Common use of Plan Administrative Expenses Clause in Contracts

Plan Administrative Expenses. If the Investor requests that MassMutual provide administrative services, MassMutual will deduct from assets invested under this Agreement amounts owed for expenses attributable to such administrative services. APPLICATION FOR GROUP ANNUITY CONTRACT to MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (MassMutual) Springfield, Massachusetts Application is hereby made for a Group Annuity Contract (the “Contract”) by Washoe County (the “Applicant”), to be issued to Washoe County (the “Investor”) by the Massachusetts Mutual Life Insurance Company (the “MassMutual”) to provide benefits for eligible employees of the Washoe County Deferred Compensation Plan and Washoe County OBRA Deferred Compensation Plan Said Contract will be prepared by MassMutual on Form No. GP 5566, or the contract form then being issued, and designated as Group Annuity Contract No. 061971, the terms and conditions of which have been mutually agreed upon by the Applicant and MassMutual. It is understood and agreed that this Application will become a part of the Contract hereby applied for, that said Contract is to be effective as of November 17, 2015 and that this Application supersedes and replaces any prior application for said Contract. I, the undersigned, have read and understood the proposal material presented to me prior to entering into this Contract and any applicable prospectus. ANY PERSON WHO KNOWINGLY, AND WITH INTENT TO DEFRAUD AN INSURANCE COMPANY OR OTHER PERSON, SUBMITS AN APPLICATION FOR INSURANCE OR FILES A CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF INSURANCE FRAUD, WHICH IS A CRIME. Signed at , this day of , 20 . (Location) Washoe County (Complete Legal Name of Applicant) By Signature and Title For Information of MassMutual: (Soliciting Agent or Broker)

Plan Administrative Expenses. If the Investor requests that MassMutual provide administrative services, MassMutual will deduct from assets invested under this Agreement amounts owed for expenses attributable to such administrative services. APPLICATION FOR GROUP ANNUITY CONTRACT to MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (MassMutual) Springfield, Massachusetts Application is hereby made for a Group Annuity Contract (the “Contract”) by Washoe County (the “Applicant”), to be issued to Washoe County (the “Investor”) by the Massachusetts Mutual Life Insurance Company (the “MassMutual”) to provide benefits for eligible employees of the Washoe County Deferred Compensation Plan and Washoe County OBRA Deferred Compensation 401(a) Plan Said Contract will be prepared by MassMutual on Form No. GP 5566, or the contract form then being issued, and designated as Group Annuity Contract No. 061971, the terms and conditions of which have been mutually agreed upon by the Applicant and MassMutual. It is understood and agreed that this Application will become a part of the Contract hereby applied for, that said Contract is to be effective as of November 17, 2015 and that this Application supersedes and replaces any prior application for said Contract. I, the undersigned, have read and understood the proposal material presented to me prior to entering into this Contract and any applicable prospectus. ANY PERSON WHO KNOWINGLY, AND WITH INTENT TO DEFRAUD AN INSURANCE COMPANY OR OTHER PERSON, SUBMITS AN APPLICATION FOR INSURANCE OR FILES A CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF INSURANCE FRAUD, WHICH IS A CRIME. Signed at , this day of , 20 . (Location) Washoe County (Complete Legal Name of Applicant) By Signature and Title For Information of MassMutual: (Soliciting Agent or Broker)) (Signature of Resident Agent Where Required

Plan Administrative Expenses. If the Investor requests that MassMutual provide administrative services, MassMutual will deduct from assets invested under this Agreement amounts owed for expenses attributable to such administrative services. APPLICATION FOR GROUP ANNUITY CONTRACT to MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (MassMutual) Springfield, Massachusetts Application is hereby made for a Group Annuity Contract (the “Contract”) by Washoe County (the “Applicant”), to be issued to Washoe County (the “Investor”) by the Massachusetts Mutual Life Insurance Company (the “MassMutual”) to provide benefits for eligible employees of the Washoe County Deferred Compensation Plan and Washoe County OBRA Deferred Compensation 401(a) Plan Said Contract will be prepared by MassMutual on Form No. GP 5566, or the contract form then being issued, and designated as Group Annuity Contract No. 061971, the terms and conditions of which have been mutually agreed upon by the Applicant and MassMutual. It is understood and agreed that this Application will become a part of the Contract hereby applied for, that said Contract is to be effective as of November 17, 2015 and that this Application supersedes and replaces any prior application for said Contract. I, the undersigned, have read and understood the proposal material presented to me prior to entering into this Contract and any applicable prospectus. ANY PERSON WHO KNOWINGLY, AND WITH INTENT TO DEFRAUD AN INSURANCE COMPANY OR OTHER PERSON, SUBMITS AN APPLICATION FOR INSURANCE OR FILES A CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF INSURANCE FRAUD, WHICH IS A CRIME. Signed at , this day of , 20 . (Location) Washoe County (Complete Legal Name of Applicant) By Signature and Title For Information of MassMutual: (Soliciting Agent or Broker)

Plan Administrative Expenses. If the Investor requests that MassMutual provide administrative services, MassMutual will deduct from assets invested under this Agreement amounts owed for expenses attributable to such administrative services. APPLICATION FOR GROUP ANNUITY CONTRACT to MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (MassMutual) Springfield, Massachusetts Application is hereby made for a Group Annuity Contract (the “Contract”) by Washoe County (the “Applicant”), to be issued to Washoe County (the “Investor”) by the Massachusetts Mutual Life Insurance Company (the “MassMutual”) to provide benefits for eligible employees of the Washoe County Deferred Compensation Plan and Washoe County OBRA Deferred Compensation Plan Said Contract will be prepared by MassMutual on Form No. GP 5566, or the contract form then being issued, and designated as Group Annuity Contract No. 061971, the terms and conditions of which have been mutually agreed upon by the Applicant and MassMutual. It is understood and agreed that this Application will become a part of the Contract hereby applied for, that said Contract is to be effective as of November 17, 2015 and that this Application supersedes and replaces any prior application for said Contract. I, the undersigned, have read and understood the proposal material presented to me prior to entering into this Contract and any applicable prospectus. ANY PERSON WHO KNOWINGLY, AND WITH INTENT TO DEFRAUD AN INSURANCE COMPANY OR OTHER PERSON, SUBMITS AN APPLICATION FOR INSURANCE OR FILES A CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF INSURANCE FRAUD, WHICH IS A CRIME. Signed at , this day of , 20 . (Location) Washoe County (Complete Legal Name of Applicant) By Signature and Title For Information of MassMutual: (Soliciting Agent or Broker)) (Signature of Resident Agent Where Required