Common use of Required Signatures Clause in Contracts

Required Signatures. I have reviewed, understand, and agree to the provisions as stated on the reverse side of this form. Participant Signature Date Great-West Registered Representative Signature Date Return Original Form to: Great-West Retirement Services 0000 X. Xxxxxxxx Xxx Xxxxx 000 Xxxxxxx, XX 00000 000-000-0000 Salary Deferral Agreement IRC Section 457 Plan Provisions Whereas the City of Houston, hereinafter referred to as “Employer” has established a deferred compensation plan, hereinafter referred to as “the Plan” pursuant to Internal Revenue Code Section 457; and Whereas I, the employee have elected to participate in the Plan by deferring a portion of my salary into the Plan, it is hereby agreed as follows: I hereby request and direct that my salary be reduced as of the effective date designated on the front of this form (this date can not precede the date this agreement is signed), and that the Employer, it’s proper officers, agents and employees contribute these deferrals into the Plan. I agree and understand that increasing, decreasing or stopping the amount deferred per pay period requires that a new Agreement be made, unless I experience an unforeseeable emergency, in which case deferrals will automatically cease for a minimum time period as designated by the Plan. I understand that Section 457 of the Internal Revenue Code limits the amount, which I may elect to defer each year. Additionally, during the three calendar years ending prior to my normal retirement age as defined by the Plan, I may be eligible to contribute a catch-up amount if I did not contribute the maximum allowable amount during any year of my participation in the plan since January 1, 1982. I understand that a catch-up contribution may not be made during the calendar year of my normal retirement age, nor may a catch-up contribution be made if I previously made a catch-up contribution under this or any other Plan. It is my responsibility to monitor the amount I contribute per pay period to ensure that my total annual contributions to the Plan do not exceed the amount permitted under the Internal Revenue Code as amended from time to time. I may need to decrease the amount I contribute to the Plan by making a new Agreement, to avoid contributing excess amounts. I understand that this Agreement is irrevocable as to salary earned while the Agreement is in effect. However, I may terminate the Agreement at any time with respect to amounts not yet earned by submitting written notice to the Employer. I understand that the Employer will reduce my salary pursuant to the terms of this Agreement only to the extent that the amount of my gross salary for any pay period exceeds the amount I have elected to defer in any pay period. I understand that in general, distributions may not be made from a Section 457 Plan until the earlier of my separation from service with the plan sponsor, attainment of age 70 ½ or upon my experiencing an unforeseeable emergency as defined by the Plan.

Required Signatures. Duty to Review Pay Records. I understand I have revieweda duty to review my pay records (pay stub, understandetc.) to confirm the Employer has properly implemented my salary deferral election. Furthermore, I have a duty to inform the Plan Administrator if I discover any discrepancy between my pay records and agree this Salary Deferral Agreement. I understand the Plan Administrator will treat my failure to the provisions as stated on the reverse side of this form. Participant Signature Date Great-West Registered Representative Signature Date Return Original Form to: Great-West Retirement Services 0000 X. Xxxxxxxx Xxx Xxxxx 000 Xxxxxxx, XX 00000 000-000-0000 report any withholding errors for any payroll to which my Salary Deferral Agreement IRC Section 457 Plan Provisions Whereas applies, by the City of Houstoncut-off date for the next following payroll, hereinafter referred as my affirmative election to as “Employer” has established a deferred compensation plandefer the amount actually withheld (including zero). However, hereinafter referred to as “the Plan” pursuant to Internal Revenue Code Section 457; and Whereas I, the employee have elected to participate in the Plan by deferring a portion of I thereafter may modify my salary into deferral election prospectively, consistent with the Plan, it is hereby agreed as follows: I hereby request and direct that my salary be reduced as of the effective date designated on the front of this form (this date can not precede the date this agreement is signed), and that the Employer, it’s proper officers, agents and employees contribute these deferrals into the Plan. I agree and understand that increasing, decreasing or stopping the amount deferred per pay period requires that a new Agreement be made, unless I experience an unforeseeable emergency, in which case deferrals will automatically cease for a minimum time period as designated by the Plancurrent Plan Document. I understand that Section 457 it may be necessary for the Plan to limit my contribution election in accordance with Plan and/or IRS limitations. Once money is contributed to the Plan, I understand that money will only be distributable upon my death, permanent disability, retirement or termination of the Internal Revenue Code limits the amount, which I may elect to defer each year. Additionally, during the three calendar years ending prior to my normal retirement age as defined employment; and if allowed by the Plan, I may be eligible to contribute a catch-up amount if I did not contribute the maximum allowable amount during any year of my participation withdrawn in the plan since January 1event of serious financial hardship, 1982a Plan loan and/or attainment of a specified age (59 ½ or later). All distributions will be verified for compliance with current Plan provisions and IRS regulations. I understand that a catch-up contribution if I have elected life insurance through the Plan, minimum contributions may not have to be made during the calendar year of my normal retirement age, nor may a catch-up contribution be made if I previously made a catch-up contribution under this or any other Plan. It is my responsibility to monitor the amount I contribute per pay period to ensure that my total annual contributions to the Plan do not exceed the amount permitted under the Internal Revenue Code as amended from time to timemeet IRS guidelines. Therefore, I may need to decrease the amount I contribute to must contact the Plan by making a new AgreementAdministrator if I am decreasing my contributions. Further, if I am reducing my contribution to avoid contributing excess amounts. I understand that this Agreement is irrevocable as to salary earned while 0% and have life insurance through the Agreement is in effect. HoweverPlan for which premiums can no longer be paid with funds from the Plan, I may terminate the Agreement at any time with respect to amounts not yet earned by submitting written notice to the Employermust make an election concerning my life insurance coverage. I understand that the Employer will reduce my salary pursuant to the terms of this Agreement only to the extent that the amount of my gross salary for any pay period exceeds the amount I have elected to defer in any pay period. I understand that in general, distributions may not be made from a Section 457 Plan until the earlier of my separation from service with the plan sponsor, attainment of age 70 ½ or upon my experiencing an unforeseeable emergency as defined by the Plan.Participant Signature Date

