In compliance with the USA PATRIOT Act, all financial institutions (including mutual funds) are required to obtain, verify and record the following information for all registered owners or others who may be authorized to act on an account: full name, date of birth, Social Security Number and permanent street address. Corporate, trust, and other entity accounts require additional documentation. This information will be used to verify your true identity. We will return your application if any of this information is missing, and we may request additional information from you for verification purposes. In the rare event that we are unable to verify your identity, Nationwide Funds reserves the right to redeem your account at the current day’s net asset value.
INveStor INformatIoN | Select one
Individual
First nameFirst name
Social Security number
Social Security number
last name
last name
Date of Birth (MM/DD/YYYY)
Date of Birth (MM/DD/YYYY) M.I.
M.I.
Joint Owner
Registration will be Joint Tenancy with Rights of Survivorship (JTWROS) unless otherwise specified.
To designate a Transfer on Death beneficiary, complete and attach a Nationwide Transfer on Death Form available at nationwide.com/mutualfunds.
custodian’s First name (onlY one)
Minor’s First name (onlY one) custodian’s Social Security number
Minor’s Social Security number Minor’s State of Residence last name
last name
Date of Birth (MM/DD/YYYY)
Date of Birth (MM/DD/YYYY) M.I.
M.I.
Gift to Minor
(UGMA/UTMA)
1Designation of Successor Custodian or Successor Responsible Individual
In the event of my incapacity or death, I hereby designate the individual named above to act as successor custodian or successor responsible individual for the minor on Nationwide Funds and account number referenced on this form.
Successor custodian’s First name (onlY one)
Successor custodian’s Social Security number
last name Date of Birth (MM/DD/YYYY)
M.I.
New account application
Please do not use this application for IRA’s
Please include additional sheets if more than two owners.
for additional information please call toll-free 1-800-848-0920 or visit us on the Web at nationwide.com/mutualfunds. mail: Nationwide Funds
c/o U.S. Bancorp Fund Services, LLC PO Box 701
Milwaukee, WI 53201-0701
overnight express mail: Nationwide Funds
c/o U.S. Bancorp Fund Services, LLC 615 E. Michigan St., FL3
Milwaukee, WI 53202-5207 mail this form, along with any required documents to:
Please print clearly in blue or black ink.
Street
city city
Street
Daytime Phone number
e-Mail Address*
evening Phone number
State State
Apt / Suite
ZIP code ZIP code
Apt / Suite Residential Address or Principal Place of Business - Foreign addresses and P.O.
Boxes are not allowed. Mailing Address1 (if different from Permanent Address)
If completed, this address will be used as the Address of Record for all statements, checks and required mailings. Foreign addresses are not allowed.
1A P.O. Box may be used as the mailing address. PermaNeNt Street addreSS
e-delIvery oPtIoNS
2
3
By selecting any of the above options, you agree to waive the physical delivery of the prospectus, fund reports, account statements and/or tax forms. If you have opted to receive your statements or tax forms electronically, you will need to establish online access to your account, which you may do once your account has been established by visiting nationwide.com/mutualfunds and selecting Sign Up for account access. Please note, you must provide your email address in Section 2 to enroll in edelivery.
The Cost Basis Method you elect applies to all covered shares acquired from January 1, 2012 forward and to all identically registered existing and future accounts you may establish, unless otherwise noted. The Cost Basis Method you select will determine the order in which shares are redeemed and how your cost basis information is calculated and subsequently reported to you and to the Internal Revenue Service (IRS). Please consult your tax advisor to determine which Cost Basis Method best suits your specific situation. Note: If you do not elect a Cost Basis Method, your account will default to Average Cost.
