Name of prior plan provider:

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ROTH IRA APPLICATION

Great-West Lifetime Advantage IRA – Roth

740501-R3

Last Name First Name MI

Street Address (No P.O. Box)

City State Zip Code

Owner Information

( )

Home Phone

Social Security Number E-Mail Address

( )

Work Phone

All pages must be returned excluding the Fee Schedule, Advisory Services Agreement, Individual Retirement Custodial Account Agreement, Disclosure Statement, Privacy Notice, Business Continuity Plans, and FINRA Investor Education and BrokerCheck Notifi cation.

Female Male

Married Unmarried

Mo Day Year Date of Birth Mailing Address (if different)

City State Zip Code Check box if you prefer to receive quarterly account _{statements in Spanish}

Initial Contribution Type

Approximate Amount of Contribution/Rollover/Transfer $ What is the source of funding for the account? (Please select one)

Ƒ

Direct Rollover from eligible employer sponsored retirement plan (Prior provider will issue a check or wire payable to Great-West Trust Company, LLC.)

Ƒ

Check here if prior provider was Great-West Retirement Services®_{. Current Plan #}

Ƒ

Check here if another prior provider. Must include a copy of a most recent account statement from prior employer’s plan. Name of prior plan provider: ______________________________________________________

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Roth IRA to Roth IRA Transfer (Trustee-to-Trustee from a Roth IRA). Please complete and attach a Great-West Roth IRA Transfer form along with this application. Must include a copy of a most recent account statement from Roth IRA provider.

Name of prior Roth IRA provider:

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Roth Conversion from a Traditional IRA (Great-West will receive a check or wire payable to Great-West Trust Company, LLC from my prior IRA provider). Check here if prior provider was Great-West Financial®. Current Plan # _______________

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Check here if Traditional IRA provider was Great-West Retirement Services®_.

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Check here if another IRA provider. Must include a copy of a most recent account statement from prior IRA provider. Name of prior Traditional IRA provider:

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Personal Check, please indicate source of funding below:

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60-Day Rollover (Funds were previously invested in a qualiﬁ ed retirement plan or Roth IRA and I am depositing within 60 days after the distribution.) Must include a copy of a most recent account statement with application.

Check here if Traditional IRA provider was Great-West Financial®.

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New Contributions ($500 minimum): Tax Year: (Check coming from a personal account made payable to Great-West Trust Company, LLC). Contribution must be postmarked no later than the individual’s tax ﬁ ling deadline without extension.

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IRA Recharacterization (I would like to treat my current Traditional IRA contribution as my Roth IRA contribution).

Investment Selection

Please complete the Investment Selection section below. Please note that completing the Investment Selection section is optiona l and not a requirement to open an account. Please refer to your communication materials for information about each investment option.

Please determine which of the following options you would like, then go to the appropriate section to complete. • Specific Fund Election - complete Section 1

• Managed Account Service - complete Section 2

For detailed descriptions about each option, please go to www.ira.gwrs.com or call 1-877-804-6257.

Empower Retirement Roth IRA

Check here if prior provider was Empower Retirement

Check here if Traditional IRA provider was Empower Retirement.

60-Day Rollover (Funds were previously invested in a qualifi ed retirement plan or Roth IRA and I am depositing within 60 days after the distribution). Must include a copy of most recent account statement with this application. Please note, only one distribution from an IRA (Traditional, Roth, or Simple) can be rolled over in a twelve month period regardless of the number of IRAs you own.

Roth Conversion from a Traditional IRA (Empower Retirement will receive a check or wire payable to Great-West Trust Company, LLC from my prior provider).

Roth IRA to Roth IRA Transfer (Trustee-to-Trustee from a Roth IRA). Please complete and attach a Empower Retirement Roth IRA Transfer form along with this application. Must include a copy of a most recent account statement from Roth IRA provider.

For detailed descriptions about each option, please go to www.empower-retirement.com/ira or call 1-877-804-6257.

][A01:042314

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740501-R3

Last Name First Name MI Social Security Number IRA Number

740501-R3

Section 1 - Specifi c Fund Election

Investment Option Name Investment

Option Code

*Great-West SecureFoundation®_{LT 2015 L ... MXLEX ______%}

*Great-West SecureFoundation®_{LT 2020 L ... MXLFX ______%}

*Great-West SecureFoundation®_{LT 2025 L ... MXLHX ______%}

*Great-West SecureFoundation®_{LT 2030 L ... MXLIX ______%}

*Great-West SecureFoundation®_{LT 2035 L ... MXLJX ______%}

*Great-West SecureFoundation®_{LT 2040 L ... MXLKX ______%}

*Great-West SecureFoundation®_{LT 2045 L ... MXLNX ______%}

*Great-West SecureFoundation®_{LT 2050 L ... MXLOX ______%}

*Great-West SecureFoundation®_{LT 2055 L ... MXLPX ______%}

*Great-West SecureFoundation®_{Balanced L ... MXLDX ______%}

Great-West Lifetime 2015 Fund II L ... MXLQX ______% Great-West Lifetime 2025 Fund II L ... MXCDX ______% Great-West Lifetime 2035 Fund II L ... MXLRX ______% Great-West Lifetime 2045 Fund II L ... MXYLX ______% Great-West Lifetime 2055 Fund II L ... MXZLX ______% Putnam RetirementReady 2015A ... PRRHX ______% Putnam RetirementReady 2020A ... PRRMX ______% Putnam RetirementReady 2025A ... PRROX ______% Putnam RetirementReady 2030A ... PRRQX ______% Putnam RetirementReady 2035A ... PRRWX ______% Putnam RetirementReady 2040A ... PRRZX ______% Putnam RetirementReady 2045A ... PRVLX ______% Putnam RetirementReady 2050A ... PT2050 ______% Putnam RetirementReady 2055A ... PT2055 ______% Putnam Retirement Income Lifestyle A3 ... PISFX ______% Great-West Conserv Profile II Fund L ... MXIPX ______% Great-West Mod Conserv Profile II Fund L ... MXHPX ______% Great-West Moderate Profile II Fund L ... MXGPX ______% Great-West Mod Aggr Profile II Fund L ... MXFPX ______% Great-West Aggressive Profile II Fund L ... MXEPX ______% Putnam Dynamic Asset Allocation Cns A ... PACAX ______% Putnam Dynamic Asset Allocation Bal A ... PABAX ______% Putnam Dynamic Asset Allocation Gr A ... PAEAX ______% Artisan International Inv ... ARTIX ______% Artisan International Value Investor ... ARTKX ______% Blackrock Interational Opp Inv A ... BREAZ ______% Great-West MFS Intl Value Fund L ... MXMIX ______% JPMorgan International Val A ... JFEAX ______% Janus Global Research S ...JWGRX1 ______% Lazard Emerging Markets Open ... LZOEX ______% MFS Emerging Markets Equity Fund - A ... MEMAX ______% Oakmark International I ... OAKIX ______% Oppenheimer Global Fund A ... OPPAX ______% Putnam Global Equity A ... PEQUX ______% Putnam International Capital Opp A ... PNVAX ______% Putnam International Growth A ... PINOX ______%

