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MUNICIPAL FIRE & POLICE RETIREMENT SYSTEM OF IOWA 7155 Lake Drive Suite 201, West Des Moines, IA 50266 Phone: (515) 254-9200 Fax: (515) 254-9300 Toll free: (888) 254-9200 Email: pensions@mfprsi.org ww.mfprsi.org DESIGNATION

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2009 IOWA MANAGEMENTFormsBenefitsDesi mfprsi IES SSN notarial ww Moines DESIGINATION predecease pensionsmfprsi affixed probated designations undersigned foregoing WHEREOF DESIGNATION Accrued beneficiaries irrevocable IA Pursuant certify permitting PARTICI

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