 505 for details. See also Nonperiodic payments— Your filing status is single. You expect the taxable amount of
10% withholding above. your payment to be $20,000. Appropriate amounts have
been withheld for all other sources of income and any
Payments to nonresident aliens and foreign estates. Do deductions or credits.
not use Form W-4R. See Pub. 515, Withholding of Tax on
Nonresident Aliens and Foreign Entities, and Pub. 519, U.S. Example 1. You expect your total income to be $62,000
Tax Guide for Aliens, for more information. without the payment. Step 1: Because your total income
without the payment, $62,000, is greater than $61,750 but
Tax relief for victims of terrorist attacks. If your disability less than $115,125, the corresponding rate is 22%. Step 2:
payments for injuries incurred as a direct result of a terrorist Because your total income with the payment, $82,000, is
attack are not taxable, enter “-0-” on line 2. See Pub. 3920, greater than $61,750 but less than $115,125, the
Tax Relief for Victims of Terrorist Attacks, for more details. corresponding rate is 22%. Because these two rates are the
same, enter “22” on line 2.
Specific Instructions
Example 2. You expect your total income to be $43,700
Line 1b without the payment. Step 1: Because your total income
For an estate, enter the estate’s employer identification without the payment, $43,700, is greater than $26,200 but
number (EIN) in the area reserved for “Social security less than $61,750, the corresponding rate is 12%. Step 2:
number.” Because your total income with the payment, $63,700, is
Form W-4R (2024) Page 3

greater than $61,750 but less than $115,125, the Failure to provide a properly completed form will result in
corresponding rate is 22%. The two rates differ. $18,050 of your payment(s) being subject to the default rate; providing
the $20,000 payment is in the lower bracket ($61,750 less fraudulent information may subject you to penalties.
your total income of $43,700 without the payment), and Routine uses of this information include giving it to the
$1,950 is in the higher bracket ($20,000 less the $18,050 that Department of Justice for civil and criminal litigation, and to
is in the lower bracket). Multiply $18,050 by 12% to get cities, states, the District of Columbia, and U.S.
$2,166. Multiply $1,950 by 22% to get $429. The sum of commonwealths and territories for use in administering their
these two amounts is $2,595. This is the estimated tax on tax laws. We may also disclose this information to other
your payment. This amount corresponds to 13% of the countries under a tax treaty, to federal and state agencies to
$20,000 payment ($2,595 divided by $20,000). Enter “13” on enforce federal nontax criminal laws, or to federal law
line 2. enforcement and intelligence agencies to combat terrorism.
You are not required to provide the information requested
Privacy Act and Paperwork Reduction Act Notice. We ask
on a form that is subject to the Paperwork Reduction Act
for the information on this form to carry out the Internal
unless the form displays a valid OMB control number. Books
Revenue laws of the United States. You are required to
or records relating to a form or its instructions must be
provide this information only if you want to (a) request
retained as long as their contents may become material in
additional federal income tax withholding from your
the administration of any Internal Revenue law. Generally,
nonperiodic payment(s) or eligible rollover distribution(s); (b)
tax returns and return information are confidential, as
choose not to have federal income tax withheld from your
required by section 6103.
nonperiodic payment(s), when permitted; or (c) change a
previous Form W-4R (or a previous Form W-4P that you The average time and expenses required to complete and
completed with respect to your nonperiodic payments or file this form will vary depending on individual
eligible rollover distributions). To do any of the circumstances. For estimated averages, see the instructions
aforementioned, you are required by sections 3405(e) and for your income tax return.
6109 and their regulations to provide the information If you have suggestions for making this form simpler, we
requested on this form. Failure to provide this information would be happy to hear from you. See the instructions for
may result in inaccurate withholding on your payment(s). your income tax return.
 SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS

Important information about your Qualified Retirement Plan Distribution

YOUR ROLLOVER OPTIONS

You are receiving this notice because all or a portion of a payment you are receiving from the Plan is eligible to be rolled over
to an IRA or an employer plan. This notice is intended to help you decide whether to do such a rollover.

This notice describes the rollover rules that apply to payments from the Plan that are not from a designated Roth account (a type
of account in some employer plans that is subject to special tax rules) – Section A, and to payments from the Plan that are from
a designated Roth account – Section B. If you receive a payment from both accounts, the Plan administrator or the payor will
tell you the amount that is being paid from each account.

Rules that apply to most payments from a plan are described in the “General Information About Rollovers” paragraph under
Sections A and B. Special rules that only apply in certain circumstances are described in the “Special Rules and Options”
paragraph under Sections A and B.

As a participant in your employer’s qualified retirement plan you may receive your vested account balance only if you incur a
triggering event. You must refer to your Summary Plan Description or Plan document to identify the specific triggering events
which apply under your Plan. This Notice may provide information on distribution options not allowed under your Plan.

A. FOR PAYMENTS NOT FROM A DESIGNATED ROTH ACCOUNT

GENERAL INFORMATION ABOUT ROLLOVERS

How can a rollover affect my taxes?

