Common use of Participant Contributions Clause in Contracts

Participant Contributions. If more than 2 Investment Providers, attach separate sheet. This Salary Reduction Agreement REPLACES AND CANCELS ALL PREVIOUS AGREEMENTS ON FILE, UNLESS THE ONE-TIME ELECTION IS SELECTED. ONLY the contribution to the investment provider(s) shown below will continue after the effective date of this agreement, UNLESS THE ONE-TIME ELECTION IS SELECTED. Complete all sections and forward to PlanConnect using the instructions under the contact section of this form. Prior elections on file will resume for ONE-TIME ELECTIONS ONLY. Effective Date of Agreement: □ Next Permissible Date □ Other: _ □ One-Time Election Payout Date: _ If the effective date specified does not align with a permissible plan entry date or pay cycle, the election will be effective as soon as administratively possible thereafter. Remit Contributions To: Contributions must be listed as either all percentages or dollar amounts. Percentages and amounts are on a per pay basis. I have an Account with this provider. *Percent Amount Contribution Source Check one: Begin/Continue Change‌ Stop One Time Investment Provider/Account Number □ Yes □ No OR □ Pre-Tax □ Xxxx □ Employer* % $ Begin/Continue Change‌ Stop One Time Investment Provider/Account Number □ Yes □ No OR □ Pre-Tax □ Xxxx □ Employer* % $ EMPLOYER CONTRIBUTIONS (if applicable), will be allocated proportionately in accordance with the investment provider elections you have specified above, unless specified differently by the employer. Must indicate a percentage for EMPLOYER and Post Retirement Contributions. CONTACT EXPRESS MAIL: PlanConnect 000 Xxxxxxx Xxxxxx Xxxxxxxx, XX 00000 REGULAR MAIL: PlanConnect PO Box 4940 Syracuse, NY 13221 FAX: (000) 000-0000 PHONE: (000) 000-0000 Monday-Friday, 9AM to 5PM ET xxx.xxxxxxxxxxx.xxx SIGN Incomplete forms will result in a processing delay or may not be accepted. Employee Signature: Date: Advisor Signature: Date: KEEP A COPY FOR YOUR RECORDS (Check your earnings statement to verify this Salary Reduction Agreement was processed accurately.)

Participant Contributions. If more than 2 Investment Providers, attach separate sheet. This Salary Reduction Agreement REPLACES AND CANCELS ALL PREVIOUS AGREEMENTS ON FILE, UNLESS THE ONE-TIME ELECTION IS SELECTED. ONLY the contribution to the investment provider(s) shown below will continue after the effective date of this agreement, UNLESS THE ONE-TIME ELECTION IS SELECTED. Complete all sections and forward to PlanConnect using the instructions under the contact section of this form. Prior elections on file will resume for ONE-TIME ELECTIONS ONLY. Current provider and source will be utilized on forms where "CHANGE" is selected and investment provider and source are omitted. Effective Date of Agreement: □ Next Permissible Date □ Other: _ □ One-Time Election Payout Date: _ If the effective date specified does not align with a permissible plan entry date or pay cycle, the election will be effective as soon as administratively possible thereafter. Remit Contributions To: Contributions must be listed as either all percentages or dollar amounts. Percentages and amounts Amounts are on a per pay basis. I have an Account with this provider. *Percent Amount Contribution Source Check one: Begin/Continue Change‌ Stop Change Stop‌‌ One Time Investment Provider/Account Number □ AXA ■ Yes □ No OR □ 100 $ ■ Pre-Tax □ Xxxx □ Employer* % $ ■ Begin/Continue Change‌ Stop Change Stop‌‌ One Time Investment Provider/Account Number □ Yes □ No OR □ $ Pre-Tax □ Xxxx □ Employer* % $ EMPLOYER CONTRIBUTIONS (if applicable), will be allocated proportionately in accordance with the investment provider elections you have specified above, unless specified differently by the employer. Must indicate a percentage for EMPLOYER and Post Retirement Contributions. CONTACT EXPRESS MAIL: PlanConnect 000 Xxxxxxx Xxxxxx Xxxxxxxx, XX 00000 REGULAR MAIL: PlanConnect PO Box 4940 Syracuse, NY 13221 FAX: (000) 000-0000 PHONE: (000) 000-0000 Monday-Friday, 9AM to 5PM ET xxx.xxxxxxxxxxx.xxx SIGN Incomplete forms will result in a processing delay or may not be accepted. Employee Signature: Date: Advisor Signature: Date: KEEP A COPY FOR YOUR RECORDS (Check your earnings statement to verify this Salary Reduction Agreement was processed accurately.)

