EXHIBIT 4.3
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ADOPTION AGREEMENT FOR
AUTOMATIC DATA PROCESSING
NON-STANDARDIZED 401(K) PLAN
The undersigned Employer adopts Automatic Data Processing Prototype Non-
Standardized 401(k) Plan and elects the following provisions:
CAUTION: Failure to properly fill out this Adoption Agreement may result
in disqualification of the Plan.
EMPLOYER INFORMATION
(An amendment to the Adoption Agreement is not needed solely to reflect a
change in the information in this Employer Information Section.)
1. EMPLOYER'S NAME, ADDRESS AND TELEPHONE NUMBER
Name: XXXXXXXX, INC.
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Address: 0 XXXXXXX XXXX
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Xxxxxx
XXXXXXXX XX 00000
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City State Zip
Telephone: (000) 000-0000
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2. Date of incorporation or date business began: 06/01/1954
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3. EMPLOYER'S TAXPAYER IDENTIFICATION NUMBER 00-0000000
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4. TYPE OF ENTITY
a. [ x ] Corporation (including Tax-exempt or Non-profit
Corporation)
b. [ ] Professional Service Corporation
c. [ ] S Corporation
d. [ ] Limited Liability Company that is taxed as:
1. [ ] a partnership or sole proprietorship
2. [ ] a Corporation
3. [ ] an S Corporation
e. [ ] Sole Proprietorship
f. [ ] Partnership (including Limited Liability)
g. [ ] Other:
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AND, the Employer is a member of (select all that apply):
h. [ x ] a controlled group
i. [ ] an affiliated service group
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5. EMPLOYER FISCAL YEAR means the 12 consecutive month period:
Beginning on October 01 (e.g., January 1st)
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month day
and ending on September 30
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month day
PLAN INFORMATION
(An amendment to the Adoption Agreement is not needed solely to
reflect a change in the information in Questions 9. through 11.)
6. PLAN NAME:
XXXXXXXX, INC. 401(k) RETIREMENT PLAN
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7. EFFECTIVE DATE
a. [ ] This is a new Plan effective as of __/__/__ (hereinafter
called the "Effective Date").
b. [ x ] This is an amendment and restatement of a previously
established qualified plan of the Employer which was
originally effective 01/01/1993 (hereinafter called the
"Effective Date"). The effective date of this
amendment and restatement is 08/01/2004.
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c. [ ] FOR GUST RESTATEMENTS: This is an amendment and
restatement of a previously established qualified plan of
the Employer to bring the Plan into compliance with GUST
(GATT, USERRA, SBJPA and TRA '97). The original Plan
effective date was __________(hereinafter called the
"Effective Date"). Except as specifically provided in the
Plan, the effective date of this amendment and
restatement is __________.
(May enter a restatement date that is the first day of
the current Plan Year. The Plan contains appropriate
retroactive effective dates with respect to provisions
for the appropriate laws.)
8. PLAN YEAR means the 12 consecutive month period:
Beginning on January 01 (e.g., January 1st)
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month day
and ending on December 31
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month day
EXCEPT that there will be a Short Plan Year:
a. [ x ] N/A
b. [ ] beginning on (e.g., July 1, 2000)
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month day, year
and ending on
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month day, year
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9. PLAN NUMBER assigned by the Employer
a. [ ] 001
b. [ ] 002
c. [ x ] 003
d. [ ] Other: __________
10. TRUSTEE:
Name: State Street Bank & Trust Co.
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Address: 000 Xxxxxxx Xxxxxx
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Xxxxxx
Xxxxx Xxxxxx XX 00000
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City State Zip
Telephone: (000) 000-0000
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An executed copy of the trust agreement between the Trustee and the
Employer must be completed in accordance with Plan Section 7.1 and
attached to this Plan. The Plan and trust agreement will be read and
construed together. The responsibilities, rights and powers of the
Trustee shall be those specified in the trust agreement.
11. PLAN ADMINISTRATOR'S NAME, ADDRESS AND TELEPHONE NUMBER:
(If none is named, the Employer will become the Administrator.)
a. [ x ] Employer (Use Employer address and telephone number).
b. [ ] Use name, address and telephone number below:
Name:
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Address:
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City State Zip
Telephone:
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12. CONSTRUCTION OF PLAN
This Plan shall be governed by the laws of the state or commonwealth
where the Employer's principal place of business is located unless
another state or commonwealth is specified:
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ELIGIBILITY REQUIREMENTS
13. ELIGIBLE EMPLOYEES (Plan Section 1.18)
FOR ALL PURPOSES OF THE PLAN, means all Employees (including Leased
Employees) EXCEPT:
a. [ ] N/A. No exclusions.
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b. [ x ] The following are excluded, except that if b.3. is
selected, such Employees will be included (select all
that apply):
1. [ x ] Union Employees (as defined in Plan Section
1.18)
2. [ ] Non-resident aliens (as defined in Plan
Section 1.18)
3. [ ] Employees who became Employees as the result
of a "Code Section 410(b)(6)(C) transaction"
(as defined in Plan Section 1.18)
4. [ ] Salaried Employees
5. [ ] Highly Compensated Employees
6. [ ] Leased Employees
7. [ ] Other: ____________________
14. THE FOLLOWING AFFILIATED EMPLOYER (Plan Section 1.6) will adopt this
Plan as a Participating Employer (if there is more than one, or if
Affiliated Employers adopt this Plan after the date the Adoption
Agreement is executed, attach a list to this Adoption Agreement of
such Affiliated Employers including their names, addresses and
taxpayer identification numbers).
NOTE: Employees of an Affiliated Employer that does not adopt this
Adoption Agreement as a Participating Employer shall not be
Eligible Employees. This Plan could violate the Code Section
410(b) coverage rules if all Affiliated Employers do not adopt
the Plan.
a. [ ] N/A
b. [ x ] Name of First Affiliated Employer:
HOMEBUYERS PREFERED INC
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Address: 0 XXXXXXX XXXX
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Xxxxxx
XXXXXXXX XX 00000
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City State Zip
Telephone: (000) 000-0000
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Taxpayer
Identification
Number: 00-0000000
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15. CONDITIONS OF ELIGIBILITY (Plan Section 3.1)
Any Eligible Employee will be eligible to participate in the Plan
upon satisfaction of the conditions set forth below, if any:
NOTE: If the Year(s) of Service selected is or includes a fractional
year, an Employee will not be required to complete any
specified number of Hours of Service to receive credit for such
fractional year. If expressed in months of service, an Employee
will not be required to complete any specified number of Hours
of Service in a particular month, unless elected in b.4. or
h.4. below.
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ELIGIBILITY FOR ALL PURPOSES OF THE PLAN (EXCEPT AS ELECTED IN e.-j.
