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Mister Car Wash 401k Retirement Plan
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Page 1: Mister Car Wash 401k Retirement Planbenefits.mistercarwash.com/wp-content/uploads/2017/03/Mister-Car... · 2 Access to KeyTalk and/or any website may be limited or unavailable during

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Mister Car Wash 401k Retirement Plan

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Read the informationprovided in this bookletregarding your investmentoptions to help you builda diversified portfolio.1

Once you've made yourinvestment selections,assign a percentage of yourcontribution amount to eachof your investment choicesby entering a percentagebetween 1% and 100% nextto your investment choice(s)on the form. Your choicesmust total 100%.

Are You Ready For A Bright Financial Future?Making the decision to enroll in your employer-sponsored retirement plan is a great start. Enrolling is the most important step

in your journey to retirement readiness. And this guide puts you on the right path quickly and easily.

Before you enroll, it’s a good idea to review all of the information in this guide in order to make decisions that meet your

individual needs:

• Plan Features and Highlights – Provides specific information about your plan’s features

• Forms – All of the paperwork you need to enroll successfully

• Fund Information – Includes fund objectives and risk levels

• Fund Performance and Fees – Shows asset class categories, fund returns over time, and any fund fees.

Once you have learned about your plan and are ready to enroll, follow these two

simple steps.

Step 1:Complete the Participant Enrollment Form

To access the Participant Enrollment Form, turn to the first page after the tab in this

booklet. You will need to provide the following information:

• Personal Information – Provide your name, address, Social Security number, date

of birth, etc.

• Contribution Amount – Contribute more today to potentially have more for your

future

• Fund Choices – Build a diversified portfolio based on your retirement goals1

Step 2:Select Your Beneficiary

Here is the information you’ll need to provide when choosing your beneficiaries:

• Your Personal Information

• Personal Information for Your Primary Beneficiary

• Personal Information for Your Contingent Beneficiary (if applicable)

Note: If you don't have all the necessary information for your beneficiaries at this time,you can still enroll, but you should choose your beneficiaries as soon as possible once youhave the information needed.

1 Diversification does not ensure a profit and does not protect against loss in declining markets.

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Quick TipGet the most out of this valuable employer-provided benefit with a higher contribution amount. The

more you save today means potentially more for your future. Get the retirement income you want and

deserve so you can continue your current lifestyle when you’re retired by contributing as much as you

can.

Important ReminderLet us know if you have assets from a previous employer’s plan or

an IRA. If your employer allows rollovers, we can help you roll that

money into your current plan for a simplified, one-stop retirement

planning strategy.2

For More Information

Visit3

www.empower-retirement.com/participant

Call3

1-800-338-4015

Remember:You can make changes to your plan at any time by visiting

www.empower-retirement.com/participant.3

2 You are encouraged to discuss rolling money from one account to another with your financial advisor/ planner, considering any potential fees and/or limitation of investment options.

3 Access to KeyTalk® and/or any website may be limited or unavailable during periods of peak demand, market volatility, systems upgrades/maintenance or other reasons.PT#193392 (03/2014)Pg 2 of 36

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Mister Car Wash 401(k) Retirement Plan Features and Highlights

1

Read these highlights to learn more about your Plan. If there are any discrepancies between this document and the Plan Document the Plan Document will govern.

About the 401(k) Plan A 401(k) plan is a retirement savings plan designed to allow eligible employees to supplement any existing retirement and pension benefits by saving and investing before – tax dollars through a voluntary salary contribution. Contributions and any earnings on contributions are tax-deferred until money is withdrawn.

Eligibility Requirements To enroll in the Plan, employees must meet the following criteria:

� Be age 21 or older � Completed 1 year of service

Eligible employees may enroll the first day of each quarter January 1, April 1, July 1, and October 1.

The following employees are not eligible to participate in the Plan:

� Leased employees � Highly Compensated Employees � Part-Time/Temporary/Seasonal employees

Enrollment You may enroll by completing an enrollment form and returning it to your Plan administrator.

2016 Contribution Limits � Combined maximum limit of 100% of your

compensation or $18,000, whichever is less for all retirement contributions.

Participants turning age 50 or older in 2016 may contribute an additional $5,500.

Generally, the maximum contribution amount then may be indexed for inflation in subsequent years.

Employer Contributions Your Plan may contribute a discretionary match. This contribution will only apply to a participant’s deferrals that do not exceed a dollar amount or percentage of included compensation that is determined by the employer.

Vesting Schedule Vesting refers to the percentage of your account you are entitled to receive upon the occurrence of distributable events. Your contributions and any earning are always 100% vested (including rollovers from previous employers).

The value of employer match contributions to the Plan, and any earnings they generate, are vested as follows:

Years of Vested Percentage of Service Employer Contributions Less than 1 year 0%

1 year 100%

Investment Options1 A wide array of core investment options are available through your Plan. Each option is explained in further detail in your Plan’s fund sheets. Once you have enrolled, investment option information is also available through the website at www.empower-retirement.com/participant or by calling KeyTalk® toll free at (800) 338-4015. The website and KeyTalk are available to you 24 hours a day, seven days a week.2

Transfers and Allocation Changes Use your Personal Identification Number3 (PIN) and Username to access the website, or you can use your Social Security number and PIN to access KeyTalk. You can move all or a portion of your existing balances among investment options (subject to Plan rules) and change how your payroll contributions are invested.2

Rollovers Only Plan administrator approved balances from an eligible governmental 457(b), 401(k), 403(b) or 401(a) plan or an Individual Retirement Account (IRA) may be rolled over to the Plan. Some Plans may only allow rollovers from other 401(k) plans.

You are encouraged to discuss rolling money from one account to another with your financial advisor/planner, considering any potential fees and/or limitation of investment options.

Withdrawals Qualifying distribution events are as follows:

� Disability � Retirement � Financial hardship (as defined by the Internal

Revenue Code and your Plan’s provisions) � Severance of employment (as defined by the

Internal Revenue Code provisions) � Attainment of age 59 ½ � Death (your beneficiary receives your

benefits) Ordinary income tax will apply to each distribution. Distributions received prior to age 59½ may also be assessed a 10% early withdrawal federal tax penalty. Refer to your Summary Plan Description for more information about distributions.

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401(k) Plan 2

Plan Fees Distribution Fees: Benefit disbursement fee $50.00 Periodic payment setup fee $50.00 Quarterly periodic payment $6.25

Investment Option Fees: Each investment option has its own operating expenses. These fees are deducted by each investment option’s management company before the daily price or performance is calculated. Fees pay for trading of securities within the investment options and other management expenses. Funds may impose redemption fees and/or transfer restrictions if assets are held for less than the published holding period. Asset allocation funds are generally subject to a fund operating expense at the fund level, as well as prorated fund operating expenses of each underlying fund in which they invest. For more information, please refer to the fund prospectus and/or disclosure document. Funds are subject to the risks of the underlying funds. There may be a recordkeeping or administrative fee for investing in certain investment options. Please contact your Empower RetirementTM representative for more information about any potential investment option fees.

