Loan Payoff Form
2. Instructions
Please complete the appropriate information below and make your certified bank check or money order payable to the: T
rustee for Windstream 401
(k) Plan, and include your Social Security number in the memo section of your check. Please call 1-800-228-401K if you have any questions
regarding this form. Note: Merrill Lynch and Co. and its subsidiaries may not accept money orders that total more than $5,000, in aggregate, per
participant. Please note that this is a lifetime limit.
Office Use Only
Date Received by Merrill Lynch _____________________________
5. Participant Signature
I acknowledge that this deposit is being made in accordance with the provisions of the plan. I further acknowledge that I have read the prospectuses for
t
he mutual funds and that this deposit will be invested in accordance with the terms and conditions specified therein.
Participant’s Signature ______________________________________________________________________ Date ________________________
3. Mail Your Payment To:
PLEASE REMEMBER TO:
1) Sign your check and sign this form (see last box).
2
) Enclose your certified bank check or money order made payable to the: “Trustee for Windstream 401(k) Plan”
3) Keep a copy of this form for your records.
4) Mail check and this form to the above address.
Retirement & Benefit Plan Services
1400 American Blvd. Mail-Stop NJ2-140-03-50
Pennington, NJ 08534
4. Loan Details
TOTAL AMOUNT OF DEPOSIT $
_____________________________
LOAN PAYOFF: LOAN #: _________________ LOAN TYPE: ____________________________
(General Purpose or Principal Residence)
LOAN PAYMENT: LOAN #: _________________ LOAN TYPE: ____________________________
(General Purpose or Principal Residence)
Please note that this payoff amount will be applied to principal only and that any amount that exceeds the required amount to satisfy this loan will be
returned to you at the above address. If the amount does not satisfy the required loan payoff amount, this payment will be returned to you at
the above address. If making a partial payment, the payment must be an exact multiple of the expected payment.
1. Participant Identification Pl
ease Print
Windstream 401(k) Plan # 609951
Street Address:_
________________________________________________________________________________
City:
_______________________________________________________ State: ________________ Zip: _______________________
Social Security Number
La
st First MI
Name: ___________________________________________________________________________________________________________
Merrill Lynch Wealth Management makes available products and services offered by Merrill Lynch, Pierce, Fenner
& Smith Incorporated (MLPF&S) and other subsidiaries of Bank of America Corporation. MLPF&S is a registered
broker-dealer, Member SIPC and a wholly owned subsidiary of Bank of America Corporation.
Investment Products:
MLPF&S makes available investment products sponsored, managed, distributed or provided by companies that
are affiliates of Bank of America Corporation or in which Bank of America Corporation has a substantial economic
interest, including BofA™ Global Capital Management.
Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value
©2012 Bank of America Corporation. All rights reserved.
609951lpf 04/11/16nvf