Required Signatures. Duty to Review Pay Records. I understand I have revieweda duty to review my pay records (pay stub, understandetc.) to confirm the Employer has properly implemented my salary deferral election. Furthermore, I have a duty to inform the Plan Administrator if I discover any discrepancy between my pay records and agree this Salary Deferral Agreement. I understand the Plan Administrator will treat my failure to report any withholding errors for any payroll to which my Salary Deferral Agreement applies, by the cut-off date for the next following payroll, as my affirmative election to defer the amount actually withheld (including zero). However, I thereafter may modify my salary deferral election prospectively, consistent with the current Plan Document. I understand that it may be necessary for the Plan to limit my contribution election in accordance with Plan and/or IRS limitations. Once money is contributed to the Plan, I understand that money will only be distributable upon my death, permanent disability, retirement or termination of employment; and if allowed by the Plan, may be withdrawn in the event of serious financial hardship, a Plan loan and/or attainment of a specified age (59 ½ or later). All distributions will be verified for compliance with current Plan provisions as stated on and IRS regulations. I understand that if I have elected life insurance through the reverse side of this formPlan, minimum contributions may have to be made to the Plan to meet IRS guidelines. Therefore, I must contact the Plan Administrator if I am decreasing my contributions. Further, if I am reducing my contribution to 0% and have life insurance through the Plan for which premiums can no longer be paid with funds from the Plan, I must make an election concerning my life insurance coverage. Participant Signature Date Great-West Registered Representative Signature Date Return Original Form to: Great-West Retirement Services 0000 X. Xxxxxxxx Xxx Xxxxx 000 Xxxxxxx, XX 00000 000-000-0000 Salary Deferral Agreement IRC Section 457 Plan Provisions Whereas the City of Houston, hereinafter referred to as “Employer” has established a deferred compensation plan, hereinafter referred to as “the Plan” pursuant to Internal Revenue Code Section 457; and Whereas I, the employee have elected to participate in the Plan by deferring a portion of my salary into the Plan, it is hereby agreed as follows: I hereby request and direct that my salary be reduced as of the effective date designated on the front of this form (this date can not precede the date this agreement is signed), and that the Employer, it’s proper officers, agents and employees contribute these deferrals into the Plan. I agree and understand that increasing, decreasing or stopping the amount deferred per pay period requires that a new Agreement be made, unless I experience an unforeseeable emergency, in which case deferrals will automatically cease for a minimum time period as designated by the Plan. I understand that Section 457 of the Internal Revenue Code limits the amount, which I may elect to defer each year. Additionally, during the three calendar years ending prior to my normal retirement age as defined by the Plan, I may be eligible to contribute a catch-up amount if I did not contribute the maximum allowable amount during any year of my participation in the plan since January 1, 1982. I understand that a catch-up contribution may not be made during the calendar year of my normal retirement age, nor may a catch-up contribution be made if I previously made a catch-up contribution under this or any other Plan. It is my responsibility to monitor the amount I contribute per pay period to ensure that my total annual contributions to the Plan do not exceed the amount permitted under the Internal Revenue Code as amended from time to time. I may need to decrease the amount I contribute to the Plan by making a new Agreement, to avoid contributing excess amounts. I understand that this Agreement is irrevocable as to salary earned while the Agreement is in effect. However, I may terminate the Agreement at any time with respect to amounts not yet earned by submitting written notice to the Employer. I understand that the Employer will reduce my salary pursuant to the terms of this Agreement only to the extent that the amount of my gross salary for any pay period exceeds the amount I have elected to defer in any pay period. I understand that in general, distributions may not be made from a Section 457 Plan until the earlier of my separation from service with the plan sponsor, attainment of age 70 ½ or upon my experiencing an unforeseeable emergency as defined by the Plan.PLEASE RETURN THIS FORM TO THE PLAN ADMINISTRATOR