Prototype Cash or
Deferred Profit-
Sharing Plan #004
EXHIBIT 4
NONSTANDARDIZED
ADOPTION AGREEMENT
PROTOTYPE CASH OR DEFERRED PROFIT-SHARING
PLAN AND TRUST/CUSTODIAL ACCOUNT
Sponsored by
SUNTRUST
The Employer named below hereby establishes a Cash or Deferred Profit-Sharing
Plan for eligible Employees as provided in this Adoption Agreement and the
accompanying Basic Prototype Plan and Trust/Custodial Account Basic Plan
Document #04.
1. EMPLOYER INFORMATION
NOTE: If multiple Employers are adopting the Plan, complete this section
based on the lead Employer. Additional Employers may adopt this Plan
by xxxxxxxxx executed signature pages to the back of the Employer's
Adoption Agreement.
(a) NAME AND ADDRESS:
Nobility Homes, Inc.
0000 XX 0xx Xxxxxx
Xxxxx, XX 00000
(b) TELEPHONE NUMBER: (000) 000-0000
(c) TAX ID NUMBER: 00-0000000
(d) FORM OF BUSINESS:
[ ] (i) Sole Proprietor
[ ] (ii) Partnership
[x ] (iii) Corporation
[ ] (iv) "S" Corporation (formerly known as Subchapter S)
Page 1 of Exhibit 4
[ ] (v) Other: _________________________
(e) NAME OF INDIVIDUAL AUTHORIZED TO ISSUE INSTRUCTIONS TO THE
TRUSTEE/CUSTODIAN:
Those as certified by the employer (P&T 11.4(d))
(f) NAME OF PLAN:Nobility Homes, Inc. 401(k) Profit Sharing Plan
(g) THREE DIGIT PLAN NUMBER FOR ANNUAL RETURN/REPORT: 001
2. EFFECTIVE DATE
(a) This is a new Plan having an effective date of ____________.
(b) This is an amended Plan.
The effective date of the original Plan was January 1, 1996.
The effective date of the amended Plan is April 1, 1999.
(c) If different from above, the Effective Date for the Plan's Elective
Deferral provisions shall be ___________.
NOTE: See Appendix A before Signatures at Paragraph 23 for provisions
which differ from this final Tax Reform Act of 1986 Plan Document
and their effective periods.
3. DEFINITIONS
(a) "Collective or Commingled Funds" (Applicable to institutional
Trustees only.) Investment in collective or commingled funds as
permitted at paragraph 13.3(b) of the Basic Plan Document #04
shall only be made to the following specifically named fund(s):
SunTrust Employee Benefit Stable Asset Fund
Funds made available after the execution of this Adoption
Agreement will be listed on schedules attached to the end of this
Adoption Agreement.
(b) "Compensation" Compensation shall be determined on the basis of the:
[x] (i) Plan Year.
Page 2 of Exhibit 4
[ ] (ii) Employer's Taxable Year.
[ ] (iii) Calendar Year.
NOTE: If Plan Year is selected, Compensation will only include amounts
earned while a Participant.
Compensation shall be determined on the basis of the following
safe-harbor definition of Compensation in IRS Regulation Section
1.414(s)-1(c):
[x] (iv) Code Section 6041 and 6051 Compensation,
[ ] (v) Code Section 3401(a) Compensation, or
[ ] (vi) Code Section 415 Compensation.
Compensation [x] shall [ ] shall not include Employer
contributions made pursuant to a Salary Savings Agreement which
are not includable in the gross income of the Employee for the
reasons indicated in the definition of Compensation at 1.12 of the
Basic Plan Document #04.
NOTE: Any exclusion of Compensation must satisfy the requirements of
Section 1.401(a)(4) of the Income Tax Regulations and Code Section
414(s) and the regulations thereunder.