BELOW FOR EMPLOYER CONTRIBUTIONS) (select either a. OR b. and c., and
if applicable, d.):
a.-d., below, apply to:
[ ] Elective Deferrals and if applicable, Employee Voluntary
Contributions
[ x ] All purposes of the Plan
a. [ ] No age or service required. (Go to e.-f. below)
b. [ x ] Completion of the following service requirement which is
based on Years of Service (or Periods of Service if the
Elapsed Time Method is elected):
1. [ ] No service requirement
2. [ ] 1/2 Year of Service or Period of Service
3. [ ] 1 Year of Service or Period of Service
4. [ ] ______ (not to exceed 1,000) Hours of Service
within ______ (not to exceed 12) months from
the Eligible Employee's employment
commencement date. If an Employee does not
complete the stated Hours of Service during
the specified time period, the Employee is
subject to the Year of Service requirement in
b.3. above.
5. [ x ] Other: 6 month(s)
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(may not exceed one (1) Year of Service or Period
of Service; must be expressed in whole months)
c. [ x ] Attainment of age:
1. [ ] No age requirement
2. [ ] 20 1/2
3. [ x ] 21
4. [ ] Other: __________ (may not exceed 21)
d. [ ] The service and/or age requirements specified above shall
be waived with respect to any Eligible Employee who was
employed on __________ and such Eligible Employee shall
enter the Plan as of such date.
HOWEVER, DIFFERENT ELIGIBILITY CONDITIONS WILL APPLY (select one):
e. [ x ] N/A. The options selected in a.- d. above apply for all
purposes of the Plan.
f. [ ] For purposes of all Employer contributions other than
Elective Deferrals . . .
If f. IS SELECTED, the following eligibility conditions apply for
such purposes (select g. OR h. and i., and if applicable j.:
g. [ ] No age or service requirements
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h. [ ] Completion of the following service requirement which is
based on Years of Service (or Periods of Service if the
Elapsed Time Method is elected):
1. [ ] No service requirement
2. [ ] 1/2 Year of Service or Period of Service
3. [ ] 1 Year of Service or Period of Service
4. [ ] __________ (not to exceed 1,000) Hours of
Service within __________ (not to exceed 12)
months from the Eligible Employee's
employment commencement date. If an Employee
does not complete the stated Hours of Service
during the specified time period, the
Employee is subject to the Year of Service
requirement in h.3. above.
5. [ ] 1 1/2 Years of Service or Periods of Service
6. [ ] 2 Years of Service or Periods of Service
7. [ ] Other: __________
(may not exceed two (2) Years of Service or
Periods of Service)
NOTE: If more than one (1) Year of Service is elected,
100% immediate vesting is required.
i. [ ] Attainment of age:
1. [ ] No age requirement
2. [ ] 20 1/2
3. [ ] 21
4. [ ] Other: __________ (may not exceed 21)
j. [ ] The service and/or age requirements specified above shall
be waived with respect to any Eligible Employee who was
employed on __/__/__ and such Eligible Employee shall
enter the Plan as of such date.
16. EFFECTIVE DATE OF PARTICIPATION (Plan Section 3.2)
An Eligible Employee who has satisfied the eligibility requirements
will become a Participant for all purposes of the Plan (except as
elected in h. - p. below for Employer contributions):
a., b., c., d., e. or f. applies to:
[ ] Employee Deferrals and if applicable, Employee Voluntary
Contributions
[ x ] All purposes of the Plan
a. [ ] as soon as administratively feasible following the date
on which such requirements are satisfied.
b. [ x ] the first day of the month coinciding with or next
following the date on which such requirements are
satisfied.
c. [ ] the first day of the plan year quarter coinciding with or
next following the date on which such requirements are
satisfied.
d. [ ] the earlier of the first day of the seventh month or the
first day of the Plan Year coinciding with or next
following the date on which such requirements are
satisfied.
e. [ ] the first day of the Plan Year next following the date on
which such requirements are satisfied. (Eligibility must
be 1/2 Year of Service (or Period of Service) or less and
age must be 20 1/2 or less.)
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f. [ ] other: _________,
NOTE: If a. or f. is selected an Eligible Employee who
has satisfied the maximum age (21) and service
requirements (one (1) Year or Period of Service) and who
is otherwise entitled to participate, shall commence
participation no later than the earlier of (a) 6 months
after such requirements are satisfied, or (b) the first
day of the first Plan Year after such requirements are
satisfied, unless the Employee separates from service
before such participation date.
HOWEVER, different entry dates will apply (select one):
g. [ x ] N/A. The options elected in a.-f. above apply for all
purposes of the Plan.
h. [ ] For purposes of all Employer contributions other than
Elective Deferrals
IF h. IS SELECTED, the following entry dates apply for such purposes
(select one):
i. [ ] as soon as administratively feasible following the date
on which such requirements are satisfied.
j. [ ] the first day of the month coinciding with or next
following the date on which such requirements are
satisfied.
k. [ ] the first day of the plan year quarter coinciding with or
next following the date on which such requirements are
satisfied.
l. [ ] the first day of the Plan Year in which such requirements
are satisfied.
m. [ ] the first day of the Plan Year in which such requirements
are satisfied, if such requirements are satisfied in the
first 6 months of the Plan Year, or as of the first day
of the next succeeding Plan Year if such requirements are
satisfied in the last 6 months of the Plan Year.
n. [ ] the earlier of the first day of the seventh month or the
first day of the Plan Year coinciding with or next
following the date on which such requirements are
satisfied.
o. [ ] the first day of the Plan Year next following the date on
which such requirements are satisfied. (Eligibility must
be 1/2 (or 1 1/2 if 100% immediate Vesting is selected)
Year of Service (or Period of Service) or less and age
must be 20 1/2 or less.)
p. [ ] other: ____________________,
NOTE: If i. or p. is selected, an Eligible Employee who
has satisfied the maximum age (21) and service
requirements (one (1) Year or Period of Service (or more
than one (1) year if full and immediate vesting)) and who
is otherwise entitled to participate, shall commence
participation no later than the earlier of (a) 6 months
after such requirements are satisfied, or (b) the first
day of the first Plan Year after such requirements are
satisfied, unless the Employee separates from service
before such participation date.
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SERVICE
17. RECOGNITION OF SERVICE WITH PREDECESSOR EMPLOYER (Plan Sections 1.57
and 1.85)
a. [ x ] No service with a predecessor Employer shall be
recognized.
b. [ ] Service with ____________________
will be recognized except as follows (select 1. or all that
apply of 2. through 4.):
1. [ ] N/A, no limitations.
2. [ ] service will only be recognized for vesting
purposes.