You will be taxed on a payment from the Plan if you do not roll it over. If you are under age 59½ and do not do a rollover, you
will also have to pay a 10% additional income tax on early distributions (generally, distributions made before age 59½), unless
an exception applies. However, if you do a rollover, you will not have to pay tax until you receive payments later and the 10%
additional income tax will not apply if those payments are made after you are age 59½ (or if an exception to the 10% additional
income tax applies).

What types of retirement accounts and plans may accept my rollover?

You may roll over the payment to either an IRA (an individual retirement account or individual retirement annuity) or an employer
plan (a tax-qualified plan, section 403(b) plan, or governmental section 457(b) plan) that will accept the rollover. The rules of the
IRA or employer plan that holds the rollover will determine your investment options, fees, and rights to payment from the IRA or
employer plan (for example, IRAs are not subject to spousal consent rules, and IRAs may not provide loans). Further, the amount
rolled over will become subject to the tax rules that apply to the IRA or employer plan.

How do I do a rollover?

There are two ways to do a rollover. You can do either a direct rollover or a 60- day rollover.

If you do a direct rollover, the Plan will make the payment directly to your IRA or an employer plan. You should contact the IRA
sponsor or the administrator of the employer plan for information on how to do a direct rollover.

If you do not do a direct rollover, you may still do a rollover by making a deposit into an IRA or eligible employer plan that will
accept it. Generally, you will have 60 days after you receive the payment to make the deposit. If you do not do a direct rollover,
the Plan is required to withhold 20% of the payment for federal income taxes (up to the amount of cash and property received
other than employer stock). This means that, in order to roll over the entire payment in a 60-day rollover, you must use other

402(f) Notice 1.1 September 2023

funds to make up for the 20% withheld. If you do not roll over the entire amount of the payment, the portion not rolled over will
be taxed and will be subject to the 10% additional income tax on early distributions if you are under age 59½ (unless an exception
applies).

How much may I roll over?

If you wish to do a rollover, you may roll over all or part of the amount eligible for rollover. Any payment from the Plan is eligible
for rollover, except:

• Certain payments spread over a period of at least 10 years or over your life or life expectancy (or the joint lives or joint life
expectancies of you and your beneficiary);
• Required minimum distributions after age 70½ (if you were born before July 1, 1949), after age 72 (if you were born after June
30, 1949, and before January 1, 1951), after age 73 (if you were born after December 31, 1950), or after death;
• Hardship distributions;
• Payments of employee stock ownership plan (ESOP) dividends;
• Corrective distributions of contributions that exceed tax law limitations;
• Loans treated as deemed distributions (for example, loans in default due to missed payments before your employment ends);
• Cost of life insurance paid by the Plan;
• Payments of certain automatic enrollment contributions that you request to withdraw within 90 days of your first contribution;
• Amounts treated as distributed because of a prohibited allocation of S corporation stock under an ESOP (also, there generally
will be adverse tax consequences if you roll over a distribution of S corporation stock to an IRA); and
•Distributions of certain premiums for health and accident insurance.

The Plan administrator or the payor can tell you what portion of a payment is eligible for rollover.

If I don’t do a rollover, will I have to pay the 10% additional income tax on early distributions?

If you are under age 59½, you will have to pay the 10% additional income tax on early distributions for any payment from the
Plan (including amounts withheld for income tax) that you do not roll over, unless one of the exceptions listed below applies.
This tax applies to the part of the distribution that you must include in income and is in addition to the regular income tax on the
payment not rolled over.

The 10% additional income tax does not apply to the following payments from the
Plan:

• Payments made after you separate from service if you will be at least age
55 in the year of the separation;
• Payments that start after you separate from service if paid at least annually in equal or close to equal amounts over your life
or life expectancy (or the joint lives or joint life expectancies of you and your beneficiary);
• Payments made due to disability;
• Payments made while you are terminally ill;
• Payments after your death;
• Payments of ESOP dividends;
• Corrective distributions of contributions that exceed tax law limitations;
• Cost of life insurance paid by the Plan;
• Payments made directly to the government to satisfy a federal tax levy;
• Payments made under a qualified domestic relations order (QDRO);
• Payments of up to $5,000 made to you from a defined contribution plan if the payment is a qualified birth or adoption distribution;
• Payments up to the amount of your deductible medical expenses (without regard to whether you itemize deductions for the
taxable year);
• Certain payments made while you are on active duty if you were a member of a reserve component called to duty after

402(f) Notice 1.1 September 2023

 September 11, 2001 for more than 179 days;
• Payments of certain automatic enrollment contributions that you request to withdraw within 90 days of your first contribution;
• Payments of up to $22,000 made in connection with federally-declared disasters; and
• Phased retirement payments made to federal employees.

If I do a rollover to an IRA, will the 10% additional income tax apply to early distributions from the IRA?

If you receive a payment from an IRA when you are under age 59½, you will have to pay the 10% additional income tax on early
distributions on the part of the distribution that you must include in income, unless an exception applies. In general, the
exceptions to the 10% additional income tax for early distributions from an IRA are the same as the exceptions listed above for
early distributions from a plan. However, there are a few differences for payments from an IRA, including:

• The exception for payments made after you separate from service if you will be at least age 55 in the year of the separation (or
age 50 or following 25 years of service for qualified public safety employees and employees providing firefighting services) do
not apply;
• The exception for qualified domestic relations orders (QDROs) does not apply (although a special rule applies under which, as
part of a divorce or separation agreement, a tax-free transfer may be made directly to an IRA of a spouse or former spouse); and
• The exception for payments made at least annually in equal or close to equal amounts over a specified period applies without
regard to whether you have had a separation from service.

