Garmin International, Inc.
Retirement Plan
Rollover Contribution Letter of Instruction
Dear Plan Participant:
Use this form to roll over your eligible rollover distribution from a 401(a) qualified retirement plan, conduit IRA,
403(b) plan, 408(b) annuity, governmental 457(b) plan, Traditional IRA1 or SIMPLE IRA2 to your current
employer’s plan. The plan will accept a direct or indirect rollover of taxable amounts from a former employer’s
qualified plan, a conduit IRA, Traditional IRA, Simple IRA (only allowed if distribution occurs after 2 years of
participation in the SIMPLE IRA plan), or a direct rollover of a designated Roth account from a former
employer’s plan.
After-tax contributions made to a former employer’s plan are not eligible for rollover into this plan. You must
use your former employer’s plan forms or other procedures to request a distribution from your former
employer’s plan.
Direct rollover from plan or Traditional IRA. The check will be issued from your former plan or IRA
custodian and must be made payable to the current plan for your benefit.
For example: Trustee of Garmin International, Inc. Retirement Plan
For the benefit of (FBO): [your name]
Indirect rollover from plan or Traditional/SIMPLE IRA. The distribution must be deposited into the current
plan within 60 days of your receipt of it. It is possible for you to use personal funds to make up the amount that
was withheld for taxes. You may endorse the check from your former plan (or Traditional/SIMPLE IRA) to the
current plan, or you may send a certified check, cashier’s check, or money order.
If this is an indirect rollover from a Traditional or SIMPLE IRA, you must attach a check stub or other statement
from your IRA identifying the account as an IRA and showing the date and gross amount of the IRA
distribution, as well as the amount of federal income taxes withheld from the IRA distribution to you. If this is a
rollover from a SIMPLE IRA and the IRA statement indicates that the SIMPLE IRA maintained by your
employer was held at the IRA institution for less than two years, you must provide documentation, such as IRA
statements from other IRA institutions, to substantiate that you participated in the IRA of your employer for two
years before the distribution was made.
Note: Payments from a designated Roth account in a Code Section 401(a) qualified plan or annuity, a Code
Section 403(b) tax-sheltered annuity or a governmental 457(b) plan may be directly rolled over to the plan.
Please have your former Plan Administrator complete the appropriate section of the form certifying the Roth
contribution basis and the year of the first Roth contribution.
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If you have any questions, please contact T. Rowe Price at 1-800-922-9945. Representatives are available
business days between 7 a.m. and 10 p.m. eastern time. For TDD access, call 1-800-521-0325. You may also
access your account by visiting the T. Rowe Price website at rps.troweprice.com, available 24 hours a day.
Sincerely,
T. Rowe Price Retirement Plan Services, Inc.
1 This includes SEP-IRAs, SAR-SEPs, and conduit/rollover IRAs.
2 Distribution proceeds from a SIMPLE IRA can be rolled over into another retirement plan when the distribution occurs at least two
years after the first SIMPLE IRA contribution was credited.
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Participant Information (Please print clearly)
Name Social Security Number
Street Address
City, State, ZIP Code
Daytime Phone Number Evening Phone Number Date of Birth
WHICH INVESTMENTS DO YOU WANT YOUR MONEY ROLLED INTO?
Select the investment option(s) in which you would like your rollover invested. If you would like the money invested in
accordance with your investment election for new contributions, you may check the box below. A list of available
investment options is included with this kit. Any rollover money you wish to invest in the Plan must be allocated to one of
those investment options.
Please invest my rollover contribution according to my current investment election for new contributions.
Please invest my rollover contribution according to my election below.
Build-Your-Own Portfolio
You may build your own portfolio by investing in any of the funds below. The total election must equal 100%.
% of assets being % of assets being
Investment Option rolled over Investment Option rolled over
AMER BEAC SMALL CAP VAL INST % GARMIN LIMITED STOCK %
INVESCO SMALL CAP DISCOVERY Y % JPMORGAN INTREPID VALUE R6 %
LAZARD EMERGING MKTS PORT. % MFS INTERNATIONAL VALUE R4 %
MID-CAP VALUE FUND % OPPENHEIMER INTL GROWTH Y %
PRUDENTIAL TOTAL RETURN BOND Z % T ROWE PRICE GOVERNMENT MONEY %
TROWEPRICE RET HYB 2005 TR T10 % TROWEPRICE RET HYB 2010 TR T10 %
TROWEPRICE RET HYB 2015 TR T10 % TROWEPRICE RET HYB 2020 TR T10 %
TROWEPRICE RET HYB 2025 TR T10 % TROWEPRICE RET HYB 2030 TR T10 %
TROWEPRICE RET HYB 2035 TR T10 % TROWEPRICE RET HYB 2040 TR T10 %
TROWEPRICE RET HYB 2045 TR T10 % TROWEPRICE RET HYB 2050 TR T10 %
TROWEPRICE RET HYB 2055 TR T10 % TROWEPRICE RET HYB 2060 TR T10 %
TRP GROWTH STOCK TRUST D % TRP STABLE VALUE FUND - N %
U.S. MID-CAP GROWTH EQ TRUST D % VANGUARD INST INDEX %
VANGUARD MID-CAP INDEX, INST % VANGUARD SMALL CAP INDEX INSTL %
Employee Certification
I certify the following statements regarding the rollover money:
• I did not receive the money as a non-spouse beneficiary of a death benefit.
