Common use of SRA Clause in Contracts

SRA. You must list all new and existing 403(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount Type of Deferrals Requested Action Effective Date** Pre-Tax 403(b) Xxxx 403(b) Other $ New Change Existing Cancel 1, 2022 $ New Change Existing Cancel 1, 2022 $ New Change Existing Cancel 1, 2022 Total Monthly Contributions *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at xxx.xxxxxxxxxxx.xxx/000x for a current listing of providers that have agreed to pay the fee. **Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.

SRA. You must list all new and existing 403(b457(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount or Type of Deferrals Requested Action Effective Percentage Amount 457(b) Xxxx 457(b) Other New Existing Date** Pre-Tax 403(b) Xxxx 403(b) Other $ New or % Change Existing Cancel 1, 2022 New Existing $ New or % Change Existing Cancel 1, 2022 New Existing $ New or % Change Existing Cancel 1, 2022 Total Monthly Contributions *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at xxx.xxxxxxxxxxx.xxx/000x for a current listing of providers that have agreed to pay cover the fee. **Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.

SRA. You must list all new and existing 403(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount Type of Deferrals Requested Action Effective Date** Pre-Tax 403(b) Xxxx 403(b) Other $ New Change Existing Cancel 1, 2022 2021 $ New Change Existing Cancel 1, 2022 2021 $ New Change Existing Cancel 1, 2022 2021 Total Monthly Contributions *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at xxx.xxxxxxxxxxx.xxx/000x for a current listing of providers that have agreed to pay the fee. **Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.

SRA. You must list all new and existing 403(b457(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount Type of Deferrals Requested Action Effective Amount 457(b) Xxxx 457(b) Other New Existing Date** Pre-Tax 403(b) Xxxx 403(b) Other $ New Change Existing Cancel 1, 2022 New Existing $ New Change Existing Cancel 1, 2022 New Existing $ New Change Existing Cancel 1, 2022 Total Monthly Contributions *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at xxx.xxxxxxxxxxx.xxx/000x for a current listing of providers that have agreed to pay cover the fee. **Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.

SRA. You must list all new and existing 403(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount Type of Deferrals Requested Action Effective Date** Amount Pre-Tax 403(b) Xxxx 403(b) Other New Existing Date** $ New Change Existing Cancel 1, 2022 2021 New Existing $ New Change Existing Cancel 1, 2022 2021 New Existing $ New Total Monthly Contributions Change Existing Cancel 1, 2022 Total Monthly Contributions 2021 *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at xxx.xxxxxxxxxxx.xxx/000x for a current listing of providers that have agreed to pay the fee. **Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.

SRA. You must list all new and existing 403(b457(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount or Type of Deferrals Requested Action Effective Percentage Amount 457(b) Xxxx 457(b) Other New Existing Date** Pre-Tax 403(b) Xxxx 403(b) Other $ New or % Change Existing Cancel 1, 2022 2021 New Existing $ New or % Change Existing Cancel 1, 2022 2021 New Existing $ New or % Change Existing Cancel 1, 2022 2021 Total Monthly Contributions *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at xxx.xxxxxxxxxxx.xxx/000x for a current listing of providers that have agreed to pay cover the fee. **Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.

SRA. You must list all new and existing 403(b457(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount or Type of Deferrals Requested Action Effective Percentage Amount 457(b) Xxxx 457(b) Other New Existing Date** Pre-Tax 403(b) Xxxx 403(b) Other $ or % Change Cancel New Existing $ or % Change Cancel New Existing $ or % Change Cancel 1, 2022 $ New Change Existing Cancel 1, 2022 $ New Change Existing Cancel 1, 2022 Total Monthly Contributions *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at xxx.xxxxxxxxxxx.xxx/000x for a current listing of providers that have agreed to pay cover the fee. **Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.

SRA. You must list all new and existing 403(b) deductions on this SRA form or they will be cancelled. The salary reductions identified in the space below will be the only deductions performed starting on the Effective Date. Investment Provider Name* Monthly Dollar Amount or Type of Deferrals Requested Action Effective Date** Percentage Amount Pre-Tax 403(b) Xxxx 403(b) Other New Existing Date** $ New or % Change Existing Cancel 1, 2022 New Existing $ New or % Change Existing Cancel 1, 2022 New Existing $ New or % Total Monthly Contributions Change Existing Cancel 1, 2022 Total Monthly Contributions *Please Note: Certain investment providers may not pay the administration fee. If you select an investment provider that does not pay the administration fee, the fee will be deducted and paid from your salary reduction amount. Please refer to the approved vendor list at xxx.xxxxxxxxxxx.xxx/000x for a current listing of providers that have agreed to pay the fee. *** Please submit the SRA to NBS 5 business days prior to the SRA due date to ensure your contributions begin as you intended.