Election to Revoke Participation. I do not want to participate in the Plan at this time. I understand that I may change this election by completing a new Enrollment Form prior to the next Plan Entry Date. Please discontinue my Salary Deferral Contributions to the Plan. I understand that I will be able to resume participation by completing a new Enrollment Form prior to the next Plan Entry Date. I direct my new money to be invested in the funds selected below. I understand these investment directions will remain in effect until I direct new elections through the Plan’s web site or voice response system. Investment Elections Fund Name Amount to Traditional 403(b) (Per Pay Period) AXA Equitable American Funds - R1 Investments American Funds - R2 Investments American Funds - R3 Investments American Funds - R4 Investments Ameriprise Financial Services Great American Insurance Group Xxxxxx Xxxx Insurance Co. Lincoln Investment Planning MetLife MetLife Insurance Company USA Modern Woodmen of America Investment Elections (Continued) Fund Name Amount to Traditional 403(b) (Per Pay Period) Xxxxxxxxxxx Funds Reliastar Life Insurance Company Security Benefit Vanguard Investments Variable Annuity Life Insurance Company (VALIC) Voya Retirement Insurance and Annuity Company Total By signing this Agreement, Employee agrees to modify his/her salary as indicated above and Employer agrees to contribute this amount on Employee’s behalf into the 403(b) annuity(ies) or custodial account(s) selected by Employee and authorized by the Employer. It is intended that the requirements of all applicable state and federal tax rules and regulations (Applicable Law) will be met. Employee understands and agrees that this Agreement:
Election to Revoke Participation. I do not want to participate in the Plan at this time. I understand that I may change this election by completing a new Enrollment Form prior to the next Plan Entry Date. Please discontinue my Salary Deferral Contributions to the Plan. I understand that I will be able to resume participation by completing a new Enrollment Form prior to the next Plan Entry Date. I direct my new money to be invested in the funds selected below. I understand these investment directions will remain in effect until I direct new elections through the Plan’s web site or voice response system. Investment Elections Fund Name Account/Contract Number REQUIRED Amount to Traditional 403(b) (Per Pay Period) AXA Equitable C&A Financial Group Great American Financial Resources GWN Securities Inc. Security Benefit X. Xxxx Xxxxx*** (Grandfathered Contracts) Total ***Beginning on 01/01/2017, no new accounts may be established with the above investment providers. Participants with existing accounts will not be affected. By signing this Agreement, Xxxxxxxx agrees to modify his/her salary as indicated above and Employer agrees to contribute this amount on Employee’s behalf into the 403(b) annuity(ies) or custodial account(s) selected by Employee and authorized by the Employer. It is intended that the requirements of all applicable state and federal tax rules and regulations (Applicable Law) will be met. Employee understands and agrees that this Agreement:
Election to Revoke Participation. I do not want to participate in the Plan at this time. I understand that I may change this election by completing a new Agreement Form prior to the next Plan Entry Date. Please discontinue my Salary Deferral Contributions to the Plan. I understand that I will be able to resume participation by completing a new Agreement Form prior to the next Plan Entry Date.