Investment Option Code

BREAX

American Century Real Estate Inv ... REACX ______% Goldman Sachs Technology Tollkeeper Svc ... GITSX ______% MFS Utilities A ... MMUFX ______% NW Ziegler NYSE Arca Tech 100 Index A ... NWJCX ______% Oppenheimer Gold & Special Minerals A ... OPGSX ______% Oppenheimer SteelPath MLP Alpha A ... MLPAX ______% Putnam Global Utilities Fund A ... PUGIX ______% Third Avenue Real Estate Value Instl ... TAREX ______% Virtus Real Estate Securities A ... PHRAX ______% Alger Small Cap Growth Institutional I ... ALSRX ______% Baron Small Cap Retail ... BSCFX ______% Great-West S&P SmallCap 600 Index Fund L ... MXNSX ______% Janus Venture S ... JVTSX ______% JPMorgan US Small Company A ... JTUAX ______% MainStay US Small Cap A ... MOPAX ______% Putnam Capital Opportunities A ... PCOAX ______% Putnam Small Cap Value A ... PSLAX ______% RidgeWorth Small Cap Growth Stock I ... SSCTX ______%

Option Code

Royce Total Return K ... RTRKX ______% Undiscovered Mgrs Behavioral Value A ... UBVAX ______% Alger SMid Cap Growth A ... ALMAX ______% Goldman Sachs Small/Mid Cap Growth S ... GSMQX ______% Great-West Ariel Mid Cap Value Fund L ... MXAMX ______% Great-West T Rowe Price MidCap Gr Fund L ... MXTMX ______% Janus Enterprise S ... JGRTX1 ______% JPMorgan Intrepid Mid Cap A ... PECAX ______% Munder Mid-Cap Core Growth A ... MGOAX ______% Oppenheimer Main Street Mid Cap A ... OPMSX ______% Perkins Mid Cap Value S ... JMVIX1 ______% Putnam Capital Spectrum A ... PTACSP ______% Putnam Equity Spectrum A ... PYSAX ______% Putnam Multi-Cap Value A ... PMVAX ______% Alger Capital Appreciation Instl I ... ALARX ______% American Century Equity Income Inv ... TWEIX ______% American Century Inc & Growth Fund Inv ... BIGRX ______% American Century Ultra Investor ... TWCUX ______% American Century Value Fund Inv ... TWVLX ______% Calvert Equity Portfolio A ... CSIEX ______% Great-West S&P 500 Index Fund L ... MXVJX ______% Great-West T. Rowe Price Eq Inc Fund L ... MXTQX ______% IXIS Harris Associates Large Cap Value A ... NEFOX ______% Janus Forty S ... JARTX ______% Jensen Quality Growth J ... JENSX ______% JPMorgan Growth Advantage A ... VHIAX ______% JPMorgan Growth & Income A ... VGRIX ______% JPMorgan Large Cap Growth A ... OLGAX ______% JPMorgan Value Advantage A ... JVAAX ______% MFS Core Equity A ... MRGAX ______% MFS Value A ... MEIAX ______% Oppenheimer Main Street Select A ... OMSOX ______% Putnam Equity Income A ... PEYAX ______% Putnam Fund for Growth & Income A ... PGRWX ______% Putnam Growth Opportunities A ... POGAX ______% Putnam Investors A ... PINVX ______% Putnam Multi-Cap Core A ... PMYAX ______% T. Rowe Price Blue Chip Growth Adv ... PABGX ______% T. Rowe Price Growth Stock Adv ... TRSAX ______% MFS Total Return A ... MSFRX ______% Oakmark Equity & Income I ... OAKBX ______% JPMorgan Income Builder A ... JNBAX ______% BlackRock US Government Bond Inv A ... CIGAX ______% Great-West Bond Index Fund L ... MXBJX ______% JPMorgan Core Plus Bond A ... ONIAX ______% JPMorgan High Yield A ... OHYAX ______% JPMorgan Limited Duration Bd A ... ONUAX ______% JPMorgan Total Return A ... JMTAX ______% Oppenheimer International Bond Fund A ... OIBAX ______% PIMCO Real Return A ... PRTNX ______% PIMCO Total Return A ... PTTAX ______% Pioneer Strategic Income A ... PSRAX ______% Putnam American Government Income A ... PAGVX ______% Putnam Global Income A ... PGGIX ______% Putnam High Yield A ... PHIGX ______% Putnam Income Fund A ... PINCX ______% Putnam US Government Income A ... PGSIX ______% Thompson Bond Fund ... THOPX ______% Wells Fargo Advantage Income Plus A ... STYAX ______% Wells Fargo Advantage Intl Bond A ... ESIYX ______% Wells Fargo Advantage Core Bond Admin ... MNTRX ______% Great-West Money Market Fund I ... MXMMF _____% Putnam Money Market T ... PTTMMF _____% **The Bancorp Bank Master Demand Account ... BNCMDA _____% MUST INDICATE WHOLE PERCENTAGES = 100%

Investment Option Code

* I understand that a Product Prospectus and additional documentation concerning the features associated with the Great-West Secure Foundation® Guaranteed Lifetime Withdrawal Benefi t (GLWB) is available at www.ira.gwrs.com. If you have any questions, please call your Service Provider at 1-866-317-6586.