For purposes of the Plan, Compensation shall be limited to $____,
the maximum amount which will be considered for Plan purposes. [If
an amount is specified, it will limit the amount of contributions
allowed on behalf of higher compensated Employees. Completion of
this section is not intended to coordinate with the $150,000 of
Code Section 401(a)(17), thus the amount should be less than
$150,000 as adjusted for cost-of-living increases.]
If the Employer chooses a non-integrated allocation formula,
Compensation will exclude:
[ ] (1) overtime.
[ ] (2) bonuses.
[ ] (3) commissions.
[ ] (4) _________________.
Page 3 of Exhibit 4
NOTE: Any exclusion of Compensation must satisfy the requirements of
Section 1.401(a)(4) of the Income Tax Regulations and Code Section
414(s) and the regulations thereunder.
For purposes of ADP and ACP testing, calculations shall be
determined based on [x] Compensation amounts for the periods which
the Employee was eligible to participate or [ ] Compensation
amounts for the entire Plan Year, whether or not the Employee was
a Participant for the entire Plan Year.
(c) "Entry Date"
[ ] (i) The first day of the Plan Year nearest the date
on which an Employee meets the eligibility
requirements.
[x] (ii) The earlier of the first day of the Plan
Year or the first day of the seventh month of
the Plan Year coinciding with or following the
date on which an Employee meets the eligibility
requirements.
[ ] (iii) The first day of the Plan Year following the date
on which the Employee meets the eligibility
requirements. If this election is made, the
Service requirement at 4(a)(ii) may not exceed
1/2 year and the age requirement at 4(b)(ii) may
not exceed 20 1/2.
[ ] (iv) The first day of the month coinciding with or
following the date on which an Employee meets the
eligibility requirements.
[ ] (v) The first day of the Plan Year, or the first day
of the fourth month, or the first day of the
seventh month or the first day of the tenth
month, of the Plan Year coinciding with or
following the date on which an Employee meets the
eligibility requirements.
(d) "Hours of Service" Shall be determined on the basis of the method
selected below. Only one method may be selected. The method
selected shall be applied to all Employees covered under the Plan
as follows:
[x] (i) On the basis of actual hours for which an
Employee is paid or entitled to payment.
[ ] (ii) On the basis of days worked.
An Employee shall be credited with ten (10)
Hours of Service if under paragraph 1.44 of the
Basic Plan Document #04 such Employee would be
credited with at least one (1) Hour of Service
during the day.
Page 4 of Exhibit 4
[ ] (iii) On the basis of weeks worked.
An Employee shall be credited with forty-five
(45) Hours of Service if under paragraph 1.44
of the Basic Plan Document #04 such Employee
would be credited with at least one (1) Hour of
Service during the week.
[ ] (iv) On the basis of semimonthly payroll periods.
An Employee shall be credited with ninety-five
(95) Hours of Service if under paragraph 1.44
of the Basic Plan Document #04 such Employee
would be credited with at least one (1) Hour of
Service during the semimonthly payroll period.
[ ] (v) On the basis of months worked.
An Employee shall be credited with
one-hundred-ninety (190) Hours of Service if
under paragraph 1.44 of the Basic Plan Document
#04 such Employee would be credited with at
least one (1) Hour of Service during the month.
(e) "Limitation Year" The 12-consecutive month period commencing on
January 1 and ending on December 31.
If applicable, the Limitation Year will be a short Limitation Year
commencing on ____________ and ending on ____________. Thereafter,
the Limitation Year shall end on the date last specified above.
(f) "Net Profit"
[x] (i) Not applicable (profits will not be required for
any contributions to the Plan).
[ ] (ii) As defined in paragraph 1.51 of the Basic Plan
Document #04.
[ ] (iii) Shall be defined as:
__________________________________
(Only use if definition in paragraph 1.51 of the Basic
Plan Document #04 is to be superseded.)
(g) "Plan Year" The 12-consecutive month period commencing on January 1
and ending on December 31.