Additional exceptions apply for payments from an IRA, including:

• Payments for qualified higher education expenses;

• Payments up to $10,000 used in a qualified first-time home purchase;
• Payments for health insurance premiums after you have received unemployment compensation for 12 consecutive weeks (or
would have been eligible to receive unemployment compensation but for self- employed status); and
• Payments of net income attributable to an excess IRA contribution made in a calendar year where such amounts are distributed
by tax return deadline for the year (including extensions) and no deduction is allowed for the excess contribution.

Will I owe State income taxes?

This notice does not address any State or local income tax rules (including withholding rules).

SPECIAL RULES AND OPTIONS

If your payment includes after-tax contributions

After-tax contributions included in a payment are not taxed. If you receive a partial payment of your total benefit, an allocable
portion of your after-tax contributions is included in the payment, so you cannot take a payment of only after-tax contributions.
However, if you have pre-1987 after-tax contributions maintained in a separate account, a special rule may apply to determine
whether the after-tax contributions are included in the payment. In addition, special rules apply when you do a rollover, as
described below.

You may roll over to an IRA a payment that includes after-tax contributions through either a direct rollover or a 60-day rollover.
You must keep track of the aggregate amount of the after-tax contributions in all of your IRAs (in order to determine your taxable
income for later payments from the IRAs). If you do a direct rollover of only a portion of the amount paid from the Plan and at
the same time the rest is paid to you, the portion rolled over consists first of the amount that would be taxable if not rolled over.
For example, assume you are receiving a distribution of $12,000, of which $2,000 is after-tax contributions. In this case, if you
directly roll over $10,000 to an IRA that is not a Roth IRA, no amount is taxable because the $2,000 amount not rolled over is
treated as being after-tax contributions. If you do a direct rollover of the entire amount paid from the Plan to two or more
destinations at the same time, you can choose which destination receives the after-tax contributions.

402(f) Notice 1.1 September 2023

Similarly, if you do a 60-day rollover to an IRA of only a portion of a payment made to you, the portion rolled over consists first
of the amount that would be taxable if not rolled over. For example, assume you are receiving a distribution of $12,000, of which
$2,000 is after-tax contributions, and no part of the distribution is directly rolled over. In this case, if you roll over $10,000 to an
IRA that is not a Roth IRA in a 60-day rollover, no amount is taxable because the $2,000 amount not rolled over is treated as
being after-tax contributions.

You may roll over to an employer plan all of a payment that includes after-tax contributions, but only through a direct rollover
(and only if the receiving plan separately accounts for after-tax contributions and is not a governmental section 457(b) plan).
You can do a 60-day rollover to an employer plan of part of a payment that includes after-tax contributions, but only up to the
amount of the payment that would be taxable if not rolled over.

If you miss the 60-day rollover deadline

Generally, the 60-day rollover deadline cannot be extended. However, the IRS has the limited authority to waive the deadline
under certain extraordinary circumstances, such as when external events prevented you from completing the rollover by the 60-
day rollover deadline. Under certain circumstances, you may claim eligibility for a waiver of the 60-day rollover deadline by
making a written self-certification. Otherwise, to apply for a waiver from the IRS, you must file a private letter ruling request with
the IRS. Private letter ruling requests require the payment of a nonrefundable user fee. For more information, see IRS
Publication 590-A, Contributions to Individual Retirement Arrangements (IRAs).

If your payment includes employer stock that you do not roll over

If you do not do a rollover, you can apply a special rule to payments of employer stock (or other employer securities) that are
either attributable to after-tax contributions or paid in a lump sum after separation from service (or after age 59½, disability, or
the participant’s death). Under the special rule, the net unrealized appreciation on the stock will not be taxed when distributed
from the Plan and will be taxed at capital gain rates when you sell the stock. Net unrealized appreciation is generally the increase
in the value of employer stock after it was acquired by the Plan. If you do a rollover for a payment that includes employer stock
(for example, by selling the stock and rolling over the proceeds within 60 days of the payment), the special rule relating to the
distributed employer stock will not apply to any subsequent payments from the IRA or, generally, the Plan. The Plan administrator
can tell you the amount of any net unrealized appreciation.

If you have an outstanding loan that is being offset

If you have an outstanding loan from the Plan, your Plan benefit may be offset by the outstanding amount of the loan, typically
when your employment ends. The offset amount is treated as a distribution to you at the time of the offset. Generally, you may
roll over all or any portion of the offset amount. Any offset amount that is not rolled over will be taxed (including the 10% additional
income tax on early distributions, unless an exception applies). You may roll over offset amounts to an IRA or an employer plan
(if the terms of the employer plan permit the plan to receive plan loan offset rollovers).