**Bancorp Bank Master Demand Account (MDA) is a liquid asset account that offers pass-through FDIC insurance to depositors for balances up to $250,000. As a liquid account, the MDA trades daily and investors are able to purchase and redeem MDA shares from Bancorp on a daily basis. The MDA is offered by the Bancorp Bank (“Bancorp”), which is an unaffi liated FDIC-insured online commercial bank operated by The Bancorp, Inc. As the deposit agent and fi duciary, Bancorp undertakes and is responsible to maintain the MDA and its books and records to comply with the procedures * I understand that a Product Prospectus and additional documentation concerning the features associated with the Great-West Secure Foundation® Guaranteed Lifetime Withdrawal Benefi t (GLWB) is available at www.empower-retirement.com/ira If you have any questions, please call your Service Provider at 1-866-317-6586.

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740501-R3

Restoration of Great-West SecureFoundation®_{Benefit Base}

This section is applicable if you have established a Great-West SecureFoundation®_{Benefit Base (“Benefit Base”) in your employer sponsored retirement plan.}

The selection below will apply to existing plan assets with a Great-West SecureFoundation®_{Benefit Base only.}

I have established my Benefit Base in my employer sponsored retirement plan account and would like to restore my Benefit Base in my Great-West Lifetime Advantage IRA®_{Solution by directly rolling assets from the portfolio in my employer sponsored retirement plan to the approved portfolio in my}

IRA. By making this election, I understand the following:

• This option is only available if I live in a jurisdiction where Great-West SecureFoundation®_{is available to individual investors.}

• By making this election, I understand that I must also include either an a Great-West SecureFoundation®_{election form or application (dependent on}

state of residence). I can request a form at www.ira.gwrs.com or by calling 1-877-804-62571_.

• I understand that applicable funds in my Great-West Lifetime Advantage IRA®_{Solution may have different fees and expenses than in my employer}

740501-R3

Application Submission and Payment Instructions

Please remember to sign and date page 6 and fax pages 1 through 6 (inclusive) of this application to 1-866-633-5212 and forward the

funds according to the instructions below.

Make check payable to:

Great-West Trust Company, LLC

Include the following information on the check (missing information could result in delayed processing):

FBO Owner Name Social Security Number IRA #: 740501-R3

IRA Name: Great-West Lifetime Advantage Roth IRA®

Wire instructions (missing information could result in delayed processing or rejection):

Account of: Great-West Trust Company, LLC Bank: Wells Fargo

Account no: 0193184611 Routing Transit #: 121000248 Attention: Financial Control Reference:

FBO Owner Name Social Security Number IRA #: 740501-R3

IRA Name: Great-West Lifetime Advantage Roth IRA®

Regular mail address for the check and form (if mailed together): Great-West Trust Company, LLC

PO Box 910893 Denver, CO 80291-0893

Overnight mail address for the check and form (if mailed together): Wells Fargo, N.A.

Great-West Trust Co/IRA Dept 893 1700 Lincoln St Lower Level 3 Denver, CO 80274

Contact: Great-West Retirement Services®

Phone #: 1-877-804-6257

Please remember that this application form needs to arrive prior to or simultaneously with the funds arriving to invest according to the

allocations on this form.

Owner Acknowledgements

Investment Options - If I elect to direct my own investments, I understand that by signing and submitting this Roth IRA Application for processing, I am requesting to have investment options established as specified on this form. I understand and acknowledge that all payments and account values, when based on the experience of the investment options, may not be guaranteed and may fluctuate and upon redemption, shares may be worth more or less than their original cost. I acknowledge that investment option information, including prospectuses, disclosure documents and Fund Profile Sheets, have been made available to me prior to this transaction and I understand the risks of investing. It is my responsibility to read the prospectus(es) carefully before investing. I understand if I elect to have my account managed by AAG, that my entire account, including any transfers or rollovers, will be professionally managed. Dollar cost averaging and asset allocation are not available if my account is professionally managed. I understand that the applicable fees will be deducted from my account. In order to enroll in the Managed Accounts Service, I understand that I must provide my Social Security number, date of birth, gender, marital status and annual income. If any of this information is not provided, I understand that I will not be enrolled in the Managed Accounts Service.

General Information - I understand that only certain types of distributions are eligible for transfer/rollover treatment and that it is solely my responsibility to ensure such eligibility. By signing below, I affirm that the funds I am transferring/rolling are in fact eligible for such treatment. I authorize these funds to be transferred into my IRA and to be invested according to the information specified in the Investment Section.

I understand that the Custodian/Provider may require that I furnish additional information before processing the transaction requested on this form, and Service Provider is not responsible for determining the transaction that I have requested. It is entirely my responsibility to provide the Custodian/Provider with any information that they may require, and/or to notify Service Provider of any information that the Custodian/Plan/Provider may wish to obtain in order to effect the transaction.

Incomplete Forms - I understand that in the event my Roth IRA Application is incomplete or is not received by Service Provider, funds will be returned to the sender. If the Investment Section is missing or incomplete, I specifically consent to Custodian allocating all monies to the default investment option identified in the Individual Retirement Custodial Account Agreement. Once my account has been established, I understand that I must call the Voice Response System at 1-866-317-6586 or access the Web site at www.ira.gwrs.com in order to transfer monies from the default investment option. Also, I understand all contributions received after my account is established will be applied to the investment options I have most recently selected.

Account Corrections - I understand that it is my obligation to review all confirmations and quarterly statements for discrepancies or errors. Corrections will be made only for errors which I communicate within 30 calendar days of the last calendar quarter. After this 30 day period, account information shall be deemed accurate and acceptable to me. If I notify Service Provider of an error after this 30 day period, the correction will only be processed from the date of notification forward and not on a retroactive basis.

Compliance With Internal Revenue Code - I understand that the maximum amount I may contribute to this IRA is determined under the Internal Revenue Code (the “Code”). I understand it is my responsibility to monitor my total annual contributions to any and all IRAs and to ensure I do not exceed the amount permitted. If I exceed the contribution limit, I assume full responsibility for any tax, penalty or costs that may be incurred.

Owner Email Address - By providing Service Provider with my email address during this Application Process, I acknowledge and agree that I am responsible for immediately notifying Service Provider of any changes to my email address and I am solely responsible for any liability that may arise out of my failure to provide such updates. I agree to receive via the email address I provided documents related to my Great-West Lifetime Advantage IRA®_{account, including}

without limitation account statements, activity confirmations, updates to my account agreements, tax and/or regulatory notices or disclosures, and any other documents which Service Provider or its affliates provide now and/or in the future. I understand that I may elect to no longer receive electronic delivery of documents by providing notification to Service Provider.

