Common use of CERTIFICATION STATEMENT Clause in Contracts

CERTIFICATION STATEMENT. I elect to contribute to the 457(b) tax-sheltered annuity/investment plan offered by Baltimore County Public Schools (BCPS). With respect to salary earned on a biweekly basis, I understand and agree that this SRA: • Is legally binding, governed by IRS Code, and irrevocable for amounts earned with this SRA in effect; • Shall remain in effect for the duration of my employment with BCPS or until you give written authorization to change or cancel it. You may change the amount of your contribution of your 457(b) company by completing a new SRA and sending it to the Office of Benefits and by giving the company written notice of changes or cancellation at least 10 days in advance of the next regularly scheduled payroll deduction. Any change in contributions will apply only to your unearned salary and not to amounts already earned. • Contributions may not exceed the dollar limits on elective deferrals contained in IRS Code. The dollar limit on contributions applies to ALL annuity contracts or custodial accounts in which you elect to invest. An additional contribution can be made if you are age 50 or older by the end of the calendar year. • This Agreement is subject to the terms and conditions of BCPS’ 457(b) Retirement Plan. Employee Signature Date

CERTIFICATION STATEMENT. I elect to contribute to the 457(b403(b) tax-sheltered annuity/investment plan offered by Baltimore County Public Schools (BCPS). With respect to salary earned on a biweekly basis, I understand and agree that this SRA: •  Is legally binding, governed by IRS Code, and irrevocable for amounts earned with this SRA in effect; •  Shall remain in effect for the duration of my employment with BCPS or until you give written authorization to change or cancel it. You may change the amount of your contribution of your 457(b403(b) company by completing a new SRA and sending it to the Office of Benefits and by giving the company written notice of changes or cancellation at least 10 days in advance of the next regularly scheduled payroll deduction. Any change in contributions will apply only to your unearned salary and not to amounts already earned. •  Contributions may not exceed the dollar limits on elective deferrals contained in IRS Code. The dollar limit on contributions applies to ALL annuity contracts or custodial accounts in which you elect to invest. An additional contribution can be made if you are age 50 or older by the end of the calendar year. •  This Agreement is subject to the terms and conditions of BCPS’ 457(b403(b) Retirement Plan. Employee Signature DateDate Employee Phone Number

CERTIFICATION STATEMENT. I elect to contribute to the 457(b403(b) tax-sheltered annuity/investment plan offered by Baltimore County Public Schools (BCPS). With respect to salary earned on a biweekly basis, I understand and agree that this SRA: • Is legally binding, governed by IRS Code, and irrevocable for amounts earned with this SRA in effect; • Shall remain in effect for the duration of my employment with BCPS or until you give written authorization to change or cancel it. You may change the amount of your contribution of your 457(b403(b) company by completing a new SRA and sending it to the Office of Benefits and by giving the company written notice of changes or cancellation at least 10 days in advance of the next regularly scheduled payroll deduction. Any change in contributions will apply only to your unearned salary and not to amounts already earned. • Contributions may not exceed the dollar limits on elective deferrals contained in IRS Code. The dollar limit on contributions applies to ALL annuity contracts or custodial accounts in which you elect to invest. An additional contribution can be made if you are age 50 or older by the end of the calendar year. • This Agreement is subject to the terms and conditions of BCPS’ 457(b403(b) Retirement Plan. Employee Signature Date