I WANT TO. BEGIN Contribution(s) CHANGE Future Contribution(s) CANCEL All Contributions Effective date: Next Available Pay Date Future Pay Date Investment Provider: Dollar Amount Empower )%& 457(b) $ Total Deduction Per Paycheck $ 3. Financial Advisor/Agent Information Financial Advisor/Agent Name Financial Advisor/Agent Phone Number OK to contact my agent on my behalf Financial Advisor/Agent Email Address
I WANT TO. BEGIN Contribution(s) CHANGE Future Contribution(s) CANCEL All Contributions Effective date: Next Available Pay Date Future Pay Date Investment Provider: Dollar Amount SchoolsFirst FCU 457(b) DCP Share Certificate: Membership Number Term (12, 36, 60) $ 0.00 Nationwide Retirement Builder Plan (RBP) 457(b) $ _0.00 _ Other District Specific 457(b) _SECURITY BENEFIT $ _ Total Deduction Per Paycheck $ _ 3. Financial Advisor/Agent Information XXXXXXX XXXXX FINANCIAL 000-000-0000 Financial Advisor/Agent Name XXXXXX@XXXXXXXXX.XXX Financial Advisor/Agent Phone Number OK to contact my agent on my behalf Financial Advisor/Agent Email Address
I WANT TO. BEGIN Contribution(s) CHANGE Future Contribution(s) CANCEL All Contributions Effective date: Next Available Pay Date Future Pay Date Investment Provider: Dollar Amount Empower / FBC 457(b) $ Total Deduction Per Paycheck $
I WANT TO. □ BEGIN contributions □ CHANGE contribution □ A mounts and/or □ Company(ies) □ STOP contributions Xxxx 457(b) (After-Tax)
I WANT TO. □ BEGIN contributions □ CHANGE contribution □ Amountsand/or□Company(ies) □ STOP contributions Complete the section below only if you have selected to begin or change contributions Complete the section below only if you have selected to begin or Deduct $ total per paycheck Deduct $ total per paycheck □ All or □ %* to AIG Retirement Services □ All or □ %* to AIG Retirement Services □ All or □ %* to Equitable Advisors (AXA) □ All or □ %* toEquitable Advisors(AXA)
I WANT TO. □ BEGIN contributions □ CHANGE contribution □ Amounts and/or □ Company(ies) □ STOP contributions Xxxx 457(b) (After-Tax) I WANT TO: □ BEGIN contributions □ CHANGE contribution □ Amounts and/or □ Company(ies) □ STOP contributions Complete the section below only if you have selected to begin or change contributions Complete the section below only if you have selected to begin or change contributions Deduct $ per paycheck and send Deduct $ per paycheck and send □ All or □ %* to AXA Advisors □ All or □ %* to AXA Advisors □ All or □ %* to Lincoln Investment Planning □ All or □ %* to Lincoln Investment Planning □ All or □ %* to MetLife □ All or □ %* to MetLife □ All or □ %* to TIAA □ All or □ %* to TIAA □ All or □ %* to VALIC □ All or □ %* to VALIC *IMPORANT: All changes to the 457(b) plan must be received by the end of the month prior to the requested effective date. (Treasury Regulation § 1.457-4(b)) (Ex: Any changes for any June checks must be received by the end of May)
I WANT TO elect a dollar amount for my catch-up contribution on either a pre-tax basis, after-tax Xxxx basis or a combination of both. I understand that my contributions will be deducted in equal semi-monthly or bi-weekly amounts over the course of the year or the remaining pay periods I elect to make a catch-up contribution of $ per year on a pre-tax basis. I elect to make a catch-up contribution of $ per year on an after-tax Xxxx basis. The combination of the two cannot exceed the annual catch-up contribution limit. This agreement will be put into effect as of the pay date following the date the agreement is received by the Benefits Office or as soon as administratively feasible thereafter. I further understand that I can make a change to this agreement during the calendar year which will be effective with the next available pay date. If the amount of contributions exceeds the limitations of Internal Revenue Code (IRC) Section 414(v)(2)(B), I agree that contributions may be suspended automatically at such time. If in any calendar year the amount of my salary reduction contribution is suspended as per the previous sentence, then the amount of my salary reduction contribution shall be resumed automatically at its unreduced level at the beginning of the following calendar year. While this agreement is irrevocable with respect to compensation that is payable to me while the agreement is in effect, I understand that either I or the University may terminate this agreement with respect to any future compensation not yet payable to me. I further understand that this agreement will automatically terminate on the date I (a) terminate employment, (b) commence an unpaid leave of absence,
I WANT TO. □ BEGIN contributions □ CHANGE contribution □ Amounts and/or □ Company(ies) □ STOP contributions Complete the section below only if you have selected to begin or c hange contributions Complete the section below only if you have selected to begin or change contributions Deduct $ per paycheck and send Deduct $ per paycheck and send □ All or □ %* to AXA Advisors □ All or □ %* to AXA Advisors □ All or □ %* to Lincoln Investment Planning □ All or □ %* to Lincoln Investment Planning □ All or □ %* to MetLife □ All or □ %* to MetLife □ All or □ %* to TIAA □ All or □ %* to TIAA □ All or □ %* to VALIC □ All or □ %* to VALIC *IMPORANT: All changes to the 457(b) plan must be received by the end of the month prior to the requested effective date. (Treasury Regulation § 1.457-4(b)) (Ex: Any changes for any June checks must be received by the end of May)
I WANT TO. □ BEGIN contributions □ CHANGE contribution □ Amounts and/or □ Company(ies) □ STOP contributions Xxxx 457(b) (After-Tax) I WANT TO: □ BEGIN contributions □ CHANGE contribution □ Amounts and/or □ Company(ies) □ STOP contributions Complete the section below only if you have selected to begin orchange contributions Complete the section below only if you have selected to begin or Deduct $ total per paycheck Deduct $ total per paycheck □ All or □ %* to AXA Advisors □ All or □ %* to AXA Advisors □ All or □ %* to Lincoln Investment Planning □ All or □ %* to Lincoln Investment Planning □ All or □ %* to VALIC □ All or □ %* to VALIC checks must be received by the end of May)
I WANT TO. □ BEGIN contributions □ CHANGE contribution □ Amounts and/or □ Company(ies) □ STOP contributions Complete the section below only if you have selected to begin or c hange contributions Deduct $ per paycheck and send Complete the section below only if you have selected to begin or change contributions Deduct $ per paycheck and send □ All or □ %* to AXA Advisors □ All or □ %* to AXA Advisors □ All or □ %* to Lincoln Investment Planning □ All or □ %* to Lincoln Investment Planning □ All or □ %* to MetLife □ All or □ %* to MetLife □ All or □ %* to TIAA □ All or □ %* to TIAA □ All or □ %* to VALIC □ All or □ %* to VALIC FOR SDP USE ONLY