Please remember to sign and date page 5 and fax pages 1 through 6 (inclusive) of this application to 1-866-633-5212 and forward the funds according to the instructions below.

IRA Name: Empower Retirement Roth IRA

Retirement Solutions Center

Incomplete Forms - I understand that in the event my Roth IRA Application is incomplete or is not received by Service Provider, funds will be returned to the sender. If the Investment Section is missing or incomplete, I specifi cally consent to Custodian allocating all monies to the default investment option identifi ed in the Individual Retirement Custodial Account Agreement. Once my account has been established, I understand that I must call the Voice Response System at 1-866-317-6586 or access the Web site at www.empower-retirement.com/ira in order to transfer monies from the default investment option. Also, I understand all contributions received after my account is established will be applied to the investment options I have most recently selected.

Owner Email Address - By providing Service Provider with my email address during this Application Process, I acknowledge and agree that I am responsible for immediately notifying Service Provider of any changes to my email address and I am solely responsible for any liability that may arise out of my failure to provide such updates. I agree to receive via the email address I provided, documents related to my Empower Retirement IRA account, including without limitation account statements, activity confi rmations, updates to my account agreements, tax and/or regulatory notices or disclosures, and any other documents which Service Provider or its affl iates provide now and/or in the future. I understand that I may elect to no longer receive electronic delivery of documents by providing notifi cation to Service Provider.

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740501-R3

Managed Accounts Service Fee - If I elect the Managed Accounts Service, a quarterly fee will be assessed. If I wish to opt-out in the future, I will call an AAG Representative at 1-866-317-6586.

Financial Advisor Fee – If I have a financial advisor in conjunction with this Roth IRA I understand that my financial advisor may receive compensation of 0.25% (based upon investment selections) paid from fund expenses already paid by me and based upon investment selections.

Financial Advisor Information NOTE: This section is not applicable if the Roth IRA Applicant has selected the Managed Accounts Service.

Broker/Dealer Name & Number Financial Advisor Name

Branch Number Financial Advisor Phone Number

GWRS Broker Number (if applicable) Financial Advisor Street Address

Rep ID Financial Advisor City/State/Zip

Required Signatures

I have read, understand, and agree to all terms and conditions of this Roth IRA Application, including the terms of the Advisory Services Agreement, the Roth Individual Retirement Custodial Account Agreement, the Disclosure Statement, and the Fee Schedule. I understand that all documents can be found and were provided to me as part of this application package.

I understand that Service Provider and Custodian are required to comply with the regulations and requirements of the Office of Foreign Assets Control, Department of the Treasury (“OFAC”). As a result, Service Provider and Custodian cannot conduct business with persons in a blocked country or any person designated by OFAC as a specially designated national or blocked person. For more information, please access the OFAC Web site at:

http://www.treasury.gov/about/organizational-structure/offices/Pages/Office-of-Foreign-Assets-Control.aspx.

In addition, the USA PATRIOT Act of 2001 requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. You must provide your name, address, date of birth, and other information that will allow Service Provider and Custodian to identify you. If you fail to provide all of the required information, processing of your application will be delayed until all of the information has been provided. You understand that Service Provider and Custodian may use a third party information provider for verification purposes and/or ask for a copy of your driver’s license or other identifying documents.

Any person who presents a false or fraudulent claim is subject to criminal and civil penalties.

Note: Owner forward form as shown on Page 4 in the Payment Instructions section.

Owner Signature Date

For questions, please call: 1-877-804-6257

Great-West Financial® refers to products and services provided by Great-West Life & Annuity Insurance Company (GWL&A), Corporate Headquarters: Greenwood Village, CO; Great-West Life & Annuity Insurance Company of New York (GWL&A of NY), Home Offi ce: White Plains, NY; and their subsidiaries and affi liates, including Great-West Funds, Inc. and Great-West Trust Company, LLC. All trademarks, logos, service marks, and design elements used are owned by their respective owners and are used by permission.

Empower Retirement refers to the products and services offered in the retirement markets by Great-West Life & Annuity Insurance Company (GWL&A), Corporate Headquarters: Greenwood Village, CO; Great-West Life & Annuity Insurance Company of New York, Home Offi ce: White Plains, NY; and their subsidiaries and affi liates. The trademarks, logos, service marks, and design elements used are owned by GWL&A.

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GREAT-WEST LIFETIME ADVANTAGE IRA – ROTH

FEE SCHEDULE

1

Set-Up Fee $60 for initial deposits of $5,000 or less

Transfer-In/Rollover-In Fee $0

Annual Administration Fee $50, if account balance is $5,000 or less;

$30, if account balance is greater than $5,000 but less than$30,0002;

$0, if account balance is greater than $30,0002

Transaction Fees $0

Asset Holding Fees $0

Account Closure Fee3 $50

Sales Load $0

Miscellaneous Fees Special Services, including but not limited to, wires, overnight delivery services, stop payments on checks, non-sufficient funds checks, and additional statement copies may be charged a separate fee. Advisory Services4 On-Line Investment Guidance Quarterly Fee Annual Fee No Fee No Fee On-Line Investment Advice Quarterly Fee Annual Fee $6.25 $25 Managed Accounts Account Balance Quarterly Fee Annual Fee <$100,000 0.1375% 0.55% Next $150,000 0.1125% 0.45% Next $150,000 0.0875% 0.35% >$400,000 0.0625% 0.25%

Initial Investment, Distribution, and Account Balance Minimums

Minimum Initial Investment5 $500

Minimum Distribution Amount $50

Minimum Balance Required to Keep IRA open $50

The Custodian and Service Provider reserve the right to change the Fee Schedule and Initial Investment, Distribution, and Account Balance Minimums upon 30 days’ written notice to the IRA owner.

1

I understand that funds may impose redemption fees on certain transfers, redemptions or exchanges if assets are held less than the period stated in the fund’s prospectus or other disclosure documents.

I will refer to the fund’s prospectus and/or disclosure documents for more information.

2

Determined as of each calendar quarter end date.

