Common use of Participant Certification Clause in Contracts

Participant Certification. My signature on this form acknowledges that I have read, understand and agree to the SDO participation requirements above. I recognize that there may be changes to these requirements in the future. I will be notified of any major changes, and it is my responsibility to read and be aware of these. I have been provided and read the applicable brochures, available upon request, regarding the SDO and understand this information. SSN: Signed: Date: Return completed form to:

Participant Certification. My signature on this form acknowledges that I have read, understand and agree to the SDO participation requirements above. I recognize that there may be changes to these requirements in the future. I will be notified of any major changeschanges in the Plan quarterly newsletter, and it is my responsibility to read and be aware of these. I have been provided and read the applicable brochures, available upon request, regarding the SDO and understand this information. SSN: Signed: Date: Form Return Please return your completed form to:by: Mail: Nationwide Retirement Solutions PO Box 182797

Participant Certification. My signature on this form acknowledges that I have read, understand and agree to the SDO participation requirements above. I recognize that there may be changes to these requirements in the future. I will be notified of any major changes, and it is my responsibility to read and be aware of these. I have been provided and read the applicable brochures, available upon request, request regarding the SDO and understand this information. SSN: Signed: Date: Return completed form to:..