Primary Method (Select only one)
Average Cost – averages the purchase price of acquired shares
First In, First Out – oldest shares are redeemed first
Last In, First Out – newest shares are redeemed first
Low Cost – least expensive shares are redeemed first
High Cost – most expensive shares are redeemed first
Loss/Gain Utilization – depletes shares with losses prior to shares with gains and short-term shares prior to long-term shares
Specific Lot Identification – you must specify the share lots to be sold at the time of a redemption (This method requires you elect a Secondary CoSt BaSIS method
4
Secondary Method – applies only if Specific Lot Identification was elected as the Primary Method (Select only one)
First In, First Out
Last In, First Out
Low Cost
High Cost
Loss/Gain Utilization
Note: If a Secondary Method is not elected, First In, First Out will be used.
*Please note, you must provide your email address to enroll in edelivery.
name of trust / corporation / Partnership and State of origination
name(s) of trustee(s)
Social Security number / tax I.D. number Date of Agreement (MM/DD/YYYY)
Tax Exempt Organization
C Corporation
S Corporation
Trust Other Entity
Partnership Limited Liability Company
You must supply documentation to substantiate existence of your organization (i.e., Articles of Incorporation/Formation/Organization, Trust Agreements [including the powers and limitations section(s)], Partnership Agreement, or other official documents).
Remember to include a separate sheet detailing the full name, date of birth, Social Security Number and permanent street address for all authorized individuals.
Check here if you are a government entity or affiliated with a government entity.
Additional Account Types:
INveStor INformatIoN | Select one (contInueD)
1
I would like to:
Receive all documents electronically or Select document type:
Receive prospectuses, annual reports and semiannual reports electronically Receive statements electronically
Receive tax forms electronically
Fund name
Fund name
Investment $ Amount or % Fund number
Investment $ Amount or % Fund number
Fund name
Fund name Fund name
Investment $ Amount or % Fund number
Investment $ Amount or % Fund number
Investment $ Amount or % Fund number
Share class
Share class
A C
A C
Share class
A C
Share class
A C
Share class
A C
5
Checks must be made payable to Nationwide funds.
Type of Investment Net Asset Value privilege (Class A shares only): Please complete Sales Load Waiver Certification form. (Please refer to Nationwide Funds prospectus or SAI found on our website at nationwide.com/mutualfunds for information regarding eligibility.)
Type of Payment Check (in U.S. dollars) payable to Nationwide Funds By wire (Call 1-800-848-0920 for further instructions.)
Transfer funds from another Nationwide Funds account ______________________________ Indicate fund(s), investment amount(s) in dollars and share class(es).
Nationwide Funds
($2,000 minimum per fund; $100 subsequent deposits by check. No minimum for accounts opened with an Automatic Investment Plan of at least $50 per month.) A complete list of fund names and numbers can be found on the Nationwide Funds list page of this application.
I wish to open my account with a monthly Automatic Investment Plan (Complete Section 8). INveStmeNtS
5
If you check the “Reinvest” box below, all dividend and capital gain distributions will be reinvested in additional shares. If you prefer that distributions be paid in cash, check the “Pay in cash” box below. If you do not make an election, all dividends and capital gains distributions will be reinvested.
Dividends: Reinvest Pay in cash Capital Gains: Reinvest Pay in cash dIStrIBUtIoN oPtIoNS
telePhoNe aNd INterNet oPtIoNS
6
7
You automatically have the ability to make telephone and/or Internet purchases*, redemptions* or exchanges per the prospectus, unless you specifically decline below. See the prospectus for minimum and maximum amounts.
*You must provide bank instructions and a voided check in Section 9.
Please check the box below if you wish to decline these options. If the options are not declined, you are acknowledging acceptance of these options.
I decline telephone and/or Internet transaction privileges.
Should you wish to add the options at a later date, a signature guarantee may be required. Please refer to the prospectus or call our shareholder services department for more information.
aUtomatIC INveStmeNt PlaN (aIP)
8
If you choose this option, funds will be automatically transferred from your bank account. Please attach a voided check or savings deposit slip to Section 9 of this application. We are unable to debit mutual fund or pass-through (“for further credit”) accounts. draw money for my aIP (check one): Monthly Bimonthly Quarterly Biannually Annually
If no option is selected, the frequency will default to monthly.