How long you have to complete the rollover depends on what kind of plan loan offset you have. If you have a qualified plan loan
offset, you will have until your tax return due date (including extensions) for the tax year during which the offset occurs to complete
your rollover. A qualified plan loan offset occurs when a plan loan in good standing is offset because your employer plan
terminates, or because you sever from employment. If your plan loan offset occurs for any other reason (such as a failure to
make level loan repayments that results in a deemed distribution), then you have 60 days from the date the offset occurs to
complete your rollover.

If you were born on or before January 1, 1936

If you were born on or before January 1, 1936 and receive a lump sum distribution that you do not roll over, special rules for
calculating the amount of the tax on the payment might apply to you. For more information, see IRS Publication 575, Pension
and Annuity Income.

If you roll over your payment to a Roth IRA

If you roll over a payment from the Plan to a Roth IRA, a special rule applies under which the amount of the payment rolled over

402(f) Notice 1.1 September 2023

(reduced by any after-tax amounts) will be taxed. In general, the 10% additional income tax on early distributions will not apply.
However, if you take the amount rolled over out of the Roth IRA within the 5-year period that begins on January 1 of the year of
the rollover, the 10% additional income tax will apply (unless an exception applies).

If you roll over the payment to a Roth IRA, later payments from the Roth IRA that are qualified distributions will not be taxed
(including earnings after the rollover). A qualified distribution from a Roth IRA is a payment made after you are age 59½ (or after
your death or disability, or as a qualified first-time homebuyer distribution of up to $10,000) and after you have had a Roth IRA
for at least 5 years. In applying this 5-year rule, you count from January 1 of the year for which your first contribution was made
to a Roth IRA. Payments from the Roth IRA that are not qualified distributions will be taxed to the extent of earnings after the
rollover, including the 10% additional income tax on early distributions (unless an exception applies). You do not have to take
required minimum distributions from a Roth IRA during your lifetime. For more information, see IRS Publication 590-A,
Contributions to Individual Retirement Arrangements (IRAs), and IRS Publication 590-B, Distributions from Individual Retirement
Arrangements (IRAs).

If you do a rollover to a designated Roth account in the Plan

You cannot roll over a distribution to a designated Roth account in another employer’s plan. However, you can roll the distribution
over into a designated Roth account in the distributing Plan. If you roll over a payment from the Plan to a designated Roth
account in the Plan, the amount of the payment rolled over (reduced by any after-tax amounts directly rolled over) will be taxed.
In general, the 10% additional income tax on early distributions will not apply. However, if you take the amount rolled over out
of the Roth IRA within the 5-year period that begins on January 1 of the year of the rollover, the 10% additional income tax will
apply (unless an exception applies).

If you roll over the payment to a designated Roth account in the Plan, later payments from the designated Roth account that are
qualified distributions will not be taxed (including earnings after the rollover). A qualified distribution from a designated Roth
account is a payment made both after you are age 59½ (or after your death or disability) and after you have had a designated
Roth account in the Plan for at least 5 years. In applying this 5-year rule, you count from January 1 of the year your first
contribution was made to the designated Roth account. However, if you made a direct rollover to a designated Roth account in
the Plan from a designated Roth account in a plan of another employer, the 5-year period begins on January 1 of the year you
made the first contribution to the designated Roth account in the Plan or, if earlier, to the designated Roth account in the plan of
the other employer. Payments from the designated Roth account that are not qualified distributions will be taxed to the extent
of earnings after the rollover, including the 10% additional income tax on early distributions (unless an exception applies). With
respect to taxable years beginning after 2023, you are not required to take required minimum distributions from a designated
Roth account during your lifetime.

If you are not a Plan participant

Payments after death of the participant. If you receive a distribution after the participant’s death that you do not roll over, the
distribution generally will be
taxed in the same manner described elsewhere in this notice. However, the 10% additional income tax on early distributions
and the special rules for public safety officers do not apply, and the special rule described under the section “If you
were born on or before January 1, 1936” applies only if the deceased participant was born on or before January 1, 1936.

If you are a surviving spouse. If you receive a payment from the Plan as the surviving spouse of a deceased participant, you
have the same rollover options that the participant would have had, as described elsewhere in this notice. In addition, if you
choose to do a rollover to an IRA, you may treat the IRA as your own or as an inherited IRA.

An IRA you treat as your own is treated like any other IRA of yours, so that payments made to you before you are age 59½ will
be subject to the 10% additional income tax on early distributions (unless an exception applies) and required minimum
distributions from your IRA do not have to start until after you are age 70½ (if you were born before July 1, 1949), age 72 (if you
were born after June 30, 1949, and before January 1, 1951), or after age 73 (if you were born after December 31, 1950).

If you treat the IRA as an inherited IRA, payments from the IRA will not be subject to the 10% additional income tax on early
distributions. However, if the participant had started taking required minimum distributions, you will have to receive required
minimum distributions from the inherited IRA. If the participant had not started taking required minimum distributions from the

402(f) Notice 1.1 September 2023

Plan, you will not have to start receiving required minimum distributions from the inherited IRA until the year the participant would
have been age 70½ (if the participant was born before July 1, 1949), age 72 (if the participant was born after June 30, 1949 and
before January 1, 1951), or age 73 (if the participant was born after December 31, 1950).

