recordkeeperdirect®- retirement plan...

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• Type or clearly print all information in order to expedite plan installation.

• Before returning this form, be sure you have supplied all requested information and obtained all required signatures in Sections 4 and 20.

1 Employer (Plan Sponsor)Signatures of individuals authorized to sign on the employer’s behalf are required in Section 20.

Legal name of employer/company (print) Taxpayer Identification Number

Type of entity (corporation, partnership, S corp, etc.)

Address (physical address required — no P.O. boxes) City State ZIP -

Mailing address (if different from above) City State ZIP -

Name of contact Title

( ) Ext. ( )Daytime phone Fax Email address

2 Plan informationAll trustees and authorized signers listed in this section must sign in Section 20. If using Capital Bank and Trust CompanySM (CB&T) trustee services (optional) or requesting a 403(b) plan in which CB&T custodial services are required, the plan’s authorized signers should be listed below AND must sign in Section 20. IMPORTANT: All information must be provided to avoid delays in processing.

Plan name

Name of trustee (print) Name of trustee (print)

Authorized signer (non-trustee) (print) Authorized signer (non-trustee) (print)

3 Trustee and custodial services

□ Check here if this plan is a 401(k) or another qualified plan AND will use CB&T as the trustee of the plan. This service is optional.

Note: An annual trustee fee of $750 will be charged to the plan quarterly in arrears. Please read, sign and enclose the Trust Agreement.

□ Check here if this plan is a 403(b). ALL 403(b) plans must use CB&T as the custodian of the plan.

Note: An annual custodial fee of $750 will be charged to the plan quarterly in arrears. Please read, sign and enclose the Custodial Agreement.

Important: Enclose all information and documents identified on the trustee or custodial services checklist.

RecordkeeperDirect®

RetirementPlanSpecifications

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RecordkeeperDirectRetirement Plan Specifications

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4 Financial professional

□ Investment Advisor Representatives (IARs) at Registered Investment Advisor (RIA) firms (Proceed to Section 4-D on page 3.)

□ Financial representatives at broker-dealer firms (Must complete Section 4-A OR 4-B then 4-C below.)

We authorize Capital Research and Management CompanySM to act as an agent for this account. If there is more than one registered representative, use the joint registered representative ID number assigned by the broker-dealer home office.

A. Single registered representative designation

PSWRepresentative name (as it appears on firm’s registration) Rep number Branch number Existing RecordkeeperDirect Web ID

Address of office servicing account City State ZIP -

( ) Ext. ( )IARD/CRD number Email address Daytime phone Fax

B. Joint registered representative designations

Joint rep ID Dealer firm name Dealer number Branch number

Address of joint team City State ZIP -

The joint representative ID number listed above includes the following individual representatives:

1. PSWRepresentative name (exactly as it appears on firm’s registration) Rep number Existing RecordkeeperDirect Web ID

( ) Ext.IARD/CRD number Email address Daytime phone





C. Dealer firm with Selling Group Agreement (SGA)

( )Firm name (as it appears on the SGA) Dealer number Daytime phone

Address City State ZIP -

X / /Signature of person authorized to sign for the firm Date (mm/dd/yyyy)

Continued on next page

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4 Financial professional(continued)

D. IAR/RIA firm (36000)

IAR information

PSW Name of IAR (print) Advisor number (assigned by American Funds) Existing RecordkeeperDirect Web ID

Address (if different from firm address) City State ZIP -

( ) Ext. ( )Email address Daytime phone (if different from firm) Fax

801- —SEC number IARD/CRD number State registration and number

RIA firm information

( ) Ext.Name of RIA firm (as it appears on Form ADV or home office) Firm number (assigned by American Funds)* Daytime phone

Firm address City State ZIP -

By signing below, I certify that the firm listed above:

1) is an RIA with a current Form ADV filed with the U.S. Securities and Exchange Commission or a state regulatory agency,

2) is providing investment advisory services to the employer identified in Section 1 and

3) indemnifies American Funds and its affiliates for all losses they may incur as a result of misrepresentations or omissions by the RIA in connection with the RIA firm making the American Funds available to its clients.

