401k Change Request Instructions for Employee Use this form to provide your informational changes. Contact your Plan Administrator to make any other personal data changes not provided for by this form. You may email any requests to hr@allegiant-mgmt.com If you wish to change your investments, please log onto the participant website at www.myplan.johnhancock.com or call 1(800)395-1113. PARTICIPANT INFORMATION First Name Mid Init Last Name Soc Sec Number CHANGE OF PERSONAL INFORMATION ONLY COMPLETE THIS SECTION IF CHANGES ARE REQUIRED CURRENT INFORMATION ON FILE First Name Mid Init Last Name Soc Sec Number NEW/REVISED INFORMATION First Name Mid Init Last Name Soc Sec Number Date of Birth CHANGE ONGOING CONTRIBUTION INSTRUCTIONS ONLY COMPLETE THIS SECTION IF CHANGES ARE REQUIRED Would you like to Change or Add a Pre-tax 401(k) Contribution? Yes No 401(k) Pre-Tax Contributions I elect to defer a % (percent of pay) I elect to defer a $ (specific amount) I elect not to defer at this time Percent Amount % Dollar Amount $ I elect to defer this amount from my salary/wages per pay period as ongoing contributions (Not to exceed current Plan and/or IRS limitations). Would you like to Change or Add a ROTH 401(k) After Tax Contribution? Yes No ROTH 401(k) After Tax Contributions I elect to defer a % (percent of pay) I elect to defer a $ (specific amount) I elect not to defer at this time Percent Amount % Dollar Amount $ I elect to defer this amount from my salary/wages per pay period as ongoing contributions (Not to exceed current Plan and/or IRS limitations). AUTHORIZATION Signature of Employee Clear Employee Name Date Submit