Select one below Sample Clauses
Select one below. □ New Enrollment □ Change Amount □ Add a 2nd Account □ Cancel Account Employee: SSN: Address: City: State: Zip: Phone Number: Date of Birth: I. Employee Deferrals – Section 403(b) or 457(b) Pre-tax Deferral Election. I hereby authorize the Kenosha Unified School District ("District") to withhold $ OR % (whole dollar amount or whole percentage of total pay period compensation) from my compensation per pay period. This Agreement shall be effective as of the first pay date which is not less than ten (10) business days following the date of execution of this Agreement. The District shall remit the withheld funds to the following Vendor(s) that I have selected: $ OR % $ OR % Please use the back of this form, continuing in the same fashion above if you wish to select additional vendors.
Select one below. I am transferring a decedent’s existing Pacific Funds IRA account to an Inherited IRA. I have completed the IRA Inheritance Request Form and have included it with this application. I am requesting a trustee-to-trustee transfer of assets from an existing Inherited IRA held at another insitituion. I have completed the enclosed I am establishing an inherited IRA to accept a non-spouse beneficiary direct rollover from a 403(b) or qualified plan.
Select one below o For active Participants only. ý For active Participants, terminated Participants and Beneficiaries.
Select one below. The sections not marked shall not be a part of this Agreement.]
Select one below. □ New Enrollment □ Change Amount □ Add a 2nd Account □ Cancel Account Employee: SSN: Address: City: State: Zip: Phone Number: Date of Birth: I. Employee Deferrals – Section 403(b) & 457(b) Pre-tax Deferral Election. I hereby authorize the Kenosha Unified School District ("District") to withhold % (whole dollar amount or whole percentage of total pay period compensation) from my compensation per pay period. This Agreement shall be effective as of the first pay date which is not less than ten (10) business days following the date of execution of this Agreement. The District shall remit the withheld funds to the following Vendor(s) that I have selected: Amount (whole dollar/percentage) District-Approved Vendor Name $ OR % Amount (whole dollar/percentage) District-Approved Vendor Name $ OR % Please use the back of this form, continuing in the same fashion above if you wish to select additional vendors.