Common use of EMPLOYEES OF PUBLIC SCHOOL DISTRICTS Clause in Contracts

EMPLOYEES OF PUBLIC SCHOOL DISTRICTS. I acknowledge receipt of investment fee information at the point of sale from the investment provider agent/representative as required under CT Act 17-142. Employee Signature Date: (mm/dd/yyyy) Agent/Representative I hereby acknowledge my responsibility to comply with Employer’s written directives regarding solicitation of Employees. I also acknowledge my responsibility to assist the Employee in determining the maximum contribution limits. (Please Print) Agent/Representative Name Date: (mm/dd/yyyy) Employer Employer hereby agrees to this Salary Reduction Agreement and further agrees to identify both the pre-tax contributions and the after- tax contributions at the time of remittance to the selected Investment or Insurance Provider(s).

EMPLOYEES OF PUBLIC SCHOOL DISTRICTS. I acknowledge receipt of investment fee information at the point of sale from the investment provider agent/representative as required under CT Act 17-142. Employee Signature Date: (mm/dd/yyyy) Agent/Representative I hereby acknowledge my responsibility to comply with Employer’s written directives regarding solicitation of Employees. I also acknowledge my responsibility to assist the Employee in determining the maximum contribution limits. (Please Print) Agent/Representative Name Date: (mm/dd/yyyy) Employer Employer: XXXXX COUNTY PUBLIC SCHOOLS Employer hereby agrees to this Salary Reduction Agreement and further agrees to identify both the pre-tax contributions and the after- tax contributions at the time of remittance to the selected Investment or Insurance Provider(s).