How Can I Get More Information? Visit the website at www.empower-retirement.com/participant or call KeyTalk® toll free at (800) 338-4015 for more information. The website provides information regarding your Plan, as well as financial education information, financial calculators and other tools to help you manage your account. 1 All information contained on the website, in prospectuses, and in other investment option documents is offered in English. Please have this information translated for your understanding. 2 Access to KeyTalk and/or any website may be limited or unavailable during periods of peak demand, market volatility, systems upgrades/maintenance or other reasons. Transfer requests made via the website or KeyTalk received on business days prior to close of the New York Stock Exchange (4:00 p.m. Eastern Time or earlier on some holidays or other special circumstances) will be initiated at the close of business the same day the request was received. The actual effective date of your transaction may vary depending on the investment option selected. 3 The account owner is responsible for keeping the assigned PIN confidential. Please contact a client service representative immediately if you suspect any unauthorized use.

Core securities, when offered, are offered through GWFS Equities, Inc. and/or other broker dealers.

GWFS Equities, Inc., Member FINRA/SIPC, is a wholly owned subsidiary of Great-West Life & Annuity Insurance Company.

Representatives of GWFS Equities, Inc. are not registered investment advisors and cannot offer financial, legal or tax advice. Please consult with your financial planner, attorney and/or tax advisor as needed.

Empower RetirementTM refers to the products and services offered in the retirement markets by Great-West Life & Annuity Insurance Company (GWL&A), Corporate Headquarters: Greenwood Village, CO; Great-West Life & Annuity Insurance Company of New York, Home Office: White Plains, NY; and their subsidiaries and affiliates. The trademarks, logos, service marks, and design elements used are owned by their respective owners and are used by permission.

©2015 Great-West Life & Annuity Insurance Company. All rights reserved.Form# 943928-01PH 401(k) 03/30/2016 PT# 214855 (01/2015)

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FOR

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FUN

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FOR

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FOR

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& F

UN

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��������� �� ][��������)( ��������� ����� ���][�����������

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Participant Enrollment401(k) Plan

Mister Car Wash 401k Retirement Plan 943928-01

Participant Information

Last Name First Name MI Social Security Number

Address - Number & Street E-Mail Address

City State Zip Code Mo Day Year Female Male

( ) ( ) Date of Birth Married UnmarriedHome Phone Work Phone

Check box if you prefer to receive quarterly account statements inSpanish.

Do you have a retirement savings account with a previous employer or an IRA? Yes No

Would you like help consolidating your other retirement accounts into your account with Empower Retirement?* Yes, I would like a representativeto call me at phone # - - to review my options and assist me with the process. The best time to call is to A.M./P.M. (circle one - available 8:00 A.M. to 6:00 P.M. MST). *Rollovers are subject to your Plan's provisions.

Payroll Information

I elect to contribute $_____________ or ________% ($1.00 - $18,000.00 or 1% - 100%) per pay period of my compensation as before-taxcontributions to the 401(k) Plan until such time as I revoke or amend my election.

Note: The total of your before-tax deferrals cannot exceed 100% or $18,000.00. If I am 50 years of age or older and I am eligible for a catch-upcontribution, I understand I may exceed this total.I decline to make contributions to the Plan at this time.

Payroll Effective Date: Date of Hire:Mo Day Year Mo Day Year

Age 50 Catch-Up Election

I elect to contribute $_____________ or ________% per pay period of my compensation as before-tax contributions to the 401(k) Plan as additionalAge 50 Catch-Up of my eligible compensation.

The total before-tax Age 50 Catch-Up amount cannot exceed $6,000.00 of my eligible compensation in the 2016 tax year. I must be age 50 or olderduring this calendar year and I must be currently deferring the maximum amount allowable under the Internal Revenue Code and applicable regulationsand/or my Plan. If I stop my deferrals and/or do not defer the maximum amount during this calendar year, the Age 50 Catch-Up amount I have electedto contribute will not be considered a Catch-Up deferral. The Catch-Up contributions will be allocated in the same manner as my regular contributions.

To be completed by Human Resources

Division Name Division Number

Investment Option Information (applies to all contributions) - Please refer to your enrollment packet for investment descriptions.

I understand that funds may impose redemption fees on certain transfers, redemptions or exchanges if assets are held less than the period stated in thefund's prospectus or other disclosure documents. I will refer to the fund's prospectus and/or disclosure documents for more information.

See below for Participation Agreement and Required Signatures

Investment Option Name InvestmentOption Code

(Internal Use Only)Vanguard Target Retirement Income Inv. . . . . . . . . . . . . . . VTINX ______%Vanguard Target Retirement 2010 Inv. . . . . . . . . . . . . . . . . VTENX ______%Vanguard Target Retirement 2015 Inv. . . . . . . . . . . . . . . . . VTXVX ______%Vanguard Target Retirement 2020 Inv. . . . . . . . . . . . . . . . . VTWNX ______%Vanguard Target Retirement 2025 Inv. . . . . . . . . . . . . . . . . VTTVX ______%Vanguard Target Retirement 2030 Inv. . . . . . . . . . . . . . . . . VTHRX ______%Vanguard Target Retirement 2035 Inv. . . . . . . . . . . . . . . . . VTTHX ______%Vanguard Target Retirement 2040 Inv. . . . . . . . . . . . . . . . . VFORX ______%Vanguard Target Retirement 2045 Inv. . . . . . . . . . . . . . . . . VTIVX ______%

Investment Option Name InvestmentOption Code

(Internal Use Only)Victory Trivalent Int'l Small-Cap R6. . . . . . . . . . . . . . . . . . . MSSIX ______%Franklin Small Cap Value R6. . . . . . . . . . . . . . . . . . . . . . . . . . FRSCV6 ______%Voya SmallCap Opportunities I. . . . . . . . . . . . . . . . . . . . . . . . NSPIX ______%Vanguard Small Cap Value Index Admiral. . . . . . . . . . . . . VSIAX ______%Vanguard Extended Market Idx Adm. . . . . . . . . . . . . . . . . . VEXAX ______%Alger Capital Appreciation Instl I. . . . . . . . . . . . . . . . . . . . . . ALARX ______%Columbia Dividend Opportunity Y. . . . . . . . . . . . . . . . . . . . . CDOYX ______%Vanguard 500 Index Admiral. . . . . . . . . . . . . . . . . . . . . . . . . . . VFIAX ______%Principal Diversified Real Asset Inst. . . . . . . . . . . . . . . . . . . PDRDX ______%

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943928-01Last Name First Name M.I. Social Security Number Number

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Investment Option Name InvestmentOption Code

(Internal Use Only)Vanguard Target Retirement 2050 Inv. . . . . . . . . . . . . . . . . VFIFX ______%Vanguard Target Retirement 2055 Inv. . . . . . . . . . . . . . . . . VFFVX ______%Vanguard Target Retirement 2060 Inv. . . . . . . . . . . . . . . . . VTTSX ______%American Funds Capital World G/I R6. . . . . . . . . . . . . . . . . RWIGX ______%American Funds EuroPacific Gr R6. . . . . . . . . . . . . . . . . . . . RERGX ______%

Investment Option Name InvestmentOption Code

(Internal Use Only)BlackRock Strategic Income Opps Instl. . . . . . . . . . . . . . . . BSIIX ______%PACE Mort-Backed Sec Fixed Inc Invest Y. . . . . . . . . . . . PFXYX ______%PIMCO Total Return Instl. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PTTRX ______%Key Guaranteed Portfolio Fund. . . . . . . . . . . . . . . . . . . . . . . . . KGPF ______%MUST INDICATE WHOLE PERCENTAGES =100%

Participation AgreementWithdrawal Restrictions - I understand that the Internal Revenue Code (the "Code") and/or my employer's Plan Document may impose restrictionson transfers and/or distributions. I understand that I must contact the Plan Administrator to determine when and/or under what circumstances I ameligible to receive distributions or make transfers.

