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MUTUALOF AMERICA
LIFE INSURANCE COMPANY
February20,2014
MUTUALOFAMERICA
320PARK AVENUE
NEW YORK NY100226839
8004683785
2122242516 FAX
LOAN ADMINISTRATION
LutheranSocialServicesofIllinois
Ms.KarenGapinski,BenefitsManager
1001ETouhyAveSte50A
DesPlaines,IL60018
DearAuthorizedRepresentative:
Re:Ms.MaAsuncionSanRamon
403BPlanRequestERNo.428014C
InaccordancewiththeprovisionsoftheLutheranSocialServicesofIllinoisretirementplan,theemployeereferenced
abovehasappliedforaloan.Enclosedarethefollowingdocuments:
l
l
l
l
l
EmployeeLetter
LoanFactSheet
TransferForm
LoanAgreement
PayrollDeductionAgreement
PleasegiveyouremployeetheentirepacketofinformationandhavethemcompleteandsigntheLoanApplicationand
PayrollDeductionAgreement.YouwillalsoneedtosignthePayrollDeductionAgreement.Pleaseretainyourcopyof
thePayrollDeductionAgreement,provideyouremployeewithacopy,andhaveyouremployeereturntheoriginaltous.
Aftertheloancheckismailedtotheemployee,theBillingStatementproducedforyournextpayrolldeductionperiodwill
includetheinitialloanrepaymentamounttobedeductedforthisnewloan.Subsequently,atthebeginningofeachpayroll
period,youwillbepresentedwithaBillingStatementofscheduledloanrepaymentstobedeductedfromtheemployee's
salaryforthatpayrollperiod.ThetotalamountdeductedshouldberemittedtoMutualofAmericaassoonaspossible.
WhenusingourHotlinePlusOnlineLoanBillingSystemtoremitpayments,pleaseremembertoincludetheLoan
PaymentNumbertoexpediteprocessing.
Ifyouhaveanyquestions,pleasefeelfreetocontactusatourtollfreenumber18004683785(Option3).
Sincerely,
LoanAdministration
PSPleaseadviseyouremployeethattheycancheckthestatusoftheirloanapplicationonlineatmutualofamerica.com
byfirstloggingintotheiraccount,thenselectingLoanCenter.
MUTUALOF AMERICA
LIFE INSURANCE COMPANY
February20,2014
MUTUALOFAMERICA
320PARK AVENUE
NEW YORK NY100226839
8004683785
2122242516FAX
LOAN ADMINISTRATION
Ms.MaAsuncionSanRamon
9648GolfTer
DesPlaines,IL60016
DearMs.SanRamon:
Re:403BLoanRequestERNo.428014C
Asperyourrequest,enclosedarethefollowingdocuments:
l
l
l
l
LoanFactSheet
TransferForm
LoanAgreement
PayrollDeductionAgreement
Themaximumloanyoumayrequesttobesecuredbyyourretirementaccountcannotbedeterminedwithoutadditional
informationfromyourPlanAdministrator.Themaximumloanyoumayrequestissubjecttofinalverificationuponreceipt
ofyourLoanApplication.
Thisisavariablerateloanwithacurrentinterestrateof4.00%.Theinterestrateisreevaluatedeachcalendarquarter.
Important:
Ifyouaremarried,yourspousemustsigntheconsentportionoftheLoanApplication.Also,yoursignature
andthatofyourspousemustbewitnessedbyanotaryoraplanadministrator.
PleasecompleteandsigntheLoanApplicationandPayrollDeductionAgreement,andhaveyourPlanAdministratorsign
thePayrollDeductionAgreementandLoanApplicationtoapprovetheloan.OnecopyofthePayrollDeduction
Agreementisforyouremployerandonecopyisforyourrecords.Returntheoriginalsigneddocumentsintheenvelope
provided.Afterwereceiveyourcompletedpaperwork,acheckwillbemailedtoyouwithinfive(5)businessdays.
Ifyouwouldliketohaveyourloanproceedssentviawiretransfer,pleasechecktheboxontheloanagreementand
provideuswithanoriginal,voidedbankcheck.
FundsheldintheInterestAccumulationAccountarerestrictedwithrespecttowithdrawalsandtransferswhile
theloanisoutstanding.Onlytheportionofsuchaccountthatisinexcessoftheamountowedplusa20%
reservewillbeavailableforwithdrawalortransfertotheSeparateAccountinvestmentalternatives.
Ifyouhaveanyquestions,pleasefeelfreetocontactusatourtollfreenumber18004683785(Option3).
Sincerely,
LoanAdministration
PSYoucancheckthestatusofyourloanapplicationonlineatmutualofamerica.combyfirstloggingintoyouraccount,
thenselectingLoanCenter.
320 PARK AVENUE NEW YORK NY 10022-6839 1 800 468 3785 212 224 2516 FAX
Pension/Thrift Loan Fact Sheet

