Common use of SRA Clause in Contracts

SRA. You must list all new and existing 403(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount Type of Deferrals Requested Action Effective Date** Pre-Tax 403(b) ▇▇▇▇ 403(b) Other $ New Change Existing Cancel 1, 2022 $ New Change Existing Cancel 1, 2022 $ New Change Existing Cancel 1, 2022 Total Monthly Contributions *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇.▇▇▇/▇▇▇▇ for a current listing of providers that have agreed to pay the fee. **Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.

SRA. You must list all new and existing 403(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount Type of Deferrals Requested Action Effective Date** Pre-Tax 403(b) ▇▇▇▇ 403(b) Other $ New Change Existing Cancel 1, 2022 2021 $ New Change Existing Cancel 1, 2022 2021 $ New Change Existing Cancel 1, 2022 2021 Total Monthly Contributions *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇.▇▇▇/▇▇▇▇ for a current listing of providers that have agreed to pay the fee. **Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.