Investment Options - I understand that by signing and submitting this Participant Enrollment form for processing, I am requesting to have investmentoptions established under the Plan as specified in the Investment Option Information section. I understand and agree that this account is subject to theterms of the Plan Document. I understand and acknowledge that all payments and account values, when based on the experience of the investmentoptions, may not be guaranteed and may fluctuate, and, upon redemption, shares may be worth more or less than their original cost. I acknowledge thatinvestment option information, including prospectuses, disclosure documents and Fund Profile sheets, have been made available to me and I understandthe risks of investing.

Compliance With Plan Document and/or the Code - I agree that my employer or Plan Administrator may take any action that may be necessary toensure that my participation in the Plan is in compliance with any applicable requirement of the Plan Document and/or the Code. I understand that themaximum annual limit on contributions is determined under the Plan Document and/or the Code. I understand that it is my responsibility to monitormy total annual contributions to ensure that I do not exceed the amount permitted. If I exceed the contribution limit, I assume sole liability for anytax, penalty, or costs that may be incurred.

Incomplete Forms - I understand that in the event my Participant Enrollment form is incomplete or is not received by Service Provider at the addressbelow prior to the receipt of any deposits, I specifically consent to Service Provider retaining all monies received and allocating them to the defaultinvestment option selected by the Plan. If no default investment option is selected, funds will be returned to the payor as required by law. Once myaccount has been established, I understand that I must call 1-800-338-4015 or access the Web site in order to transfer monies from the default investmentoption. Also, I understand all contributions received after my account is established will be applied to the investment options I have most recentlyselected.

Account Corrections - I understand that it is my obligation to review all confirmations and quarterly statements for discrepancies or errors. Correctionswill be made only for errors which I communicate within 90 calendar days of the last calendar quarter. After this 90 days, account information shallbe deemed accurate and acceptable to me. If I notify Service Provider of an error after this 90 days, the correction will be only processed from thedate of notification forward and not on a retroactive basis.

Required Signature(s) - I have completed, understand and agree to all pages of this Participant Enrollment form. I understand that Service Provideris required to comply with the regulations and requirements of the Office of Foreign Assets Control, Department of the Treasury ("OFAC"). As a result,Service Provider cannot conduct business with persons in a blocked country or any person designated by OFAC as a specially designated national orblocked person. For more information, please access the OFAC Web site at:http://www.treasury.gov/about/organizational-structure/offices/Pages/Office-of-Foreign-Assets-Control.aspx.

Participant Signature Date

Authorized Plan Administrator/Trustee Date

Participant forward to Plan Administrator/TrusteePlan Administrator forward to Service Provider at:Empower RetirementPO Box 173764Denver, CO 80217-3764Express Address:8515 E. Orchard Road, Greenwood Village, CO 80111Phone#: 1-800-338-4015Fax#: 1-866-633-5212

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Incoming Direct Rollover401(k) Plan

Mister Car Wash 401k Retirement Plan 943928-01

Participant Information

Last Name First Name MI Social Security Number

Address - Number & Street E-Mail Address

City State Zip Code Mo Day Year Female Male

( ) ( ) Date of Birth Married UnmarriedHome Phone Work Phone

To be Completed by Human Resources

Division Name Division Number

Direct Rollover InformationCurrent Plan Administrator must authorize by signing in the Required Signatures section.

I am choosing a:

Direct Rollover, as allowed by your Plan, from a qualified:

401(a) Plan

401(k) Plan

Governmental 457(b) Plan

403(b) Plan

Direct Rollover from a Traditional IRA, as allowed by your Plan (Non-deductible contributions/basis may not be rolled over)

Previous Provider Information:

Company Name Account Number

Mailing Address

( )City/State/Zip Code Phone Number

Amount of Direct Rollover: $ (Enter approximate amount if exact amount is not known.)

Investment Option Information - Please refer to your communication materials for investment option designations.

I understand that funds may impose redemption fees on certain transfers, redemptions or exchanges if assets are held less than the period stated in thefund's prospectus or other disclosure documents. I will refer to the fund's prospectus and/or disclosure documents for more information.

Select either existing ongoing allocations (A) or your own investment options (B).

(A) Existing Ongoing Allocations

I wish to allocate this rollover the same as my existing ongoing allocations.

(B) Select Your Own Investment Options

Please Note: For automatic dollar-cost averaging, call Client Service Department or access our Web site.

Investment Option Name Investment Option Code(Internal Use Only)

Vanguard Target Retirement Income Inv. . . . . . . . . VTINX %

Vanguard Target Retirement 2010 Inv. . . . . . . . . . . . VTENX %

Vanguard Target Retirement 2015 Inv. . . . . . . . . . . . VTXVX %

Vanguard Target Retirement 2020 Inv. . . . . . . . . . . . VTWNX %

Vanguard Target Retirement 2025 Inv. . . . . . . . . . . . VTTVX %

Investment Option Name Investment Option Code(Internal Use Only)

Victory Trivalent Int'l Small-Cap R6. . . . . . . . . . . . . . MSSIX %

Franklin Small Cap Value R6. . . . . . . . . . . . . . . . . . . . . FRSCV6 %

Voya SmallCap Opportunities I. . . . . . . . . . . . . . . . . . . NSPIX %

Vanguard Small Cap Value Index Admiral. . . . . . . VSIAX %

Vanguard Extended Market Idx Adm. . . . . . . . . . . . . VEXAX %

Pg 15 of 36

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943928-01Last Name First Name M.I. Social Security Number Number

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Investment Option Name Investment Option Code(Internal Use Only)

