Forms checklist

Helping to prevent Not In Good Order issues

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Page 1 Are the plan name and billing group number indicated in the Plan Information section? Is the participant Social security number CLEAR and legible? Is the participant information section complete with a street address (not just a PO Box) Have you selected the Type of Withdrawal and indicated the percentage or dollar amount being requested?

Page 2 For cash distributions only requesting an electronic funds transfer: Have you selected the type of account - checking or savings? Are the 9 digit ABA routing number and the participant bank account number clear and legible? For rollover and participant check requests, are the payment and mailing instructions complete?

Page 3 Has only one reason for withdrawal been selected? Are the Withdrawal amount or Vesting percentage completed for all sources requested to be handled? (Deferral, Match, Rollover, Profit Sharing, Employer Contribution, Safe Harbor etc). If there are non vested amounts have you marked the appropriate box on how to handle those funds? Has an authorized plan trustee on record with ING signed the Employer/Plan Sponsor/Named Fiduciary’s signature

section.

This checklist pertains to the following form numbers:

Withdrawal Request Termination/Retirement #83244Withdrawal Request – In Service #83062Withdrawal Request 401 – Corp. #83062 Aces TPA

ACES Money Out; Corporate

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ACES Money Out; Health, Education, Government

Please refer to the chart on the front page of the request regarding requirement of your Employer’s signature.

A Plan name or Billing Group Number(s) is listed in the Plan Information section.

The Participant Information section is complete and a street address is provided even if mailing address is a PO Box.

The Withdrawal amount has been indicated. The Participant’s Authorized Signature section has been signed. If your plan is Erisa, you may also need to complete the Spousal Consent. If your funds are being moved to another carrier, a Letter of Acceptance been

sent to us or is included with this request.

This checklist pertains to the following form numbers:

Employee Termination/Retirement Withdrawal Request #83501Deferred Compensation Withdrawal Request #83504Hardship Withdrawal Request #83488Unforeseeable Emergency Withdrawal Request #83498Miscellaneous Withdrawal Request #83503

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Death Claims

A Plan name or Billing Group Number(s) is listed in the Plan Information section.

Submit a certified death certificate. Please check your plan requirements. The Participant Information section is complete and a street address is

provided even if mailing address is a PO Box. Indicate a percentage or dollar amount, if a Partial Withdrawal is requested. Indicate your tax election after reading the tax section carefully. Make sure all appropriate signatures are on the forms, including the employer,

if applicable. If your funds are being moved to another carrier, a Letter of Acceptance been

sent to us or is included with this request. An estate/trust tax identification number is required with this request, if

payment sent is being made to an estate/trust.

This checklist pertains to the following form numbers:Death Claim Form #83400Death Claim Form #83265Death Claim Form #83077

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A Plan name or Billing Group Number(s) is listed in the Plan Information Section. The Participant Information section is complete and a street address is provided

even if mailing address is a PO Box. A Reason for Withdrawal has been indicated. A Product option in the Rollover Product section has been selected. The Type of Withdrawal indicates an amount or percentage. Participant Election section and Spousal Consent sections are complete (if applicable). The Participant Consent section has been signed. If your plan is subject to Erisa or a 401 plan, the Trustee or Named Fiduciary signature is required. If your plan is a 401(k), on the last page of the withdrawal form, the Withdrawal Information, TPA certification, and Vesting information needs to be provided. Also, the Trustee or Named Fiduciary’s Certification signature section has been signed.

This checklist pertains to the following form number:Internal Rollover Form 83421

Central Rollover Unit

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An Account or Contract Number(s) is listed in the top fill able section.

The Participant Information section is complete and a street address is provided even if mailing address is a PO Box (form #83366 only).

The Withdrawal amount has been indicated.

A Reason for Withdrawal has been selected.

The Payment Information section is complete and a street address is provided even if mailing address is a PO Box (form #39298 only).

The Contract Owner/Investor’s signature section has been completed and signature is present.

This check list pertains to the following form numbers:

ING Rollover Advantage #83366Pension IRA #39298

Central Rollover Unit; continued

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Pension IRA or ING Rollover Advantage New Business Applications

Please make sure you have the correct version of the application in accordance to your state.

The name of applicant/Contract holder Information needs to be completed in its entirety.

The Participant Information section is complete and a street address is provided even if mailing address is a PO Box.

Please be sure that all columns in the Beneficiary Information section are filled in and at least one Primary Beneficiary is listed.

If applicable, in the Allocation section, please be sure that the percentages add up to 100%.

The Contract Holder’s signature section has been signed and dated.

The Producer Information section needs to be filled out in its entirety and signed by the Producer/Agent.

Central Rollover Unit; continued

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A contract number and/or Billing Group has been indicated. The participant Information Section is complete and a street address is provided even if

mailing address is a PO Box. Only one election for payout (ECO or SWO, and only one of the SWO options chosen). If SWO, the amount, specified amount of years, or percentage (if applicable) is indicated

on the line provided. If a prior year is needed/allowable, please be sure to check off the corresponding box. You choose a start date month and year, and check off one box 15th or 28th. NO other

date may be indicated. Your tax election for Federal and State Taxes (if choosing withholding) is indicated with

the proper percentage you want withheld (or provide us with the appropriate state form). If you choose to have EFT, please make sure you complete the EFT section of the form

in writing. NOTE: your first payment will be a check. Electronic deposit will start with the next payout cycle.

The participant’s Authorized Signature section on page 2 is completed, and if the Employer/TPA signature is required that it also has been signed by an authorized signer.

If plan is ERISA, the spousal consent form is completed and attached (if required).

This checklist pertains to the following form numbers:SWO/ECO Standard #83235Individual Products # 83210Other (non Gov’t 457’s) #83353

ECO/SWO/LEO (Systematic Distributions)