Common use of Election to Revoke Participation Clause in Contracts

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 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 systemelections. Investment Elections Prior Deferral Amount: $ Per Pay Fund Name Account/Contract Number REQUIRED Amount to Traditional Pre-Tax 403(b) (Per Pay Period) AXA Equitable C&A Amount to Xxxx 403(b) (Per Pay Period) Penselect (formerly Foresters Financial Group Great American Financial Resources GWN Securities Inc. Security Benefit X. Xxxx Xxxxx*** (Grandfathered ContractsServices) 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 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 Effective Date: Fund Name Account/Contract Number REQUIRED Amount to Xxxx 403(b) (Per Pay Period) Amount to Traditional 403(b) (Per Pay Period) AXA AIG Retirement Services Equitable C&A Financial Group Great American Financial Resources GWN Securities Inc. MetLife MetLife Insurance Company USA N/A Security Benefit X. Xxxx Xxxxx*** (Grandfathered Contracts) Voya Retirement Insurance and Annuity Company 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 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 Ameriprise Financial Group Great American Financial Resources GWN Securities Inc. Security Benefit X. Xxxx Xxxxx*** (Grandfathered ContractsServices Lincoln Investment Planning MultiChoice 403(b) Retirement Solution Xxxxxxxxxxx Funds 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 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 Xxxx 403(b) (Per Pay Period) Amount to Traditional 403(b) (Per Pay Period) ASPire Financial Services, LLC AXA Equitable C&A Financial Group Great American Financial Resources GWN Securities Inc. Security Benefit X. Xxxx Xxxxx*** (Grandfathered Contracts) -Xxxxxxxx Lincoln Investment Planning 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 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 American Funds - R3 Investments Ameriprise Financial Group Services Great American Financial Resources GWN Securities Inc. Security Benefit X. Xxxxxx Xxxx Xxxxx*** Insurance Co. ING Life and Annuity Company (Grandfathered ContractsILIAC) Life Insurance Co. of the Southwest MetLife Variable Annuity Life Insurance Company (VALIC) 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 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 Xxxx 403(b) (Per Pay Period) 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*** Primerica TIAA-CREF Variable Annuity Life Insurance Company (Grandfathered ContractsVALIC) Voya Retirement Insurance and Annuity Company 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 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 Account Number REQUIRED (Required) Amount to Traditional 403(b) (Per Pay Period) AXA Amount to Xxxx 403(b) (Per Pay Period) CalSTRS Pension 2 Equitable C&A Financial Industrial Alliance Pacific Invesco MetLife National Life Group Great American Financial Resources GWN Securities Inc. Security Benefit X. Xxxx Xxxxx*** (Grandfathered Contracts) PlanMember Services Reliastar Life Insurance Company Vanguard Investments 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 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 Xxxx 403(b) (Per Pay Period) Amount to Traditional 403(b) (Per Pay Period) AIG Retirement Services AXA Equitable C&A Financial Group Great American Financial Resources GWN Securities Inc. MetLife MetLife Insurance Company USA Security Benefit X. Xxxx Xxxxx*** (Grandfathered Contracts) Voya Retirement Insurance and Annuity Company 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 thiselection 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 willbe 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 Idirect new elections through the Plan’s web site or voice response system. Investment Elections Fund Name Account/Contract Account Number REQUIRED (Required) Amount to Traditional 403(b) (Per Pay Period) AXA AIG Retirement Services American Funds - R4 Investments Ameriprise Financial Services Equitable C&A Financial Group Great American Financial Resources GWN Securities Inc. Security Benefit X. Fidelity Investments Xxxxxx Xxxx Xxxxx*** (Grandfathered Contracts) Insurance Co. Invesco Lincoln Investment Planning Vanguard Voya Retirement Insurance and Annuity Company 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 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 Account Number REQUIRED (Required) Amount to Traditional 403(b457(b) (Per Pay Period) AXA Amount to Xxxx 457(b) (Per Pay Period) ASPire Financial Services Equitable C&A Financial Group Great American Financial Resources GWN Securities Inc. Security Benefit X. Xxxx Xxxxx*** (Grandfathered Contracts) -Xxxxxxxx Lincoln Investment Planning 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 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 Xxxx 403(b) (Per Pay Period) Amount to Traditional 403(b) (Per Pay Period) AXA Equitable C&A Financial American Funds - R1 Investments American Funds - R2 Investments American Funds - R3 American Funds - R4 Investments MetLife The Legend Group Great American Financial Resources GWN Securities Inc. Security Benefit X. Xxxx Xxxxx*** (Grandfathered Contracts) Vanguard Investments 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 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 Pre-Tax 403(b) (Per Pay Period) AXA Amount to Xxxx 403(b) (Per Pay Period) Equitable C&A Financial Group Great American Financial Resources GWN Securities Inc. Security Benefit X. Xxxx Xxxxx*** (Grandfathered Contracts) Fidelity Investments Lincoln Investment Planning 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 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 Account Number REQUIRED Amount to Traditional 403(b) (Per Pay Period) AXA Equitable C&A Financial Group Great Amount to Xxxx 403(b) (Per Pay Period) American Financial Resources GWN Securities Inc. Security Benefit X. Xxxx Funds - R1 Investments American Funds - R3 Investments American Funds - R4 Investments Xxxxx*** (Grandfathered Contracts) -Xxxxxxxx Lincoln Investment Planning PlanMember Services Reliastar Life Insurance Company 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 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. Xxxxxx Xxxx Xxxxx*** (Grandfathered Contracts) Insurance Co. Life Insurance Co. of the Southwest 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 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) Xxxx 457 (Per Pay Period) AXA Equitable C&A Financial Group Great American Financial Resources GWN Securities Inc. Amount to Traditional 457 (Per Pay Period) AIG Retirement Services 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) 403(b)/457 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 Xxxx 403(b) (Per Pay Period) 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*** TIAA-CREF Variable Annuity Life Insurance Company (Grandfathered ContractsVALIC) 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. 0 0 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: