Common use of PARTICIPATION ELECTIONS Clause in Contracts

PARTICIPATION ELECTIONS. Salary Deferral Elections I hereby apply for Participation in the above-named 403(b) Plan and direct my employer to withhold through payroll reduction the following amounts from each pay. I understand this election will be applied to future contributions only and will remain in effect until I direct new elections through the Plan’s Internet or Voice Response System. NOTE: I understand that if I am 50 years of age or will reach the age of 50 during this calendar year any contribution deferrals in excess of the traditional salary will be applied to the Age 50 Catch-up option. Election to Defer Participation 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 Total 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:

PARTICIPATION ELECTIONS. Salary Deferral Elections I hereby apply for Participation in the above-named 403(b) Plan and direct my employer to withhold through payroll reduction the following amounts from each pay. I understand this election will be applied to future contributions only and will remain in effect until I direct new elections through the Plan’s Internet or Voice Response System. NOTE: I understand that if I am 50 years of age or will reach the age of 50 during this calendar year any contribution deferrals in excess of the traditional salary will be applied to the Age 50 Catch-up option. Election to Defer Participation 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 Ameriprise Financial Services Lincoln Investment Planning MultiChoice 403(b) Retirement Solution Xxxxxxxxxxx Funds Total 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:

PARTICIPATION ELECTIONS. Salary Deferral Elections I hereby apply for Participation in the above-named 403(b) Plan and direct my employer to withhold through payroll reduction the following amounts from each pay. I understand this election will be applied to future contributions only and will remain in effect until I direct new elections through the Plan’s Internet or Voice Response System. NOTE: I understand that if I am 50 years of age or will reach the age of 50 during this calendar year any contribution deferrals in excess of the traditional salary will be applied to the Age 50 Catch-up option. Election to Defer Participation 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 Commonwealth Annuity and Life Insurance Co. Great American Insurance Group Xxxxx-Xxxxxxxx Lincoln Investment Planning MetLife New York Life and Annuity Insurance Company Xxxxxxxxxxx Funds Investment Elections (Continued) Fund Name Amount to Traditional 403(b) (Per Pay Period) Reliastar Life Insurance Company Security Benefit Vanguard Investments Xxxxxxx & Xxxx Total 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:

PARTICIPATION ELECTIONS. Salary Deferral Elections I hereby apply for Participation in the above-named 403(b) Plan and direct my employer to withhold through payroll reduction the following amounts from each pay. I understand this election will be applied to future contributions only and will remain in effect until I direct new elections through the Plan’s Internet or Voice Response System. NOTE: I understand that if I am 50 years of age or will reach the age of 50 during this calendar year any contribution deferrals in excess of the traditional salary will be applied to the Age 50 Catch-up option. Election to Defer Participation 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 American Funds - R4 Investments Xxxxxx Xxxx Insurance Co. Xxxxx-Xxxxxxxx Lincoln Investment Planning MetLife Participant Fees PlanMember Services Security Benefit Investment Elections (Continued) Fund Name Amount to Traditional 403(b) (Per Pay Period) Symetra Life Insurance Company Vanguard Investments Total 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:

PARTICIPATION ELECTIONS. Salary Deferral Elections I hereby apply for Participation in the above-named 403(b) Plan and direct my employer to withhold through payroll reduction the following amounts from each pay. I understand this election will be applied to future contributions only and will remain in effect until I direct new elections through the Plan’s Internet or Voice Response System. NOTE: I understand that if I am 50 years of age or will reach the age of 50 during this calendar year any contribution deferrals in excess of the traditional salary will be applied to the Age 50 Catch-up option. Election to Defer Participation 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 Xxxxxxxxxxx Funds Investment Elections (Continued) Fund Name Amount to Traditional 403(b) (Per Pay Period) 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, 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:

PARTICIPATION ELECTIONS. Salary Deferral Elections I hereby apply for Participation in the above-named 403(b457(b) Plan and direct my employer to withhold through payroll reduction the following amounts from each pay. I understand this election will be applied to future contributions only and will remain in effect until I direct new elections through the Plan’s Internet or Voice Response System. NOTE: I understand that if I am 50 years of age or will reach the age of 50 during this calendar year any contribution deferrals in excess of the traditional salary will be applied to the Age 50 Catch-up option. Election to Defer Participation 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 Number (Required) Amount to Traditional 403(b457(b) (Per Pay Period) AXA Equitable Xxxxxx Xxxx Insurance Co. Xxxxx-Xxxxxxxx Lincoln Investment Planning Security Benefit Total Participant Name Social Security No. 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(b457(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:

PARTICIPATION ELECTIONS. Salary Deferral Elections I hereby apply for Participation in the above-named 403(b) Plan and direct my employer to withhold through payroll reduction the following amounts from each pay. I understand this election will be applied to future contributions only and will remain in effect until I direct new elections through the Plan’s Internet or Voice Response System. NOTE: I understand that if I am 50 years of age or will reach the age of 50 during this calendar year any contribution deferrals in excess of the traditional salary will be applied to the Age 50 Catch-up option. Election to Defer Participation 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 Xxxxxxxxxxx Funds Investment Elections (Continued) Fund Name Amount to Traditional 403(b) (Per Pay Period) 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, 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:

PARTICIPATION ELECTIONS. Salary Deferral Elections I hereby apply for Participation in the above-named 403(b) Plan and direct my employer to withhold through payroll reduction the following amounts from each pay. I understand this election will be applied to future contributions only and will remain in effect until I direct new elections through the Plan’s Internet or Voice Response System. NOTE: I understand that if I am 50 years of age or will reach the age of 50 during this calendar year any contribution deferrals in excess of the traditional salary will be applied to the Age 50 Catch-up option. Election to Defer Participation 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 - R3 Ameriprise Financial Services Great American Financial Resources Xxxxxx Xxxx Insurance Co. Lincoln Investment Planning MetLife MetLife Insurance Company USA Xxxxxxxxxxx Funds The Legend Group Total 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: