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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Xxxx 403(b) Other New Existing 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.

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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount 457(b) Xxxx 403(b457(b) Other New Existing Date** $ or % Change Cancel 1, 2022 $ or % Change Cancel 1, 2022 $ or % Change 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** *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Dollar Amount Pre-Tax 403(b) Xxxx 403(b) Other New Existing 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.

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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Xxxx 403(b) Other New Existing Date** $ Change Cancel 1, 2021 $ Change Cancel 1, 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(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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Xxxx Pre-Tax 403(b) Other New Existing Date** $ or % Change Cancel 1, 2022 $ or % Change Cancel 1, 2022 $ or % 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(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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Xxxx 403(b) Other New Existing Date** $ Change Cancel 1, 2022 $ Change 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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Xxxx 403(b457(b) Other New Existing Date** $ Change Cancel 1, 2022 $ Change Cancel 1, 2022 $ Change 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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Xxxx 403(b) Other New Existing SRA Due Date from employer website prior to desired payroll date % 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.

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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount 457(b) Xxxx 403(b457(b) Other New Existing Date** $ or % $ or % $ or % 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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Pre-Tax 403(b) Xxxx 403(b) Other New Existing Date** $ or % Change Cancel 1, 2020 $ or % Change Cancel 1, 2020 $ or % 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(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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Pre-Tax 403(b) Xxxx 403(b) Other New Existing Date** $ or % Change Cancel 1, 2022 $ or % Change Cancel 1, 2022 $ or % 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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount 457(b) Xxxx 403(b457(b) Other New Existing Date** $ or % Change Cancel 1, 2021 $ or % Change Cancel 1, 2021 $ or % Change Cancel 1, 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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Xxxx 403(b457(b) Other New Existing SRA Due Date from emloyer website prior to desired payroll date % 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.

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* *I have established *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date Amount Xxxx 403(b) Other New Existing Date** $ Change Cancel 1, 2021 $ Change Cancel 1, 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.