Vanguard Target Retirement 2030 Inv. . . . . . . . . . . . VTHRX %

Vanguard Target Retirement 2035 Inv. . . . . . . . . . . . VTTHX %

Vanguard Target Retirement 2040 Inv. . . . . . . . . . . . VFORX %

Vanguard Target Retirement 2045 Inv. . . . . . . . . . . . VTIVX %

Vanguard Target Retirement 2050 Inv. . . . . . . . . . . . VFIFX %

Vanguard Target Retirement 2055 Inv. . . . . . . . . . . . VFFVX %

Vanguard Target Retirement 2060 Inv. . . . . . . . . . . . VTTSX %

American Funds Capital World G/I R6. . . . . . . . . . . RWIGX %

American Funds EuroPacific Gr R6. . . . . . . . . . . . . . . RERGX %

Investment Option Name Investment Option Code(Internal Use Only)

Alger Capital Appreciation Instl I. . . . . . . . . . . . . . . . . ALARX %

Columbia Dividend Opportunity Y. . . . . . . . . . . . . . . CDOYX %

Vanguard 500 Index Admiral. . . . . . . . . . . . . . . . . . . . . VFIAX %

Principal Diversified Real Asset Inst. . . . . . . . . . . . . . PDRDX %

BlackRock Strategic Income Opps Instl. . . . . . . . . . . BSIIX %

PACE Mort-Backed Sec Fixed Inc Invest Y. . . . . . PFXYX %

PIMCO Total Return Instl. . . . . . . . . . . . . . . . . . . . . . . . . PTTRX %

Key Guaranteed Portfolio Fund. . . . . . . . . . . . . . . . . . . KGPF %

MUST INDICATE WHOLE PERCENTAGES = 100%

Participation Agreement

General Information - I understand that only certain types of distributions are eligible for rollover treatment and that it is solely my responsibilityto ensure such eligibility. By signing below, I affirm that the funds I am rolling are in fact eligible for such treatment. I authorize these funds to betransferred into my employer's Plan and to be invested according to the information specified in the Investment Option Information section. I understandand agree that this account is subject to the terms of the Plan Document.

If the investment option information is missing or incomplete, I authorize Service Provider to allocate the direct rollover assets ("assets") the same asmy ongoing contributions (if I have an account established) or to the default investment option selected by my Plan (if I do not have an investmentelection on file). If no default investment option is selected by my Plan, the funds will be returned to the payor as required by law. If additional assetsfrom the same provider are received more than 180 calendar days after Service Provider receives this Incoming Direct Rollover form (this "form"),I authorize Service Provider to allocate all monies received the same as my ongoing allocation election on file with Service Provider. I understand Imust call the Voice Response System at 1-800-338-4015 or access Web site at www.empower-retirement.com/participant in order to make changesor transfer monies from the default investment option. If my initial rollover assets are received more than 1 year after Service Provider receives andapproves this Incoming Direct Rollover form, I understand Service Provider will require the submission of a new form for approval. I understand thatthis completed form must be received by Service Provider at the address provided on this form.

I understand that the current Custodian/Provider may require that I furnish additional information before processing the transaction requested on thisform, and Service Provider is not responsible for determining the status of any transaction that I have requested. It is entirely my responsibility toprovide the current Custodian/Provider with any information that they may require, and/or to notify Service Provider of any information that the currentCustodian/Provider may wish to obtain in order to effect the transaction.

Withdrawal Restrictions - I understand that the Internal Revenue Code and/or my employer's Plan Document may impose restrictions on directrollovers and/or distributions. I understand that I must contact the Plan Administrator/Trustee, if applicable, to determine when and/or under whatcircumstances I am eligible to receive distributions or make direct rollovers.

Investment Options - I understand and acknowledge that all payments and account values, when based on the experience of the investment options, maynot be guaranteed and may fluctuate, and, upon redemption, shares may be worth more or less than their original cost. I acknowledge that investmentoption information, including prospectuses, disclosure documents and Fund Profile sheets, have been made available to me and I understand the risksof investing.

Account Corrections - I understand that it is my obligation to review all confirmations and quarterly statements for discrepancies or errors. Correctionswill be made only for errors which I communicate within 90 calendar days of the last calendar quarter. After this 90 days, account information shallbe deemed accurate and acceptable to me. If I notify Service Provider of an error after this 90 days the correction will only be processed from the dateof notification forward and not on a retroactive basis.

Payment InstructionsMake check payable to:Great-West Trust Company, LLC

Include the following information on the check:Participant Name, Social Security Number,Plan Number, Plan Name

Regular mail address for thecheck and form (if mailed together):Great-West Trust Company, LLCAttn: 401K OperationsDept # 1148Denver, CO 80256-1148

Wire instructions:Account of: Great-West Trust Company, LLCBank: US BankAccount no: 103656586049Routing transit no: 102000021Attention: Financial ControlReference: Participant Name, Social Security Number,Plan Number, Plan Name

Overnight mail address for thecheck and form (if mailed together):US Bank10035 East 40th Avenue Suite 100Dept 1148Denver, CO 80238Contact: Empower RetirementPhone#: 1-800-338-4015

If sending the "form" only, please fax to 1-866-633-5212 or follow mailing instructions above. Funds received will not be invested unlessaccompanied by a completed Incoming Direct Rollover form. Funds will be invested on the day that both a completed Incoming Direct Rolloverform and funds are received prior to market close.

Pg 16 of 36

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943928-01Last Name First Name M.I. Social Security Number Number

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Required Signatures - My signature indicates that I have read, understand the effect of my election and agree to all pages of this Incoming DirectRollover form. I affirm that all information provided is true and correct. I understand that Service Provider is required to comply with the regulationsand requirements of the Office of Foreign Assets Control, Department of the Treasury ("OFAC"). As a result, Service Provider cannot conduct businesswith persons in a blocked country or any person designated by OFAC as a specially designated national or blocked person. For more information,please access the OFAC Web site at:http://www.treasury.gov/about/organizational-structure/offices/Pages/Office-of-Foreign-Assets-Control.aspx.

Participant Signature Date Participant forward to Plan Administrator/TrusteePlan Administrator forward or fax as shown above in thePayment Instructions section

I acknowledge and agree that the Plan Administrator/Trustee for the PreviousEmployer's plan is released from and the Plan Administrator/Trustee for the CurrentEmployer's Plan shall assume all obligations associated with any amounts transferredunder this Incoming Direct Rollover form.

Authorized Plan Administrator/Trustee Signature DateFor Current Employer's Plan

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Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide current income and some capital appreciation.The fund invests in other Vanguard mutual funds according to an assetallocation strategy designed for investors currently in retirement. Its indirect bondRetirement Income Invholdings are a diversified mix of short-, intermediate-, and long-term U.S.government, U.S. agency, and investment-grade U.S. corporate bonds; inflation-

Fund Manager: Coleman/Nejman protected public obligations issued by the U.S. Treasury; mortgage-backed andPeriod Ending: 12/31/2015 asset-backed securities; and government, agency, corporate, and securitized

investment-grade foreign bonds issued in currencies other than the U.S. dollar.Fund Operating Expenses:The Barcalys Capital Aggregate Bond Index is an unmanaged index consideredGross 0.14%, Net 0.14%indicative of the domestic fixed income market. The Index is made up of theBarclays Capital Govt/Credit Bond Index, Mortgage-Backed Securities Index, andRisk/Potential Return MeterAsset-Backed Securities Index.

