Common use of Contribution Information Clause in Contracts

Contribution Information. (Select all that apply & complete amounts in part 3) **All deductions are taken on a post-tax basis** New salary reduction and/or district match amount Effective Date:* Change salary reduction amount and/or district match amount Discontinue TSA salary reduction with the following Service Provider(s): Employee’s deductions (this tax year) to all 403b plans or all 457 plans are expected to exceed $20,500/year. Employee is over age 50 and planning to deduct an additional $6,500 in the current calendar year Employee’s Birth Date: (Maximum payroll deduction amounts are limited to the basic limit plus additional allowances for over age 50) ▪ Requests are accepted any time from September 1st – May 31st. Requests received over the summer will be held until September 1st. ▪ Completed Salary Reduction Agreement forms must be received prior to the current payroll or they will be held until the following payroll. ▪ All deductions are taken post tax

Contribution Information. (Select all that apply & complete amounts in part 3) **All deductions are taken on a post-tax basis** New salary reduction and/or district match amount Effective Date:* Change salary reduction amount and/or district match amount Discontinue TSA salary reduction with the following Service Provider(s): Employee’s deductions (this tax year) to all 403b plans or all 457 plans are expected to exceed $20,50019,000/year. Employee is over age 50 and planning to deduct an additional $6,500 6,000 in the current calendar year Employee’s Birth Date: (Maximum payroll deduction amounts are limited to the basic limit plus additional allowances for over age 50) ▪ Requests are accepted any time from September 1st – May 31st. Requests received over the summer will be held until September 1st. ▪ Completed Salary Reduction Agreement forms must be received prior to the current payroll or they will be held until the following payroll. ▪ All deductions are taken post tax

Contribution Information. (Select all that apply & complete amounts in part 3) **All deductions are taken on a post-tax basis** New salary reduction and/or district match amount Effective Date:* Change salary reduction amount and/or district match amount Discontinue TSA salary reduction with the following Service Provider(s): Employee’s deductions (this tax year) to all 403b plans or all 457 plans are expected to exceed $20,50019,500/year. Employee is over age 50 and planning to deduct an additional $6,500 in the current calendar year Employee’s Birth Date: (Maximum payroll deduction amounts are limited to the basic limit plus additional allowances for over age 50) ▪ Requests are accepted any time from September 1st – May 31st. Requests received over the summer will be held until September 1st. ▪ Completed Salary Reduction Agreement forms must be received prior to the current payroll or they will be held until the following payroll. ▪ All deductions are taken post tax

Contribution Information. (Select all that apply & complete amounts in part 3) **All deductions are taken on a post-tax basis** New salary reduction and/or district match amount Effective Date:* Change salary reduction amount and/or district match amount Discontinue TSA salary reduction with the following Service Provider(s): Employee’s deductions (this tax year) to all 403b plans or all 457 plans are expected to exceed $20,50022,500/year. Employee is over age 50 and planning to deduct an additional $6,500 7,500 in the current calendar year Employee’s Birth Date: (Maximum payroll deduction amounts are limited to the basic limit plus additional allowances for over age 50) ▪ Requests are accepted any time from September 1st – May 31st. Requests received over the summer will be held until September 1st. ▪ Completed Salary Reduction Agreement forms must be received prior to the current payroll or they will be held until the following payroll. ▪ All deductions are taken post tax