X / /Signature of person authorized to sign for the RIA Date (mm/dd/yyyy)

*If you need assistance, call (800) 421-5450.

5 Third-Party Administrator (TPA)The TPA must be authorized for the RecordkeeperDirect program. Call us at (800) 421-9900 if you are not sure if the TPA is authorized.

Name of TPA firm (print) Taxpayer Identification Number

( ) Ext. ( ) PSW Daytime phone Fax Existing RecordkeeperDirect Web ID

Address City State ZIP -

( ) Ext.Name of installation contact Daytime phone Email address

( ) Ext.Name of ongoing services contact Daytime phone Email address

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6 Plan detailsNote: All plans must be participant directed. RecordkeeperDirect cannot support trustee-directed plans.

A. Plan status

□ Start-up plan

□ Start-up plan with rollovers. Anticipated rollover amount $

□ Transfer plan. Complete the following:

Are assets now with American Funds? □ No □ Yes If yes, account number

Prior recordkeeper

Prior investment manager

Plan assets $ as of (mm/dd/yyyy)

Active participants

Number of account balances maintained for terminated/retired employees

B. Basic plan information (You must complete all three items below.)

1. Plan’s original effective date (mm/dd/yyyy)

2. Plan tax year is: □ Calendar □ Fiscal For fiscal-year plans, through (mm/dd) (mm/dd)

3. Plan’s normal retirement age

C. Fee deduction

□ Check here to have recordkeeping fees and trustee/custodial fees (if applicable) deducted directly from participant accounts. These fees will be deducted on a pro-rata basis and may be subject to minimum average participant account value criteria.

□ Check here to authorize TPA distribution fees from participant accounts for the following fee types (TPA fees will be remitted via Automated Clearing House (ACH) to your TPA):

Distribution fee (excluding QDROs and RMDs) — Fees are deducted from one-time distributions $

Loan initiation fee — Fees are deducted in addition to the loan amount $

□ Check here to authorize RIA fees (only if using an RIA firm). Provide basis points per year

Frequency: How frequently would you like these fees paid out? (Select only one option below.)

□ Monthly □ Quarterly □ Semiannually □ Annually

Note: You may request payment of other TPA or RIA fees via ACH on our website: americanfunds.com/retiresponsor.

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7 Contribution typesAll contributions must be submitted via ACH.

Check all that will apply:

Employee contributions: Employer contributions:

□ Pre-tax elective deferrals □ Employer match

□ Roth elective deferrals □ Safe harbor match

□ Voluntary participant after-tax contributions □ QACA match

□ Rollover contributions □ Employer profit-sharing (discretionary nonelective)

□ Roth rollover contributions □ Safe harbor nonelective

□ QACA nonelective

□ QNEC

□ QMAC

□ Money purchase contribution

8 LoansAn $85 loan setup fee and a $50 annual maintenance fee will be deducted from the participant’s account.

Does your plan offer participant loans? □ Yes □ No

Does the plan currently have any outstanding loans? □ Yes □ No

What is the payroll frequency for your plan? □ Weekly □ Biweekly □ Semimonthly □ Monthly □ Quarterly

Loans will be allowed for:

□ General purpose. Repayment term years (maximum is five)

□ Purchase of primary residence. Maximum term years

What is the interest rate calculated as? Prime + %

What is the minimum loan amount? $ (not to exceed $1,000)

What is the maximum loan amount? $ (not to exceed $50,000) OR % of vested account balance (not to exceed 50%)

How many loans will be permitted at one time? (If left blank, the default will be one (1) loan.)