Risk and Return ProfileThis investment option may be most appropriate for someone willing to acceptsome risk, but seeking to preserve capital and is willing to accept lower potentialFOR ILLUSTRATIVE PURPOSES ONLYreturns in exchange. Investors choosing this option want to invest in a mixture ofdiverse investments suiting their needs but do not have the time, desire, orknowledge to select and manage their own portfolios. Asset allocation andbalanced investment options are subject to the risks of the underlying funds,which can be a mix of stocks/stock funds and bonds/bond funds. Stock valuesfluctuate in response to the activities of the general market, individual companiesand economic conditions. Bond values fluctuate in response to the financialcondition of individual issuers, general market and economic conditions, andchanges in interest rates. In general, when interest rates rise, bond values falland investors may lose principal value.VTINX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2010 Invplanning to retire and leave the workforce in or within a few years of 2010 (thetarget year). Its asset allocation will become more conservative over time,

Fund Manager: Coleman/Nejman meaning that the percentage of assets allocated to stocks will decrease while thePeriod Ending: 12/31/2015 percentage of assets allocated to bonds and other fixed income investments willFund Operating Expenses: increase. The MSCI US Broad Market Index is the aggregation of the MSCI US

Gross 0.14%, Net 0.14% Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro Cap Indices. Thisindex represents approximately 99.5% of the capitalization of the U.S. equity

Risk/Potential Return Meter market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to acceptsome risk, but seeking to preserve capital and is willing to accept lower potential

FOR ILLUSTRATIVE PURPOSES ONLY returns in exchange. Investors choosing this option want to invest in a mixture ofdiverse investments suiting their needs but do not have the time, desire, orknowledge to select and manage their own portfolios. Asset allocation andbalanced investment options are subject to the risks of the underlying funds,which can be a mix of stocks/stock funds and bonds/bond funds. Stock valuesfluctuate in response to the activities of the general market, individual companiesand economic conditions. Bond values fluctuate in response to the financialcondition of individual issuers, general market and economic conditions, andchanges in interest rates. In general, when interest rates rise, bond values falland investors may lose principal value.VTENX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2015 Invplanning to retire and leave the workforce in or within a few years of 2015 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.14%, Net 0.14% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to acceptsome risk, but seeking to preserve capital and is willing to accept lower potential

FOR ILLUSTRATIVE PURPOSES ONLY returns in exchange. Investors choosing this option want to invest in a mixture ofdiverse investments suiting their needs but do not have the time, desire, orknowledge to select and manage their own portfolios. Asset allocation andbalanced investment options are subject to the risks of the underlying funds,which can be a mix of stocks/stock funds and bonds/bond funds. Stock valuesfluctuate in response to the activities of the general market, individual companiesand economic conditions. Bond values fluctuate in response to the financialcondition of individual issuers, general market and economic conditions, andchanges in interest rates. In general, when interest rates rise, bond values falland investors may lose principal value.VTXVX_2

Higher

Lower

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Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2020 Invplanning to retire and leave the workforce in or within a few years of 2020 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.14%, Net 0.14% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to acceptsome degree of risk in exchange for potentially higher long-term returns.

FOR ILLUSTRATIVE PURPOSES ONLY Investors choosing this option want to invest in a mixture of diverse investmentssuiting their needs but do not have the time, desire, or knowledge to select andmanage their own portfolios. Asset allocation and balanced investment optionsare subject to the risks of the underlying funds, which can be a mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in response to theactivities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.VTWNX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2025 Invplanning to retire and leave the workforce in or within a few years of 2025 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.15%, Net 0.15% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to acceptsome degree of risk in exchange for potentially higher long-term returns.

FOR ILLUSTRATIVE PURPOSES ONLY Investors choosing this option want to invest in a mixture of diverse investmentssuiting their needs but do not have the time, desire, or knowledge to select andmanage their own portfolios. Asset allocation and balanced investment optionsare subject to the risks of the underlying funds, which can be a mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in response to theactivities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.VTTVX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2030 Invplanning to retire and leave the workforce in or within a few years of 2030 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.15%, Net 0.15% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to accept amoderate degree of risk in exchange for potentially higher long-term returns.

FOR ILLUSTRATIVE PURPOSES ONLY Investors choosing this option want to invest in a mixture of diverse investmentssuiting their needs but do not have the time, desire, or knowledge to select andmanage their own portfolios. Asset allocation and balanced investment optionsare subject to the risks of the underlying funds, which can be a mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in response to theactivities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.VTHRX_2

Higher

Lower

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Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2035 Invplanning to retire and leave the workforce in or within a few years of 2035 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.15%, Net 0.15% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to accept amoderate degree of risk in exchange for potentially higher long-term returns.

FOR ILLUSTRATIVE PURPOSES ONLY Investors choosing this option want to invest in a mixture of diverse investmentssuiting their needs but do not have the time, desire, or knowledge to select andmanage their own portfolios. Asset allocation and balanced investment optionsare subject to the risks of the underlying funds, which can be a mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in response to theactivities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.VTTHX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2040 Invplanning to retire and leave the workforce in or within a few years of 2040 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.16%, Net 0.16% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to accept amoderately higher degree of risk in exchange for potentially higher long-term

FOR ILLUSTRATIVE PURPOSES ONLY returns. Investors choosing this option want to invest in a mixture of diverseinvestments suiting their needs but do not have the time, desire, or knowledge toselect and manage their own portfolios. Asset allocation and balancedinvestment options are subject to the risks of the underlying funds, which can bea mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate inresponse to the activities of the general market, individual companies andeconomic conditions. Bond values fluctuate in response to the financial conditionof individual issuers, general market and economic conditions, and changes ininterest rates. In general, when interest rates rise, bond values fall and investorsmay lose principal value.VFORX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2045 Invplanning to retire and leave the workforce in or within a few years of 2045 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.16%, Net 0.16% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to accept amoderately higher degree of risk in exchange for potentially higher long-term

FOR ILLUSTRATIVE PURPOSES ONLY returns. Investors choosing this option want to invest in a mixture of diverseinvestments suiting their needs but do not have the time, desire, or knowledge toselect and manage their own portfolios. Asset allocation and balancedinvestment options are subject to the risks of the underlying funds, which can bea mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate inresponse to the activities of the general market, individual companies andeconomic conditions. Bond values fluctuate in response to the financial conditionof individual issuers, general market and economic conditions, and changes ininterest rates. In general, when interest rates rise, bond values fall and investorsmay lose principal value.VTIVX_2

Higher

Lower

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Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2050 Invplanning to retire and leave the workforce in or within a few years of 2050 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.16%, Net 0.16% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to accept ahigher degree of risk in exchange for potentially higher long-term returns.