3

Assessed when the account is closed upon full distribution or transfer of the IRA, or when the IRA balance falls below $50 (in which case the IRA Custodian will terminate the IRA.)

4 _{Managed account, guidance and advice services are offered by Advised Assets Group, LLC (AAG), and a federally registered investment adviser.}

More information can be found at www.adviserinfo.sec.gov. Ibbotson Associates, Inc. is a registered investment adviser and is not affiliated with AAG, its parent company Great-West Life & Annuity Insurance Company or any of its subsidiaries.

Great-West Trust Company, LLC is a wholly owned subsidiary of Great-West Life & Annuity Insurance Company.

5_{Minimum Initial Investment Requirement may be waived for incoming rollover initiated due to mandatory distribution provisions under an eligible}

retirement plan.

1

GWFS Equities, Inc. is a Member of the Securities Investor Protection Corporation (“SIPC”). You may obtain information about SIPC, including the SIPC brochure, by contacting SIPC.

Securities Investor Protection Corporation 805 15th Street, N.W. Suite 800

Washington, D.C. 20005-2215 Email: [email protected] Tel: (202)371-8300

Information about SIPC is also available at www.sipc.org.

less than$30,000 ;

$0, if account balance is greater than $30,000, , ; 2 $30, if account balance is greater than $5,000 but

less than$30,0002;

2 $50, if account balance is $5,000 or less;

$75

Assessed when the account is closed upon full distribution or transfer of the IRA, or when the IRA balance falls below $75 (in which case the IRA Custodian will terminate the IRA.)

$0

$35,

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ADVISED ASSETS GROUP, LLC

ADVISORY SERVICES IRA AGREEMENT

Please read the following terms and conditions carefully before using or enrolling in any of the services described below.

Your use of any service will signify your consent to be bound by the terms and conditions set forth in this Agreement.

You also agree that you have read and received the attached ADV Form Part II from Advised Assets Group, LLC (“AAG”).

Fees for the Service

Fees for each service are shown below. The fees are assessed on a quarterly basis and the chart below reflects the

quarterly and annual fee amount.

Online Investment Guidance

Quarterly Fee

Annual Fee

No Fee

Online Investment Advice

Quarterly Fee

Annual Fee

$6.25

$25

Managed Account Service

Account Balance

Quarterly Fee

Annual Fee

<$100,000.00 0.1375%

0.55%

Next $150,000.00

0.1125%

0.45%

Next $150,000.00

0.0875%

0.35%

>$400,000.00 0.0625%

0.25%

For example, if your account balance subject to Managed Accounts is $50,000, the maximum annual fee is 0.55 % of the

account balance. The amount collected quarterly will be based upon your account balance on the day of fee assessment.

If your account balance subject to Managed Accounts is $500,000, the first $100,000will be subject to a maximum annual

fee of 0.55 % (quarterly 0.1375%), the next $150,000 will be subject to a maximum annual fee of 0.45 % (0.1125%), the

next $150,000 will be subject to a maximum annual fee of 0.35 % (0.0875%), and any amounts over $400,000 will be

subject to a maximum annual fee of 0.25 % (0.0625%). All fees are assessed on a quarterly basis. For example, the

maximum quarterly fee for an account balance less than $100,000 (subject to maximum annual fee of 0.55%) would be

0.1375% as demonstrated above.

The fees for Online Investment Advice and Managed Account services will generally be debited from your account within

the last five (5) to seven (7) business days of each quarter of enrollment, which may or may not correspond to a calendar

quarter; however, if you cancel participation in Managed Accounts, the fee will be based on your account balance on the

date of cancellation and will be debited from your account within five (5) to seven (7) business days of the end of the

quarter in which the cancellation occurred. Use of online investment advice at any time during a quarter will result in your

account being debited the quarterly fee.

DISCLAIMERS

AAG uses reasonable care, consistent with industry practice, in providing services to you. We do not guarantee the future

performance of your account or that the investments we recommend will be profitable. Investment return and principal

value will fluctuate with market conditions, and you may lose money. The investments we may recommend, or purchase

for your account, if applicable, are subject to various risks, including without limitation business, market, currency,

economic, and political risks. AAG does not provide advice for, recommend allocations of, or manage individual stocks,

self-directed brokerage accounts, or guaranteed certificate funds or any other investment with fixed holding period, even if

they are available for investment in your IRA. We do not select the investment options available for investment in your

IRA. By recommending allocations among the available investment options, we are not endorsing the selection of

particular investments options available in your IRA.

AAG and its employees will not be liable to you for any loss caused by (1) our prudent, good faith decisions or actions, (2)

following your instructions, or (3) any person other than AAG or its affiliates who provides services for your account. AAG

will not be liable to you for any losses resulting from your disclosure of your personal information or your PIN number to

third parties even if the purpose of your disclosure is to enable such person to enroll you in, or cancel your enrollment in,

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Advisory Services. AAG is not responsible for voting proxies for the securities in your account. We do not guarantee that

the services or any content will be delivered to you uninterrupted, timely, secure, or error-free.

TO THE MAXIMUM EXTENT PERMITTED BY LAW, AAG DISCLAIMS ALL REPRESENTATIONS AND WARRANTIES,

EXPRESS OR IMPLIED, WITH RESPECT TO THE SERVICES AND THE SERVICE CONTENT, AND ALL

INFORMATION DERIVED FROM THEM, INCLUDING, BUT NOT LIMITED TO, IMPLIED WARRANTIES OF

MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, QUALITY, TIMELINESS, ACCURACY, AND

IMPLIED WARRANTIES ARISING FROM COURSE OF PERFORMANCE OR COURSE OF DEALING. IN ADDITION,

AAG DOES NOT WARRANT THAT THE SERVICE OR CONTENT CONTAINED IN IT WILL BE UNINTERRUPTED,

ERROR-FREE, FULLY AVAILABLE AT ALL TIMES OR THAT ANY INFORMATION OR OTHER MATERIAL

ACCESSIBLE THROUGH THE SERVICE IS FREE OF ERRORS OR OTHER HARMFUL CONTENT.

