Instructions Order #154195 12/11/2017

mutual fund custodial accounttransfer or rollover request section-By-section instructions

Section 1: Account owner informAtion•Listaccountownername,addressandcompleteSocialSecurityNumber/TaxIdentificationNumber.

Section 3: trAnSfer or roLLoVer Amount•Indicateamountbyselectingtheoptionsavailable.•Timingforthetransferorrollover,selectassoonaspossibleorindicateaspecificdate.•Ifrequestingapartialtransferorrollover,includethepercentageordollaramount.

Section 5: continuAtion of PreViouS 72(t) eLection•Completethissectiononlyifitappliestothisparticulartransferorrollover.

Section 6: AuthorizAtion•Theaccountownermustsignanddatethissection.•Ifthereisanauthorizedsigner,suchasapowerofattorney,includethesigner’stitleandanysupportingpaperwork

•Completeallfieldsinthissection.•Includethestreetaddressandphonenumber for thecurrent trustee/custodian/insurancecarrier.Youmustprovidetheactualstreetaddress;noPostOfficeboxes.

•TimingforTransferorRollover:Oncewereceivearequest,weforwardittothecurrenttrustee/custodian/insurancecarrier.Somecurrenttrustees/custodians/insurancecarrierswillnothonoraspecificdateandwillinsteadprocesstherequestonthedatetheyreceiveit.Youshouldcontactthecurrenttrustee/custodian/insurancecarriertoverifytheirpolicy.

Section 2: current truStee/cuStodiAn/inSurAnce cArrier informAtion

Section 4: Account trAnSfer or roLLoVer•“TransferorRolloverFrom”=thecurrentproducttype.•“TransferorRolloverTo”=thenewproducttype.•For transfer to or from an IRAwhich involves a conversion or recharacterization, please include the IRAConversion or IRARecharacterizationRequest(154174)withthisrequest.

VoyaInstitutionalTrustCompany,CustodianRecordkeepingprovidedbyVoyaRetirementInsuranceandAnnuityCompany(the“Company”)Members of the Voya® family of companiesfax: 860-580-0919email: mutualfundService@voya.commail: Po Box 10450, des moines, iA 50306-0450 CustomerService:699WalnutStreetSTE.1350,DesMoines,IA50309-3942Website:Voya.comPhone:888-854-5950

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PhoneCarrierName

StateCity ZIP

StreetAddress(PO boxes are not permitted)

AnnuityContractNumber/AccountNumberbeingtransferred

2. current truStee/cuStodiAn/inSurAnce cArrier informAtion

cFixedAnnuitycVariableAnnuitycMutualFundcBrokeragecCD

cOther

type (Select one)

i wish to liquidate and transfer or rollover: (Select one)

cthefullvalue(approximate amount) $ .

capartialvalueintheamountof$_________________or____________%ofmypresentaccount.

to acNeworcExistingAccount(Provide existing account number)

i understand i will incur a penalty of: c 0% or %, totaling $ , by liquidating the requested amount.

3. trAnSfer or roLLoVer Amount

mutual fund custodial accounttransfer or rollover request

1. Account owner informAtion SSN/TIN (Required)

Name

City State ZIP

Address

cAssoonaspossibleorcOnaspecificdate______/______/______

timing for transfer or rollover

VoyaInstitutionalTrustCompany,CustodianRecordkeepingprovidedbyVoyaRetirementInsuranceandAnnuityCompany(the“Company”)Members of the Voya® family of companiesfax: 860-580-0919email: mutualfundService@voya.commail: Po Box 10450, des moines, iA 50306-0450 CustomerService:699WalnutStreetSTE.1350,DesMoines,IA50309-3942Website:Voya.comPhone:888-854-5950

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4. Account trAnSfer or roLLoVer

5. continuAtion of PreViouS 72(t) eLection

cCheckhereifyouplantocontinueyour72(t)program.You must complete and submit a 72(t) Payment request (154733) to initiate payments for your new account. to obtain a 72(t) Payment request, please contact us at 888-854-5950.

this election can only be made if the transfer or rollover is into a new account.

Iamcurrently receivingsubstantiallyequalperiodicpayments thatcomplywith InternalRevenueCodeSection72(t)(2)(A)(iv),asapplicable,whichpermitmetoreceivepaymentsinsubstantiallyequalinstallmentswithoutincurringanypenaltytaxesnormallyapplicabletodistributionsbeforeage591/2.Itismyintentionthatthesepaymentscontinuetobedistributedfromthenewaccountinthesameamountandunderthesamemethodaswasbeingusedbeforethetransferorrollover(orundertherequiredminimumdistributionmethod,ifachangetothatmethodispermittedunderRev.Rule2002-62).

trAnSfer or roLLoVer from: trAnSfer or roLLoVer to:

cTraditionalIRA cTraditionalIRA

cRothIRA cRothIRA

cSIMPLEIRA3ParticipationDate cSIMPLEIRA5,6

cSEP-IRA cSEP-IRA5

c401(k)2,4

cTSA/403(b)1,2

cGovernmental457(b)

cNon-qualifiedascontribution

cQualifiedOther

Beneficial(Inherited)IRA

cTraditionalIRAcRothIRAcSIMPLEIRA3

cSEP-IRA

1All existing Tax Sheltered Annuity (TSA) loans must be reconciled with your current trustee/custodian/carrier before the transfer or rollover.2For direct rollover only.3Not eligible to be transferred to a Traditional IRA or SEP-IRA in first 2 years.4Verify all plan requirements with plan administrator before submitting.5For Voya Select Advantage IRA and Voya Select Advantage Advisory IRA only. 6 In the first 2 years, only rollovers from another SIMPLE IRA are permitted. After two years of participation, rollovers can be accepted from other IRAs or Qualified Plans. SIMPLE IRAs may not accept rollovers from Roth IRAs or designated Roth accounts of employer-sponsored plans.

for transfer to or from an irA which involves a conversion or recharacterization, please include the irA conversion or irA recharacterization request (154174) with this request.

Beneficial(Inherited)IRA5

cTraditionalIRAcRothIRAcSIMPLEIRAcSEP-IRA

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6. AuthorizAtion (Signatureguaranteemayberequired)

Youherebycertifythatyouhavereadandunderstandthetermsofthisformandthattheinformationprovidedonthisformistrueandcompletetothebestofyourknowledge.

OwnerSignature DateSignature Guarantee (Ifapplicable)

Affixyourmedallionsignatureguaranteestampbelow.Pleasenotethat this formmaybe imagedandyour transactionmaybedelayedwhenthestampisillegibleonscanneddocuments.Theservicingproducerisnotpermittedtoactassignatureguarantee.

FirmNameonMedallion ID# Phone

u.S. tAXPAYer certificAtionSunder penalties of perjury, i certify that:

1. the taxpayer identification number that appears on this form is correct. 2. i am not subject to back-up withholding due to failure to report interest and dividend income; cif i am subject to backup withholding, i have checked here. 3. i am a u.S. person.

if you are a non-resident alien, please check the box and provide your country of residence below.

c under penalties of perjury, i certify that i am a non-resident alien, and my country of residence is: .

the amount paid to you will be subject to 30% tax withholding unless you submit an irs form W-8 and are entitled to claim a reduced rate of withholding under the applicable u.s. tax treaty.

the internal revenue Service does not require your consent to any provision of this document other than the certifications (in bold above) required to avoid back-up withholding.