3. [ ] service will only be recognized for eligibility
purposes.
4. [ ] service prior to ___/___/___ will not be
recognized.
NOTE: If the predecessor Employer maintained this qualified
Plan, then Years of Service (and/or Periods of Service)
with such predecessor Employer shall be recognized
pursuant to Plan Sections 1.57 and 1.85 and b.1. will
apply.
18. SERVICE CREDITING METHOD (Plan Sections 1.57 and 1.85)
NOTE: If no elections are made in this Question, then the Hours of
Service Method will be used and the provisions set forth in the
definition of Year of Service in Plan Section 1.85 will apply.
ELAPSED TIME METHOD shall be used for the following purposes (select
all that apply):
a. [ ] N/A. Plan only uses the Hours of Service Method.
b. [ ] eligibility to participate and vesting. (If selected,
skip to Question 19.)
c. [ x ] eligibility to participate.
d. [ ] vesting.
NOTE: Elapsed time method should not be selected for purposes of
determining eligibility to participate if option 4. is selected under
Question 15.b.
HOURS OF SERVICE METHOD shall be used for the following purposes
(select all that apply):
e. [ x ] N/A. Plan only uses the Elapsed Time Method.
f. [ ] eligibility to participate in the Plan. The eligibility
computation period after the initial eligibility
computation period shall...
1. [ ] shift to the Plan Year after the initial
computation period.
2. [ ] be based on the date an Employee first
performs an Hour of Service (initial
computation period) and subsequent
computation periods shall be based on each
anniversary date thereof.
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g. [ ] vesting. The vesting computation period shall be...
1. [ ] the Plan Year.
2. [ ] the date an Employee first performs an Hour
of Service and each anniversary thereof.
NOTE: IF THE HOURS OF SERVICE METHOD IS BEING USED, the Hours of
Service method will be used for all Employees.
ON THE BASIS OF:
h. [ ] actual hours for which an Employee is paid or entitled to
payment.
i. [ ] months worked. An Employee will be credited with one
hundred ninety (190) Hours of Service if under the Plan
such Employee would be credited with at least one (1)
Hour of Service during the month.
AND, a Year of Service means the applicable computation period during
which an Employee has completed at least:
j. [ ] __________ (may not be more than 1,000) Hours of Service
(if left blank, the Plan will use 1,000 Hours of
Service).
VESTING
19. VESTING OF PARTICIPANT'S INTEREST (Plan Section 6.4(b))
Vesting for Employer Contributions (except as otherwise elected in
j.-q. below for matching contributions). The vesting schedule, based
on a Participant's Years of Service (or Periods of Service if the
Elapsed Time Method is elected), shall be as follows:
a. [ x ] 100% upon entering Plan. (Required if eligibility
requirement is greater than one (1) Year of Service or
Period of Service.)
b. [ ] 3 Year Cliff:
0-2 years 0%
3 years 100%
c. [ ] 5 Year Cliff:
0-4 years 0%
5 years 100%
d. [ ] 6 Year Graded:
0-1 year 0%
2 years 20%
3 years 40%
4 years 60%
5 years 80%
6 years 100%
e. [ ] 4 Year Graded:
1 year 25%
2 years 50%
3 years 75%
4 years 100%
f. [ ] 5 Year Graded:
1 year 20%
2 years 40%
3 years 60%
4 years 80%
5 years 100%
7 years 100%
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g. [ ] 7 Year Graded:
0-2 years 0%
3 years 20%
4 years 40%
5 years 60%
6 years 80%
7 years 100%
h. [ ] Other - Must be at least as liberal as either c. or g.
above.
Service Percentage
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VESTING FOR EMPLOYER MATCHING CONTRIBUTIONS
The vesting schedule for Employer matching contributions, based on a
Participant's Years of Service (or Periods of Service if the Elapsed
Time Method is elected) shall be as follows:
i. [ x ] N/A. There are no matching contributions subject to a
vesting schedule OR the schedule in a.-h. above shall
also apply to matching contributions.
j. [ ] 100% upon entering Plan. (Required if eligibility
requirement is greater than one (1) Year of Service or
Period of Service.)
k. [ ] 3 Year Xxxxx
x. [ ] 5 Year Xxxxx
x. [ ] 6 Year Graded
n. [ ] 4 Year Graded
o. [ ] 5 Year Graded
p. [ ] 7 Year Graded
q. [ ] Other - Must be at least as liberal as either l. or p.
above.
Service Percentage
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20. FOR AMENDED PLANS (Plan Section 6.4(f))
If the vesting schedule has been amended to a less favorable
schedule, enter the pre-amended schedule below:
a. [ x ] Vesting schedule has not been amended, amended schedule
is more favorable in all years or prior schedule was
immediate 100% vesting.
b. [ ] Pre-amended schedule:
Service Percentage
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21. TOP HEAVY VESTING (Plan Section 6.4(c))
If this Plan becomes a Top Heavy Plan, the following vesting
schedule, based on number of Years of Service (or Periods of Service
if the Elapsed Time Method is elected), shall apply and shall be
treated as a Plan amendment pursuant to this Plan. Once effective,
this schedule shall also apply to any contributions made before the
Plan became a Top Heavy Plan and shall continue to apply if the Plan
ceases to be a Top Heavy Plan unless an amendment is made to change
the vesting schedule.
a. [ x ] N/A (the regular vesting schedule already satisfies one
of the minimum top heavy schedules).
b. [ ] 6 Year Graded:
0-1 year 0%
2 years 20%
3 years 40%
4 years 60%
5 years 80%
6 years 100%
c. [ ] 3 Year Cliff:
0-2 years 0%
3 years 100%
d. [ ] Other - Must be at least as liberal as either b. or c.
above.
Service Percentage
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22. EXCLUDED VESTING SERVICE
a. [ x ] No exclusions.
b. [ ] Service prior to the Effective Date of the Plan or a
predecessor plan.
23. NORMAL RETIREMENT AGE ("NRA") (Plan Section 1.45) means the:
date of a Participant's 65.0 birthday (not to exceed 65th).
24. EARLY RETIREMENT DATE (Plan Section 1.15) means the:
a. [ ] No Early Retirement provision provided.
b. [ x ] date on which a Participant...
1. [ ] attains age __________.
2. [ x ] attains age 55.0 and completes at least
10 Years of Service (or Periods of Service)
for vesting purposes.
COMPENSATION
25. COMPENSATION (Plan Section 1.11) with respect to any Participant
means one of the following, each as modified to include all amounts
specified in Section 1.11:
a. [ x ] Wages, tips and other compensation on Form W-2.
b. [ ] Section 3401(a) wages (wages for withholding purposes).
c. [ ] 415 safe-harbor compensation.
