INVESTMENT OPTION ADDITION REQUEST RETIREMENT By signing this document the Plan Trustee/Plan Representative

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  • INVESTMENT OPTION ADDITION REQUEST

    Nationwide Retirement Plans • 1-800-548-6436 • Fax: 1-877-NF401ks (1-877-634-0157)

    Section 1 GENERAL INFORMATION

    The Plan Sponsor of_____________________________________________________________________________________________

    wishes to add the following fund(s) as investment option(s) to the Plan. Please indicate the funds selected with an "X" below:

    (Legal Plan Name as stated on the Program Agreement Face Page)

    (Obtain this information from your Pension Plan Administrator)

    RETIREMENT INNOVATOR

    Case Number: _______________________________________________

    By signing this document the Plan Trustee/Plan Representative recognizes that some funds within the list below have identical

    portfolio holdings but different share classes and pricing tiers. Further, by choosing to offer more than one share class of the same

    fund, the Plan Trustee/Plan Representative understands that participants invested in different share classes of the same fund will

    incur different Asset Fees and may realize different performance results.

    (must be a Nationwide business date): _________________(MM/DD/YYYY) (Requests will not be accepted prior to one month in advance of the above process date. If no date provided, standard processing applies.

    Requested Process Date

    Select FUND NAME VRU Code

    Total Fund Prospectus

    Gross Expense Ratio

    Fund Payments to NationwideFund Code

    Abrden Divrs Altrnatv A 1703 2.20.5GASA

    Abrden Emrg Mkt A 4370 1.450.5BWTA

    Abrden Eq Lng Shrt A 1704 2.850.5GMLA

    Abrden Glbl Eq A 253 1.730.5GGLA

    Abrden Glbl Natrl Rsrc A 1525 1.560.4GGNA

    Abrden Intl Eq A 251 1.420.5GIGA

    Abrden US Eq A 254 1.330.5GGTA

    Alger Cap App Focs I 1872 1.150.5ALXA

    Alger Cap App Inst I 1871 1.190.5ALRA

    Alger Grn A 4433 1.490.5BZGA

    Alger MdCap Gr Inst I 1873 1.230.5ALMA

    Alger Spectra Inst 4319 1.430.5BURA

    AllBer Blnd Style Intl A 2218 2.090.5AIZA

    AllBer Cor Oppr K 1849 1.480.5ADKA

    AllBer Disc Gr K 1855 1.260.5AKKA

    AllBer Disc Val K 1856 1.250.5ASSA

    AllBer Eq Inc K 1857 1.120.5AUXA

    AllBer Glbl RealEstInvmt K 2216 1.430.5AKRA

    AllBer Glbl Rsk Alloc K 1848 1.070.5ACKA

    AllBer Glbl Val K 1850 2.110.5AGKA

    AllBer Gr Inc K 1851 1.050.5ALKA

    AllBer Hi Inc A 1007 0.910.5AGDA

    AllBer Intl Gr K 1852 1.290.5AAWA

    AllBer Intl Val K 1853 1.280.5AAKA

    AllBer Intmd Bd K 2217 0.990.5AQKA

    PNF-0180AO.121

    This is page _____ of _____. To facilitate processing of your fund addition, please indicate how many pages are included in this request. The page 1 and the signature page must always be submitted to complete the request.