Please note that employer-sponsored retirement plans are intended to enable and encourage employees to save for
retirement. Although your Plan contains a loan provision, Mutual of America does not encourage participants to take
loans, and your Plan savings are not intended to be used for current expenses. There are participant charges for loans
and loan servicing and significant adverse tax consequences to participants who do not repay loans on a timely basis.
Failing to repay loans may have a negative impact on the ability of participants to meet their retirement savings goals.
We encourage you to carefully evaluate these issues before applying for a loan.
INTERNAL REVENUE CODE RESTRICTIONS
The maximum amount permitted by the Internal Revenue Code is the lesser of $50,000 or 1/2 of the vested account
balance under all plans with your present employer. This maximum is reduced by any outstanding plan loans you
may have had in the past 12 months. It is recommended that you consult with your own tax or legal adviser before
taking any action.
DEPARTMENT OF LABOR REGULATIONS
Pension/Thrift loans are generally subject to Department of Labor Regulations regarding adequate security. Under
these regulations, the maximum loan plus the reserve amount cannot exceed 1/2 of the account balance. This
effectively caps the loan at 41-2/3% of the balance.
REPAYMENT SCHEDULE
Loans from your retirement plan must be repaid in substantially equal installments on a payroll period basis. Your
employer will receive a repayment schedule indicating the amount to be deducted from your salary. The total
amount collected will be remitted to Mutual of America. However, if your loan is being repaid via Home Billing
(as opposed to Payroll Deduction), certain fees will be assessed for payments received 30 days after the due date.
These fees are the lesser of $15.00 or 5% of the payment that was due.
LOAN SECURITY
Mutual of America requires that 120% of the outstanding loan balance be maintained as collateral in the Interest
Accumulation Account of the General Account. The amount you borrow is not withdrawn from your account.
Rather, the loan plus an additional 20% must be held in the Interest Accumulation Account. Funds held in the
Interest Accumulation Account are restricted with respect to withdrawals and transfers while the loan is
outstanding. Only the portion of such account that is in excess of the amount owed plus a 20% reserve will be
available for withdrawal or transfer to the Separate Account investment alternatives.
LOAN TERM
The maximum loan term is five years. A loan term of up to ten years may be selected if the loan proceeds are to
be used for the purchase of your principal residence.
LOAN DETERMINATION PROCESS
It is important to understand that approval of your loan request is not automatic upon submission of the completed
application to Mutual of America. You should be careful not to make financial commitments on the assumption
that you will receive a loan in the amount you requested. We will notify you whether the loan is approved or not
(and, if approved, the amount). If the loan is approved, the proceeds may be sent to you either by check or via
Electronic Funds Transfer.
INTEREST CALCULATION
The Loan Rate is 3% higher than the interest rate we credit to amounts held in the General Account as collateral
for the loan and there are no origination and maintenance fees.
MUTUAL OF AMERICA LIFE INSURANCE COMPANY, 320 PARK AVENUE, NEW YORK, NY 10022-6839
6720.F (PD)
3/12
Tax-Deferred Annuity, Thrift Plan and

Defined Contribution Plan Transfer Form
To Secure a Retirement Plan Loan
mutualofamerica.com
Send this form to the attention of the Loan Administration Department

Mutual of America, 320 Park Avenue, New York, NY 10022-6839
EMPLOYERS NAME
EMPLOYER NUMBER
EMPLOYEES NAME
CUSTOMER IDENTIFICATION NUMBER
__ __ -__ __ __ __ __ __-__
EMPLOYEES ADDRESS
Number and Street
City
State
Zip Code
TRANSFERS
You may transfer any part of your balance in any investment fund to the Interest Accumulation Account. You may express the amount as a
dollar figure or a percentage of your balance. If you want to transfer your entire account balance in an investment fund to the Interest
Accumulation Account, express the amount as 100%.
In order to properly secure your loan, an amount equal to 120% of your requested loan amount must be maintained in the Interest
Accumulation Account.
Please Print or Type
FROM
MUTUAL
OF OF
AMERICA
MUTUAL
AMERICA
Money Market Fund
Mid-Term Bond Fund
Bond Fund
Composite Fund
Conservative Allocation Fund
Moderate Allocation Fund
Aggressive Allocation Fund
Equity Index Fund
All America Fund
Small Cap Value Fund
Small Cap Growth Fund
Mid Cap Value Fund
Mid-Cap Equity Index Fund
International Fund
Retirement Income Fund
2010 Retirement Fund
????????? FIDELITY
FIDELITY INVESTMENTS
VIP Asset ManagerSM Portfolio
VIP Mid Cap Portfolio
VIP Equity-Income Portfolio
VIP Contrafund Portfolio
VANGUARD VARIABLE
INSURANCE FUND
VANGUARD
VIF Diversified Value Portfolio
VIF International Portfolio
VIF REIT Index Portfolio
AMERICAN CENTURY
AMERICAN
CENTURY
VP Capital Appreciation Fund
AMERICAN
FUNDS
AMERICAN
FUNDS
Insurance Series New World Fund
CALVERT CALVERT
VP SRI Balanced Portfolio
DWS DWS
Variable Series I Capital Growth VIP
??????? OPPENHEIMER
OPPENHEIMER
Main Street Fund/VA
PIMCO
PIMCO
VIT Real Return Institutional Portfolio
T. ROWE
ROWEPRICE
PRICE
Blue Chip Growth Fund
TO
DOLLARS
OR
PERCENTAGES
Interest Accumulation Account