ADJUSTMENTS TO COMPENSATION
d. [ ] N/A. No adjustments.
e. [ x ] Compensation shall be adjusted by: (select all that
apply)
1. [ x ] excluding reimbursements or other expense
allowances, fringe benefits (cash or non
cash), moving expenses, deferred compensation
(other than deferrals specified in 1. above)
and welfare benefits
2. [ ] excluding Compensation paid during the
determination period while not a Participant
in the component of the Plan for which the
definition is being used
3. [ ] excluding overtime
4. [ ] excluding bonuses
5. [ ] excluding commissions
6. [ x ] other: EXCESS LIFE INSURANCE & STOCK
OPTIONS OR GRANTS
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NOTE: Options 3., 4., 5., or 6. may not be selected if an
integrated allocation formula is selected (i.e., if 30.e.
is selected). In addition, if 3., 4., 5., or 6. is
selected, the definition of Compensation could violate
the nondiscrimination rules.
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CONTRIBUTIONS AND ALLOCATIONS
26. SALARY REDUCTION ARRANGEMENT - ELECTIVE DEFERRALS (Plan Section 12.2)
Each Participant may elect to have Compensation deferred by:
a. [ x ] up to 20%.
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b. [ ] from __________% to __________%.
AND, Highly Compensated Employee may only elect to reduce
Compensation by:
c. [ x ] Same limits as specified above.
d. [ ] up to __________%.
e. [ ] from __________% to __________%.
MAY PARTICIPANTS make a special salary deferral election with respect
to bonuses?
f. [ ] No.
g. [ x ] Yes, a Participant may elect to defer up to 20% of
any bonus.
AUTOMATIC ELECTION: Shall Participants who do not affirmatively elect
to receive cash or have a specified amount contributed to the Plan
automatically have Compensation deferred?
h. [ x ] No.
i. [ ] Yes, by __________% of Compensation.
27. 401(k) SAFE HARBOR PROVISIONS (Plan Section 12.8)
Will the ADP and/or ACP test safe harbor provisions be used? (select
a., b. or c.)
a. [ x ] No. (If selected, skip to Question 28.)
b. [ ] Yes, but only the ADP (and NOT the ACP) Test Safe Harbor
provisions will be used.
c. [ ] Yes, both the ADP and ACP Test Safe Harbor provisions
will be used.
IF c. is selected, does the Plan permit matching contributions in
addition to any safe harbor contributions elected in d. or e. below?
1. [ ] No or N/A. Any matching contributions, other
than any Safe Harbor Matching Contributions
elected in d. below, will be suspended in any
Plan Year in which the safe harbor provisions
are used.
2. [ ] Yes, the Employer may make a discretionary
matching contribution in addition to any Safe
Harbor Matching Contributions elected in d.
below. (If elected, complete the applicable
provisions of the Adoption Agreement relating
to matching contributions (i.e., Questions
31. and 32.) that will apply in addition to
any elections made in d. below. NOTE:
Question 28 must be completed so that only
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Elective Deferrals up to 6% of Compensation
are taken into account in applying the match
set forth in that question and the maximum
discretionary matching contribution that may
be made on behalf of any Participant is no
greater than 4% of Compensation.)
THE EMPLOYER WILL MAKE THE FOLLOWING ADP TEST SAFE HARBOR
CONTRIBUTION FOR THE PLAN YEAR:
NOTE: The ACP Test Safe Harbor is automatically satisfied if the only
matching contribution made to the Plan is either (1) a Basic
Matching Contribution or (2) an Enhanced Matching Contribution
that does not provide a match on Elective Deferrals in excess
of 6% of Compensation.
d. [ ] Safe Harbor Matching Contribution (select 1. or 2. AND
3.)
1. [ ] BASIC MATCHING CONTRIBUTION. The Employer
will make Matching Contributions to the
account of each "Eligible Participant" in an
amount equal to the sum of 100% of the amount
of the Participant's Elective Deferrals that
do not exceed 3% of the Participant's
Compensation, plus 50% of the amount of the
Participant's Elective Deferrals that exceed
3% of the Participant's Compensation but do
not exceed 5% of the Participant's
Compensation.
2. [ ] ENHANCED MATCHING CONTRIBUTION. The Employer
will make Matching Contributions to the
account of each "Eligible Participant" in an
amount equal to the sum of:
a. [ ] __________% (must be at least
100%) of the Participant's
Elective Deferrals that do not
exceed _______% (if over 6% or if
left blank, the ACP test will
still apply) of the Participant's
Compensation, plus
b. [ ] __________% of the Participant's
Elective Deferrals that exceed
_______% of the Participant's
Compensation but do not exceed
_______% (if over 6% or if left
blank the ACP test will still
apply) of the Participant's
Compensation.
NOTE: a. and b. must be completed so that, at
any rate of Elective Deferrals, the
matching contribution is at least equal
to the matching contribution receivable
if the Employer were making Basic
Matching Contributions, but the rate of
match cannot increase as deferrals
increase. For example, if a. is
completed to provide a match equal to
100% of deferrals up to 4% of
Compensation, then b. need not be
completed.
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3. [ ] The safe harbor matching contribution will be
determined on the following basis (and
Compensation for such purpose will be based
on the applicable period):
a. [ ] the entire Plan Year.
b. [ ] each payroll period.
e. [ ] Nonelective Safe Harbor Contributions
The Employer will make a Safe Harbor Nonelective
Contribution to the account of each "Eligible
Participant" in an amount equal to ________% (may not be
less than 3%) of the Employee's Compensation for the Plan
Year.
SPECIAL EFFECTIVE DATE OF ADP AND ACP TEST SAFE HARBOR PROVISIONS
f. [ ] N/A. The safe harbor provisions are effective as of the
later of the Effective Date of this Plan or, if this is
an amendment or restatement, the effective date of the
amendment or restatement.
g. [ ] The ADP and ACP Test Safe Harbor provisions are effective
for the Plan Year beginning:
__/__/__ (enter the first day of the Plan Year for which
the provisions are (or, for GUST updates, were) effective
and, if necessary, enter any other special effective
dates that apply with respect to the provisions).
28. FORMULA FOR DETERMINING EMPLOYER MATCHING CONTRIBUTIONS (Plan Section
12.1(a)(2))
NOTE: If the ACP test safe harbor is being used (i.e., Question 27.c.
is selected), then this Question 28 must be completed as
follows: Any matching contribution under this Question 28 shall
be limited to a discretionary matching contribution. Question
28 must also be completed so that only Elective Deferrals up to
6% of Compensation are taken into account in applying the match
set forth below and the maximum discretionary matching
contribution that may be made on behalf of any Participant is
no greater than 4% of Compensation. The rate of matching
contributions may not increase as the rate of Elective
Deferrals increases.
a. [ ] N/A. There will not be any matching contributions (Skip
to Question 29).
b. [ x ] The Employer ... (select 1. or 2.)
