529 College Savings Plan Beneficiary Change

529 College Savings Plan

Beneficiary Change

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Use this form to change your Beneficiary. Amount requested in Section 4 will be transferred into a new account for the new Beneficiary.Units in your current account will be distributed and proceeds will be invested in the new account.A Beneficiary on a Custodial (UGMA/UTMA) account cannot be changed.

Type on screen or fill in using CAPITAL letters and black ink.

If you do not have a 529 College Savings Plan account for your new Beneficiary, the information and instructions (excluding systematic investment, dollar cost averaging, and bank information) provided on your current account will be transferred to your new account. If you want to establish a systematic investment, dollar cost averaging, or bank information on your new account, you will need to complete and submit the 529 College Savings Plan Service Options form.

1. Participant and Beneficiary InformationIf the existing 529 College

Savings Plan account is linked to a 529 College

Savings Rewards Credit Card, you must call

Elan Financial Services at 888-551-5144 with the

new account number. Elan Financial Services requires

the 15-digit Fidelity account number (4-digit

529 portfolio number and 11-digit account number).

Participant Name First, M.I., Last Participant SSN required

Trust Name if applicable Trust Tax I.D. Number if applicable

Existing Participant Account Number required Daytime Phone Date of Birth/Date of Trust MM DD YYYY

Email

Do you have an existing 529 College Savings Plan account for the new Beneficiary?

■ Yes The Account Number is: Account Number

■ No Complete the information below:Broker Identification Number (BIN) for New Beneficiary Account

Beneficiary/Minor Name First, M.I., Last Beneficiary/Minor SSN required

Citizenship (Nonresident Aliens may not be designated as beneficiaries): ■ U.S. Citizen ■ U.S. Resident Alien

Beneficiary Date of Birth MM DD YYYY

If the address of the Beneficiary is not the same as the Participant, complete the information below.

Street Address Apartment

City State Zip/Postal Code

1.765026.120 015340801

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2. Financial RepresentativeYou are required to have

appointed a Financial Representative as agent

on your 529 College Savings Plan account to execute investment and other instructions made

by you or on your behalf.

Firm Name Financial Representative Name First, M.I., Last

Phone

3. Relationship between BeneficiariesDescribe the relationship

between your original Beneficiary and your

new Beneficiary. If no box is checked, the

default is Other Relationship, which results in a transfer out of family.

■ Member of Family (Considered an income-tax-free transfer.)

Describe Relationship: __________________________________________

■ Other Relationship (Earnings distributed are subject to income tax at the Distributee’s rate and a 10% federal penalty tax.)

Describe Relationship: __________________________________________If the new beneficiary is a member of a younger generation relative to the original beneficiary, the transfer may be subject to federal gift and generation-skipping transfer taxes.

4. InstructionsUnits in your account will

be distributed and the proceeds will be invested

in your account for your new Beneficiary.For a complete

list of 529 Portfolios and Portfolio

Numbers, visit i.fidelity.com.

Unless you indicate otherwise, any money in Static or Individual Fund Portfolios will remain there, and any money in an Age-Based Portfolio will be transferred to the Age-Based Portfolio that is designed for the new Beneficiary’s birth year. Elect to transfer a partial dollar amount or all units. If you fail to designate whether all or part of your 529 is to be transferred to an account for the new Beneficiary, all units will be transferred.

Only the portion of the account balance that does not exceed the maximum contribution amount for your new Beneficiary will be transferred. Any amounts that cannot be transferred will remain in your account for your current Beneficiary. Any fees will be deducted from the transfer amount if the new beneficiary is not a “family member” as defined in the 529 College Savings Offering Statement.If you are changing a Portfolio, you are required to select a Portfolio within the same Class of Units as your current Portfolio.If you are requesting a Partial Account Transfer, detail your liquidation instructions below:

From: Pool Number To: Pool Number ■ All† OR ■ Part Dollar Amount

$ .


$ .


$ .


$ .

† If a Portfolio is fully distributed, any systematic investment program or dollar cost averaging program on that Portfolio will be cancelled.

015340802

Fidelity Investments Institutional Operations Company LLC935492.2.0 1.765026.120 1120

The trademarks and service marks appearing herein are the property of FMR LLC.

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5. Signature and Date Form cannot be processed without signature and date.

By signing below, I, the Participant, agree to the following terms and conditions and indicate that I must READ this section, the Offering Statement, and the Participation Agreement.Participation Agreement Acknowledgement• I understand that if the Beneficiary is not

a “member of the family” (as defined in the 529 College Savings Plan Offering Statement) of the current designated Beneficiary, the transfer of assets to the new Beneficiary will be considered a non-qualified distribution subject to all applicable taxes and penalties.