FOR ILLUSTRATIVE PURPOSES ONLY Investors choosing this option want to invest in a mixture of diverse investmentssuiting their needs but do not have the time, desire, or knowledge to select andmanage their own portfolios. Asset allocation and balanced investment optionsare subject to the risks of the underlying funds, which can be a mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in response to theactivities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.VFIFX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2055 Invplanning to retire and leave the workforce in or within a few years of 2055 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.16%, Net 0.16% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to accept ahigher degree of risk in exchange for potentially higher long-term returns.

FOR ILLUSTRATIVE PURPOSES ONLY Investors choosing this option want to invest in a mixture of diverse investmentssuiting their needs but do not have the time, desire, or knowledge to select andmanage their own portfolios. Asset allocation and balanced investment optionsare subject to the risks of the underlying funds, which can be a mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in response to theactivities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.VFFVX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Target The investment seeks to provide capital appreciation and current incomeconsistent with its current asset allocation. The fund invests in other Vanguardmutual funds according to an asset allocation strategy designed for investorsRetirement 2060 Invplanning to retire and leave the workforce in or within a few years of 2060 (thetarget year). The fund’s asset allocation will become more conservative over

Fund Manager: Coleman/Nejman time, meaning that the percentage of assets allocated to stocks will decreasePeriod Ending: 12/31/2015 while the percentage of assets allocated to bonds and other fixed incomeFund Operating Expenses: investments will increase. The MSCI US Broad Market Index is the aggregation

Gross 0.16%, Net 0.16% of the MSCI US Large Cap 300, Mid Cap 450, Small Cap 1, 750 and Micro CapIndices. This index represents approximately 99.5% of the capitalization of the

Risk/Potential Return Meter U.S. equity market and includes approximately 3, 900 companies.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to accept ahigher degree of risk in exchange for potentially higher long-term returns.

FOR ILLUSTRATIVE PURPOSES ONLY Investors choosing this option want to invest in a mixture of diverse investmentssuiting their needs but do not have the time, desire, or knowledge to select andmanage their own portfolios. Asset allocation and balanced investment optionsare subject to the risks of the underlying funds, which can be a mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in response to theactivities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.VTTSX_2

Higher

Lower

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Investment Objective & Strategy ◆American Funds The investment seeks long-term growth of capital while providing current income.The fund invests primarily in common stocks of well-established companiesCapital World G/I R6 located around the world, many of which have the potential to pay dividends. Itinvests, on a global basis, in common stocks that are denominated in U.S.dollars or other currencies. Under normal market circumstances, the fund willFund Manager: Team Managedinvest a significant portion of its assets in securities of issuers domiciled outsidePeriod Ending: 12/31/2015the United States, including those based in developing countries.Fund Operating Expenses:

Gross 0.45%, Net 0.45%Risk and Return Profile

Risk/Potential Return Meter International investments may be most appropriate for someone looking forgreater potential returns and willing to accept a higher degree of risk.�

International investment may provide diversification for a domestic portfolio.Foreign funds involve special risks, including currency fluctuations and politicaldevelopments.

FOR ILLUSTRATIVE PURPOSES ONLY

RWIGX_2

Higher

Lower

Investment Objective & Strategy ◆American Funds The investment seeks long-term growth of capital. The fund invests primarily incommon stocks of issuers in Europe and the Pacific Basin that the investmentEuroPacific Gr R6 adviser believes have the potential for growth. Growth stocks are stocks that theinvestment adviser believes have the potential for above-average capitalappreciation. It normally invests at least 80% of its net assets in securities ofFund Manager: Team Managedissuers in Europe and the Pacific Basin. The fund may invest a portion of itsPeriod Ending: 12/31/2015assets in common stocks and other securities of companies in emergingFund Operating Expenses:markets.Gross 0.49%, Net 0.49%

Risk and Return ProfileRisk/Potential Return MeterInternational investments may be most appropriate for someone looking for�

greater potential returns and willing to accept a higher degree of risk.International investment may provide diversification for a domestic portfolio.Foreign funds involve special risks, including currency fluctuations and political

FOR ILLUSTRATIVE PURPOSES ONLYdevelopments.

RERGX_2

Higher

Lower

Investment Objective & Strategy ◆Victory Trivalent The investment seeks long-term growth of capital. The advisor pursues long-termgrowth of capital in the fund by investing primarily in equity securities (i.e.,Int’l Small-Cap R6 common stocks, depositary receipts, preferred stocks, convertible securities,rights and warrants) of companies in countries represented in the S&P�

Developed ex-U.S. SmallCap Index, but may also invest in companies from otherFund Manager: LeVan/Everscountries, including emerging market countries. Under normal circumstances, atPeriod Ending: 12/31/2015least 80% of the fund’s assets will be invested in securities of small-capitalizationFund Operating Expenses:companies.Gross 1.73%, Net 1.12%

Risk and Return ProfileRisk/Potential Return MeterInternational investments may be most appropriate for someone looking for�

greater potential returns and willing to accept a higher degree of risk.International investment may provide diversification for a domestic portfolio.Foreign funds involve special risks, including currency fluctuations and political

FOR ILLUSTRATIVE PURPOSES ONLYdevelopments.

MSSIX_2

Higher

Lower

Investment Objective & Strategy ◆Franklin Small Cap The investment seeks long-term total return. The fund normally invests at least80% of its net assets in investments of small-capitalization (small-cap)Value R6 companies. Small-cap companies are companies with market capitalizations (thetotal market value of a company’s outstanding stock) under $3.5 billion at thetime of purchase. It generally invests in equity securities that the fund’sFund Manager: Raineri/Meeker/Taylorinvestment manager believes are undervalued at the time of purchase and havePeriod Ending: 12/31/2015the potential for capital appreciation. It may invest up to 25% of its total assets inFund Operating Expenses:foreign securities.Gross 0.61%, Net 0.61%

Risk and Return ProfileRisk/Potential Return MeterSmall-cap investments may be most appropriate for someone willing to accept a�

high degree of market volatility in exchange for greater potential returns overtime. Stock investments tend to be more volatile than bond, stable value ormoney market investments. Equity securities of small-sized companies may be

FOR ILLUSTRATIVE PURPOSES ONLYmore volatile than securities of larger, more established companies.

FRSCV6_2

Higher

Lower

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Investment Objective & Strategy ◆Voya SmallCap The investment seeks capital appreciation. Under normal market conditions, thefund invests at least 80% of its net assets in common stocks of smaller, lesser-Opportunities I known U.S. companies. It normally invests in companies that the sub-adviserbelieves have above average prospects for growth. For this fund, smallercompanies are those with market capitalizations that fall within the range ofFund Manager: Hasso/Bassetcompanies in the Russell 2000� Growth Index at the time of purchase. ThePeriod Ending: 12/31/2015Russell 2000� Growth Index is an index that measures the performance of smallFund Operating Expenses:growth companies.Gross 1.11%, Net 1.11%

Risk and Return ProfileRisk/Potential Return MeterSmall-cap investments may be most appropriate for someone willing to accept a�

high degree of market volatility in exchange for greater potential returns overtime. Stock investments tend to be more volatile than bond, stable value ormoney market investments. Equity securities of small-sized companies may be

FOR ILLUSTRATIVE PURPOSES ONLYmore volatile than securities of larger, more established companies.

