EXHIBIT 10.9
PARTICIPATION AGREEMENT AND DEFERRAL ELECTION
U.S.FILTER
Management Deferred Compensation Plan
* * *
1997
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Please print your full name below: Print your Social Security Number below:
_________________________________ ________________________________________
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This Agreement is entered into between United States Filter Corporation (the
"Company") and the Employee, pursuant to the United States Filter Corporation
Management Deferred Compensation Plan (the "Plan").
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1. Provisions of the Plan
I hereby acknowledge receipt of a copy of the Plan Highlights. In addition, I
acknowledge having read and understood the provisions of the Plan respecting the
entitlement to and calculation of benefits, and that the Plan may be amended or
terminated only by the Board of Directors at any time in accordance with its
terms. All of the terms and conditions of the Plan are contained in the Plan
Document.
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2. Election to Participate
I hereby elect to defer the following portion of my compensation, which is to be
credited to my Account (minimum annual total deferral of $5,000; specify a
dollar or percentage amount):
Deferral of Base Compensation: You may defer up to 25% of your total 1997
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base compensation.
__________ of annual base compensation, (optional) not to exceed: $_______.
Deferral of Bonus: Beginning in the December enrollment period you will be
able to defer bonuses.
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3. Expected Deferral Level
For Company planning purposes, I expect to defer the following amounts and
understand that this estimate is non-binding (minimum annual total deferral of
$5,000; specify a dollar or percentage amount. Although you will not be
permitted to make your election to defer bonuses until the December enrollment
period, please estimate how much of your bonus you will likely elect defer in
December.):
Salary:____________ for _______ years beginning in 1998.
Bonus: ____________ for _______ years beginning in 1998.
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4. Investment Selection
I hereby designate the following investment selection for amounts to be
contributed to my Account and acknowledge that I may change my investment mix on
a quarterly basis. I also acknowledge that no money is actually being
contributed to the funds I designate, and that my investment selection is used
solely as an index for determining earnings or losses on my Account. (Investment
allocations must be in whole percents, and your total investment allocation must
equal 100%. See the Portfolio Roadmap accompanying your enrollment materials and
the Manulife prospectus for complete information about each portfolio.)
Equity Index, Balanced and Equity funds: Money Market and Fixed Income funds:
Equity Index (S&P 500): % Money Market (Manulife): %
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Balanced fund (Founders): % Investment Quality Bond (Wellington): %
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Value Fund (MAS*): % Strategic Bond (Solomon Brothers): %
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Blue Chip Growth Fund (X. Xxxx Price): % High Yield Bond (MAS*): %
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Emerging Growth (Xxxxxxx Xxxxxx): % Real Estate Securities (Manulife): %
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Science & Technology (X. Xxxx Price): %
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Worldwide Growth (Founders): %
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International Stock Fund (X. Xxxx Price): % * Xxxxxx Xxxxxxxx & Xxxxxxxx, LLP
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(over)
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5. Retirement Income Benefit
I acknowledge that this election may be changed no more than once yearly, and
that it must be at least one year prior to the first day of the year of my
retirement to make a change. I further acknowledge that, under Treasury
Department regulations adopted in 1996, there may be potential adverse income
tax consequences if I elect to receive a lump sum of 5 annual payments (see the
Plan Highlights, question 30). I hereby request that my Retirement Income
Benefit be paid in the following manner (check one);
[_] Lump-sum Payment [_] 5 Annual Payments* [_] 10 Annual Payments*
[_] 15 Annual Payments*
* If you choose a stream of payments, your declining Account balance will
continue to earn interest based upon your chosen investment mix. If, at
retirement or any time after retirement, you wish to change your designation
from annual payments to a sump-sum payment, your distribution will be subject
to a 10% penalty, which will be forfeited to the Company.
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6. In-service Distributions
I hereby elect to receive payments from this Plan as specified below. Any
amounts not paid as in-service, termination or survivor benefit distributions
are paid as retirement benefits pursuant to my Retirement Income Benefit
election in item 5. In addition, I acknowledge that I may not receive more than
one In-service Distribution in any one calendar year and that all In-service
Distributions are subject to income taxes in effect during the year received.
(If more space is needed, attach a separate sheet. Distributions may be
scheduled for any date on or after January 1, 2000. Note that this is an
election you may only make upon your initial enrollment in the Plan; therefore,
you should take into account the amount of future deferrals you will make when
scheduling your In-service Distributions.)
Amount of Distribution
Distribution Date (mo/yr) (specify either a dollar or percentage amount)
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___________/_____________ _____________________ of Account Balance.
___________/_____________ _____________________ of Account Balance.
___________/_____________ _____________________ of Account Balance.
___________/_____________ _____________________ of Account Balance.
Note: At any time, you may, at your sole discretion, withdrawn up to an amount
equal to your Account Balance minus a penalty of 10% of the amount
withdrawn (the amount of the penalty is forfeited to the Company). You may
also extend or cancel any In-service Distribution at least one year prior
to the first day of the calendar year in which the originally scheduled
distribution would take place.
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7. Pre-retirement Termination Payout
I hereby request that, in the event that I terminate employment with the
Company for reasons other than death or disability prior to eligibility for
retirement benefits, my Account Balance should be paid in the following manner
and acknowledge that I may not change this election after I make it (check one):
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[_] Lump sum [_] 3 annual installments*
* Your Account Balance will continue to earn interest based upon your chosen
investment mix, and you will be permitted to change your investment mix
quarterly.
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8. Acknowledgement of Benefits
I hereby agree on my own behalf and on behalf of ny Beneficiaries to accept
those benefits under the Plan to which I and my Beneficiaries may become
entitled and to be bound by all of the terms and conditions of the Plan. I
acknowledge that I may look solely to the Company for payment of all benefits
under the Plan and that, to the extent that the Company has set aside any assets
to pay benefits in the future, the assets are subject to the claims of general
creditors of the Company.
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Employee Signature Date
_______________________________________________________________________
Employer Signature Title Date
Please send this form to:
Xxx Xxxxxxx
Vice President Human Resources
United States Filter Corporation
00-000 Xxxx Xxxxxx
Xxxx Xxxxxx, XX 00000