• I am aware that this form becomes effective when delivered to Fidelity Investments Institutional Operations Company LLC (FIIOC) and will remain

in effect until I deliver to FIIOC another form with a later date. I authorize FIIOC to process this Beneficiary change from the 529 College Savings Plan account indicated in this instruction. I authorize FIIOC to sell units in my current account and transfer the proceeds to an account for my new Beneficiary. The undersigned agrees that the statements made herein are true and correct and agrees to indemnify and to hold FIIOC harmless for any loss suffered or liability incurred by

acting hereunder. I agree to adopt and be bound to the terms and conditions of the Participation Agreement and Offering Statement as are currently in effect and as may be amended from time to time. I hereby ratify this written instruction and any telephone instructions given pursuant to this authorization and agree that neither the Plan nor FIIOC will be liable for any loss, liability, cost, or expense for acting upon such instructions.

Print Participant/Trustee Name First, M.I., Last Participant/Trustee Signature* Date MM - DD - YYYY

SIG

N

* Electronically signed documents may only be submitted by your intermediary firm, which has executed a signed Electronic Signature Use and Indemnification Agreement with FIIOC, and no notary or signature guarantee is required.

Did you print and sign the form, and attach any necessary documents? Send the form and any necessary documents to Fidelity.Questions? For help completing this form, contact your representative or call Fidelity at 800-522-7297 (Financial Representatives) or 877-208-0098 (Shareholders) any day the New York Stock Exchange is open, or visit i.fidelity.com.

Regular mailFidelity Investments Institutional Operations Company LLC (FIIOC) P.O. Box 770002 Cincinnati, OH 45277-0086

Overnight mailFidelity Investments Institutional Operations Company LLC (FIIOC) 100 Crosby Parkway, KC1G Covington, KY 41015

015340803

529 College Savings Plan

Service Optionsfor Existing Accounts

Use this form to add or change features to an existing account.

Do not use this form to open a 529 College Savings Plan account. Refer to the 529 College Savings Plan Offering Statement for details regarding specific feature options.

Type on screen or fill in using CAPITAL letters and black ink.

1. Participant and Beneficiary InformationParticipant/Trustee Name First, M.I., Last SSN or TIN

529 College Savings Plan Account Number Daytime Phone

Beneficiary Name First, M.I., Last Beneficiary SSN

2. Systematic Investment ProgramYou must complete Section 3 if you are establishing a new systematic investment program.

Frequency: Monthly or Quarterly. Program

begins with the first available business cycle, based on date selected.

If a frequency is not selected, your transaction

will occur monthly.Transaction dates falling

on non-business days will occur the previous

business day. If a selection is not made or is invalid,

the transaction will occur on the 15th.

Fidelity requests the draft from your bank account 2 business days prior to

the investment date.

■ Establish new Systematic Investment Program.

■ Change existing Systematic Investment Program.

Pool Number Amount Start Date MM DD YYYY Frequency

■ M ■ Q$ .Pool Number Amount Start Date MM DD YYYY Frequency



■ M ■ Q$ .

1.763048.134 013841201Page 1 of 8

3. Systematic Withdrawal ProgramA. Distribution Allocation

Frequency: Monthly, Quarterly, Semiannually, or Annually. Semiannual not applicable for Class C. Program begins with

the first available business cycle, based on date selected. Transaction dates falling on non-

business days will occur the previous business day.

If no selection is made, the transaction will occur on the 15th.

* Maximum daily ACH withdrawal limit of $100,000 per fund

■ Establish new Systematic Withdrawal Program.

■ Change existing Systematic Withdrawal Program.

From: Pool Number Amount* Start Date MM DD YYYY Frequency

■ M ■ Q ■ S ■ A$ .From: Pool Number Amount* Start Date MM DD YYYY Frequency




■ M ■ Q ■ S ■ A$ .B. Distribution Reason

If the reason for your distribution is listed,

check the appropriate box in order to waive any

applicable Contingent Deferred Sales Charges

(CDSC) on your distribution.

If no box is checked, it is assumed the distribution is for another reason and

any applicable CDSC will apply.

This distribution may have tax consequences depending on how it is used. It is your responsibility to maintain adequate documentation that the distribution you are requesting is used for qualified higher education expenses. You should consult your tax advisor prior to requesting a distribution.

■ Tuition and Fees at an eligible educational institution.

■ Room and Board for students who attend school at least half-time at an eligible educational institution.

■ Books, supplies, computer equipment and technology, and equipment required for enrollment at an eligible educational institution.