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• I did not receive the money as one of a series of periodic payments.
• I did not receive the money as a hardship distribution.
• These monies would be included in my gross income if not rolled over (no after-tax funds).
• If I am over 70½, the monies do not include any required minimum distributions.
• I am rolling over the money within 60 days of the date I received the money from the eligible employer plan,
Traditional IRA or SIMPLE IRA.
• If this is a rollover from a Traditional IRA, I have attached the required IRA documentation.
• If this is a rollover from a SIMPLE IRA, I received the money after the expiration of the two-year period beginning
on the date that I first participated in the SIMPLE IRA Plan maintained by my employer.
• If the rollover contribution is from a conduit IRA, I further certify that:
• I rolled over the money from the qualified plan named in Section 5 to the IRA within 60 days of the date I
received the money from the qualified plan.
• I have not added any additional money to the conduit IRA.
• I am rolling over the money within 60 days of the date I received the money from the IRA.
• I have attached the required IRA documentation.
Signature
I understand that if a determination is made that the rollover was an invalid rollover, the amount of the invalid rollover plus
any earnings attributable to it will be distributed to me within a reasonable time after such determination is made. I agree
to notify the trustees of the plan upon receipt of information about such determination.
I agree to be bound by the terms of the prospectus for each fund I have selected as an investment option. I understand
that I will receive the prospectus after I purchase shares in the fund.
I agree that neither the trustee, nor T. Rowe Price Group, Inc., its affiliates, or its funds will be liable for any loss when
acting upon instructions believed to be genuine.
Date Participant’s Signature Social Security Number
The former employer plan administrator should complete the information below.
Plan Distribution Information
Your rollover cannot be processed unless this section is complete.
Please provide the following Information concerning the plan from which the distribution was made.
Plan Name
Plan Type: 401(a) (including 401(k) plan) 403(b) Governmental 457(b) 408(b)
I certify that the plan named above is intended to satisfy the requirements of the Internal Revenue Code for the plan type
above, and I am not aware of any plan provision or operation that would result in the disqualification of the plan.
Gross amount of distribution: $ Date of distribution issued:
Pretax contributions and earnings (taxable amount of distribution): $
After-tax contributions (excluding designated Roth contributions): $
Designated Roth contributions and earnings (total Roth distribution): $
Designated Roth contributions (basis): $
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Year of initial Roth contribution:
Does the distribution qualify as an “eligible rollover distribution” under §402(c) of the Internal Revenue Code?
Please sign this form in the space provided to certify that the information contained above is accurate.
Signature of Former Employer Plan Administrator Date
Print Name Title
Address Contact Phone Number
Note to plan administrator: Please return this form to the former participant.
Note to participant: Please return this completed form to:
Regular Mail Overnight/Express Mail
T. Rowe Price Retirement Plan Services, Inc. T. Rowe Price Retirement Plan Services, Inc.
Special Attn.: Forms Enclosed Mail Code: 17215
P.O. Box 17215 4515 Painters Mill Road
Baltimore, Maryland 21297-1215 Owings Mills, Maryland 21117-4903
The T. Rowe Price Stable Value Common Trust Fund (the “Trust”) is not a mutual fund. It is a common trust fund established by the T. Rowe Price Trust
Company under Maryland banking law, and its units are exempt from registration under the Securities Act of 1933. Investments in the Trust are not
deposits or obligations of, or guaranteed by, the U.S. government or its agencies or T. Rowe Price Trust Company. Although the Trust seeks to preserve
the value of your investment at $1.00 per unit, it is possible to lose money by investing in the Trust.
The Trust imposes a 90-day “equity wash” provision on exchanges to competing investment options. The Trust is interest rate sensitive; therefore, direct
exchanges from the Trust to money market funds and certain short-term bond funds are not permitted. Permissible, or eligible, investment options
include most common stock funds and any fixed income fund with a duration that is equal to or greater than three years. Exchanges from the Trust must
remain invested in eligible investment options for at least 90 days before exchanging into competing investment options.
The T. Rowe Price Retirement Hybrid Trust(s) (Trust(s)) is/are not mutual funds. They are common trust funds established by T. Rowe Price Trust
Company under Maryland banking law, and their units are exempt from registration under the Securities Act of 1933. Investments in the Trusts are not
deposits or obligations of, or guaranteed by, the U.S. government or its agencies or T. Rowe Price Trust Company and are subject to investment risks,
including possible loss of principal.
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