1. [ x ] may make matching contributions equal to a
discretionary percentage (which may be
designated by each tier of Elective Deferrals
if applicable), to be determined by the
Employer, of the Participant's Elective
Deferrals.
2. [ ] will make matching contributions equal to
______% (e.g., 50) of the Participant's
Elective Deferrals, plus:
a. [ ] N/A.
b. [ ] an additional discretionary
percentage, to be determined by
the Employer.
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AND, in determining the matching contribution above, only
Elective Deferrals up to the percentage or dollar amount
specified below will be matched:
(select 3. and/or 4.)
3. [ ] ______% of a Participant's Compensation.
4. [ x ] a discretionary percentage of a Participant's
Compensation or a discretionary dollar
amount, the percentage or dollar amount to be
determined by the Employer on a uniform basis
to all Participants.
c. [ ] The Employer will make matching contributions equal to
the sum of ______% of the portion of the Participant's
Elective Deferrals which do not exceed ______% of the
Participant's Compensation plus _______% of the portion
of the Participant's Elective Deferrals which exceed
______% of the Participant's Compensation but does not
exceed ______% of the Participant's Compensation.
NOTE: If c. above is elected, the Plan may violate the Code Section
401(a)(4) nondiscrimination requirements if the rate of
matching contributions increases as a Participant's Elective
Deferrals or Years of Service (or Periods of Service) increase.
PERIOD OF DETERMINING MATCHING CONTRIBUTIONS
Matching contributions will be determined on the following basis (and
any Compensation or dollar limitation used in determining the match
will be based on the applicable period):
d. [ x ] the entire Plan Year.
e. [ ] each payroll period.
f. [ ] all payroll periods ending with or within each month
within the Plan Year.
g. [ ] all payroll periods ending with or within the Plan Year
quarter.
THE MATCHING CONTRIBUTION MADE ON BEHALF OF ANY PARTICIPANT for any
Plan Year will not exceed:
h. [ x ] N/A.
i. [ ] $_____.
MATCHING CONTRIBUTIONS WILL BE MADE ON BEHALF OF:
j. [ x ] all Participants.
k. [ ] only Non-Highly Compensated Employees.
29. ONLY PARTICIPANTS WHO SATISFY THE FOLLOWING CONDITIONS WILL BE
ELIGIBLE TO SHARE IN THE ALLOCATION OF MATCHING CONTRIBUTIONS:
REQUIREMENTS FOR PARTICIPANTS WHO ARE ACTIVELY EMPLOYED AT THE END OF
THE PLAN YEAR.
a. [ ] N/A.
b. [ x ] No service requirement.
c. [ ] A Participant must complete a Year of Service. (Could
cause the Plan to violate coverage requirements under
Code Section 410(b).)
16
d. [ ] A Participant must complete at least ______ (may not be
more than 1,000) Hours of Service during the Plan Year.
(Could cause the Plan to violate coverage requirements
under Code Section 410(b).)
REQUIREMENTS FOR PARTICIPANTS WHO ARE NOT ACTIVELY EMPLOYED AT THE
END OF THE PLAN YEAR
e. [ ] A Participant must complete more than ______ Hours of
Service (not more than 500).
f. [ ] A Participant must complete a Year of Service. (Could
cause the Plan to violate coverage requirements under
Code Section 410(b).)
g. [ ] Participants will NOT share in such allocations,
regardless of service. (Could cause the Plan to violate
coverage requirements under Code Section 410(b).)
h. [ x ] Participants will share in such allocations, regardless
of service.
NOTE: Participants who are not actively employed at the end of the
Plan Year due to death, Total and Permanent Disability or Early
or Normal Retirement shall be eligible to share in the
allocation of matching contributions regardless of the above
conditions.
AND, if 29.c., d., f., or g. is selected, shall the 410(b) ratio
percentage fail safe provisions apply (Plan Section 12.3(f))?
i. [ x ] No or N/A.
j. [ ] Yes (If selected, the Plan must satisfy the ratio
percentage test of Code Section 410(b)).
30. FORMULA FOR DETERMINING EMPLOYER'S PROFIT SHARING CONTRIBUTION (Plan
Section 12.1(a)(3))
a. [ ] N/A. No Employer Profit Sharing Contributions may be made
(other than top heavy minimum contributions)(Skip to
Question 32.)
b. [ x ] Discretionary, to be determined by the Employer, not
limited to current or accumulated Net Profits.
c. [ ] Discretionary, to be determined by the Employer, out of
current or accumulated Net Profits.
CONTRIBUTION ALLOCATIONS
If b. or c. above is selected, the Employer's discretionary profit
sharing contribution for a Plan Year will be allocated as follows:
d. [ x ] NON-INTEGRATED ALLOCATION
1. [ x ] In the same ratio as each Participant's
Compensation bears to the total of such
Compensation of all Participants.
2. [ ] In the same dollar amount to all Participants
(per capita).
3. [ ] In the same dollar amount per Hour of Service
completed by each Participant.
17
4. [ ] In the same proportion that each
Participant's points bears to the total of
such points of all Participants. A
Participant's points with respect to any Plan
Year shall be computed as follows (select all
that apply):
a. [ ] ______ point(s) shall be
allocated for each Year of
Service. However, the maximum
Years of Service taken into
account shall not exceed ______
(leave blank if no limit on
service applies).
b. [ ] point(s) shall be allocated for
each full $______ (may not exceed
$200) of Compensation.
c. [ ] ______ point(s) shall be
allocated for each year of age as
of the end of the Plan Year.
e. [ ] INTEGRATED ALLOCATION
In accordance with Plan Section 4.3(b)(2) based on a
Participant's Compensation in excess of:
1. [ ] The Taxable Wage Base.
2. [ ] ______% (not to exceed 100%) of the Taxable
Wage Base. (See Note below)
3. [ ] 80% of the Taxable Wage Base plus $1.00.
4. [ ] $______ (not greater than the Taxable Wage
Base). (See Note below)
NOTE: The integration percentage of 5.7% shall be reduced
to:
1. 4.3% if 2. or 4. above is more than 20% and
less than or equal to 80% of the Taxable Wage
Base.
2. 5.4% if 3. is elected or if 2. or 4. above is
more than 80% of the Taxable Wage Base.
31. REQUIREMENTS TO SHARE IN ALLOCATIONS OF EMPLOYER DISCRETIONARY PROFIT
SHARING CONTRIBUTION AND FORFEITURES
a. [ ] N/A. Plan does not permit such contributions.
b. [ x ] Requirements for Participants who are actively employed
at the end of the Plan Year.