■ “Special needs services” incurred by a special needs beneficiary in connection with enrollment/attendance at an eligible educational institution.

■ Disability of the Beneficiary (include a doctor’s note on doctor’s letterhead certifying the disability).

■ Receipt of a scholarship by the Beneficiary, as long as the distribution does not exceed the amount of the scholarship (include a copy of the letter from the party awarding the scholarship/grant).

■ Beneficiary’s attendance at a U.S. military academy.

C. Distribution Payment Method

Check one. ■ Electronic payment to Participant via Fidelity Advisor Money Line (feature already established on this 529). Payment will be sent to your bank account via the Automated Clearing House (ACH) and should be received buy your bank in 2-3 business days.

■ Electronic payment to Participant via Fidelity Advisor Money Line (feature not already established on this 529). Payment will be sent to your bank account via ACH. Complete Section 4.

■ Distribute to Participant via check to address of record. You must have your signature guaranteed in Section 7b if the distribution is greater than $100,000.

■ Electronic payment to Beneficiary via Fidelity Advisor Money Line (feature already established on this 529). Payment will be sent to your bank account via the Automated Clearing House (ACH) and should be received buy your bank in 2-3 business days.

■ Electronic payment to Beneficiary via Fidelity Advisor Money Line (feature not already established on this 529). Payment will be sent to your bank account via ACH. Complete Section 4.

■ Distribute to Beneficiary via check to beneficiary's address of record.

Complete one form for each payee – only one payee is allowed

per form.

■ Distribute to eligible educational institution* via check to:

Payee Name FBO

Street Address Apartment

City State Zip/Postal Code

* For distributions for qualified higher education expenses, if you have attached a copy of your invoice or bill from a qualified educational institution, we will follow the payment instructions on your invoice or bill and mail payment directly to the institution. You do not need to complete this section.

013841202Page 2 of 8

4. Bank Information/Fidelity Advisor Money Line®

Fidelity Advisor Money Line allows you and/

or your Financial Representative to

electronically transfer money between

bank/credit union account listed

below and account listed in Section 1,

systematically or on demand. This feature is

restricted from use for 10 calendar days

after activation.

■ Add bank information below to my Fidelity Advisor Money Line feature.

■ Replace my existing Money Line bank information with information on attached check.

■ Use Bank Wire feature to allow proceeds to be transferred via the Federal Reserve System. Payment will be wired to your bank account. Your bank may charge a fee for this transaction.

If the 529 College Savings Plan account and the bank account identified DO NOT include at least one common owner, the 529 College Savings Plan account owner and all bank account owners must sign in Section 7 and have their signatures notarized. If a company check is provided for a non-entity account, all account owners must sign the request and a corporate resolution is required.

Provide a preprinted voided check along with

this form (preferred).

OR

Enter your bank information in the

fields to the right.

Bank Name

Bank Account Owner Name(s)

ABA Routing Number Bank Account Number

5. Reduced Sales ChargeShould you and/or

your spouse have other investments in 529

College Savings Plan accounts or Fidelity

Advisor Funds,® you may qualify for a

reduced sales charge on purchases of

Class A units. Refer to the Offering

Statement for details.

Applicable account numbers are as follows:Rights of Accumulation

Account Number Applicable SSN/TIN BIN

Account Number Applicable SSN/TIN BIN

Letter of Intent

I agree to the terms of the Letter set forth in the 529 College Savings Plan Offering Statement. Though I am not obligated to do so, it is my intention to invest over a 13-month period in units that total an aggregate amount at least equal to that indicated. If the amount indicated is not invested within 13 months, reduced sales charges do not apply. Refer to the Offering Statement for additional details.

The aggregate amount will be at least: ■ $50,000 ■ $100,000 ■ $250,000 ■ $500,000 ■ $1,000,000

013841203Page 3 of 8

6. Dollar Cost Averaging/Systematic ExchangeThe establishment of

Dollar Cost Averaging is considered one of the

two exchanges among Portfolios allowed per

calendar year. Refer to the Offering Statement for

additional details.Frequency: Monthly (12

Exchanges), Quarterly (4 Exchanges), Semiannually

(2 Exchanges), or Annually (1 Exchange). Program

begins with the first available business cycle, based on date selected.

If a frequency is not selected, your transaction

will occur monthly.Transaction dates falling

on non-business days will occur the previous

business day. If a selection is not made or is invalid, the transaction will occur

on the 15th.

Use for systematic exchanges within your 529 College Savings Plan account indicated in Section 1. Systematic exchange instances between the same from-and-to fund combination must be for the same amount and frequency and cannot exceed four instances.