Please keep in mind that:
• Participation in the plan will be terminated upon redemption of all shares.
• If the date you choose to start your AIP falls on a weekend or holiday the transfer will move to the next business day after your selected date.
• Nationwide Funds reserves the right to terminate the AIP if purchases cannot be made.
Your signed application must be received at least 15 business days prior to initial transaction.
Amount Per Draw ($50 minimum)
Amount Per Draw ($50 minimum)
Amount Per Draw ($50 minimum)
Amount Per Draw ($50 minimum) Fund name
Fund name
Fund name
Fund name
AIP Start Month
AIP Start Month
AIP Start Month
AIP Start Month
AIP Start Day
AIP Start Day
AIP Start Day
AIP Start Day
BaNk INformatIoN
9
If you have selected an automatic investment plan, wire redemptions, EFT purchases, EFT redemptions or cash distributions, a voided bank check or preprinted savings deposit slip (not a counter deposit slip) is required. We are unable to debit or credit mutual fund or pass-through (“for further credit”) accounts.
Please contact your financial institution to determine if it participates in the Automated Clearing House system (ACH).
John Doe Jane Doe 123 Main St. Anytown, USA 12345
Pay to the order of _____________________________________________________ $ _______________ ____________________________________________________________________________DOLLARS 53289
Memo___________________________
VOID
Signed_________________________________________ letter of INteNt (oPtIoNal)10
I understand and agree to the terms of Nationwide Funds’ policies concerning letter of intent discount as discussed in the prospectus under Reduction of Class A Sales Charges. I want to establish a Letter of Intent for the Nationwide Fund(s) listed below and during a 13-month period, I will invest the following amount:$_____________________
NOTE: You can also combine your purchase of Class A Shares with other family members living at the same address or your purchases of Class B and Class C shares of these and other Nationwide Funds (except the Nationwide Money Market Fund) to fulfill your Letter of Intent. You are not legally required to complete the purchases indicated in your Letter of Intent. However, if you do not fulfill your Letter of Intent, additional sales charges may be due and shares in your account will be liquidated to cover those sales charges. Please note that purchases made prior to the start date of the LOI are not counted toward the breakpoint.
Account number(s):
Share class
A C
Share class
A C
Share class
A C
Share class
A C
rIghtS of aCCUmUlatIoN
11
If you have additional Nationwide Funds accounts, please list them here:
existing Account number(s):
You may elect to establish check writing privileges for the Nationwide Money Market Fund Prime Shares. Checks will be mailed within 10 (ten) business days after your account is opened. The minimum amount for any check written is $500. All authorized account owners must sign below exactly as their names appear in Section 1.
Nationwide Money Market Fund Prime Shares
I/We guarantee the authenticity of each signature and understand the request is subject to the terms below.
I/We authorize U.S. Bank to honor these share drafts and to redeem sufficient shares in my/our account to cover payment of such checks. I/We understand that: (1) this privilege may be terminated at any time by Nationwide Funds or the bank and that neither shall incur any liability for loss or expense or cost to me/us for honoring checks, or for effecting redemptions to pay checks, or for returning checks which have not been accepted; (2) by signing this card I/We certify that each of the statements set forth on the purchase application are true and accurate.
authorized Signatures
(For joint accounts, all owners must sign.) One signature required
Two signatures required
X
X
CheCk WrItINg oPtIoN
12
I understand Nationwide Funds’ policies regarding rights of accumulation as described in the prospectus under “Reduction of Class A Sales Charges” and that I may be able to reduce or eliminate front-end sales charges to me and other family members living at the same address by adding the current value of any Class A, Class B, or Class C shares in all Nationwide Funds (except the Nationwide Money Market Fund) that are currently owned or are currently being purchased to the value of my Class A purchase.SIgNatUre aNd CertIfICatIoN reqUIred By the INterNal reveNUe ServICe
13
I have received and understand the prospectus for the Nationwide Funds. I understand Nationwide Funds’ investment objectives and policies and agree to be bound by the terms of the prospectus. I acknowledge and consent to the householding (i.e. consolidation of mailings) of regulatory documents such as prospectuses, shareholder reports, proxies, and other similar documents. I may contact Nationwide Funds to revoke my consent. I agree to notify Nationwide Funds of any errors or discrepancies within 45 days after the date of the statement confirming a transaction. The statement will be deemed to be correct, and Nationwide Funds and its transfer agent shall not be liable if I fail to notify Nationwide Funds within such time period. I certify that I am of legal age and have legal capacity to make this purchase.
