Common use of ELECTION OF BENEFITS Clause in Contracts

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩ I receive my paychecks: ⬜ Weekly(52) ⬜ Biweekly(26) ⬜ Biweekly(24) ⬜ Semimonthly(24) ⬜ Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩ I receive my paychecks: ⬜ Weekly(52) ⬜ Biweekly(26) ⬜ Biweekly(24) ⬜ Semimonthly(24) ⬜ Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩  I receive my paychecks: ⬜  Weekly(52) ⬜  Biweekly(26) ⬜  Biweekly(24) ⬜  Semimonthly(24) ⬜  Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩  I receive my paychecks: ⬜  Weekly(52) ⬜  Biweekly(26) ⬜  Biweekly(24) ⬜  Semimonthly(24) ⬜  Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT (Plan Year Amt ÷  # Pay Periods) PLAN YEAR ELECTION AMOUNT (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩ I receive my paychecks: ⬜ ⬜ Weekly(52) ⬜ Biweekly(26) ⬜ Biweekly(24) ⬜ Semimonthly(24) ⬜ Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩ I receive my paychecks: ⬜ ⬜ Weekly(52) ⬜ Biweekly(26) ⬜ Biweekly(24) ⬜ Semimonthly(24) ⬜ Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩  I receive my paychecks: ⬜   Weekly(52) ⬜ Biweekly(26) ⬜  Biweekly(24) ⬜  Semimonthly(24) ⬜  Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩  I receive my paychecks: ⬜   Weekly(52) ⬜ Biweekly(26) ⬜ ✔ Biweekly(24) ⬜  Semimonthly(24) ⬜  Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩  I receive my paychecks: ⬜   Weekly(52) ⬜  Biweekly(26) ⬜  Biweekly(24) ⬜ Semimonthly(24) ⬜  Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩  I receive my paychecks: ⬜   Weekly(52) ⬜ Biweekly(26) ⬜  Biweekly(24) ⬜  Semimonthly(24) ⬜  Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩ I receive my paychecks: ⬜ ⬜ Weekly(52) ⬜ Biweekly(26) ⬜ ⬜✔ Biweekly(24) ⬜ Semimonthly(24) ⬜ Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩ I receive my paychecks: ⬜ Weekly(52) ⬜ Biweekly(26) ⬜ Biweekly(24Biweekly(26 or 24) ⬜ Semimonthly(24) ⬜ Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT (Pay Period Amt x # Pay Periods)

ELECTION OF BENEFITS. In accordance with my rights under the Plan, I elect the following amounts for each benefit I have selected. The Employer and I agree that my cash compensation will be redirected by the amounts set forth below for the Plan Year designated above. ⏩ I receive my paychecks: ⬜ ⬜ Weekly(52) ⬜ Biweekly(26) ⬜ Biweekly(24) ⬜ Semimonthly(24) ⬜ Monthly(12) FLEXIBLE SPENDING ACCOUNT OPTIONS PAY PERIOD ELECTION AMOUNT AMOUNT‌ (Plan Year Amt ÷ # Pay Periods) PLAN YEAR ELECTION AMOUNT AMOUNT‌ (Pay Period Amt x # Pay Periods)