Inception Date MM YYYY

From: Pool Number To: Pool Number Frequency Day Amount

■ M ■ Q ■ S ■ A $ .From: Pool Number To: Pool Number Frequency Day Amount



■ M ■ Q ■ S ■ A $ .The establishment of Dollar Cost Averaging is considered one of the two exchanges among portfolios allowed per calendar year. Refer to the Offering Statement for additional details on this feature.

013841204Page 4 of 8

7. Signatures and Dates Form cannot be processed without signatures and dates.

Authorization of Fidelity and Financial Representative

• I hereby authorize FIIOC to accept instructions from both me or a representative of my intermediary firm, for transactions that result in funds being electronically transferred between my Fidelity account and my bank account.

• I understand that it is my responsibility to read the Offering Statement and Participation Agreement. I have read, understood, and agree to the terms and conditions set forth in the separate Offering Statement and Participation Agreement as is currently in effect and as may be amended from time to time.

• If I have completed Section 6, I hereby authorize FIIOC to make exchanges within this account in accordance with the instructions given and agree that neither the Portfolio nor FIIOC will be liable for any loss, cost, or expense for acting upon

such instructions. I acknowledge that the establishment of the Dollar Cost Averaging option is considered one of the two exchanges among portfolios allowed per calendar year.

• I hereby authorize FIIOC, upon either receiving instructions from me, the intermediary firm for my account, or in accordance with the instructions provided in Sections 4, 5, and 6 of this form, to make payments of amounts representing redemptions by me, or distributions payable to me, or to secure payments of amounts to be invested by me, by initiating credit or debit entries to the bank/credit union account indicated in Section 4 (Bank). I authorize and request the Bank indicated in Section 4 to accept such entries from FIIOC, and to credit or debit, as indicated, my account at that Bank in accordance with

these entries. I hereby ratify any instructions given pursuant to this authorization and agree that neither the Portfolio, nor FIIOC, will be liable for any loss, liability, cost, or expense for establishing these privileges or acting upon such instructions. I acknowledge that this authorization may only be revoked by providing written notice of revocation to FIIOC, in such time and manner as to afford FIIOC and the Bank a reasonable opportunity to act upon it. The rights and obligations herein shall inure to the benefit of and be binding upon any successor to FIIOC.

• Portfolio units are not deposits or obligations of, or guaranteed by, any depository institution. Units are not insured by the FDIC, the Federal Reserve Board, or any other agency, and are subject to investment risks, including possible loss of principal amount invested.

7a. Notarization

Print Participant/Trustee Name First, M.I., Last Print Additional Trustee Name First, M.I., Last

Participant/Trustee Signature Date MM - DD - YYYY

SIG

N

Print Participant/Trustee Name First, M.I., Last Print Additional Trustee Name First, M.I., Last

Additional Trustee Signature Date MM - DD - YYYY

SIG

N

Statement of Notary Public In this section, “You” and “you” refer to the Notary Public. You certify that the individual signing above appeared before you on the date indicated below, that they are known to you to be the individuals they claim to be, and that they represented to you that they made the certifications above their signature of their own free will.

NOTARIZATION 1

State County Identification

Print Notary Name Commission Expires MM - DD - YYYY

Notary Signature Date MM - DD - YYYY

SIG

N

▼ NOTARY STAMP OR SEAL ▼

NOTARIZATION 2




SIG

N


continued on next page

013841205Page 5 of 8


• Your signature must be notarized if the 529 College Savings Plan account and the bank account identified in Section 4 do not include at least one common owner. The 529 College Savings Plan account owner must sign above and have his/her signature notarized. Money Line Only – All bank account owners must sign below and have their signatures notarized.

Print Bank Account Owner Name First, M.I., Last

Bank Account Owner Signature Date MM - DD - YYYY

SIG

N

Print Bank Account Owner Name First, M.I., Last

Bank Account Owner Signature Date MM - DD - YYYY

SIG

N

Statement of Notary Public In this section, “You” and “you” refer to the Notary Public. You certify that the individual signing above appeared before you on the date indicated below, that they are known to you to be the individuals they claim to be, and that they represented to you that they made the certifications above their signature of their own free will.