$
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I have read the current prospectus and am familiar with the objectives of the Investment Funds.
SIGNATURE
6757.Q - INT
DATE
8/13
(L)
(APPLICATION)
320 PARK AVENUE

NEW YORK NY 10022-6839
212 224 1600
212 224 2500 FAX
Pension/Thrift
Loan Agreement
CUSTOMER
IDENTIFICATION
NUMBER: __________________________________
NAME: _______________________________________________________
(Please include dashes)
ADDRESS:__________________________________________________ CITY:_____________________________ STATE:______ ZIP: _____________

PH: (H)_______________________________ (W)____________________________________ SINGLE:________ MARRIED: _________
EMPLOYER NAME: ___________________________________________________ EMPLOYER NUMBER:_______________________
LOAN AMOUNT: ___________________________________________________
PLAN TYPE:
TERM OF LOAN:
5 YRS.
1 YR.
2 YRS.
3 YRS.
4 YRS.
Other
____________ YRS. (6 TO 10 YRS., please see #3 below.)
PENSION
THRIFT
If proceeds of this loan are to be used for purchase of principal residence, sign here _______________________________________.
Do you have an outstanding retirement plan loan that is in default with another company?
Yes
No
Have you had any outstanding retirement plan loans over the past 12 months:
with Mutual of America
Yes
No
with any other company
Yes
No
If yes, list highest loan balance for that period __________________________ .
Please check the box on the left if you would like to receive your loan proceeds via electronic fund transfer using the ACH system
(Automated Clearing House). There is no fee for this service. Please verify with your bank the correct ACH routing number,
and enclose a voided personal check with your application.
This agreement is made as of the date set forth below between the Participant named above and the Plan of the Employer. In
consideration of the mutual promises herein contained, the parties named above hereto agree as follows:
1. The Participant understands that the Employee Retirement Income Security Act of 1974 (ERISA) and the Tax Equity and Fiscal
Responsibility Act of 1982 (TEFRA) permit participants to borrow from certain plans, and that any loan not within the limits
imposed by ERISA and TEFRA will be considered a currently taxable distribution. The Participant accepts full responsibility for
compliance with all applicable regulations.
2. Subject to the Participants account balance under the plan or contract specified in this Agreement, the maximum amount that the
Participant may borrow, plus the collateral, may not exceed one-half of the Participants vested interest under the plan. Plans
exempt from ERISA are not subject to this Department of Labor regulation.
3. Any loan made pursuant to this Agreement must be repaid within five years from the date the loan is made unless the loan is to
be used to acquire the principal residence of the Participant.
4. The Participant agrees that the loan terms shall be governed both by the terms of the Agreement and by the provisions of the
Employers Group Annuity Contract, and that the Participants account balance in the Interest Accumulation Account under such
Group Annuity Contract will serve as the sole collateral security for the loan. The Plan shall have a lien against the Participants
account balance which shall be equal to the sum of:
a) the outstanding principal loan balance, and
b) any due and unpaid interest and penalties.
6721.H
12/10
An additional amount shall be set aside as a reserve to cover expense charges over the life of the loan, projected penalties that
may be owed if a default in payment occurs, and withholding, if applicable.
The Participant understands that while any portion of the principal loan balance is outstanding, transfers and withdrawals from
the Participants account balance in the Interest Accumulation Account shall be permitted only to the extent that his balance
exceeds the amounts specified above.
5. The initial interest rate on the loan shall be the rate of interest declared by Mutual of America Life Insurance Company (The
Company). The Company may increase or decrease the rate of interest payable on the outstanding principal loan balance, as of
each quarter, if the current loan interest rate differs from the rate applicable to this loan by 1/2% or more. Any such increase or
decrease shall be upon notice to the Participant.
6. The Participant agrees to make installment payments of principal and interest in accordance with the method and at the frequency
set forth in this Agreement or any payroll deduction agreement executed in connection with this agreement, but in no case will
payments be due less frequently than quarterly. If any installment payment under this Agreement is not paid when due and remains
unpaid on the last day of the calendar month following the calendar month in which it was originally due,the Participant will be
in default. All interest payments, inclusive of administrative expense charges, shall be paid to the Company on behalf of the Plan.
In the event the Participant is in default, the total amount due under the plan may be required to be reported as a distribution from
the Plan which is subject to taxation. Furthermore, in the event of a default, the Participants account balance in the Interest
Accumulation Account may be debited, if then permitted by applicable law, for the amount payable inclusive of unpaid interest or
other applicable charges. To the extent the reduction cannot then be made, the Interest Accumulation Account will be debited upon
the earliest occurrence of an event which, under applicable law, would permit such a reduction to be made.
7. The Participant shall have the right to prepay the entire principal loan balance at any time.
8. The Plan shall release any lien that it may have pursuant to this Agreement after all amounts payable have either been paid by the
Participant or withdrawn from the Participants account balance in the Interest Accumulation Account as specified herein.
9. If the Participant is married at the time this loan is made, the Participants spouse must also execute this loan agreement. Spousal
signature must be witnessed by Plan Administrator or Notary Public.
10. The outstanding balance of the loan plus interest must be repaid on the earlier of the date of the Participants death or Annuity
Commencement Date as defined in the contract.
I certify, that by signing this form, that the information shown is true.
______________________
_________________________________________________
DATE
BORROWERS SIGNATURE
_________________________________________________
SPOUSES SIGNATURE
_________________________________________________
NOTARY OR PLAN ADMINISTRATORS SIGNATURE
TO BE COMPLETED BY AUTHORIZED REPRESENTATIVE OF THE EMPLOYER