Participant Contributions. If more than 2 Investment Providers, attach separate sheet. This Salary Reduction Agreement REPLACES AND CANCELS ALL PREVIOUS AGREEMENTS ON FILE, UNLESS THE ONE-TIME BEGIN / RESUME / CHANGE ELECTION IS SELECTED. ONLY the contribution to the investment provider(s) shown below will continue after the effective date of this agreement, UNLESS THE ONE-TIME ELECTION IS SELECTED. Complete all sections and forward to PlanConnect using the instructions under the contact section of this form. Prior elections on file will resume for ONE-TIME ELECTIONS ONLY. Effective Date of Agreement: □ Next Permissible Date □ Other: _ □ One-Time Election Payout Date: _ If the effective date specified does not align with a permissible plan entry date or pay cycle, the election will be effective as soon as administratively possible thereafter. Remit Contributions To: Contributions must be listed as either all percentages or dollar amounts. Percentages and amounts are on a per pay basis. I have an Account with this provider. *Percent Amount Contribution Source Check one: Begin/Continue Change‌ Stop Change Stop‌ One Time Begin/Continue Change Stop‌ One Time Investment Provider/Account Number Investment Provider/Account Number □ Yes □ No OR □ Yes □ No □ Pre-Tax OR □ Xxxx □ Employer* % $ Begin/Continue Change‌ Stop One Time Investment Provider/Account Number □ Yes □ No Post Retirement* OR □ Pre-Tax □ Xxxx □ % $ Employer* % $ Post Retirement* EMPLOYER CONTRIBUTIONS (if applicable), will be allocated proportionately in accordance with the investment provider elections you have specified above, unless specified differently by the employer. Must indicate a percentage for EMPLOYER and Post Retirement Contributions. CONTACT EXPRESS MAIL: PlanConnect 000 Xxxxxxx Xxxxxx XxxxxxxxSyracuse, XX 00000 NY 13202 REGULAR MAIL: PlanConnect PO Box 4940 Syracuse, NY 13221 FAX: (000) 000-0000 PHONE: (000) 000-0000 Monday-Friday, 9AM to 5PM ET xxx.xxxxxxxxxxx.xxx SIGN Incomplete forms will result in a processing delay or may not be accepted. SIGN Employee Signature: Date: Advisor Signature: Date: KEEP A COPY FOR YOUR RECORDS (Check your earnings statement to verify this Salary Reduction Agreement was processed accurately.)

