Gypsum Management and Supply, Inc. 401(k) Savings Plan
E n r o l l m e n t R e q u e s t an d C o n t r i b u t i o n A g r e e m e n t
Name:
SSN:
Address:
Birth Date:
Hire Date:
Dept./Div.:
I hereby elect not to participate in the Plan at this time. (Sign and date this section only )
_____
Employee Signature
Date
_____
Plan Administrator Signature
Date
I hereby elect to participate in the Plan. (Complete Sections 1 and 2 below)
SECTION 1. DEFERRAL ELECTION
Your salary deferral contributions are subject to a statu tory limitation ($18,000 for 2015 ). However, if you are now
age 50 or over, or will be by the end of the year, you may elect to make additional salary deferral contributions (i.e.
“catch-up contributions”) up to a statutory limitation ($6,0 00 for 2015) by completing a Catch-Up Provision Election
Form. Please see your Benefits Coordinator to obtain this form.
I hereby elect to have the following amount withheld from my pay each pay period and contributed to the Plan:
(Complete one – whole numbers only).
% of my Annual Compensation (as defined in the Plan) Per Pay Period (2% Minimum) OR
$
Per Pay Period ($10 Minimum)
I hereby authorize the payroll deductions above and understand that my election shall take effect on the next
quarterly entry date (January 1, April 1, July 1 or O ctober 1) after the Plan administrator processes my request. I
understand that I may revoke or change my deferral election only as provided in the Plan and summarized in the
Summary Plan Description and the enrollment materials provided to me. I further acknowledge receipt of the
notice regarding the default investment and the summaries for fund s available under Section 2.
_____
Employee Signature
Date
_____
Plan Administrator Signature
Date
PLEASE NOTE:
To finalize this Enrollment Request and Contribution Agreement, please
complete pages 2 and 3 of this form. This information will direct how your deferrals are to be
invested.
Page 1 of 3
SECTION 2. INVESTMENT ELECTIONS
Indicate below fund allocations for the investment of your total account in whole percentages.
The investment lineup is divided into 2 categories, Target Date Funds and Core Funds.
“Target Date” Funds are designed for participants that want a diversified portfolio that becom es more
conservative as they move toward retirement. The funds offered in this category are the T. Rowe Price
Target Date Funds and are listed below. While these funds target a participant ’s retirement date, there
is no guarantee at any time of a certain level of income or the participant’s ability to retire. That is
dependent upon many other decisions including how much you contribute and investment changes.
These funds are offered in 5 year increments that are designed to correspond with the year you will be at
or near age 65. For example, if you are 32 years old today, you will retire in 33 years. 2012+33 = 2045.
The T. Rowe Price Retirement 2045 fund would be the fund designed for your current age.
%
T. Rowe Price Retirement 2010 (TRRAX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born in or before 1947 should consider this fund.
%
T. Rowe Price Retirement 2015 (TRRGX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born between 1948 and 1952 should consider this fund.
%
T. Rowe Price Retirement 2020 (TRRBX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born between 1953 and 1957 should consider this fund.
%
T. Rowe Price Retirement 2025 (TRRHX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born between 1958 and 1962 should consider this fund.
%
T. Rowe Price Retirement 2030 (TRRCX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born between 1963 and 1967 should consider this fund.
%
T. Rowe Price Retirement 2035 (TRRJX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born between 1968 and 1972 should consider this fund.
%
T. Rowe Price Retirement 2040 (TRRDX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born between 1973 and 1977 should consider this fund.
%
T. Rowe Price Retirement 2045 (TRRKX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born between 1978 and 1982 should consider this fund.
%
T. Rowe Price Retirement 2050
(TRRMX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born between 1983 and 1987 should consider this fund.
%
T. Rowe Price Retirement 2055 (TRRNX)
The objective is to provide the highest total return over time consistent with
an emphasis on both capital growth and income.
Individuals born between 1988 and 1992 should consider this fund.
Please initial: ________________________
Page 2 of 3
The second category of funds offered is the “Core Funds.” These are individual funds that represent a
particular area of the market, for example Large Cap Growth or Fixed Income. These fund options are
designed for the participant that would like to be more involved in creating his/her portfolio and want to
be responsible for the diversification of the portfolio.
Allocation %
%
Category/
Fund Name
Stable Account
Galliard/WF Stable Value Fund (QWNWQ)
%
Fixed Income
Harbor Bond Fund I (HABDX)
%
Balanced
Vanguard Wellington Adm** (VWENX)
%
Equity Large Cap Value
T. Rowe Price Equity Income I (PRFDX)
%
Equity Large Cap Blend
Fidelity Spartan U.S. Equity Index Inv
(FUSEX)
%
Equity Large Cap Growth
Vanguard Growth Index I (VIGIX)
%
Equity Small Cap Value
Northern Small Cap Value (NOSGX)
%
Equity International
Harbor International Fund I (HAINX)
100%
Seeks total return. This fund primarily invests in governmental and
corporate insurers of U.S. and foreign securities.
The fund seeks long-term capital appreciation and reasonable current
income. Invests in stocks and bonds with 60%-70% invested in stocks.
The Fund seeks to provide substantial dividend income as well as longterm growth of capital. The Fund will normally invest primarily in
common stocks, with 65% in the common stocks of well-established
Companies paying above average dividends.
Seeks to duplicate the composition and total return of the S&P 500
Index. In order to mirror the index as closely as possible, the manager
frequently rebalances the portfolio as S&P shifts.
The investment seeks to track the performance of the MSCI US Prime
Market Growth Index, a broadly diversified index made-up of growth
stocks of large U.S. companies. The fund invests all of it’s assets in the
stocks that make up the index, holding each stock in the same
proportion as its weighting in the Index.
The investment seeks long-term capital appreciation. The fund
normally invests at least 80% of net assets in equity securities of smallcapitalization companies with market capitalizations that are, at the
time of purchase, within the range of the Russell 2000 Value index.
Equity Small Cap Blend
T. Rowe Price Small Cap Stock (OTCFX)
%
This fund seeks principal and consistency of returns with minimal
volatility. Typical investors would be conservative seeking more income
than money market funds without the fluctuation of stocks and bonds.
Seeks long-term growth of capital. The fund normally invests at least
80% of assets in equities traded in the U.S. over-the-counter market.
This fund is an established international fund with a track record of 17
years. Country and industry selections are made utilizing a top-down
theme-oriented approach while the stocks targeted are chosen with a
value-oriented philosophy.
Total of All Funds
(From pages 2 and 3)
**In the absence of a fund allocation election, your salary deferral contributions (including catch -up contributions)
and any employer contributions will be invested in the Vanguard Wellington Fund.
default fund and the summaries of all funds included in your enrollment materials .**
See the notice regarding the
Please initial: ________________________
Page 3 of 3