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 an account with this vendor Amount Pre-Tax 403(b) Xxxx 403(b) Other New Existing SRA Due Date from website prior to desired payroll date $ or % Change Cancel New Existing $ or % Change Cancel New Existing Total Monthly Contributions $ or % Change Cancel *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 an account with this vendor Amount Pre-Tax 403(b) Xxxx 403(b) Other New Existing SRA Due Date from employer website prior to desired payroll date % $ or % Change Cancel New Existing $ or % Change Cancel New Existing Total Monthly Contributions $ or % Change Cancel *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 an account with this vendor Amount Pre-Tax 403(b457(b) Xxxx 403(b457(b) Other New Existing SRA Due Date from emloyer website prior to desired payroll date % $ or % Change Cancel New Existing $ or % Change Cancel New Existing Total Monthly Contributions $ or % Change Cancel *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 an *Monthly Dollar or Percentage *Type of Deferrals *Requested Action *Effective Date an Name** established account with this vendor Percentage Amount Pre-Tax 403(b) Xxxx 403(b) Other New Existing Date SRA Due Date from website prior to desired payroll date $ or % Change Cancel New Existing $ or % Change Cancel New Existing Total Monthly Contributions $ or % Change Cancel **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 an account with this vendor Amount Pre-Tax 403(b457(b) Xxxx 403(b457(b) Other New Existing SRA Due Date from website prior to desired payroll date % $ or % Change Cancel New Existing $ or % Change Cancel New Existing Total Monthly Contributions $ or % Change Cancel *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 an account with this vendor Amount Pre-Tax 403(b457(b) Xxxx 403(b457(b) Other New Existing SRA Due Date from website prior to desired payroll date $ or % Change Cancel New Existing $ or % Change Cancel New Existing Total Monthly Contributions $ or % Change Cancel **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.