1. [ x ] No service requirement.
2. [ ] A Participant must complete a Year of
Service. (Could cause the Plan to violate
coverage requirements under Code Section
410(b).)
3. [ ] A Participant must complete at least _____
(may not be more than 1,000) Hours of Service
during the Plan Year. (Could cause the Plan
to violate coverage requirements under Code
Section 410(b).)
18
REQUIREMENTS FOR PARTICIPANTS WHO ARE NOT ACTIVELY EMPLOYED AT THE
END OF THE PLAN YEAR
c. [ ] A Participant must complete more than ______ Hours of
Service (not more than 500).
d. [ ] A Participant must complete a Year of Service. (Could
cause the Plan to violate coverage requirements under
Code Section 410(b).)
e. [ x ] Participants will NOT share in such allocations,
regardless of service. (Could cause the Plan to violate
coverage requirements under Code Section 410(b).)
f. [ ] Participants will share in such allocations, regardless
of service.
NOTE: Participants who are not actively employed at the end of the
Plan Year due to death, Total and Permanent Disability or Early
or Normal Retirement will be eligible to share in the
allocations regardless of the above conditions.
AND, if 31.b.2, b.3, d. or e. is selected, shall the 410(b) ratio
percentage fail safe provisions apply (Plan Section 12.3(f))?
g. [ ] No or N/A.
h. [ x ] Yes (If selected, the Plan must satisfy the ratio
percentage test of Code Section 410(b)).
32. FORFEITURES (Plan Sections 1.27 and 4.3(e))
Forfeitures will be...
a. [ ] N/A. There will be no Employer contributions made under
the Plan.
b. [ x ] used to reduce any Employer contribution.
c. [ ] allocated to all Participants eligible to share in the
allocations in the same proportion that each
Participant's Compensation for the Plan Year bears to the
Compensation of all Participants for such year.
33. LIMITATIONS ON ALLOCATIONS (Plan Section 4.4)
If any Participant is covered under another qualified defined
contribution plan maintained by the Employer, other than a Master or
Prototype Plan, or if the Employer maintains a welfare benefit fund,
as defined in Code Section 419(e), or an individual medical account,
as defined in Code Section 415(l)(2), under which amounts are treated
as Annual Additions with respect to any Participant in this Plan:
a. [ x ] N/A. The Employer does not maintain another qualified
defined contribution plan.
b. [ ] The provisions of Plan Section 4.4(b) will apply as if
the other plan were a Master or Prototype Plan.
c. [ ] Specify the method under which the plans will limit total
Annual Additions to the Maximum Permissible Amount, and
will properly reduce any Excess Amounts, in a manner that
precludes Employer discretion:
__________________________________________________.
19
DISTRIBUTIONS
34. FORM OF DISTRIBUTIONS (Plan Sections 6.5, 6.6 and 6.12)
Distribution may be made in...
a. [ ] cash only (except for insurance or annuity contracts).
b. [ x ] cash or ( to the extent permitted under Section 6.5 and
6.6) Employer stock.
AND, if this is an amendment to a Plan that contains forms of payment
that are not otherwise provided for under the Plan document, will all
such forms of payment be eliminated in accordance with Plan Section
8.1(e)?
1. [ x ] Yes, all such forms of payment will be eliminated
to the extent permissible.
2. [ ] No, certain forms of payment described in an
addendum to the plan will not be eliminated.
NOTE: In-kind distributions, other than as provided for in this
Question 34, will not be permitted under the Plan and therefore
will not be protected.
35. INVOLUNTARY DISTRIBUTIONS
Will involuntary distributions of amounts less than $5,000 be made in
accordance with the provisions of Sections 6.4, 6.5 and 6.6?
a. [ x ] Yes
b. [ ] No
36. HARDSHIP DISTRIBUTIONS (Plan Sections 6.11 and/or 12.9)
a. [ x ] No hardship distributions are permitted.
b. [ ] Hardship distributions are permitted from the following
accounts (select one):
1. [ ] All accounts.
2. [ ] Participant's Elective Deferral Account,
Participant's Rollover Account, and
Participant's Voluntary Contribution Account.
NOTE: Distributions from a Participant's Elective Deferral Account
are limited to the portion of such account attributable to such
Participant's Elective Deferrals (and earnings attributable
thereto up to December 31, 1988). Hardship distributions are
not permitted from a Participant's Qualified Non-Elective
Account (including any 401(k) Safe Harbor Contributions) or
Qualified Matching Contribution Account.
37. IN-SERVICE DISTRIBUTIONS (Plan Section 6.10)
a. [ ] In-service distributions may not be made (except as
otherwise elected for Hardship Distributions or as
provided for in Section 6.10).
b. [ x ] In-service distributions may be made to a Participant who
has not separated from service provided the participant
has attained age 59 1/2.
20
AND, in-service distributions are permitted from the following
accounts:
c. [ x ] All accounts.
d. [ ] Participant's Elective Deferral Account, Participant's
Rollover Account and Participant's Voluntary Contribution
Account only.
NOTE: Distributions from a Participant's Elective Deferral Account,
Qualified Matching Contribution Account and Qualified
Non-Elective Account (including 401(k) Safe Harbor
Contributions) are subject to restrictions and generally may
not be distributed prior to age 59 1/2.
TOP HEAVY REQUIREMENTS
38. TOP HEAVY DUPLICATIONS (Plan Section 4.3(i)): When a Non-Key Employee
is a Participant in this Plan and a Defined Benefit Plan maintained
by the Employer, indicate which method shall be utilized to avoid
duplication of top heavy minimum benefits: (If b., c., d. or e. is
elected, f. must be completed.)
a. [ ] N/A. The Employer does not maintain a Defined Benefit
Plan. (Go to next Question)
b. [ ] The full top heavy minimum will be provided in each plan
(if selected, Plan Section 4.3(i) shall not apply).
c. [ ] 5% defined contribution minimum.
d. [ ] 2% defined benefit minimum.
e. [ x ] Specify the method under which the Plans will provide top
heavy minimum benefits for Non-Key Employees that will
preclude Employer discretion and avoid inadvertent
omissions:
A MINIMUM ACCRUED BENEFIT UNDER THE DEFINED BENEFIT PLAN
EQUAL TO 2% MULTIPLIED BY THE HIGHEST AVERAGE
COMPENSATION BUT NOT MORE THAN 2% AS SPECIFIED IN SEC.
4.3(I)
-------------------------------------------------------
NOTE: If c., d., or e. is selected and the Defined Benefit Plan and
this Plan do not benefit the same Participants, the uniformity
requirement of the Section 401(a)(4) Regulations may be
violated.