Nationwide Funds, its transfer agent, and any officers, directors, employees, or agents of these entities (collectively “Nationwide Funds”) will not be responsible for banking system delays beyond their control. By completing Sections 5, 6, 7, 8, or 9, I authorize my bank to honor all entries to my bank account initiated through U.S. Bank, NA, on behalf of the applicable Fund. The Nationwide Funds will not be liable for acting upon instruction believed to be genuine and in accordance with the procedures described in the prospectus or the rules of the Automated Clearing House. When AIP or Telephone Purchase transactions are presented, sufficient collected funds must be in my account to pay them. I agree that my bank’s treatment and rights to respect each entry shall be the same as if it were signed by me personally. I agree that if any such entries are dishonored with good or sufficient cause, my bank shall be under no liability whatsoever. I further agree that any such authorization, unless previously terminated by my bank in writing, is to remain in effect until Nationwide Funds’ transfer agent receives and has had reasonable amount of time to act upon a written notice of revocation.
The assets in your account are subject to state unclaimed property laws which provide that if no activity occurs in your account within the time period specified by the particular state law, your assets must be transferred to the appropriate state. We are required by law to advise you that your assets may be transferred to an appropriate state in compliance with these state laws.
Under penalty of perjury, I certify that (1) the Social Security or taxpayer identification number shown on this form is my correct Social Security taxpayer identification number, and (2) I am not subject to backup withholding as a result of either being exempt from backup withholding, not being notified by the IrS of a failure to report all interest or dividends, or the IrS has notified me that I am no longer subject to backup withholding, , (3) I am a U.S. person (including a U.S. resident alien), and (4) I am exempt from fatCa reporting. (Cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding due to a failure to report all interest and dividends.)
the IrS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.
* If shares are to be registered in: (1) joint names, both persons must sign; (2) a custodian for a minor, the custodian should sign; (3) a trust, the trustee(s) should sign; or (4) for a corporation or other entity, an officer should sign and print name and title on the space provided for the authorized signer(s).
Signature of owner*
Signature of Joint owner*
Date (MM/DD/YYYY)
Date (MM/DD/YYYY)
Dealer name Representative’s last name First name
Dealer’s number Branch number
Address Address
telephone number telephone number
Representative’s number
M.I.
code
dealer maIN offICe INformatIoN: rePreSeNtatIve BraNCh offICe INformatIoN:
dealer INformatIoN
Before yoU maIl, have yoU:
14
!
for additional information please call toll-free 1-800-848-0920 or visit us on the Web at nationwide.com/mutualfunds.
Completed all USA PATRIOT Act required information? – Social Security or Tax ID Number in Section 1? – Date of Birth in Section 1?
– Full name in Section 1?
– Permanent street address in Section 2?
Enclosed your personal check made payable to Nationwide Funds?
Included a voided check, if applicable?
Signed your application in Section 13?
Enclosed additional documentation, if applicable?