NSPIX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Small Cap The investment seeks to track the performance of a benchmark index thatmeasures the investment return of small-capitalization value stocks. The fundValue Index Admiral employs an indexing investment approach designed to track the performance ofthe CRSP US Small Cap Value Index, a broadly diversified index of value stocksof small U.S. companies. The advisor attempts to replicate the target index byFund Manager: Buekinvesting all, or substantially all, of its assets in the stocks that make up thePeriod Ending: 12/31/2015index, holding each stock in approximately the same proportion as its weightingFund Operating Expenses:in the index.Gross 0.09%, Net 0.09%

Risk and Return ProfileRisk/Potential Return MeterSmall-cap investments may be most appropriate for someone willing to accept a�

high degree of market volatility in exchange for greater potential returns overtime. Stock investments tend to be more volatile than bond, stable value ormoney market investments. Equity securities of small-sized companies may be

FOR ILLUSTRATIVE PURPOSES ONLYmore volatile than securities of larger, more established companies.

VSIAX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard Extended The investment seeks to track the performance of a benchmark index thatmeasures the investment return of small- and mid-capitalization stocks. The fundMarket Idx Adm employs an indexing investment approach designed to track the performance ofthe Standard & Poor’s Completion Index, a broadly diversified index of stocks ofsmall and mid-size U.S. companies. It invests all, or substantially all, of its assetsFund Manager: Butlerin stocks of its target index, with nearly 80% of its assets invested inPeriod Ending: 12/31/2015approximately 1,000 of the stocks in its target index, and the rest of its assets inFund Operating Expenses:a representative sample of the remaining stocks.Gross 0.10%, Net 0.10%

Risk and Return ProfileRisk/Potential Return MeterMid-cap investments may be most appropriate for someone willing to accept a�

higher degree of market volatility in exchange for greater potential returns overtime. Stock investments tend to be more volatile than bond, stable value ormoney market investments. Equity securities of medium-sized companies may

FOR ILLUSTRATIVE PURPOSES ONLYbe more volatile than securities of larger, more established companies.

VEXAX_2

Higher

Lower

Investment Objective & Strategy ◆Alger Capital The investment seeks long-term capital appreciation. The fund normally investsat least 85% of its net assets, plus any borrowings for investment purposes, inAppreciation Instl I equity securities of companies of any market capitalization that the adviserbelieves demonstrate promising growth potential. It can invest in foreignsecurities. The Russell 1000 Growth Index measures the performance of theFund Manager: Crawford/Kellylarge-cap growth segment of the U.S. equity universe. It includes those RussellPeriod Ending: 12/31/20151000 companies with higher price-tobook ratios and higher forecasted growthFund Operating Expenses:values.Gross 1.12%, Net 1.12%

Risk and Return ProfileRisk/Potential Return MeterLarge-cap investments may be most appropriate for someone willing to accept�

some degree of market volatility in return for potential long-term capital growth.Stock investments tend to be more volatile than bond, stable value or moneymarket investments.

FOR ILLUSTRATIVE PURPOSES ONLY

ALARX_2

Higher

Lower

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Investment Objective & Strategy ◆Columbia Dividend The investment seeks a high level of current income with a secondary objectiveof growth of income and capital. The fund’s assets primarily are invested inOpportunity Y equity securities. Under normal market conditions, it will invest at least 80% of itsnet assets (including the amount of any borrowings for investment purposes) individend-paying common and preferred stocks. The fund may invest inFund Manager: Stocking/Ramos/Schrollcompanies that have market capitalizations of any size. It may invest up to 25%Period Ending: 12/31/2015of its net assets in foreign investments.Fund Operating Expenses:

Gross 0.60%, Net 0.60%Risk and Return Profile

Risk/Potential Return Meter Large-cap investments may be most appropriate for someone willing to acceptsome degree of market volatility in return for potential long-term capital growth.�

Stock investments tend to be more volatile than bond, stable value or moneymarket investments.

FOR ILLUSTRATIVE PURPOSES ONLY

CDOYX_2

Higher

Lower

Investment Objective & Strategy ◆Vanguard 500 The investment seeks to track the performance of a benchmark index thatmeasures the investment return of large-capitalization stocks. The fund employsan indexing investment approach designed to track the performance of theIndex AdmiralStandard & Poor’s 500 Index, a widely recognized benchmark of U.S. stockmarket performance that is dominated by the stocks of large U.S. companies.Fund Manager: BuekThe advisor attempts to replicate the target index by investing all, or substantiallyPeriod Ending: 12/31/2015all, of its assets in the stocks that make up the index, holding each stock inFund Operating Expenses:approximately the same proportion as its weighting in the index. The S&P 500Gross 0.05%, Net 0.05%Index is an unmanaged, market-weighted index that consists of the 500 largestpublicly traded companies and is considered representative of the broad U.S.Risk/Potential Return Meterstock market.

Risk and Return ProfileLarge-cap investments may be most appropriate for someone willing to accept

FOR ILLUSTRATIVE PURPOSES ONLY some degree of market volatility in return for potential long-term capital growth.Stock investments tend to be more volatile than bond, stable value or moneymarket investments.VFIAX_2

Higher

Lower

Investment Objective & Strategy ◆Principal Diversified The investment seeks a long-term total return in excess of inflation. The fundseeks to achieve its investment objective by allocating its assets among thefollowing general investment categories: inflation-indexed bonds, securities ofReal Asset Instreal estate companies, commodity index-linked notes, fixed-income securities,foreign currency, securities of natural resource companies, master limited

Fund Manager: Team Managed partnerships (MLPs), publicly-listed infrastructure companies, floating rate debt,Period Ending: 12/31/2015 securities of global agriculture companies, and securities of global timberFund Operating Expenses: companies. The Barclays US Government Inflation-Linked Bond Index measures

Gross 0.88%, Net 0.88% the performance of the US Treasury Inflation Protected Securities (‘‘TIPS’’)market. The index includes TIPS with one or more years remaining maturity with

Risk/Potential Return Meter total outstanding issue size of $500m or more.

�Risk and Return ProfileThis investment option may be most appropriate for someone willing to acceptsome risk, but seeking to preserve capital and is willing to accept lower potential

FOR ILLUSTRATIVE PURPOSES ONLY returns in exchange. Investors choosing this option want to invest in a mixture ofdiverse investments suiting their needs but do not have the time, desire, orknowledge to select and manage their own portfolios. Asset allocation andbalanced investment options are subject to the risks of the underlying funds,which can be a mix of stocks/stock funds and bonds/bond funds. Stock valuesfluctuate in response to the activities of the general market, individual companiesand economic conditions. Bond values fluctuate in response to the financialcondition of individual issuers, general market and economic conditions, andchanges in interest rates. In general, when interest rates rise, bond values falland investors may lose principal value.PDRDX_2

Higher

Lower

Pg 25 of 36

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Investment Objective & Strategy ◆BlackRock Strategic The investment seeks total return as is consistent with preservation of capital.The fund normally invests in a combination of fixed income securities, including,Income Opps Instl but not limited to: high yield securities, international securities, emerging marketsdebt and mortgages. It may invest significantly in non-investment grade bonds(high yield or junk bonds). The fund may also invest significantly in non-dollarFund Manager: Rieder/Millerdenominated bonds and bonds of emerging market issuers. It may invest up toPeriod Ending: 12/31/201515% of its net assets in collateralized debt obligations (‘‘CDOs’’), of which 10%Fund Operating Expenses:of its net assets may be collateralized in loan obligations (‘‘CLOs’’). The fund isGross 0.80%, Net 0.64%non-diversified.