If you are a surviving beneficiary other than a spouse. If you receive a payment from the Plan because of the participant’s
death and you are a designated beneficiary other than a surviving spouse, the only rollover option you have is to do a direct
rollover to an inherited IRA. Payments from the inherited IRA will not be subject to the 10% additional income tax on early
distributions. You will have to receive required minimum distributions from the inherited IRA.

Payments under a QDRO. If you are the spouse or former spouse of the participant who receives a payment from the Plan under
a QDRO, you generally have the same options and the same tax treatment that the participant would have (for example, you
may roll over the payment to your own IRA or an eligible employer plan that will accept it). However, payments under the QDRO
will not be subject to the 10% additional income tax on early distributions.

If you are a nonresident alien

If you are a nonresident alien and you do not do a direct rollover to a U.S. IRA or U.S. employer plan, instead of withholding
20%, the Plan is generally required to withhold 30% of the payment for federal income taxes. If the amount withheld exceeds
the amount of tax you owe (as may happen if you do a 60-day rollover), you may request an income tax refund by filing Form
1040NR and attaching your Form 1042-S. See Form W-8BEN for claiming that you are entitled to a reduced rate of withholding
under an income tax treaty. For more information, see also IRS Publication 519, U.S. Tax Guide for Aliens, and IRS Publication
515, Withholding of Tax on Nonresident Aliens and Foreign Entities.

Other special rules

If a payment is one in a series of payments for less than 10 years, your choice whether to do a direct rollover will apply to all later
payments in the series (unless you make a different choice for later payments).

If your payments for the year are less than $200 (not including payments from a designated Roth account in the Plan), the Plan
is not required to allow you to do a direct rollover and is not required to withhold federal income taxes. However, you may do a
60-day rollover.

Unless you elect otherwise, a mandatory cashout of more than $1,000 (not including payments from a designated Roth account
in the Plan) will be directly rolled over to an IRA chosen by the Plan administrator or the payor. A mandatory cashout is a
payment from a plan to a participant made before age 62 (or normal retirement age, if later) and without consent, where the
participant’s benefit does not exceed $5,000 (not including any amounts held under the plan as a result of a prior rollover made
to the plan).

You may have special rollover rights if you recently served in the U.S. Armed Forces. For more information on special rollover
rights related to the U.S. Armed Forces, see IRS Publication 3, Armed Forces’ Tax Guide. You also may have special rollover
rights if you were affected by a federally declared disaster (or similar event), or if you received a distribution on account of a
disaster. For more information on special rollover rights related to disaster relief, see the IRS website at www.irs.gov.

FOR MORE INFORMATION

You may wish to consult with the Plan administrator or payor, or a professional tax advisor, before taking a payment from the
Plan. Also, you can find more detailed information on the federal tax treatment of payments from employer plans in: IRS
Publication 575, Pension and Annuity Income; IRS Publication
590-A, Contributions to Individual Retirement Arrangements (IRAs); IRS Publication 590-B, Distributions from Individual
Retirement Arrangements (IRAs); and IRS Publication 571, Tax-Sheltered Annuity Plans (403(b) Plans). These publications are
available from a local IRS office, on the web at www.irs.gov, or by calling 1-800-TAX-FORM.

B. FOR PAYMENTS FROM A DESIGNATED ROTH ACCOUNT

402(f) Notice 1.1 September 2023

 GENERAL INFORMATION ABOUT ROLLOVERS

How can a rollover affect my taxes?

After-tax contributions included in a payment from a designated Roth account are not taxed, but earnings might be taxed. The
tax treatment of earnings included in the payment depends on whether the payment is a qualified distribution. If a payment is
only part of your designated Roth account, the payment will include an allocable portion of the earnings in your designated Roth
account.

If the payment from the Plan is not a qualified distribution and you do not do a rollover to a Roth IRA or a designated Roth account
in an employer plan, you will be taxed on the portion of the payment that is earnings. If you are under age 59½, a 10% additional
income tax on early distributions (generally, distributions made before age 59½) will also apply to the earnings (unless an
exception applies). However, if you do a rollover, you will not have to pay taxes currently on the earnings and you will not have
to pay taxes later on payments that are qualified distributions.

If the payment from the Plan is a qualified distribution, you will not be taxed on any part of the payment even if you do not do a
rollover. If you do a rollover, you will not be taxed on the amount you roll over and any earnings on the amount you roll over will
not be taxed if paid later in a qualified distribution.
A qualified distribution from a designated Roth account in the Plan is a payment made after you are age 59½ (or after your death
or disability) and after you have had a designated Roth account in the Plan for at least 5 years. In applying the 5- year rule, you
count from January 1 of the year your first contribution was made to the designated Roth account. However, if you did a direct
rollover to a designated Roth account in the Plan from a designated Roth account in another employer plan, your participation
will count from January 1 of the year your first contribution was made to the designated Roth account in the Plan or, if earlier, to
the designated Roth account in the other employer plan.

What types of retirement accounts and plans may accept my rollover?