Registered for Online Account Access and eDelivery?
mail: Nationwide Funds
c/o U.S. Bancorp Fund Services, LLC
PO Box 701
Milwaukee, WI 53201-0701
overnight express mail: Nationwide Funds
c/o U.S. Bancorp Fund Services, LLC
615 E. Michigan St., FL3
Milwaukee, WI 53202-5207
Why you should register for online account access and edelivery
Accessing and receiving your account and fund information electronically is easy, secure, efficient and environmentally friendly. Online Account Access enables you to access all of your account and fund information from your computer at any time. eDelivery sends you an email each time a new account transaction confirmation, quarterly account statement, tax form or regulatory document is available for you to view. Each email contains a link to these documents. Once you key in your security information, you will be connected immediately to your account-related information. To register, go to nationwide.com/mutualfunds and select Sign Up for Account Access.
city State ZIP code city State ZIP code
NatIoNWIde fUNdS lISt
nationwide Funds distributed by Nationwide Fund Distributors LLC, member FInRA, King of Prussia, Pa.
nationwide and the nationwide n and eagle are service marks of nationwide Mutual Insurance company. ©2015 nationwide CLASS A
SHARES FUND NUMBER
CLASS C SHARES FUND NUMBER INTERNATIONAL
nationwide Bailard emerging Markets
equity Fund 6263 6264
nationwide Bailard International
equities Fund 6230 6231
nationwide Global equity Fund 3568 3569
nationwide International Index Fund 3405 3311 SMALL CAP
nationwide Bailard cognitive Value Fund 6211 6212 nationwide Geneva Small cap
Growth Fund 6227 6228
nationwide HighMark Small cap core Fund 6251 6252 nationwide Small cap Index Fund 3402 3310 nationwide Small company Growth Fund 3554 n/A nationwide u.S. Small cap Value Fund 3276 3349 MID CAP
nationwide Geneva Mid cap Growth Fund 6223 6225 nationwide Herndon Mid cap Value Fund 6271 6272 nationwide Mid cap Market Index Fund 3415 3313 LARGE CAP
nationwide Bailard technology
& Science Fund 6215 6216
nationwide Fund 3533 3301
nationwide Growth Fund 3528 3302
nationwide HighMark large cap core
equity Fund 6234 6235
nationwide S&P 500 Index Fund 3418 3309 nationwide Ziegler equity Income Fund 6219 6221 nationwide Ziegler nYSe Arca
tech 100 Index Fund 6244 6246
ASSET ALLOCATION
nationwide Destination 2010 Fund 3266 3339 nationwide Destination 2015 Fund 3267 3340 nationwide Destination 2020 Fund 3268 3341 nationwide Destination 2025 Fund 3269 3342 nationwide Destination 2030 Fund 3270 3343 nationwide Destination 2035 Fund 3271 3344 nationwide Destination 2040 Fund 3272 3345 nationwide Destination 2045 Fund 3273 3346 nationwide Destination 2050 Fund 3274 3347 nationwide Destination 2055 Fund 3278 3351 nationwide Destination 2060 Fund 3840 3846 nationwide Investor Destinations
Aggressive Fund 3389 3303
nationwide Investor Destinations
conservative Fund 3410 3307
nationwide Investor Destinations
Moderate Fund 3395 3305
nationwide Investor Destinations
Moderately Aggressive Fund 3392 3304
nationwide Investor Destinations
Moderately conservative Fund 3398 3306
nationwide Portfolio completion Fund 3556 3557 nationwide Retirement Income Fund 3275 3348
CLASS A SHARES FUND NUMBER
CLASS C SHARES FUND NUMBER FIxED-INCOME
nationwide Amundi Global High Yield Fund 6275 6276 nationwide Amundi Strategic Income Fund 6279 6280
nationwide Bond Fund 3535 3461
nationwide Bond Index Fund 3408 3312
nationwide core Plus Bond Fund 3586 n/A
nationwide Government Bond Fund 3529 3459 nationwide High Yield Bond Fund 3572 3573
nationwide HighMark Bond Fund 6204 6206
nationwide HighMark california
Intermediate tax Free Bond Fund 6208 6209 nationwide HighMark national
Intermediate tax Free Bond Fund 6241 6242 nationwide HighMark Short term
Bond Fund 6248 6249
nationwide Inflation-Protected
Securities Fund 3576 n/A
nationwide Money Market Fund 3530 3308
nationwide Ziegler Wisconsin tax
exempt Fund 6259 6261
