Form Oom28 Ildc PDF Details

The OOM28 ILDC form serves as a vital document for state employees in Illinois, facilitating their enrollment in the State Employees' Deferred Compensation Plan. Managed by the Illinois Department of Central Management Services, this form bridges the gap between employees seeking to secure their financial future and the administrative process required to set aside part of their earnings before taxes. Prospective participants are instructed to provide personal information, choose their deferral amount which has a minimum set for every pay period or month, and select their investment strategy from a diverse range of funds. Options include T. Rowe Price Retirement Funds, designed for varying retirement years, and other select funds allowing for personalized investment mixes. Furthermore, the form highlights the importance of understanding the Retirement Plan's terms and acknowledging the receipt of mutual fund prospectuses, ensuring that employees make informed decisions about their investments. Participants are also assured of the legal protections and compliance with state and federal regulations, emphasizing a commitment to inclusivity and fairness. This form, therefore, not only acts as a gateway to financial planning for state employees but also underscores the state's dedication to their welfare and informed participation in deferred compensation plans.

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Form NameForm Oom28 Ildc
Form Length1 pages
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Avg. time to fill out15 sec
Other namesemp_defenrl cms illinois deferred compensation fax form

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I L L I N O I S

CMSDEPARTMENT OF CENTRAL

MANAGEMENT SERVICES

P.O. Box 19208, Springfield, IL 62794-9208

STATE EMPLOYEES' DEFERRED COMPENSATION PLAN

ENROLLMENT FORM

Please type or print clearly in ink. Initial any corrections, additions, deletions or changes in pen. Complete all sections.

For more information, call the Deferred Compensation Office at 1-800/442-1300, 1-217/782-7006 or TDD/TTY 1-800/526-0844.

Last Name

First

 

MiddleInitial

 

Social Security Number

 

 

Date of Birth

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

City

 

 

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

Agency or University

 

 

 

Office Phone Number

 

Home Phone Number

 

 

 

 

(

)

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

Work Address

 

 

 

 

 

Payroll Code (5 digits - refer to your pay stub)

 

 

 

 

 

 

 

 

 

 

SECTION A: TRANSACTIONTYPE

 

 

Initial Enrollment

 

Re-enrollment of a Former Participant

SECTION B: AMOUNT OF DEFERRAL - The minimum deferral is $10 per pay period or $20 per month, whichever is greater. Indicate the amount to be deducted from each paycheck in the space below. Deferrals can begin no sooner than the first pay period of the next month. By completing this section and signing this form you are electing to participate in the State Employees' Deferred Compensation Plan and are authorizing the State of Illinois to defer from your total compensation the following from each pay period until your termination, modification or revocation of this amount:

$__________________ per pay period beginning with the

 

first

 

second pay period in _____________ (mo/yr).

 

 

 

 

 

SECTION C: INVESTMENT REQUEST - Select one or a combination in which to invest your deferrals. The percentages must total 100% and must be in whole numbers with no fractions. I hereby request that my Deferred Compensation deferrals be invested in the following manner:

These funds are one-step options that make it easy for you to invest for retirement. Simply choose the fund with a target date closest to the year in which you plan to retire and your funds will be managed for you.

T. Rowe Price Retirement Funds:

______ % Retirement 2055 Fund/TRRNX

______ % Retirement 2050 Fund/TRRMX

______ % Retirement 2045 Fund/TRRKX

______ % Retirement 2040 Fund/TRRDX

______ % Retirement 2035 Fund/TRRJX

______ % Retirement 2030 Fund/TRRCX

______ % Retirement 2025 Fund/ TRRHX

______ % Retirement 2020 Fund/TRRBX

______ % Retirement 2015 Fund/TRRGX

______ % Retirement 2010 Fund/TRRAX

______ % Retirement 2005 Fund/TRRFX

______ % Retirement Income Fund/TRRIX

These funds are the options if you want to select your own investment mix.

______ % Vanguard Prime Money Market Fund Inst. Shares/VMRXX (money market)

______ %

Stable Return Fund (investment contracts)

______ %

Vanguard Total Bond Market Index Fund Inst. Shares/VBMPX (bond index)

______ %

T. Rowe Price Bond Trust I (bonds)

______ %

Fidelity Puritan Fund/FPURX (stocks & bonds)

______ %

Vanguard Institutional Index Fund Inst. Plus Shares/VIIIX (stock index)

______ %

Lord Abbett Large Cap Core Strategy Separate Acct. (large-company stocks)

______ %

LSV Value Equity (large-company stocks)

______ %

Wellington Trust Diversified Growth Portfolio (large-company stocks)

______ % Columbia Acorn Fund/ACRNX (small-company stocks)

______ %

Ariel Fund (stocks - social restrictions/advisor minority owned)

______ %

Janus Overseas Fund/JIGFX (stock outside U.S.)

______ %

Invesco International Growth Equity Trust (stocks outside U.S.)

______ %

William Blair International Small Cap Growth Fund/WISIX (stocks outside U.S.)

______ %

Northern ACW ex US Index Fund (stocks outside U.S.)

______ %

Northern S&P 400 Index Fund (mid-sized company stocks)

______ %

Northern Russell 2000 Index Fund (small-company stocks)

______ %

Northern Small Cap Value Fund (small-company stocks)

READ THIS INFORMATION COMPLETELY BEFORE SIGNING

I hereby acknowledge receipt of a copy of the Plan and agree to the terms and conditions. I hereby acknowledge that I have received and read a prospectus for each mutual fund in which I am investing. I understand and acknowledge that all amounts of compensation deferred pursuant to the Plan and all income attributabletosuchamountsshallbeheldinoneormorecustodialaccountsfortheexclusivepurposeofparticipantsandbeneficiariesunderthePlan. Iunderstand thatparticipationintheDeferredCompensationPlanisabenefitofferedbytheStateofIllinois. Inreturnforthisbenefit,Iandmyheirs,successors,andassignees shall hold harmless the State and its employees, officials, agents, assignees, and successors from any liability for all acts in good faith.

SIGNATURE X ______________________________________________________________ DATE

Send completed form to your Agency Liaison - or send directly to the Department of Central Management Services.

Liaison

Name _______________________________ Agency _________________________

Date ________________________________ Phone No.________________________

Approval of Deferred Compensation Office required before any transaction takes place.

Date

 

By

In compliance with the State and Federal Constitution, the Illinois Human Rights Act, the Americans with Disabilities Act and Section 504 of the Federal Rehabilitation Act, the Department of Central Management Servicesdoesnotdiscriminateinemployment,contracts,oranyotheractivity.

OOM28-ILDC (Rev. 01-13)

IL 401-1093

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Form Oom28 Ildc writing process described (portion 1)

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