You may roll over the payment to either a Roth IRA (a Roth individual retirement account or Roth individual retirement annuity)
or a designated Roth account in an employer plan (a tax-qualified plan, section 403(b) plan, or governmental section
457 plan) that will accept the rollover. The rules of the Roth IRA or employer plan that holds the rollover will determine your
investment options, fees, and rights to payment from the Roth IRA or employer plan (for example, Roth IRAs are not subject to
spousal consent rules, and Roth IRAs may not provide loans). Further, the amount rolled over will become subject to the tax
rules that apply to the Roth IRA or the designated Roth account in the employer plan. In general, these tax rules are similar to
those described elsewhere in this notice, but differences include:

• If you do a rollover to a Roth IRA, all of your Roth IRAs will be considered for purposes of determining whether you have satisfied
the 5-year rule (counting from January 1 of the year for which your first contribution was made to any of your Roth IRAs).
• If you do a rollover to a Roth IRA, you will not be required to take a distribution from the Roth IRA during your lifetime and you
must keep track of the aggregate amount of the after-tax contributions in all of your Roth IRAs (in order to determine your taxable
income for later Roth IRA payments that are not qualified distributions).
• Eligible rollover distributions from a Roth IRA can only be rolled over to another Roth IRA.

How do I do a rollover?

There are two ways to do a rollover. You can either do a direct rollover or a 60- day rollover.

If you do a direct rollover, the Plan will make the payment directly to your Roth IRA or designated Roth account in an employer
plan. You should contact the Roth IRA sponsor or the administrator of the employer plan for information on how to do a direct
rollover.
If you do not do a direct rollover, you may still do a rollover by making a deposit (generally within 60 days) into a Roth IRA,
whether the payment is a qualified or nonqualified distribution. In addition, you can do a rollover by making a deposit within 60
days into a designated Roth account in an employer plan if the payment is a nonqualified distribution and the rollover does not
exceed the amount of the earnings in the payment. You cannot do a 60-day rollover to an employer plan of any part of a qualified
distribution. If you receive a distribution that is a nonqualified distribution and you do not roll over an amount at least equal to

402(f) Notice 1.1 September 2023

the earnings allocable to the distribution, you will be taxed on the amount of those earnings not rolled over, including the 10%
additional income tax on early distributions if you are under age 59½ (unless an exception applies).

If you do a direct rollover of only a portion of the amount paid from the Plan and a portion is paid to you at the same time, the
portion directly rolled over consists
first of earnings.

If you do not do a direct rollover and the payment is not a qualified distribution, the Plan is required to withhold 20% of the
earnings for federal income taxes (up to the amount of cash and property received other than employer stock). This means that,
in order to roll over the entire payment in a 60-day rollover to a Roth IRA, you must use other funds to make up for the 20%
withheld.

How much may I roll over?

If you wish to do a rollover, you may roll over all or part of the amount eligible for rollover. Any payment from the Plan is eligible
for rollover, except:

• Certain payments spread over a period of at least 10 years or over your

life or life expectancy (or the joint lives or joint life expectancies of you and your beneficiary);
• For taxable years beginning on or before December 31, 2023, required minimum distributions after age 70½ (if you were born
before July 1, 1949), after age 72 (if you were born after June 30, 1949, and before January 1, 1951), after age 73 (if you were
born after December 31, 1950), or after death;
• Hardship distributions;
• Payments of employee stock ownership plan (ESOP) dividends;
• Corrective distributions of contributions that exceed tax law limitations;
• Loans treated as deemed distributions (for example, loans in default due to missed payments before your employment ends);
• Cost of life insurance paid by the Plan;
• Payments of certain automatic enrollment contributions that you request to withdraw within 90 days of your first contribution;
and
• Amounts treated as distributed because of a prohibited allocation of
S corporation stock under an ESOP (also, there generally will be adverse tax consequences if S corporation stock is held by an
IRA); and
• Distributions of certain premiums for health and accident insurance.
The Plan administrator or the payor can tell you what portion of a payment is eligible for rollover.

If I don’t do a rollover, will I have to pay the 10% additional income tax on early distributions?

If a payment is not a qualified distribution and you are under age 59½, you will have to pay the 10% additional income tax on
early distributions with respect to the earnings allocated to the payment that you do not roll over (including amounts withheld for
income tax), unless one of the exceptions listed below applies. This tax is in addition to the regular income tax on the earnings
not rolled over.

The 10% additional income tax does not apply to the following payments from the
Plan:
• Payments made after you separate from service if you will be at least age
55 in the year of the separation;
• Payments that start after you separate from service if paid at least annually in equal or close to equal amounts over your life
or life expectancy (or the joint lives or joint life expectancies of you and your beneficiary);
• Payments made due to disability;
• Payments made while you are terminally ill;
• Payments after your death;
• Payments of ESOP dividends;

402(f) Notice 1.1 September 2023

 • Corrective distributions of contributions that exceed tax law limitations;
• Cost of life insurance paid by the Plan;
• Payments made directly to the government to satisfy a federal tax levy;
• Payments made under a qualified domestic relations order (QDRO);
• Payments of up to $5,000 made to you from a defined contribution plan if the payment is a qualified birth or adoption distribution;
• Payments up to the amount of your deductible medical expenses (without regard to whether you itemize deductions for the
taxable year);
• Certain payments made while you are on active duty if you were a member of a reserve component called to duty after
September 11, 2001 for more than 179 days;
• Payments of certain automatic enrollment contributions that you request to withdraw within 90 days of your first contribution;
and
• Payments of up to $22,000 made in connection with federally declared disasters.