AND, the "Present Value of Accrued Benefit" (Plan Section 9.2) for
Top Heavy purposes shall be based on...
f. [ x ] Interest Rate: 8.00
------------------
Mortality Table: 1983 GROUP ANNUITY
------------------
39. TOP HEAVY DUPLICATIONS (Plan Section 4.3(f)): When a Non-Key Employee
is a Participant in this Plan and another defined contribution plan
maintained by the Employer, indicate which method shall be utilized
to avoid duplication of top heavy minimum benefits:
a. [ x ] N/A. The Employer does not maintain another qualified
defined contribution plan.
21
b. [ ] The full top heavy minimum will be provided in each plan.
c. [ ] A minimum, non-integrated contribution of 3% of each
Non-Key Employee's 415 Compensation shall be provided in
the Money Purchase Plan (or other plan subject to Code
Section 412).
d. [ ] Specify the method under which the Plans will provide top
heavy minimum benefits for Non-Key Employees that will
preclude Employer discretion and avoid inadvertent
omissions, including any adjustments required under Code
Section 415:
--------------------------------------------------
NOTE: If c. or d. is selected and both plans do not benefit the same
Participants, the uniformity requirement of the Section
401(a)(4) Regulations may be violated.
MISCELLANEOUS
40. LOANS TO PARTICIPANTS (Plan Section 7.3)
a. [ ] Loans are not permitted.
b. [ x ] Loans are permitted.
IF loans are permitted (select c., if it is applicable, and complete
d. and e.)
c. [ ] loans will only be made for hardship or financial
necessity.
d. [ x ] a Participant may only have 1 (e.g., one (1)) loan(s)
outstanding at any time.
e. [ x ] loans will only be permitted from the following accounts:
1. [ x ] All accounts.
2. [ ] Participant's Elective Deferral Account,
Participant's Rollover Account and
Participant's Voluntary Contribution Account.
NOTE: Department of Labor Regulations require the adoption of a
separate written loan program setting forth the requirements
outlined in Plan Section 7.3.
41. DIRECTED INVESTMENT ACCOUNTS (Plan Section 4.10)
a. [ x ] Participant directed investments are permitted for the
following accounts (select all that apply):
1. [ x ] All accounts.
2. [ ] All accounts other than the portion of
Participant's Account attributable to
Employer matching contributions and
Participant's Profit Sharing Account.
3. [ ] All accounts other than the portion of
Participant's Account attributable to
Employer matching contributions.
4. [ ] All accounts other than Participant's Profit
Sharing Account.
22
AND, will voting rights on directed investments be passed through to
Participants?
b. [ x ] No. Employer stock is not an alternative OR Plan is not
intended to comply with Act Section 404(c).
c. [ ] Yes, for Employer stock only.
42. AFTER-TAX VOLUNTARY EMPLOYEE CONTRIBUTIONS (Plan Section 4.8)
a. [ x ] After-tax voluntary Employee contributions will not be
allowed.
b. [ ] After-tax voluntary Employee contributions will be
allowed.
AND, if b. is chosen above, each Participant may elect to make after
tax voluntary Employee contributions in the following amount:
c. [ ] _____% of Compensation.
d. [ ] up to _____% of Compensation.
GUST TRANSITION RULES
The following questions only apply if this is a GUST restatement
(i.e., Question 7.c. is selected). If this is not a GUST restatement,
then this Plan will not be considered an individually designed plan
merely because the following questions are deleted from the Adoption
Agreement.
43. COMPENSATION
The family aggregation rules of Code Section 401(a)(17) as in effect
under Code Section 414(q)(6) prior to the enactment of SBJPA do not
apply to this Plan effective as of:
a. [ ] The first day of the first Plan Year beginning after
1996.
b. [ ] __/__/__ (may not be prior to the first day of the first
Plan Year beginning in 1997 and may not be later than the
first day of the Plan Year in which this GUST restatement
is adopted).
NOTE: If family aggregation continued to apply after 1996, the Plan
is not a safe harbor plan for Code Section 401(a)(4) purposes
and the Employer may not rely on the opinion letter issued by
the Internal Revenue Service that this Plan is qualified under
Code Section 401.
44. LIMITATION ON ALLOCATIONS AND TOP HEAVY RULES
If any Participant is a Participant in this Plan and a qualified
defined benefit plan maintained by the Employer, then the limitations
of Code Section 415(e) as in effect under Code Section 414(q)(6)
prior to the enactment of SBJPA do not apply to this Plan effective
with respect to Limitation Years beginning on or after:
a. [ ] N/A. The Employer does not maintain, and has never
maintained, a qualified defined benefit plan OR the
provisions of Code Section 415(e) have already been
removed from this Plan OR the Plan's original Effective
Date was after December 31, 1999 (i.e., Code Section
415(e) never applied to the Plan).
23
b. [ ] _____ (may not be prior to the first Limitation Year
beginning in 2000 and may not be later than the
Limitation Year in which this GUST restatement is
adopted).
NOTE: If the Code Section 415(e) limits continued to apply to
Limitation Years beginning after 1999, the Plan is not a safe
harbor plan for Code Section 401(a)(4) purposes and the
Employer may not rely on the opinion letter issued by the
Internal Revenue Service that this Plan is qualified under Code
Section 401.
AND, if b. is selected with a date that is later than the effective
date of this GUST restatement, then with respect to the Limitation
Year in which this restatement is adopted, if any Participant is a
Participant in this Plan and a qualified defined benefit plan
maintained by the Employer, specify the method under which the plans
involved will provide top heavy minimum benefits for Non-Key
Employees and will satisfy the limitations of Code Section 415(e) in
a manner that precludes Employer discretion:
c. [ ] N/A. The effective date of the GUST restatement is the
date the provisions of Code Section 415(e) no longer
apply to this Plan.
d. [ ] ____________________________________
NOTE: If the top heavy minimum benefit is only provided in one plan
and the Defined Benefit Plan and this Plan do not benefit the
same Participants, the uniformity requirement of the Section
401(a)(4) Regulations may be violated.
45. INVOLUNTARY DISTRIBUTIONS
If the Plan provides for involuntary distributions (i.e., 35.a. is
elected) then the increase in the involuntary amount threshold from
$3,500 to $5,000 became effective with respect to distributions made
on or after:
a. [ ] N/A. The plan doesn't provide for involuntary
distributions less than $5,000.
b. [ x ] August 6, 1997, or if later __/__/__ (leave blank if not
applicable).
46. MINIMUM DISTRIBUTIONS
The proposed Code Section 401(a)(9) Regulations issued in January
2001 apply with respect to distributions under the Plan made for
calendar years beginning on or after January 1, 2001 unless a later
date is specified below:
a. [ ] N/A
b. [ ] The Regulations apply for calendar years beginning on or
after 01/01/2001.
