Employee Signature. Check here if you control another consulting or other business or company. I understand that all rights under the annuity(s) or custodial accounts established by me under the 403(b) plan are enforceable solely by me, my beneficiary or my authorized representative. I also understand that no later than January 1, 2009, my Employer will have a 403(b) Plan in place that will require my Employer, or their designee to authorize certain distributions and loans, and that it will not be solely my responsibility to authorize such transactions. By signing this Agreement, I authorize any Service Provider, or their delegee to provide information on my Account to Employer or another Service Provider if such information is necessary for compliance purposes or to effectuate such transactions as I may request.
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for Employer to administer the Plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. Employee Signature: Date:
Employee Signature. I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me. I understand that certain information about my 403(b) account is necessary to properly maintain and administer my account under the 403(b) plan. I authorize the holder of that information to make it available to the plan sponsor, the administrator of the plan and/or their representative(s) so long as the information is used exclusively for purposes of complying with legal and regulatory requirements and proper administration of the plan and my account there under. I am aware that if I select Vanguard Funds as my investment provider, plan administration expenses will be deducted from my account on a monthly basis. This fee, $24.00 annually, may be changed in the future subject to prior notification to me of such change. Employee Signature: Date: Part 7. Representative Signature Signature: Company Name: Date: Part 8. Employer Signature Employer hereby agrees to this Salary Reduction Agreement: Employer Signature: Title: Date:
Employee Signature. I certify that I have read this complete Agreement and that my salary reductions do not exceed contribution limits as determined by Applicable Law. I also certify that I am eligible for the catch up election(s), if selected, under Part 2 above. I understand my responsibilities as an Employee under the 403(b)/403(b) Xxxx/457 programs, and I request Employer to take the action specified in this Agreement. I understand that all rights under annuity (ies) or custodial account(s) established by me under the 403(b)/403(b) Xxxx/457 program are enforceable only by me, my beneficiary or my authorized representative. Employee Signature Date
Employee Signature. I certify that I have read this complete Agreement and that my salary reductions do not exceed contribution limits as determined by Applicable Law. I also certify that I am eligible for the catch up election(s), if selected, under Part 2 above. I understand my responsibilities as an Employee under the 403(b)/403(b) Xxxx/457 programs, and I request that my Employer takes the action specified in this Agreement. I understand that all rights under annuity(ies) or custodial account(s) established by me under the 403(b)/403(b) Xxxx/457 program are enforceable only by me, my beneficiary or my authorized representative. Employee Signature Date Part 6. Acknowledgement and Representative of Sales Agent/Representative I hereby acknowledge my responsibility to comply with the Employer’s written directives regarding solicitation of Employees. I also acknowledge my responsibility to assist the Employee in determining the maximum contribution limits. Sales Agent/Representative (please print clearly) Phone Address Signature Date Part 7. Employer Signature Employer hereby agrees to this Salary Reduction Agreement. Signature of Employer Representative Date Date Received in HR
Employee Signature. 3. The janitorial service provider shall replace the janitorial worker assigned immediately at the Department of State’s request if the janitorial worker is found with contraband in his/her possession.
Employee Signature. I certify that I have read and understand this complete agreement, and that my salary reductions do not exceed contribution limits as determined by applicable law. Check each applicable statement below: I have opened my Provider Account I have been employed by the University of Massachusetts within the past year. Employee Signature: Date: Part 4 Benefit Administrator Section Name Signature Date received Date entered in Payroll System
Employee Signature. I have completed, understand and agree to the information listed above. By execution of this agreement, I hereby cancel any 403(b) agreements previously executed by me. This agreement supersedes all prior agreements. In consideration of execution by New Mexico Tech of this agreement, I, the employee, hereby agree to indemnify and hold harmless and release New Mexico Tech and all its regents, president, vice-presidents, and employees from all claims and liability of any type directly or indirectly arising out of this agreement. Signed this day of 20 Signed this day of Employee New Mexico Tech
Employee Signature. Consult your tax advisor for any tax advice concerning your plan(s). Date PEHP Approval