If I do a rollover to a Roth IRA, will the 10% additional income tax apply to early distributions from the IRA?

If you receive a payment from a Roth IRA when you are under age 59½, you will have to pay the 10% additional income tax on
early distributions on the earnings paid from the Roth IRA, unless an exception applies or the payment is a qualified distribution.
In general, the exceptions to the 10% additional income tax for early distributions from a Roth IRA listed above are the same as
the exceptions for early distributions from a plan. However, there are a few differences for payments from a Roth IRA, including:

• The exception for payment made after you separate from service if you will be at least age 55 in the year of the separation (or
age 50 or following 25 years of service for qualified public safety employees and employees providing firefighting services) do
not apply;
• The exception for qualified domestic relations orders (QDROs) does not apply (although a special rule applies under which, as
part of a divorce or separation agreement, a tax-free transfer may be made directly to a Roth IRA of a spouse or former spouse);
and
• The exception for payments made at least annually in equal or close to equal amounts over a specified period applies without
regard to whether you have had a separation from service.

Additional exceptions apply for payments from an IRA, including:

• Payments for qualified higher education expenses;

• Payments up to $10,000 used in a qualified first-time home purchase;
• Payments for health insurance premiums after you have received unemployment compensation for 12 consecutive weeks (or
would have been eligible to receive unemployment compensation but for self-employed status).
• Payments of net income attributable to an excess IRA contribution made in a calendar year where such amounts are distributed
by tax return deadline for the year (including extensions) and no deduction is allowed for the excess contribution.

Will I owe State income taxes?

This notice does not address any State or local income tax rules (including withholding rules).

SPECIAL RULES AND OPTIONS

If you miss the 60-day rollover deadline

Generally, the 60-day rollover deadline cannot be extended. However, the IRS has the limited authority to waive the deadline
under certain extraordinary circumstances, such as when external events prevented you from completing the rollover by the 60-
day rollover deadline. Under certain circumstances, you may claim eligibility for a waiver of the 60-day rollover deadline by
making a written self-certification. Otherwise, to apply for a waiver from the IRS, you must file a private letter ruling request with

402(f) Notice 1.1 September 2023

the IRS. Private letter ruling requests require the payment of a nonrefundable user fee. For more information, see IRS
Publication
590-A, Contributions to Individual Retirement Arrangements (IRAs).

If your payment includes employer stock that you do not roll over

If you receive a payment that is not a qualified distribution and you do not roll it over, you can apply a special rule to payments
of employer stock (or other employer securities) that are paid in a lump sum after separation from service (or after age 59½,
disability, or the participant’s death). Under the special rule, the net unrealized appreciation on the stock included in the earnings
in the payment will not be taxed when distributed to you from the Plan and will be taxed at capital gain rates when you sell the
stock. If you do a rollover to a Roth IRA for a nonqualified distribution that includes employer stock (for example, by selling the
stock and rolling over the proceeds within 60 days of the distribution), you will not have any taxable income and the special rule
relating to the distributed employer stock will not apply to any subsequent payments from the Roth IRA or, generally, the Plan.
Net unrealized appreciation is generally the increase in the value of the employer stock after it was acquired by the Plan. The
Plan administrator can tell you the amount of any net unrealized appreciation.

If you receive a payment that is a qualified distribution that includes employer stock and you do not roll it over, your basis in the
stock (used to determine gain or loss when you later sell the stock) will equal the fair market value of the stock at the time of the
payment from the Plan.

If you have an outstanding loan that is being offset

If you have an outstanding loan from the Plan, your Plan benefit may be offset by the outstanding amount of the loan, typically
when your employment ends. The offset amount is treated as a distribution to you at the time of the offset. Generally, you may
roll over all or any portion of the offset amount. If the distribution attributable to the offset is not a qualified distribution and you
do not roll over the offset amount, you will be taxed on any earnings included in the distribution (including the 10% additional
income tax on early distributions, unless an exception applies). You may roll over the earnings included in the loan offset to a
Roth IRA or designated Roth account in an employer plan (if the terms of the employer plan permit the plan to receive plan loan
offset rollovers). You may also roll over the full amount of the offset to a Roth IRA.

How long you have to complete the rollover depends on what kind of plan loan offset you have. If you have a qualified plan loan
offset, you will have until your tax return due date (including extensions) for the tax year during which the offset occurs to complete
your rollover. A qualified plan loan offset occurs when a plan loan in good standing is offset because your employer plan
terminates, or becauseu you sever from employment. If your plan loan offset occurs for any other reason (such as a failure to
make level repayments that results in a deemed distribution), then you have 60 days from the date the offset occurs to complete
your rollover.

If you receive a nonqualified distribution and you were born on or before

January 1, 1936

If you were born on or before January 1, 1936, and receive a lump sum distribution that is not a qualified distribution and that
you do not roll over, special rules for calculating the amount of the tax on the earnings in the payment might apply to you. For
more information, see IRS Publication 575, Pension and Annuity Income.