9 Withdrawals

A. Are hardship withdrawals allowed?

□ Yes □ No

B. What in-service withdrawals other than hardship withdrawals are allowed? (Check all that apply.)

□ Premature □ 59½ □ Normal retirement

C. Is your plan using an Eligible Automatic Contribution Arrangement (EACA) with the 90-day permissible withdrawal option?

□ Yes □ No

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10 Vesting

If your plan has multiple vesting schedules, call (800) 421-6019 for assistance in completing this section.

A. Method (choose one): □ Elapsed time □ Years of service

B. Computation period (choose one): □ Plan year □ Anniversary year

C. Automatic vestingParticipant will become 100% vested (check all that apply):

✕ At normal retirement age as designated in Section 6-B.

□ At early retirement age of Years of service required

□ Upon participant disability

□ Upon participant death

D. ScheduleVesting will be (Select one of the following two options):

1. □ Full and immediate vesting (100% at all times)

OR

2. □ Based on years of service (Select one of the following four options and complete, if applicable.)

Years of service 1 2 3 4 5 6

a. □ % % 100%

b. □ % % % 100%

c. □ % % % % 100%

d. □ 0% 20% 40% 60% 80% 100%

The vesting schedule will be based on all years of service unless one of the following is checked:

□ Years of service after reaching age 18

□ Years of service starting on or after the effective date of the plan

Notes: • Safe harbor match and safe harbor nonelective will be established with immediate vesting schedules. Qualified automatic contribution arrangements (nonelective and match) will be established with a 2-year cliff vesting schedule.

• If an immediate vesting schedule applies to the qualified automatic contribution arrangement instead, check here. □

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11 Share class selectionNote: A plan can use only one share class.

Indicate which of the following retirement plan share classes (R shares) you and your financial professional have determined is right for your plan.

□ R-2 □ R-3 □ R-4 □ R-5*

*IARs can only select R-5 shares.

12 Fund selectionSelect up to a maximum of 20 funds.

Target date

□ American Funds Target Date Retirement Series®*

* The target date series is composed of ten funds, each with a retirement date ranging from 2010 through 2055 in five-year increments. The target date series is considered one investment option for the purpose of the 20-fund limit. The American Funds Target Date Retirement Series meets the Department of Labor’s requirements for a Qualified Default Investment Alternative (QDIA) under the Pension Protection Act of 2006.

Portfolio

□ American Funds Global Growth PortfolioSM (XX55)

□ American Funds Growth PortfolioSM (XX53)

□ American Funds Growth and Income PortfolioSM (XX51)

□ American Funds Balanced PortfolioSM (XX50)

□ American Funds Income PortfolioSM (XX47)

□ American Funds Preservation PortfolioSM (XX45)

Growth

□ AMCAP Fund® (XX02)

□ EuroPacific Growth Fund® (XX16)

□ The Growth Fund of America® (XX05)

□ The New Economy Fund® (XX14)

□ New Perspective Fund® (XX07)

□ New World Fund® (XX36)

□ SMALLCAP World Fund® (XX35)

Growth-and-income

□ American Funds Developing World Growth and Income FundSM (XX100)

□ American Mutual Fund® (XX03)

□ Capital World Growth and Income Fund® (XX33)

□ Fundamental Investors® (XX10)

□ International Growth and Income FundSM (XX34)

□ The Investment Company of America® (XX04)

□ Washington Mutual Investors FundSM (XX01)

Equity-income

□ Capital Income Builder® (XX12)

□ The Income Fund of America® (XX06)

Balanced

□ American Balanced Fund® (XX11)

□ American Funds Global Balanced FundSM (XX37)

Bond

□ American Funds Mortgage Fund® (XX42)

□ American High-Income Trust® (XX21)

□ The Bond Fund of America® (XX08)

□ Capital World Bond Fund® (XX31)

□ Intermediate Bond Fund of America® (XX23)

□ Short-Term Bond Fund of America® (XX48)

□ U.S. Government Securities Fund® (XX22)

Cash-equivalent

□ American Funds Money Market Fund® (XX59)

Note: To designate a default investment option, complete Section 15.