This loan request is approved.
AUTHORIZED REPRESENTATIVES SIGNATURE
DATE
________________________________________________________________________________
AUTHORIZED REPRESENTATIVES NAME (Please Print or Type)
6721.H
TITLE (Please Print or Type)
12/10
LOAN REPAYMENT
PAYROLL DEDUCTION AGREEMENT
I,______________________________________________________________________, hereby authorize

______________________________________________________________ (Employer) to deduct from
my after-tax salary in each payroll period shown below the amounts necessary to make the repayments
specified in my Loan Agreement dated __________________________ and executed by me and my spouse
(as necessary) in connection with a loan granted to me against the security of my vested retirement plan
account balance. Furthermore, my Employer agrees to remit the specified installment amounts when due to
the administrators of the loan program.
I am paid (payroll frequency, e.g., weekly, bi-weekly, etc.), ___________________ and my next payroll date
is _________________________. I agree that my loan repayments will commence with the next payroll after
my loan is issued.
I understand that this Agreement will be terminated upon the earliest to occur of: (i) my satisfaction in full
of the above-mentioned debt; (ii) my termination of employment with my Employer; or (iii) my death,
retirement, or disability.
________________________________________________________
EMPLOYEES SIGNATURE
__________________________
DATE
__________________________________________________
CUSTOMER IDENTIFICATION NUMBER
___________________________________________________
EMPLOYERS SIGNATURE
________________________
DATE
___________________________________________________
EMPLOYERS PLAN ACCOUNT NUMBER
6818.D
5/13

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MUTUALOF AMERICA

LIFE INSURANCE COMPANY

Pension/Thrift Loan Fact Sheet

Tax-Deferred Annuity, Thrift Plan and

Send this form to the attention of the Loan Administration Department

CUSTOMER IDENTIFICATION NUMBER

Number and Street

Interest Accumulation Account

Interest Accumulation Account

Interest Accumulation Account

Interest Accumulation Account

Interest Accumulation Account

Interest Accumulation Account

Interest Accumulation Account

Interest Accumulation Account

Interest Accumulation Account

Interest Accumulation Account

320 PARK AVENUE

ADDRESS:__________________________________________________ CITY:_____________________________ STATE:______ ZIP: _____________

____________ YRS. (6 TO 10 YRS., please see #3 below.)

TO BE COMPLETED BY AUTHORIZED REPRESENTATIVE OF THE EMPLOYER

AUTHORIZED REPRESENTATIVES SIGNATURE

TITLE (Please Print or Type)

I,______________________________________________________________________, hereby authorize

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ADDRESS:____________________________________ CITY:_ STATE: ZIP: _