AND, if b. is selected, for years prior to the date specified above,
life expectancies for minimum distributions required pursuant to Code
Section 401(a)(9) shall...
c. [ ] be recalculated at the Participant's election.
d. [ ] be recalculated.
e. [ ] not be recalculated.
24
47. "REQUIRED BEGINNING DATE" TRANSITIONAL RULES (Plan Section 6.5(e))
NOTE:This Section does not apply to (1) a new Plan; (2) an amendment
or restatement of an existing Plan that never contained the
provisions of Code Section 401(a)(9) as in effect prior to the
amendments made by the Small Business Job Protection Act of 1996
(SBJPA); or (3) an amendment or restatement of an existing Plan
following the close of the GUST remedial amendment period.
The "required beginning date" for a Participant who is not a "five
percent (5%) owner" is:
a. [ ] N/A. This is a new Plan or this Plan has never included
the pre-SBJPA provisions of Code Section 401(a)(9).
b. [ ] the later of the April 1 of the calendar year following
the calendar year in which the participant attains age 70
1/2 or retires. (Also select Options 1., 2., and/or 3.,
whichever is applicable. Option 3. must be selected
unless the Plan permits a Participant to request an in-
service distribution from all accounts once the
Participant has attained age 59 1/2. If neither Option 1.
or 2. is selected, then the Plan did not utilize either
of these transition rules prior to its amendment to
utilize the post-SBJPA definition of "required beginning
date.")
1. [ ] A Participant who had not begun receiving
required minimum distributions as of ______
(not earlier than January 1, 1996) may elect
to defer commencement of distributions until
retirement.
2. [ ] A Participant who was already receiving
required minimum distributions under the
pre-SBJPA rules as of ______ (not earlier
than January 1, 1996) may elect to stop
receiving distributions and have them
recommence in accordance with the post-SBJPA
rules. Upon the recommencement of
distributions, if the Plan permits annuities
as a form of distribution then the following
will apply:
(i) [ ] N/A. Annuity distributions are
not permitted.
(ii) [ ] a new annuity starting date upon
recommencement, or
(iii) [ ] no new annuity starting date upon
recommencement.
3. [ ] The pre-retirement age 70 1/2 distribution
option is only eliminated with respect to
employees who reach age 70 1/2 in or after a
calendar year that begins after the later of
December 31, 1998, or the adoption date of
the amendment.
48. HIGHLY COMPENSATED EMPLOYEE (Plan Section 1.31)
a. [ ] The "top-paid" group election applied for purposes of
determining the Highly Compensated Employees for the
following plan years:
1. [ ] 1997 2. [ ] 1998 3. [ ] 1999
4. [ ] 2000 5. [ ] ______
25
b. [ ] The "calendar year election" applied for purposes of
determining Highly Compensated Employees for the
following plan years:
1. [ ] 1997 2. [ ] 1998 3. [ ] 1999
4. [ ] 2000 5. [ ] ______
49. ADP AND ACP TESTS. For Plan Years beginning in and prior to the Plan
Year in which the restatement is adopted, the following will apply:
ADP TEST:
a. [ ] PRIOR YEAR TESTING: The prior year ratio will be used for
the Plan Year beginning in the year specified below. (If
this election is made for the first year the Code Section
401(k) feature is added to this Plan (unless this Plan is
a successor plan), the amount taken into account as the
ADP of Non-Highly Compensated Employees for the preceding
Plan Year will be 3%.)
1. [ ] 1997 2. [ ] 1998 3. [ ] 1999
4. [ ] 2000 5. [ ] ______
b. [ ] CURRENT YEAR TESTING: The current year ratio will be used
for the Plan Year beginning in:
1. [ ] 1997 2. [ ] 1998 3. [ ] 1999
4. [ ] 2000 5. [ ] ______
ACP TEST:
c. [ ] N/A.
d. [ ] PRIOR YEAR TESTING: The prior year ratio will be used for
the Plan Year beginning in the year specified below. (If
this election is made for the first year the Code Section
401(m) feature is added to this Plan (unless this Plan is
a successor plan), the amount taken into account as the
ACP of Non-Highly Compensated Employees for the preceding
Plan Year will be 3%.)
1. [ ] 1997 2. [ ] 1998 3. [ ] 1999
4. [ ] 2000 5. [ ] ______
e. [ ] CURRENT YEAR TESTING: The current year ratio will be used
for the Plan Year beginning in:
1. [ ] 1997 2. [ ] 1998 3. [ ] 1999
4. [ ] 2000 5. [ ] ______
26
The adopting Employer may rely on an opinion letter issued by the Internal
Revenue Service as evidence that the plan is qualified under Code Section
401 only to the extent provided in Announcement 2001-77, 2001-30 I.R.B.
The Employer may not rely on the opinion letter in certain other
circumstances or with respect to certain qualification requirements, which
are specified in the opinion letter issued with respect to the plan and in
Announcement 2001-77.
In order to have reliance in such circumstances or with respect to such
qualification requirements, application for a determination letter must be
made to Employee Plans Determinations of the Internal Revenue Service.
This Adoption Agreement may be used only in conjunction with basic Plan
document #02. This Adoption Agreement, the basic Plan document and the
applicable trust agreement shall together be known as Automatic Data
Processing Prototype Non-Standardized 401(k) Plan and Trust #02-003
The adoption of this Plan, its qualification by the IRS, and the related
tax consequences are the responsibility of the Employer and its independent
tax and legal advisors.
Automatic Data Processing Federal Credit Union or its designated
representative will notify the Employer of any amendments made to the Plan
or of the discontinuance or abandonment of the Plan. Furthermore, in order
to be eligible to receive such notification, we agree to notify ADP, Inc.,
as the designated representative of Automatic Data Processing Federal
Credit Union of any change in address.
With regard to any questions regarding the provisions of the Plan, adoption
of the Plan, or the effect of an opinion letter from the IRS, call or
write:
Xx. Xxxxx Xxxxxxxxxx, CEBS
ADP, Inc.
ADP Retirement Services
0000 Xxxxxxx Xxxx Xxxxx Xx.
Xxxxx 0000
Xxxxxxxxxx, Xxxxxxxx 00000
(000) 000-0000
27
The Employer hereby causes this Plan to be executed on ____________________
EMPLOYER
By:
------------------------------
PARTICIPATING EMPLOYER
By:
------------------------------
PARTICIPATING EMPLOYER (attach additional signature pages as necessary):
By:
------------------------------
NOTE: If the Employer is authorized (by corporate resolution or otherwise)
to execute the Plan on behalf of Participating Employers,
Participating Employers need not execute this Plan.
28
