Common use of Divorce Clause in Contracts

Divorce. In the event of a divorce, the outstanding loan remains an obligation of the Participant unless it is assumed by the alternate payee through completion of the appropriate QDRO certification form. Loan repayments will be allocated to the person responsible for the repayment and, in the event of default, the defaulted amount will be tax reported to such person. PARTICIPANT SIGNATURE AND TAXPAYER CERTIFICATION This section must be signed and dated by the participant EMPLOYER, PLAN SPONSOR OR NAMED FIDUCIARY AUTHORIZED SIGNATURE AND CERTIFICATION This section must be completed by the Employer or its designee if required by a contract between the Company and the Employer. THIRD PARTY ADMINISTRATOR AUTHORIZED SIGNATURE AND CERTIFICATION This section must be completed if required by the Employer. RESET LOAN REQUEST AND AGREEMENT SECTION 403(b)/TAX SHELTERED ANNUITY CONTRACT ReliaStar Life Insurance Company (the “Company”) A member of the Voya® family of companies Home Office: Minneapolis, MN Customer Service: XX Xxx 0000, Xxxxxxxx, XX 00000-0000 Phone: 000-000-0000 Fax: 000-000-0000 Each loan is subject to the Terms and Conditions of the Loan Agreement, Annuity Contract, and 403(b) Plan Document. Your Employer, Plan sponsor, or Third Party Administrator’s signature is required on this form prior to sending it to the Company. For ERISA Plans only, complete and attach a Spousal Consent. RETURN COMPLETED FORM - Choose only one submission method. Multiple submissions may result in processing delays and/ or duplicate loans. Regular Mail: Overnight Delivery: Fax: Customer Service Customer Service Customer Service PO Box 1559 One Orange Way Toll-Free Fax: 000-000-0000 Xxxxxxxx, XX 00000-0000 Xxxxxxx, XX 00000

Divorce. In the event of a divorce, the outstanding loan remains an obligation of the Participant unless it is assumed by the alternate payee through completion of the appropriate QDRO certification form. Loan repayments payments will be allocated to the person responsible for the repayment and, in the event of default, the defaulted amount will be tax reported to such person. PARTICIPANT SIGNATURE AND TAXPAYER CERTIFICATION This section must be signed and dated by the participant EMPLOYER, PLAN SPONSOR OR NAMED FIDUCIARY AUTHORIZED SIGNATURE AND CERTIFICATION This section must be completed by the Employer or its designee if required by a contract between the Company and the Employer. THIRD PARTY ADMINISTRATOR AUTHORIZED SIGNATURE AND CERTIFICATION This section must be completed if required by the Employer. RESET LOAN REQUEST AND AGREEMENT SECTION 403(b)/TAX SHELTERED ANNUITY CONTRACT ReliaStar Life Insurance Company (the “Company”) A member of the Voya® VoyaTM family of companies Home Office: Minneapolis, MN Customer Service: XX Xxx 0000, XxxxxxxxXxxxx, XX 00000-0000 Phone: 000-000-0000 Fax: 000-000-0000 Each loan is subject to the Terms and Conditions of the Loan Agreement, Annuity Contract, and 403(b) Plan Document. Your Employer, Plan sponsor, or Third Party Administrator’s signature is required on this form prior to sending it to the Company. For ERISA Plans only, complete and attach a Spousal Consent. RETURN COMPLETED FORM - Choose only one submission method. Multiple submissions may result in processing delays and/ or duplicate loans. Regular Mail: Overnight Delivery: Fax: Customer Service Customer Service Customer Service PO Box 1559 One Orange Way TollXX Xxx 0000 0000 00xx Xxx. XX Xxxx-Free Xxxx Fax: 000-000-0000 XxxxxxxxXxxxx, XX 00000-0000 XxxxxxxXxxxx, XX 00000

Divorce. In the event of a divorce, the outstanding loan remains an obligation of the Participant unless it is assumed by the alternate payee through completion of the appropriate QDRO certification form. Loan repayments payments will be allocated to the person responsible for the repayment and, in the event of default, the defaulted amount will be tax reported to such person. PARTICIPANT SIGNATURE AND TAXPAYER CERTIFICATION This section must be signed and dated by the participant EMPLOYER, PLAN SPONSOR OR NAMED FIDUCIARY AUTHORIZED SIGNATURE AND CERTIFICATION This section must be completed by the Employer or its designee if required by a contract between the Company and the Employer. THIRD PARTY ADMINISTRATOR AUTHORIZED SIGNATURE AND CERTIFICATION This section must be completed if required by the Employer. RESET LOAN REQUEST AND AGREEMENT SECTION 403(b)/TAX SHELTERED ANNUITY CONTRACT ReliaStar Life Insurance Company (the “Company”) A member of the Voya® VoyaTM family of companies Home Office: Minneapolis, MN Customer Service: XX Xxx 0000, XxxxxxxxXxxxx, XX 00000-0000 Phone: 000-000-0000 Fax: 000-000-0000 Each loan is subject to the Terms and Conditions of the Loan Agreement, Annuity Contract, and 403(b) Plan Document. Your Employer, Plan sponsor, or Third Party Administrator’s signature is required on this form prior to sending it to the Company. For ERISA Plans only, complete and attach a Spousal Consent. RETURN COMPLETED FORM - Choose only one submission method. Multiple submissions may result in processing delays and/ or duplicate loans. Regular Mail: :Customer Service Overnight Delivery: Customer Service Fax: Customer Service Customer Service Customer Service PO Box 1559 One Orange Way TollXX Xxx 0000 0000 00xx Xxx. XX Xxxx-Free Xxxx Fax: 000-000-0000 XxxxxxxxXxxxx, XX 00000-0000 XxxxxxxXxxxx, XX 00000