Page 12 - MarDefComp
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3/5/2021                                                              National Association of Government Defined Contribution Administrators

                              Name*

                                Mr.                   Jay                            Middle Name                  Castellano



                              Organization*

                               County of San Mateo



                              Email



                               Preferred*

                                jcastellano@smcgov.org





                              1. Please list the name(s) of the plan(s) that you are authorizing your recordkeeper to transmit data for

                              below.



                              Plan Name(s):*






















                              2. Please select your recordkeeper(s) below. Check all that apply.


                              If your recordkeeper is not listed, please enter the name in the text  eld below.



                              Recordkeeper(s):*


                                     AIG Retirement Services


                                     AXA Equitable


                                     Charles Schwab




                            https://nagdca.memberclicks.net/prrl-authorization-form#/                                                                                                                                   3/5
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