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13 Forfeiture holding account

Indicate which fund should be used to hold forfeitures (the target date series is not available for this purpose).

14 Investment conversion options — for transfer plans only

Note: Select one option below. If no selection is made, option A will apply.

A. □ Target Date Retirement Series conversion (cash liquidation to the American Funds Money Market Fund holding account; conversion assets and future contributions will be allocated to the appropriate target date fund if participant elections are not updated).

• Plan assets will remain in the money market investment until American Funds receives the final valuation reconciled to participants’ accounts.

• This conversion method requires the American Funds Target Date Retirement Series to be the plan’s default investment option. Plan sponsors may receive QDIA safe harbor protection by using the target date funds as the plan’s default option and by allowing plan participants to make alternative elections before conversion.

B. □ Cash conversion (cash liquidation to the American Funds Money Market Fund holding account; conversion assets and participant future contributions will be allocated according to participant elections. If investment elections are not made, the assets will be invested in the plan’s default investment).

• Plan assets will remain in the money market investment until American Funds receives the final valuation reconciled to participants’ accounts.

• This conversion method does not require the use of the target date series as the plan’s default investment option.

C. □ Mapping conversion (cash liquidation to the American Funds Money Market Fund holding account; conversion assets and participant contribution elections will be mapped to designated funds).

• Plan assets will be invested in the money market investment until American Funds receives a fund breakdown.

• This conversion method does not require the use of the target date series as the plan’s default investment option.

Note: Consult your TPA to verify that they are able to provide the investment mapping reconciliation by fund, by money source, by participant, and to discuss any additional TPA fees.

15 Default investment option — for all plans

Which investment option will be the plan’s default investment if a participant fails to provide investment instructions? If you have selected the target date series conversion (option A above), the American Funds Target Date Retirement Series will be the default investment option.

□ American Funds Target Date Retirement SeriesWhen the target date series is used, the appropriate fund will be determined by the participant’s birth date on file and the plan’s normal retirement age. Participants who have already reached their plan’s normal retirement age will be defaulted into the most conservative target date investment — American Funds 2010 Target Date Retirement Fund.

□ Other investment option

Note: The investment option listed above must be one of the plan’s investment options selected in Section 12.

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16 Mapping conversions

Complete this page only if option C was selected on the prior page. On the lines below, indicate how current funds will be mapped to new funds.

Current fund Map to New fund (maximum is 20; use only the funds selected in Section 12)

1. 1.

2. 2.

3. 3.

4. 4.

5. 5.

6. 6.

7. 7.

8. 8.

9. 9.

10. 10.

11. 11.

12. 12.

13. 13.

14. 14.

15. 15.

16. 16.

17. 17.

18. 18.

19. 19.

20. 20.

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17 ACH bank information (required for all RecordkeeperDirect plans)

NOTE: Attach an unsigned, voided check below. The document you attach must be preprinted with the bank name and registration, routing number and account number. Please do not staple. A signature guarantee will be required in Section 20 if the name on the bank account is different from the Plan Sponsor name.

PAY TO THE ORDER OF $

DOLLARS

|:999999999|: 0000000000||:

Acme Incorporated

Anytown Bank VOIDDATE

Bank account numberBank routing number

Bank name

Bank account registration

Tape

you

r do

cum

ent h

ere.

Complete the following ONLY if you do not have a voided check for the account you plan to use. (A signature guarantee will be required in Section 20.)

Bank name Bank routing number

Bank account number Bank account registration (the name preprinted on the check)

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18 Plan Sponsor website access information

The employer-assigned contacts listed below will be provided access to the Plan Sponsor website located at americanfunds.com/retiresponsor. See below for a description of the access types.

Plan Sponsor website access levelTransactions allowed Full* Partial Limited

View plan and participant balances and transaction history • • •

Add/update participant information • • •

Process payroll contributions • • •

Order reports • •

Initiate and/or approve online requests •

*Full access is available only to Trustees and Authorized Signers.