LIMITATION OF LIABILITY

YOU UNDERSTAND THAT IN NO EVENT WILL AAG, OR ITS OFFICERS, DIRECTORS, SHAREHOLDERS,

PARENTS, SUBSIDIARIES, AFFILIATES, EMPLOYEES, CONSULTANTS, AGENTS, LICENSORS OR ANY DATA

PROVIDER BE LIABLE FOR ANY CONSEQUENTIAL, PUNITIVE, INCIDENTAL, SPECIAL OR INDIRECT DAMAGES,

LOSS OF BUSINESS REVENUE OR LOST PROFITS, WHETHER IN AN ACTION UNDER CONTRACT, NEGLIGENCE

OR ANY OTHER THEORY EVEN IF WE ARE ADVISED OF THE POSSIBILITY OF SUCH.

INDEMNIFICATION

You agree to indemnify, defend and hold harmless AAG, its officers, directors, shareholders, parents, subsidiaries,

affiliates, employees, consultants, agents and licensors from and against any and all third party claims, liability, damages

and/or costs (including but not limited to reasonable attorneys’ fees) arising from your failure to comply with this

Agreement, the information you provide us, your infringement of any intellectual property or other right of a third party, or

from your violation of applicable law.

DESCRIPTION OF SERVICES

AAG offers the following investment advisory services; Online Investment Guidance, Online Investment Advice, and the

Managed Account service through Advisory Services:

Online Investment Guidance: The Online Investment Guidance service is geared toward account owners who wish to

manage their own retirement accounts. Clients are provided access to online guidance tools.

Online Investment Advice: Online Investment Advice is geared toward account owners who wish to manage their own

retirement plans. Clients are provided online guidance and investment advice for a personalized recommended

investment portfolio. The recommended investment portfolio is based on information drawn from your account profile and

from the investment options available to you. You may then implement the recommended investment portfolio and

manage your retirement account online.

Managed Account service: The Managed Accounts service is geared toward account owners who wish to have a

qualified financial expert select among the available investment options and manage their retirement account for them.

You will receive a personalized investment portfolio that reflects the investment options and your retirement timeframe, life

stages and overall financial picture, including additional financial wealth (if you elect to provide this information), which

may be taken into consideration when determining the allocation of assets in your IRA (AAG will not provide advice for,

recommend allocations of, or manage your outside or non-IRA assets). Under the Managed Account service, AAG has

discretionary authority over allocating your assets among the investment options, without your prior approval of each

transaction.

Upon receipt of your initial deposit or rollover into your IRA, your funds will be allocated to the default investment option

specified in your custodial agreement. AAG will re-allocate your funds to your asset allocation portfolio within 5 business

days of receiving your initial deposit.

Managed Account assets in the your investment options will be automatically monitored, rebalanced and reallocated

every quarter by AAG, based on data resulting from the methodologies and software employed by the Independent

Financial Expert, to respond to market performance and to ensure optimal account performance over time. You will

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receive an account update and forecast statement annually and can update your personal information at any time by

calling AAG at our toll-free customer service number or by visiting the website.

IMPORTANT: The projections or other information generated by the advisory service product regarding the

likelihood of various investment outcomes are hypothetical in nature, do not reflect actual investment results and

are not guarantees of future results. Results may vary with each use and over time.

The Advisory Services methodology is powered by Ibbotson Associates. Ibbotson first builds stable, consistent asset

allocation models at various risk levels. Based on Monte Carlo simulations of the client’s resources, liabilities, and human

capital, an appropriate asset level portfolio is selected and a savings rate and a retirement age are determined that best

suits each client’s situation. The asset class level model portfolios are revisited annually. Investment options are then

selected to implement each asset-level model portfolio. These investment options are monitored and rebalanced

quarterly.

Your acceptance of the terms and conditions of this Agreement constitutes your authorization for AAG to deduct the

quarterly fee. The fees are subject to change.

Certain investment options in your IRA may charge a redemption fee or impose restrictions for market timing. Such

restrictions or redemption fees vary in amount and application from investment option to investment option. It is possible

that transactions initiated by AAG under Online Investment Advice or the Managed Account service may result in the

imposition of a redemption fee or marketing timing base restriction on one or more investment options available in your

IRA. Any redemption fees will be deducted from your account balance.

If you participate in the Managed Accounts service, you must allocate all of your account balance. You may not invest in

other investment options while also participating in the Managed Account service. Once enrolled in the Managed Account

service, you will no longer be able to make investment allocation changes to your account online, via paper, or through

the toll-free customer service number. This includes functionality for fund-to-fund transfers, change fund allocations, or

utilization of dollar cost averaging, or rebalancer. Once enrolled, you retain full inquiry access to your account and you

may still request a distribution. The aforementioned functionality will be restored to your account within the next business

day markets are open after you cancel participation in the Managed Account service.

You may cancel participation in the Managed Account service at any time by completing the cancellation form available

online or by calling AAG at our toll-free customer service number.

GENERAL PROVISIONS

AAG acknowledges that, as a registered investment adviser, it owes a fiduciary duty to participants with respect to

investment advice (Online Investment Advice) and investment management (Managed Account service). AAG is not a

fiduciary with respect to guidance. You may not assign this Agreement. We may not assign this Agreement (within the

meaning of the Investment Advisers Act of 1940 (“Advisers Act”) without your consent. This Agreement is entered into in

Denver, Colorado and governed by and construed in accordance with the laws of the State of Colorado, without regard to

its conflict of law provisions. You agree that proper forum for any claims under this Agreement shall be in the courts of the

State of Colorado for Arapahoe County or the United States District Court, District of Colorado. The prevailing party shall

be entitled to recovery of expenses, including reasonable attorneys’ fees. This agreement constitutes the entire

Agreement between you and AAG with respect to the subject matter herein. If for any reason a provision or portion of this

Agreement is found to be unenforceable, that provision of the Agreement will be enforced to the maximum extent

permissible so as to affect the intent of the parties, and the remainder of this Agreement will continue in full force and

effect. No failure or delay on the part of AAG in exercising any right or remedy with respect to a breach of this Agreement

by you shall operate as a waiver thereof or of any prior or subsequent breach of this Agreement by you, nor shall the

exercise of any such right or remedy preclude any other or future exercise thereof or exercise of any other right or remedy

in connection with this Agreement. Any waiver must be in writing and signed by AAG. All terms and provisions of this

Agreement, including without limitation “Disclaimers,” “Limitation of Liability,” “Indemnification,” “Intellectual Property,” and

“Privacy Policy,” which should by their nature survive the termination of this Agreement, shall so survive. This Agreement

will automatically terminate upon termination of your agreement with AAG. Nothing in this Agreement shall be construed

to waive compliance with the Advisers Act. AAG shall not be liable for any delay or failure to perform its obligations

hereunder if such delay or failure is caused by an unforeseeable event beyond its reasonable control, including without

limitation: act of God; fire; flood; earthquake; labor strike; sabotage; fiber cut; embargoes; power failure; lightning;

supplier’s failures; act or omissions of telecommunications common carriers; material shortages or unavailability or other

delay in delivery; government codes, ordinances, laws, rules, regulations or restrictions; war or civil disorder, or acts of

terrorism. AAG reserves the right to modify this Agreement at any time. You agree to review this Agreement periodically

so that you are aware of any such modifications. Your continued participation in Advisory Services shall be deemed to be

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your acceptance of the modified terms of this Agreement. This Agreement shall inure to the benefit of AAG’s successor

and assigns.