    10/2013

  • AllBer LgCap Gr K 1854 1.250.5AALA

    AllBer Shrt Dur A 2219 0.940.5ADPA

    AllBer Val K 1858 1.140.5AVKA

    AllnzGI Focs Gr A 293 1.110.5PCFA

    AllnzGI LgCap Gr A 2804 1.110.5RLAA

    AllnzGI MdCap A 2805 1.130.6RDAA

    AllnzGI NFJ Divd Val A 2011 1.060.5PNEA

    AllnzGI NFJ Intl Val A 2802 1.30.5FJAA

    AllnzGI NFJ LgCap Val A 2490 1.110.5PNBA

    AllnzGI NFJ MdCap Val A 646 1.320.5PRNA

    AllnzGI Oppr A 2803 1.320.5PPAA

    AllnzGI Tech A 1520 1.570.5PRGA

    Am Indep Stk A 3968 1.810.5BEHA

    Am Indep US Infl Indx A 3970 1.10.5BEKA

    AmBcn Bal Adv 2680 1.10.5BXXA

    AmBcn Intl Eq Adv 2551 1.320.5ANLA

    AmBcn LgCap Val Adv 2552 1.090.5LCGA

    AmBcn SmCap Val Adv 2553 1.420.5SCVA

    AmCent Cap Val A 1110 1.350.6ALVA

    AmCent Cor Pls A 2751 0.90.5AQQA

    AmCent Divrs Bd A 582 0.850.5ADBA

    AmCent Eq Gr A 714 0.930.5AEGA

    AmCent Fdmntl Eq A 2220 1.260.6ADAA

    AmCent Glbl Gr A 259 1.350.6ACTA

    AmCent GNMA A 1235 0.80.5AGNA

    AmCent Hertg A 583 1.260.6ACHA

    AmCent Inc Gr A 572 0.930.5ACIA

    AmCent Infl Adj Bd A 707 0.720.5ABIA

    AmCent Intl Bd A 1236 1.050.6AIBA

    AmCent Intl Gr A 571 1.540.6TCGA

    AmCent Lg Co Val A 469 1.120.6ALCA

    AmCent MdCap Val A 4578 00.6CFRA

    AmCent RealEst A 718 1.40.6ACRA

    AmCent Sel A 705 1.250.6ACSA

    AmCent Shrt Dur A 2752 0.850.5AQSA

    AmCent ShtDrInflPrtBd A 2681 0.820.5APOA

    AmCent Sm Co A 711 1.140.6ACQA

    AmCent ST Govt A 710 0.80.5ABGA

    AmCent Ultra A 703 1.240.6ACAA

    AmCent Val A 720 1.250.6ACVA

    AmCent Vis A 1237 1.260.6AWVA

    AmFds Am Bal R3 816 0.950.6ARLA

    AmFds Am Hi Inc Tr R3 368 1.030.6ARIA

    AmFds Am Mut R3 387 0.970.6ARMA

    AmFds AMCAP R3 292 1.040.6ARAA

    PNF-0180AO.121

    This is page _____ of _____. To facilitate processing of your fund addition, please indicate how many pages are included in this request. The page 1 and the signature page must always be submitted to complete the request.