Risk/Potential Return MeterRisk and Return Profile�

This investment may be most appropriate for someone seeking greater potentialincome than with a money market or stable value investment and willing toaccept a higher degree of risk. The investor may also desire to balance more

FOR ILLUSTRATIVE PURPOSES ONLYaggressive investments with one providing potentially steady income. A bondfund’s yield, share price and total return change daily and are based on changesin interest rates, market conditions, economic and political news, and the qualityand maturity of its investments. In general, bond prices fall when interest ratesrise and vice versa.BSIIX_2

Higher

Lower

Investment Objective & Strategy ◆PACE Mort-Backed The investment seeks current income. Under normal circumstances, the fundinvests at least 80% of its net assets (plus the amount of any borrowing forSec Fixed Inc Invest Y investment purposes) in a diversified portfolio of mortgage-related fixed incomeinstruments, such as mortgage-backed securities (including mortgage pass-through securities and collateralized mortgage obligations (‘‘CMOs’’), commercialFund Manager: Team Managedmortgage-backed securities, ‘‘to be announced’’ (or ‘‘TBA’’) securities andPeriod Ending: 12/31/2015mortgage dollar rolls). It also may invest in other types of investment grade fixedFund Operating Expenses:income instruments.Gross 0.86%, Net 0.72%

Risk and Return ProfileRisk/Potential Return MeterThis investment may be most appropriate for someone seeking greater potential�

income than with a money market or stable value investment and willing toaccept a higher degree of risk. The investor may also desire to balance moreaggressive investments with one providing potentially steady income. A bond

FOR ILLUSTRATIVE PURPOSES ONLYfund’s yield, share price and total return change daily and are based on changesin interest rates, market conditions, economic and political news, and the qualityand maturity of its investments. In general, bond prices fall when interest ratesrise and vice versa.PFXYX_2

Higher

Lower

Investment Objective & Strategy ◆PIMCO Total The investment seeks maximum total return, consistent with preservation ofcapital and prudent investment management. The fund invests at least 65% of itsReturn Instl total assets in a diversified portfolio of Fixed Income Instruments of varyingmaturities, which may be represented by forwards or derivatives such as options,futures contracts, or swap agreements. It invests primarily in investment-gradeFund Manager: Worah/Kiesel/Matherdebt securities, but may invest up to 10% of its total assets in high yieldPeriod Ending: 12/31/2015securities. It may invest up to 30% of its total assets in securities denominated inFund Operating Expenses:foreign currencies, and may invest beyond this limit in U.S. dollar-denominatedGross 0.46%, Net 0.46%securities of foreign issuers. The Barcalys Capital Aggregate Bond Index is an

Risk/Potential Return Meter unmanaged index considered indicative of the domestic fixed income market.The Index is made up of the Barclays Capital Govt/Credit Bond Index, Mortgage-�Backed Securities Index, and Asset-Backed Securities Index.

Risk and Return ProfileFOR ILLUSTRATIVE PURPOSES ONLY

This investment may be most appropriate for someone seeking greater potentialincome than with a money market or stable value investment and willing toaccept a higher degree of risk. The investor may also desire to balance moreaggressive investments with one providing potentially steady income. A bondfund’s yield, share price and total return change daily and are based on changesin interest rates, market conditions, economic and political news, and the qualityand maturity of its investments. In general, bond prices fall when interest ratesrise and vice versa.PTTRX_2

Higher

Lower

Pg 26 of 36

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Investment ObjectiveKey Guaranteed As a general account product offered through a group annuity contract,participant principal and interest are fully guaranteed by the entire generalPortfolio Fund account assets of GWL&A, which as of June 30, 2015 were $31.0 billion andinclude $1.9 billion in shareholder equity and accumulated surplus. GeneralAccount liabilities as of June 30, 2015 were $29.0 billion. This means thatPeriod Ending: 12/31/2015GWL&A holds an additional 6.6% in capital for every dollar of liability we have.Fund Operating Expenses:These assets are primarily high-quality, fixed income bonds, with 99% ratedGross 0.00%, Net 0.00%investment-grade and 16.2% rated AAA as of June 30, 2015.

Risk/Potential Return MeterRisk and Return Profile�

The investment may be most appropriate for someone wanting to safeguardprincipal value or to balance a portfolio which contains more aggressiveinvestments. The investor may be requiring stability and asset liquidity.

FOR ILLUSTRATIVE PURPOSES ONLY

KGPF_2

Higher

Lower

Pg 27 of 36

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Although data is gathered from reliable sources, including but not limited to Morningstar, Inc., the

completeness or accuracy of the data shown cannot be guaranteed. Where data is obtained from

Morningstar: ©2015 Morningstar, Inc. All Rights Reserved. The information contained herein: (1) is

proprietary to Morningstar and/or its content providers; (2) may not be copied or distributed; and (3) is not

warranted to be accurate, complete or timely. Neither Morningstar nor its content providers are responsible

for any damages or losses arising from any use of this information.

◆ Unless otherwise noted: Not a Deposit. Not FDIC Insured. Not Bank Guaranteed. Funds May Lose Value.

Not Insured by Any Federal Government Agency.

A benchmark index is not actively managed, does not have a defined investment objective, and does not

incur fees or expenses. Therefore, performance of a fund will generally be less than its benchmark index. You

cannot invest directly in a benchmark index.

Funds may impose redemption fees and/or transfer restrictions, if assets are held for less than the published

holding period. For more information, see the fund's prospectus and/or disclosure documents.

©2015 Great-West Life & Annuity Insurance Company. All rights reserved.

Holdings and composition of holdings are subject to change. Due to rounding or other factors, asset

allocations and/or largest holdings may not equal 100.0%.

The Net expense ratio shown is net of any fee waivers or expense reimbursements.

Asset allocation funds are generally subject to a fund operating expense at the fund level, as well as

prorated fund operating expenses of each underlying fund in which they invest. For more information, please

refer to the fund prospectus and/or disclosure document.

The date in a target date fund's name represents an approximate date when an investor is expected to retire

(which is assumed to be at age 65) and/or begins withdrawing money. The principal value of the funds is not

guaranteed at any time, including the target date. For more information, please refer to the fund prospectus

and/or disclosure document.

Pg 28 of 36

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