INTELLECTUAL PROPERTY

All content provided as part of Advisory Services, including without limitation names, logos, methodologies, and news or

information provided by third parties, is protected by copyrights, trademarks, service marks, patents, or other intellectual

property and proprietary rights and laws (“Intellectual Property”) and may constitute trade secrets, as defined by

applicable law. All such Intellectual Property is the property of their respective owners and no rights or licenses are

granted to you as a result of your participation in Advisory Services.

PRIVACY POLICY

AAG protects your privacy. We have strict policies in place to keep your personal information private. A summary of AAG

policies and procedures to protect the privacy and security of your personal information is set forth below.

Types of Information We Collect. AAG collects personal information about you from your applications or other forms

that you complete and from our affiliates you have conducted business with. Such information includes without limitation;

your name, address, age, salary, number of dependents, account balances and contributions. You may provide us with

additional personal information about your investments and preferences at any time. We also keep records of all

transactions in your account and any communications about your account.

Security of Your Information. We have strict procedures to protect your privacy. They include physical, administrative,

and technical safeguards.

Access to Information. The only employees who have access to your personal information are those who need it to

service your account, or to provide you with products or services.

Our Information-Sharing Practices. AAG will not disclose, sell, share, or reveal your personal information except in the

following circumstances:

x We have your authorization to share your personal information with third parties;

x We need to share your personal information with our affiliates who provide a product or service you have

requested or to maintain, service or administer your account (for example, our affiliated broker-dealer that

executes transactions in your account; such affiliates do not have the right to use your personal information other

than in the performance of services necessary to assist us);

or

x We are required by law to disclose your personal information (for example, in response to a subpoena,

governmental or regulatory request, or to protect against fraud or other illegal activity).

Analysis. We may perform analyses based on data about our customers. Such data will not contain personally

identifiable information.

Our Treatment of Information about Former Customers. Protecting your privacy goes beyond our relationship with you

as a participant in Advisory Services. If this relationship ends, we will not share your personal information with third

parties, except as law permits.

Customer Right To Change Information. For more information on our privacy practices or to correct, amend or

supplement your personal information, you may contact us at 1-877-804-6257.

ABOUT ADVISED ASSETS GROUP, LLC

AAG, a wholly owned subsidiary of Great-West Life & Annuity Insurance Company, is a registered investment adviser with

the Securities and Exchange Commission. AAG provides guidance, advisory, and management solutions to defined

contribution and deferred compensation plans and participants and to IRA account owners.

Since its inception, AAG has focused on establishing, refining, and continually improving the process of investment

planning for plan sponsors and participants. By blending best practices investment approaches with personalized plan

data and leading industry knowledge and expertise, AAG aspires to create effectively-built, diversified retirement solutions

that maximize outcomes for its clients.

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Additional information about the services provided by AAG may be found in AAG’s Form ADV Part II, which is available

free of charge online at www.advisedassetsgroup.com, upon request by calling AAG at the customer service number

1-877-804-6257, or writing AAG at: 8515 East Orchard Road, Greenwood Village, Colorado 80111.

Interest in Participant Transactions. AAG, its officers and employees may purchase securities for their own accounts

and these securities may be the same as those recommended to, or invested for, you (e.g. shares of the same mutual

fund).

The Maxim series funds and the Putnam funds are affiliates of AAG.

ABOUT IBBOTSON ASSOCIATES

AAG has teamed with Ibbotson Associates, a recognized industry leader in asset allocation and investment analytics

tools, to provide the underlying investment advice and portfolio management methodology that will power Advisory

Services.

Ibbotson Associates is a leading independent provider of asset allocation, manager selection, and portfolio construction

services. The company leverages its innovative academic research to create customized investment advisory solutions

that help investors meet their goals. Ibbotson Associates, Inc. was founded in 1977 and is a registered investment advisor

and wholly owned subsidiary of Morningstar, Inc.

AAG reserves the right to replace the Independent Financial Expert in its sole discretion and without your approval. AAG

will notify you of any fee changes resulting from the Independent Financial Expert being replaced. In the event AAG

terminates its relationship with the current Independent Financial Expert and is unable to contract with a suitable

replacement Independent Financial Expert, this Agreement shall automatically terminate upon written notice from AAG.

ACCEPTANCE OF TERMS AND CONDITIONS OF ADVISORY SERVICES AGREEMENT

If you agree to the terms and conditions set forth herein, you will be enrolled in the service you requested that is offered

under Advisory Services. Your acceptance of the terms and conditions shall signify your consent to be bound by the

applicable provisions of this Agreement, as they relate to the Online Investment Guidance, Online Investment Advice, or

Managed Account services. Please note that upon enrollment in the Managed Account service, any currently initiated

transfers or transactions will be cancelled, unless the market has already closed for the day.

If you do not agree to the terms and conditions set forth herein, you will not be enrolled in the service you requested that

is offered under Advisory Services.

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ROTH INDIVIDUAL RETIREMENT ACCOUNT CUSTODIAL AGREEMENT

Form 5305-RA under Section 408(a) of the Internal Revenue Code FORM (REV. MARCH 2002)

The Depositor named on the Application is establishing a Roth Individual Retirement Account under section 408A to provide for his or her retirement and for the support of his or her beneficiaries after death.