    10/2013

  • AmFds Bd Fd Am R3 814 0.920.6ARBA

    AmFds Cap Inc Bldr R3 484 0.980.6ARRA

    AmFds Cap Wld Bd R3 364 1.210.6ARCA

    AmFds Cap Wld Gr Inc R3 388 1.10.6ARWA

    AmFds EuroPacfc Gr R3 506 1.140.6AERA

    AmFds Fdmntl Inv R3 815 0.960.6ARFA

    AmFds Gr Fd Am R3 662 0.980.6ARGA

    AmFds Inc Fd Am R3 692 0.960.6ARDA

    AmFds Intmd Bd Fd Am R3 693 0.960.6AROA

    AmFds Invmt Co Am R3 700 0.980.6AGVA

    AmFds New Econ R3 702 1.180.6AGCA

    AmFds New Prspct R3 706 1.120.6ARNA

    AmFds New Wld R3 708 1.360.6ANWA

    AmFds SmCap Wld R3 726 1.420.6ARSA

    AmFds US Govt Sec R3 753 0.950.6ARVA

    AmFds Wshngtn Mut Inv R3 767 0.970.6AWMA

    Astn Mntg Cldwl Gr R 1145 1.310.5AMXA

    BlkRk AllCapEnrgyRsrcInv A 2852 1.350.5BACA

    BlkRk Basic Val Inv A 2013 0.860.5BMDA

    BlkRk Cap App Inv A 1051 1.090.5MFGA

    BlkRk Cor Bd Port Inv A 471 1.020.5BCBA

    BlkRk Emrg Mkt Inv A 1299 1.680.5MCXA

    BlkRk Enrgy Rsrc Inv A 1521 1.340.5BSSA

    BlkRk Eq Divd Inv A 1048 0.990.5MDVA

    BlkRk Eurofd Inv A 1049 1.330.5MDFA

    BlkRk Flex Eq A 1798 1.40.5BBMA

    BlkRk Glbl Alloc Inv A 1052 1.160.5MDLA

    BlkRk Glbl SmCap Inv A 1053 1.430.5MDGA

    BlkRk GNMA Inv A 694 1.060.5BGPA

    BlkRk Hi Yld Bd Inv A 592 1.010.5BYBA

    BlkRk Hlth Scnc Oppr Inv A 1795 1.30.5BSAA

    BlkRk Infl Prtct Bd Inv A 2809 0.960.25BPRA

    BlkRk Intl Bd Inv A 695 1.260.5BBPA

    BlkRk Intl Inv A 4242 1.650.5BQTA

    BlkRk Intl Oppr Inv A 594 1.580.5BISA

    BlkRk Invmt Grd Bd Inv A 4278 1.080.5BSUA

    BlkRk LgCap Cor Inv A 1057 1.280.5MLRA

    BlkRk LgCap Gr Inv A 1058 1.260.5MLHA

    BlkRk LgCap Val Inv A 1059 1.270.5MDXA

    BlkRk Lng Hrizn Eq Inv A 1999 1.290.5MEGA

    BlkRk Low Dur Bd Inv A 597 1.020.6BLDA

    BlkRk MdCap Gr Eq Inv A 361 1.550.5BMCA

    BlkRk MdCap Val Oppr Inv A 1061 1.250.5MDRA

    BlkRk Mgd Vltlty Inv A 1793 1.280.65BPCA

    BlkRk Natrl Rsrc Tr Inv A 1062 1.130.5MRFA

    PNF-0180AO.121

    This is page _____ of _____. To facilitate processing of your fund addition, please indicate how many pages are included in this request. The page 1 and the signature page must always be submitted to complete the request.

    10/2013

  • BlkRk Pacfc Inv A 1063 1.180.5MDCA

    BlkRk SmCap Gr Eq Inv A 362 1.170.5BSCA

    BlkRk SmCap Gr II Inv A 1064 1.580.5MDSA

    BlkRk Ttl Rtn Inv A 2014 1.120.6BMHA

    BlkRk Val Oppr Inv A 1065 1.270.5MSXA

    Calamos Glbl Eq A 2855 1.530.5CAGA

    Calamos Glbl Gr Inc A 2857 1.330.5CLOA

    Calamos Gr A 2861 1.290.4CVRA

    Calamos Gr Inc A 2859 1.090.4CVTA

    Calamos Intl Gr A 2863 1.60.5IGRA

    Calamos Mkt Nutrl Inc A 2865 1.180.5CIVA

    Clvrt Bd A 1298 1.160.5CSIA

    Clvrt Eq A 264 1.220.5CAEA

    Clvrt Glbl AltrnatvEnrgy A 2174 2.570.4CGAA

    Clvrt Inc A 261 1.30.5CAIA

    Clvrt Intl Eq A 266 1.860.5CAWA

    Clvrt SmCap A 2846 1.780.4CCVA

    Clvrt Soc Indx A 263 1.110.5CASA

    CohenStrs Intl Real A 2361 1.560.4IRFA

    Col Bal A 2890 1.190.5CBLA

    Col Contra Cor A 2893 1.210.5LCCA

    Col Divd Oppr A 2110 1.10.5AIUA

    Col Divrs Eq Inc A 120 1.120.5ADEA

    Col Emrg Mkt Bd A 3974 1.180.5BEPA

    Col Eq Val A 125 1.260.5AEVA

    Col Glbl Opp A 1976 1.260.5AIMA

    Col Hi Yld Bd A 130 1.10.5AEXA

    Col Infl Prtct Sec A 2693 1.050.5APRA

    Col Lfgoal Gr A 2913 1.330.5HBJA

    Col Lg Cor Quant A 1725 1.220.5AQEA

    Col LgCap Gr A 1869 1.210.5CLEA

    Col MdCap Val Oppr A 1975 1.310.5AMVA

    Col Mult Adv SmCap Val A 566 1.770.5AXSA

    Col Seligman Glbl Tech A 2712 1.530.5SHGA

    Col Seligman SmCap Val A 2771 1.550.5SVXA

    Col Strat Inc A 2916 1.030.5HBMA

    DE Divrs Inc A 1242 0.950.5DPDA

    DE Emrg Mkt A 1243 1.750.5DDEA

    DE Intl Val Eq A 1247 1.50.5DGXA

    DE REIT A 1402 1.350.5DPEA

    DE Sel Gr A 1606 1.270.5DADA

    DE SmCap Val A 1607 1.370.5DAEA

    DE Smid Cap Gr A 1245 1.250.5DFCA

    DE Val A 1609 1.170.5DAIA

    Diamond Hill LgCap A 1481 1.060.5DHLA

    PNF-0180AO.121

    This is page _____ of _____. To facilitate processing of your fund addition, please indicate how many pages are included in this request. The page 1 and the signature page must always be submitted to complete the request.

    10/2013

  • Diamond Hill SmCap A 1482 1.310.5DHSA

    Drey Active MdCap A 734 1.20.55DNLA

    Drey App 217 0.970.5DAFA

    Drey Bal Oppr A 1522 1.370.5DBOA

    Drey Glbl RealEst Sec A 2753 1.550.5DXLA

    Drey Glbl Stk A 2755 1.280.5DXSA