If you are not a Plan participant

Payments after death of the participant. If you receive a distribution after the participant’s death that you do not roll over, the
distribution generally will be taxed in the same manner described elsewhere in this notice. However, whether the payment is a
qualified distribution generally depends on when the participant first made a contribution to the designated Roth account in the
Plan. Also, the 10% additional income tax on early distributions and the special rules for public safety officers do not apply, and
the special rule described under the section “If you receive a nonqualified distribution and you were born on or before January
1, 1936” applies only if the deceased participant was born on or before January 1, 1936.

If you are a surviving spouse. If you receive a payment from the Plan as the surviving spouse of a deceased participant, you
have the same rollover options that the participant would have had, as described elsewhere in this notice. In addition, if you

402(f) Notice 1.1 September 2023

choose to do a rollover to a Roth IRA, you may treat the Roth IRA as your own or as an inherited Roth IRA.

A Roth IRA you treat as your own is treated like any other Roth IRA of yours, so that you will not have to receive any required
minimum distributions during your lifetime and earnings paid to you in a nonqualified distribution before you are age 59½ will be
subject to the 10% additional income tax on early distributions (unless an exception applies).

If you treat the Roth IRA as an inherited Roth IRA, payments from the Roth IRA will not be subject to the 10% additional income
tax on early distributions. An inherited Roth IRA is subject to required minimum distributions. If the participant had started taking
required minimum distributions from the Plan, you will have to receive required minimum distributions from the inherited Roth
IRA. If the participant had not started taking required minimum distributions, you will not have to start receiving required minimum
distributions from the inherited Roth IRA until the year the participant would have been age 70½ (if the participant was born
before July 1, 1949), age 72 (if the participant was born after June 30, 1949 and before January 1, 1951), or age 73 (if the
participant was born after December 31, 1950).

If you are a surviving beneficiary other than a spouse. If you receive a payment from the Plan because of the participant’s
death and you are a designated beneficiary other than a surviving spouse, the only rollover option you have is to do a direct
rollover to an inherited Roth IRA. Payments from the inherited Roth IRA, even if made in a nonqualified distribution, will not be
subject to the 10% additional income tax on early distributions. You will have to receive required minimum distributions from the
inherited Roth IRA.

Payments under a QDRO. If you are the spouse or a former spouse of the participant who receives a payment from the Plan
under a QDRO, you generally have the same options and the same tax treatment that the participant would have (for example,
you may roll over the payment to your own Roth IRA or to a designated Roth account in an eligible employer plan that will accept
it).

If you are a nonresident alien

If you are a nonresident alien, you do not do a direct rollover to a U.S. IRA or U.S. employer plan, and the payment is not a
qualified distribution, the Plan is generally required to withhold 30% (instead of withholding 20%) of the earnings for federal
income taxes. If the amount withheld exceeds the amount of tax you owe (as may happen if you do a 60-day rollover), you may
request an income tax refund by filing Form 1040NR and attaching your Form 1042-S. See Form W-8BEN for claiming that you
are entitled to a reduced rate of withholding under an income tax treaty. For more information, see also IRS Publication 519,
U.S. Tax Guide for Aliens, and IRS Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities.

Other special rules

If a payment is one in a series of payments for less than 10 years, your choice whether to do a direct rollover will apply to all later
payments in the series (unless you make a different choice for later payments).

If your payments for the year (only including payments from the designated Roth account in the Plan) are less than $200, the
Plan is not required to allow you to do a direct rollover and is not required to withhold federal income taxes. However, you can
do a 60-day rollover.

Unless you elect otherwise, a mandatory cashout from the designated Roth account in the Plan of more than $1,000 will be
directly rolled over to a Roth IRA chosen by the Plan administrator or the payor. A mandatory cashout is a payment from a plan
to a participant made before age 62 (or normal retirement age, if later) and without consent, where the participant’s benefit does
not exceed $5,000 (not including any amounts held under the plan as a result of a prior rollover made to the plan).

You may have special rollover rights if you recently served in the U.S. Armed Forces. For more information on special rollover
rights related to the U.S. Armed Forces, see IRS Publication 3, Armed Forces’ Tax Guide. You also may have special rollover
rights if you were affected by a federally declared disaster (or similar event), or if you received a distribution on account of a
disaster. For more information on special rollover rights related to disaster relief, see the IRS website at www.irs.gov.

FOR MORE INFORMATION

402(f) Notice 1.1 September 2023

You may wish to consult with the Plan administrator or payor, or a professional tax advisor, before taking a payment from the
Plan. Also, you can find more detailed information on the federal tax treatment of payments from employer plans in: IRS
Publication 575, Pension and Annuity Income; IRS Publication 590-A, Contributions to Individual Retirement Arrangements
(IRAs); IRS Publication 590-B, Distributions from Individual Retirement Arrangements (IRAs); and IRS Publication 571, Tax-
Sheltered Annuity Plans (403(b) Plans). These publications are available from a local IRS office, on the web at www.irs.gov, or
by calling 1-800-TAX-FORM.

402(f) Notice 1.1 September 2023