If you would like to provide access to the Plan Sponsor website to additional contacts, list them below and identify the access requested:

Name of employee Title □ Full □ Partial □ Limited




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19 Distribution sequence provisions

The plan document defines the rules under which distributions are to be made. The following distributions are standardized according to IRS rules:

• Loans will be processed proportionately from each contribution type unless alternate instructions are provided here:

• Hardships will come only from elective deferrals unless alternate instructions are provided here (In no event can hardship withdrawals come from QNECs, QMACs or safe harbor contributions.):

• In-service distributions prior to age 59½ will come from company contributions unless alternate instructions are provided here (In no event can in-service distributions prior to age 59½ come from elective deferrals, QNECs, QMACs or safe harbor contributions.):

• All partial distributions will be taken proportionately from each contribution type (including Roth assets) unless alternate instructions are provided here:

• ADP refunds will come from elective deferrals. Inform us when it is appropriate to forfeit an employer-matching contribution as a result of an ADP refund.

• ACP refunds will come first from employee after-tax contributions, then from company-matching contributions.

• A correction under EPCRS/415 excess will come first from unmatched employee contributions, then from matched employee contributions (associated match, if any, will be forfeited). To the extent an excess remains, employer contributions will be forfeited and placed in the plan’s forfeiture account.

• A refund of excess deferrals will be made from pre-tax and Roth elective deferral sources.

• If a participant has after-tax contributions in the plan and takes partial distributions, we will follow the regulations under Internal Revenue Code Section 72 to determine the taxable portion of the distribution.

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RecordkeeperDirectRetirementPlanSpecifications

Plan name

20 Authorized signatures and guarantees

Type or clearly print the names of all trustees and others who will have the right to approve plan transactions. All trustees and others authorized to approve plan transactions must sign here.

Capital Research and Management Company (CRMC), or one of its affiliates, is authorized to access the bank account listed on this form on behalf of the plan so that contributions can be remitted via ACH. The Plan Sponsor has full responsibility for this retirement plan. The signatory(ies) below grant(s) CRMC the authority to make withdrawals from the account.

In consideration of CRMC acting on such instructions and processing such transactions, I/we agree to hold harmless and indemnify CRMC; any of its affiliates or mutual funds managed by such affiliates; and each of their respective directors; trustees; officers; employees; and agents from any losses, expenses, costs or liability (including attorney fees) that may be incurred as a result of CRMC establishing these privileges or acting on such instructions.

The Plan Sponsor agrees to provide CRMC with 30 days’ notice prior to closing or changing the bank account provided in Section 17.

I/We, as (an) authorized signer(s), am (are) solely authorized to furnish CRMC, its representatives and affiliates (the “recordkeeper”) with employer instructions to effect plan transactions.

NOTE: The signature of one of the authorized signers named below must be guaranteed if either of the following conditions exist: the company named on the ACH bank account is different from the name of the Plan Sponsor or if you are NOT attaching a voided check.

X / /Name (print) Signature Date (mm/dd/yyyy)




If a signature guarantee is required, the guarantee must be performed by a bank, savings association, credit union, member firm of a domestic stock exchange or the Financial Industry Regulatory Authority, that is an eligible guarantor institution. A notary public is NOT an acceptable guarantor. The guarantee must be in the form of a stamp or a typewritten or handwritten guarantee that is accompanied by a raised corporate seal.

SendIfasignatureguaranteeisNOTrequired, you can fax the completed installation kit to (855) 521-9952. Otherwise, mail your completed installation forms and service agreement to the address below.

AmericanFundsRecordkeeperDirectc/o Retirement Plan Services

Regular mail Overnight mailP.O. Box 6040 12711 N. Meridian St.Indianapolis, IN 46206-6040 Carmel, IN 46032-9181

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