The Custodian named on the Application has given the Depositor the disclosure statement required by Regulations section 1.408-6. The Depositor has assigned the custodial account the sum indicated on the Application. The Depositor and the Custodian make the following agreement:

ARTICLE I

Except in the case of a rollover contribution described in section 408A(e), a recharacterized contribution described in section 408A(d)(6), or an IRA Conversion Contribution, the Custodian will accept only cash contributions up to $3,000 per year for tax years 2002 through 2004. That contribution limit is increased to $4,000 for tax years 2005 through 2007 and $5,000 for 2008 and thereafter. For individuals who have reached the age of 50 before the close of the tax year, the contribution limit is increased to $3,500 per year for tax years 2002 through 2004, $4,500 for 2005, $5,000 for 2006 and 2007, and $6,000 for 2008 and thereafter. For tax years after 2008, the above limits will be increased to reflect a cost-of-living adjustment, if any.

ARTICLE II

1. The annual contribution limit described in Article I is gradually reduced to $0 for higher income levels. For a single Depositor, the annual contribution is phased out between adjusted gross income (AGI) of $95,000 and $110,000; for a married Depositor filing jointly, between AGI of $150,000 and $160,000; and for a married Depositor filing separately, between AGI of $0 and $10,000. In the case of a conversion, the Custodian will not accept IRA Conversion Contributions in a tax year if the Depositor's AGI for the tax year the funds were distributed from the other IRA exceeds $100,000 or if the Depositor is married and files a separate return. Adjusted gross income is defined in section 408A(c)(3) and does not include IRA Conversion Contributions.

2. In the case of a joint return, the AGI limits in the preceding paragraph apply to the combined AGI of the Depositor and his or her spouse.

ARTICLE III

The Depositor's interest in the balance in the custodial account is nonforfeitable.

ARTICLE IV

1. No part of the custodial account funds may be invested in life insurance contracts, nor may the assets of the custodial account be commingled with other property except in a common trust fund or common investment fund (within the meaning of section 408(a)(5)). 2. No part of the custodial account funds may be invested in

collectibles (within the meaning of section 408(m)) except as otherwise permitted by section 408(m)(3), which provides an exception for certain gold, silver, and platinum coins, coins issued under the laws of any state, and certain bullion.

ARTICLE V

1. If the Depositor dies before his or her entire interest is distributed to him or her and the Depositor's surviving spouse is not the designated beneficiary, the remaining interest will be distributed in accordance with (a) below or, if elected or there is no designated beneficiary, in accordance with (b) below:

(a) The remaining interest will be distributed, starting by the end of the calendar year following the year of the Depositor's death, over the designated beneficiary's remaining life expectancy as determined in the year following the death of the Depositor. (b) The remaining interest will be distributed by the end of the

calendar year containing the fifth anniversary of the Depositor's death.

2. The minimum amount that must be distributed each year under paragraph 1(a) above is the account value at the close of business on December 31 of the preceding year divided by the life expectancy (in the single life table in Regulations section 1.401(a)(9)-9) of the designated beneficiary using the attained age of the beneficiary in the year following the year of the Depositor's death and subtracting 1 from the divisor for each subsequent year.

3. If the Depositor's surviving spouse is the designated beneficiary, such spouse will then be treated as the Depositor

ARTICLE VI

1. The Depositor agrees to provide the Custodian with all information necessary to prepare any reports required by sections 408(i) and 408A(d)(3)(E), Regulations sections 1.408-5 and 1.408-6, or other guidance published by the Internal Revenue Service (IRS).

2. The Custodian agrees to submit to the IRS and Depositor the reports prescribed by the IRS.

ARTICLE VII

Notwithstanding any other articles which may be added or incorporated, the provisions of Articles I through IV and this sentence will be controlling. Any additional articles inconsistent with section 408A, the related regulations, and other published guidance will be invalid.

ARTICLE VIII

This Agreement will be amended as necessary to comply with the provisions of the Code, the related Regulations, and other published guidance. Other amendments may be made with the consent of the persons whose signatures appear on the Application.

ARTICLE IX

9.01 Definitions: In this part of this Agreement (Article IX), "Depositor" means the individual who establishes the account. The "Custodian" means Great-West Trust Company, LLC, "Service Provider" means GWFS Equities, Inc., an affiliate of Great-West Trust Company, LLC. "Code" means the Internal Revenue Code of 1986, as amended from time to time, and "Regulations" means the Treasury Regulations.

9.02 Appointment of Agents and Service Providers: In its discretion, the Custodian may appoint one or more agents or service providers, who may be an affiliate of the Custodian, to carry out any of its functions, including but not limited to, recordkeeping, establishing new accounts, processing contributions and distributions, and tax withholding and reporting. In the event of such appointment, all rights and privileges of the Custodian under this agreement shall pass through to such agents or service providers who shall be entitled to enforce them as if a party to this Agreement.

The Depositor shall be responsible for providing all instructions, notices, forms, and remittance to Service Provider.

9.03 Notices and Change of Address: Any required notice regarding this Roth IRA will be considered effective when Service Provider sends it to the intended recipient at the last address which Service Provider has in its records. Any notice to be given to Service Provider will be considered effective when Service Provider actually receives it. Depositor, or the intended recipient, must notify Service Provider of any change of address.

9.04 Representations and Responsibilities: Depositor represents and warrants to the Custodian and Service Provider that any information Depositor has given or will give the Custodian and/or Service Provider with respect to this Agreement is complete and accurate. Further, Depositor agrees that any directions given to the Custodian and/or Service Provider, or action Depositor takes will be proper under this Agreement, and that the Custodian and/or Service Provider are entitled to rely upon any such information or directions. If the Custodian or Service Provider fail to receive directions from Depositor regarding any transaction, or if the Custodian or Service Provider receive ambiguous directions regarding any transaction, or either of them, in good faith, believe that any transaction requested is in dispute, the Custodian and Service Provider reserve the right to take no action until further clarification acceptable to the Custodian or Service Provider is received from Depositor or the appropriate government or judicial authority. The Custodian and Service Provider shall not be responsible for losses of any kind that may result from the Depositor’s directions or Depositor’s actions or failures to act, and Depositor agrees to reimburse the Custodian and Service Provider for any loss either of them may incur as a result of such directions, actions or failures to act. The Custodian and Service Provider shall not be responsible for any penalties, taxes, judgments or expenses Depositor incurs in