Participant Contributions. If more than 2 Investment Providers, attach separate sheet. This Salary Reduction Agreement REPLACES AND CANCELS ALL PREVIOUS AGREEMENTS ON FILE, UNLESS THE ONE-TIME BEGIN / RESUME / CHANGE ELECTION IS SELECTED. ONLY the contribution to the investment provider(s) shown below will continue after the effective date of this agreement, UNLESS THE ONE-TIME ELECTION IS SELECTED. Complete all sections and forward to PlanConnect using the instructions under the contact section of this form. Prior elections on file will resume for ONE-TIME ELECTIONS ONLY. Effective Date of Agreement: □ Next Permissible Date □ Other: _ □ One-Time Election Payout Date: _ If the effective date specified does not align with a permissible plan entry date or pay cycle, the election will be effective as soon as administratively possible thereafter. Remit Contributions To: Contributions must be listed as either all percentages or dollar amounts. Percentages and amounts are on a per pay basis. I have an Account with this provider. *Percent Amount Contribution Source Check one: Begin/Continue Change Stop‌ One Time Begin/Continue Change‌ Stop One Time Investment Provider/Account Number Investment Provider/Account Number □ Yes □ No □ Yes □ No OR □ Pre-Tax □ Xxxx □ Employer* % $ Begin/Continue Change‌ Stop One Time Investment Provider/Account Number □ Yes □ No OR □ Pre-Tax □ Xxxx □ Employer* % $ EMPLOYER CONTRIBUTIONS (if applicable), will be allocated proportionately in accordance with the investment provider elections you have specified above, unless specified differently by the employer. Must indicate a percentage for EMPLOYER and Post Retirement Contributions. CONTACT EXPRESS MAIL: PlanConnect 000 Xxxxxxx Xxxxxx XxxxxxxxSyracuse, XX 00000 NY 13202 REGULAR MAIL: PlanConnect PO Box 4940 Syracuse, NY 13221 FAX: (000) 000-0000 PHONE: (000) 000-0000 Monday-Friday, 9AM to 5PM ET xxx.xxxxxxxxxxx.xxx SIGN Incomplete forms will result in a processing delay or may not be accepted. SIGN Employee Signature: Date: Advisor Signature: Date: KEEP A COPY FOR YOUR RECORDS (Check your earnings statement to verify this Salary Reduction Agreement was processed accurately.)

Participant Contributions. If more than 2 Investment Providers, attach separate sheet. This Salary Reduction Agreement REPLACES AND CANCELS ALL PREVIOUS AGREEMENTS ON FILE, UNLESS THE ONE-TIME BEGIN / RESUME / CHANGE ELECTION IS SELECTED. ONLY the contribution to the investment provider(s) shown below will continue after the effective date of this agreement, UNLESS THE ONE-TIME ELECTION IS SELECTED. Complete all sections and forward to PlanConnect using the instructions under the contact section of this form. Prior elections on file will resume for ONE-TIME ELECTIONS ONLY. Current provider and source will be utilized on forms where "CHANGE" is selected and investment provider and source are omitted. Effective Date of Agreement: □ □■ Next Permissible Date □ Other: _ □ One-Time Election Payout Date: _ If the effective date specified does not align with a permissible plan entry date or pay cycle, the election will be effective as soon as administratively possible thereafter. Remit Contributions To: Contributions must be listed as either all percentages or dollar amounts. Percentages and amounts are on a per pay basis. I have an Account with this provider. *Percent Amount Contribution Source Check one: ■ Begin/Continue Change Stop Investment Provider/Account Number □■ Yes OR □ Pre-Tax □ Xxxx One Time Begin/Continue Change‌ Stop One Time AXA Equitable Investment Provider/Account Number □ No □ Yes □ No 100 % $ OR % $ □ Pre-Tax □ Xxxx □ Employer* % $ Begin/Continue Change‌ Stop One Time Investment Provider/Account Number □ Yes □ No OR □ Pre-Tax □ Xxxx □ Employer* % $ EMPLOYER CONTRIBUTIONS (if applicable), will be allocated proportionately in accordance with the investment provider elections you have specified above, unless specified differently by the employer. Must indicate a percentage for EMPLOYER and Post Retirement Contributions. CONTACT EXPRESS MAIL: PlanConnect 000 Xxxxxxx Xxxxxx XxxxxxxxSyracuse, XX 00000 NY 13202 REGULAR MAIL: PlanConnect PO Box 4940 Syracuse, NY 13221 FAX: (000) 000-0000 PHONE: (000) 000-0000 Monday-Friday, 9AM to 5PM ET xxx.xxxxxxxxxxx.xxx SIGN Incomplete forms will result in a processing delay or may not be accepted. SIGN Employee Signature: Date: Advisor Signature: Date: KEEP A COPY FOR YOUR RECORDS (Check your earnings statement to verify this Salary Reduction Agreement was processed accurately.)