NOTARIZATION 3




SIG

N


NOTARIZATION 4




SIG

N


continued

013841206

continued on next page

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Fidelity Investments Institutional Operations Company LLC 935661.2.0 1.763048.134 0321


Page 7 of 8


7b. Signature Guarantee

Print Participant/Trustee Name First, M.I., Last

Participant/Trustee Signature Date MM - DD - YYYY

SIG

N

Print Additional Trustee Name First, M.I., Last

Additional Trustee Signature Date MM - DD - YYYY

SIG

N

▼ SIGNATURE GUARANTEE STAMP ▼ ▼ SIGNATURE GUARANTEE STAMP ▼

A signature guarantee is designed to protect you and Fidelity from fraud. You should verify with the institution that they are an acceptable (eligible) guarantor prior to signing. A signature guarantee may be executed by any “eligible guarantor.” Eligible guarantors include Commercial Banks, Trust Companies, Savings Associations, and Credit Unions, as defined by the Federal Deposit Insurance Act. Also included are member firms of a domestic stock exchange.Your signature must be guaranteed:• For a distribution check amount of more than $100,000.

continued

013841208

Fidelity Investments Institutional Operations Company LLC 935661.2.0 1.763048.134 0321


Page 8 of 8 013841208

Did you print and sign the form, and attach any necessary documents? Send the form and any necessary documents to Fidelity.Questions? For help completing this form, contact your representative or call Fidelity at 800-522-7297 (Financial Representatives) or 877-208-0098 (Shareholders) any day the New York Stock Exchange is open, or visit i.fidelity.com.

Regular mailFidelity Investments Institutional Operations Company LLC (FIIOC) P.O. Box 770002 Cincinnati, OH 45277-0086

Overnight mailFidelity Investments Institutional Operations Company LLC (FIIOC) 100 Crosby Parkway, KC1G Covington, KY 41015

Fidelity Investments Institutional Operations Company LLC935475.2.0 1.9899644.101 0422

Fidelity Advisor 529 Plan is offered by the State of New Hampshire and managed by Fidelity Investments.


Fidelity Advisor 529 PlanSponsored by the State of New Hampshire

Investment Options

Refer to the Fidelity Advisor 529 Plan

Offering Statement for additional information.

POOL NUMBERS

Age-Based Portfolios Old Class A* Class A Class C Class P† Class D* Class I‡

FA 529 Portfolio 2039 N/A 6030 6031 6032 N/A 6033






FA 529 Portfolio 2022 1178 1213 1236 1181 1180 3384

FA 529 College Portfolio 5607 1221 1243 1061 5627 3369

Static Allocation Portfolios Old Class A* Class A Class C Class P† Class D* Class I‡

FA 529 Aggressive Growth Portfolio 5608 1223 1245 1063 5628 3371

FA 529 Moderate Growth Portfolio 5609 1222 1244 1062 5629 3370

Individual Fund Portfolios Class A Class C Class P† Class D* Class I‡

FA 529 Asset Manager 60% Portfolio 2513 2514 2515 N/A 3392

FA 529 Diversified International Portfolio 1075 1162 1064 1246 3373

FA 529 Dividend Growth Portfolio 1078 1165 1067 1249 3376

FA 529 Equity Growth Portfolio 1076 1163 1065 1247 3374

FA 529 Equity Income Portfolio 1077 1164 1066 1248 3375

FA 529 Growth Opportunities Portfolio 2516 2517 2518 N/A 3393

FA 529 High Income Portfolio 1083 1169 1072 1254 3380

FA 529 Inflation-Protected Bond Portfolio 1174 1176 1177 1257 3383

FA 529 Limited Term Bond Portfolio 1084 1170 1073 1255 3381

FA 529 Money Market Portfolio 1085 1171 1074 1256 3382

FA 529 New Insights Portfolio 1546 1548 1551 N/A 3386

FA 529 Small Cap Portfolio 1081 1167 1069 1252 3378

FA 529 Stable Value Portfolio 6559 6560 6562 N/A 6561

FA 529 Stock Selector Mid Cap Portfolio 1079 1166 1068 1251 3377

FA 529 Strategic Dividend & Income Portfolio 2510 2511 2512 N/A 3391

FA 529 Strategic Income Portfolio 1552 1554 1556 N/A 3385

FA 529 Total Bond Portfolio 2507 2508 2509 N/A 3390

FA 529 Value Strategies Portfolio 1082 1168 1071 1253 3379

* Old Class A and Class D units are only available to participants that opened their Fidelity Advisor 529 Plan accounts before June 25, 2003.

† Class P Units are only available through the Fidelity Advisor 529 Plan’s Workplace Savings Program.

‡ Class I Units are available to purchase through a broker dealer, registered investment adviser, trust institution, or a bank department that charges an asset-based or management fee and has elected to make Class I Units available for purchase to their clients. Check with your advisor to determine if Class I Units are available for purchase through your representative’s firm.

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Documents

529 College Savings Plan Beneficiary Change