Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account on a monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: Part 7. Representative Signature Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 9 contracts
Samples: Salary Reduction Agreement, Salary Reduction Agreement, Salary Reduction Agreement
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account on a monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: Part 7. Representative Signature Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 7 contracts
Samples: Salary Reduction Agreement, Salary Reduction Agreement, Salary Reduction Agreement
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account on a monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: _ Date: Part 7. Representative Signature Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 6 contracts
Samples: Salary Reduction Agreement, Salary Reduction Agreement, Salary Reduction Agreement
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account on a monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: _ Date: Part 7. Representative Signature Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 5 contracts
Samples: Salary Reduction Agreement, Salary Reduction Agreement, Salary Reduction Agreement
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account contributions on a monthly prorated “per payroll” basis. This fee, annual fee is $24.00 annually, as of 10/01/13 and may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: Part 7. Representative Signature Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 5 contracts
Samples: www.boyertownasd.org, www.boyertownasd.org, www.boyertownasd.org
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment providerparticipate through Vanguard, plan administration expenses Employer Admin Services, Inc. will be deducted deduct their $10.00 annual administrative fee from my account deductions on a pro-rated, monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: Part 7. Representative Signature Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 5 contracts
Samples: Salary Reduction Agreement, www.rtmsd.org, www.rtmsd.org
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account contributions on a monthly prorated ‘per payroll’ basis. This fee, annual fee is $24.00 annually, as of 10/1/2013 and may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: Part 7. Representative Signature Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 3 contracts
Samples: www.avongrove.org, Salary Reduction Agreement, Salary Reduction Agreement
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account on a monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: NOTE: Representative must sign form before submitting to Payroll when initiating a new agreement or changing Part 7. Representative Signature Vendor Rep. Signature: Company NameTitle: Date: Return original signed document to: Wyomissing Area School District, ATTN: Payroll, 000 Xxxxx Xxx, Wyomissing, PA 19610 Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 1 contract
Samples: cdn5-ss18.sharpschool.com
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account contributions on a monthly prorated ‘per payroll’ basis. This fee, annual fee is $24.00 annually, as of 10/1/2013 and may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: Part 7. Representative Signature Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 1 contract
Samples: 2022 Salary Reduction Agreement
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account on a monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: Part 7. Representative Signature NOTE: 403(b) Representative’s signature ONLY required for opening a new account. For NEW Vanguard accounts, in place of Representative’s signature, please write your Vanguard account number below. Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 1 contract
Samples: Salary Reduction Agreement
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account on a monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: _ Date: Part 7. Representative Signature Note: 403(b) Representative’s signature ONLY required for opening a new account. For NEW Vanguard accounts, in place of Representative’s signature, please write your Vanguard account number below. Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 1 contract
Samples: Salary Reduction Agreement
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account on a monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: Part 78. Representative Signature Signature: – Required if new enrollment. Signature Company Name: Date: Name Date Part 89. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Appears in 1 contract
Samples: Salary Reduction Agreement