Information IMPORTANT Clause Samples

Information IMPORTANT. You must have an existing §403(b) account with each investment provider listed, or file an account application with the investment provider, LIST ALL §403(b) INVESTMENTS TO CONTINUE AFTER THE EFFECTIVE DATE §403(b) §403(b) Investment Provider Action Requested: Amount per Pay Period: Start Continue Change Stop % OR $ Start Continue Change Stop % OR $ Start Continue Change Stop % OR $ Make a one-time contribution change % OR $ If you make contributions to another employer’s plan OR own or have control in another employer and make contributions to the retirement plan maintained by that employer, the test for annual contributions requires aggregation of contributions to that employer plan with your §403(b) plan for the §415 Maximum Annual Contribution Limit. Please check the following if applicable: I also participate in another employer’s §403(b), SIMPLE IRA, §401(k) or SAR-SEP (please circle applicable plan type). My elective deferrals to another employer’s plan will be $ per calendar year. Yes, I have outside business activity (eg. Consulting/Contracting) and participate in the plan maintained by an employer that I control (own more than 50% of the company).

Information IMPORTANT. You must have an existing §403(b)l§457 account with each investment provider listed, or file an account application with the investment provider, LIST ALL §403(b)/§457 INVESTMENTS TO CONTINUE AFTER THE EFFECTIVE DATE §403(b) §403(b) §457(b) ** Investment Provider Action Requested: Amount per Pay Period: Start Continue Change Stop % OR $ Start Continue Change Stop % OR $ Start Continue Change Stop % OR $ Make a one-time contribution change % OR $ If you make contributions to another employer’s plan OR own or have control in another employer and make contributions to the retirement plan maintained by that employer, the test for annual contributions requires aggregation of contributions to that employer plan with your §403(b) plan for the §415 Maximum Annual Contribution Limit. Please check the following if applicable: I also participate in another employer’s §403(b), SIMPLE IRA, §457, §401(k) or SAR-SEP (please circle applicable plan type). My elective deferrals to another employer’s plan will be $ per calendar year. Yes, I have outside business activity (eg. ConsultinglContracting) and participate in the plan maintained by an employer that I control (own more than 50% of the company).