Page 5 of Exhibit 4
If applicable, the Plan Year will be a short Plan Year commencing
on _____ and ending on ____. Thereafter, the Plan Year shall end
on the date last specified above.
(h) "Qualified Early Retirement Age" For purposes of making
distributions under the provisions of a Qualified Domestic
Relations Order, the Plan's Qualified Early Retirement Age with
regard to the Participant against whom the order is entered [x]
shall [ ] shall not be the date the order is determined to be
qualified. If "shall" is elected, this will only allow payout to
the alternate payee(s).
(i) "Qualified Joint and Survivor Annuity" The safe-harbor provisions
of paragraph 8.7 of the Basic Plan Document #04 [x] are [ ] are
not applicable. If not applicable, the survivor annuity shall be
___% (50%, 66%, 75% or 100%) of the annuity payable during the
lives of the Participant and Spouse. If no answer is specified,
50% will be used.
(j) "Taxable Wage Base"
[ ] (i) Not Applicable - Plan is not integrated with
Social Security.
[x] (ii) The maximum earnings considered wages for
such Plan Year under Code Section 3121(a).
[ ] (iii) _____% (not more than 100%) of the amount
considered wages for such Plan Year under Code
Section 3121(a).
[ ] (iv) $__________, provided that such amount is not in
excess of the amount determined under paragraph
3(j)(ii) above.
[ ] (v) For the 1989 Plan Year $10,000. For all
subsequent Plan Years, 20% of the maximum
earnings considered wages for such Plan Year
under Code Section 3121(a).
NOTE: Using less than the maximum at (ii) may result in
a change in the allocation formula in Section 7.
(k) "Valuation Date(s)" Allocations to Participant Accounts will be
done in accordance with Article V of the Basic Plan Document #04:
(i) Daily (v) Quarterly
(ii) Weekly (vi) Semiannually
(iii) Monthly (vii) Annually
(iv) Bimonthly
Page 6 of Exhibit 4
Indicate Valuation Date(s) to be used by specifying option from
list above:
Type of Contribution(s) Valuation Date(s)
----------------------- -----------------
After-Tax Voluntary Contributions [Section 6] n/a
Elective Deferrals [Section 7(b)] (i)
Matching Contributions [Section 7(c)] (i)
Qualified Non-Elective Contributions [Section 7(d)] (i)
Non-Elective Contributions [Section 7(e), (f) and (g)] (i)
Minimum Top-Heavy Contributions [Section 7(i)] (i)
(1) "Year of Service"
(i) For Eligibility Purposes: The 12-consecutive month period
during which an Employee is credited with 1,000 (not more
than 1,000) Hours of Service.
(ii) For Allocation Accrual Purposes - Employer Matching
Contributions: The 12-consecutive month period during
which an Employee is credited with 1,000 (not more than
1,000) Hours of Service.
(iii) For Allocation Accrual Purposes -All Other Employer
Contributions: The 12-consecutive month period during
which an Employee is credited with 1,000 (not more than
1,000) Hours of Service.
(iv) For Vesting Purposes: The 12-consecutive month period
during which an Employee is credited with 1,000 (not more
than 1,000) Hours of Service.
4. ELIGIBILITY REQUIREMENTS
(a) Service:
[ ] (i) The Plan shall have no Service requirement.
[x] (ii) The Plan shall cover only Employees having
completed at least 1 [not more than one (1)]
Years of Service.
NOTE: If the eligibility period selected is less than
one year, an Employee will not be required to
complete any specified number of Hours of
Service to receive credit for such period.
Page 7 of Exhibit 4
(b) Age:
[ ] (i) The Plan shall have no minimum age requirement.
[x] (ii) The Plan shall cover only Employees having
attained age 21 (not more than age 21).
(c) Classification:
The Plan shall cover all Employees who have met the age and
service requirements with the following exceptions:
[ ] (i) No exceptions.
[x] (ii) The Plan shall exclude Employees included
in a unit of Employees covered by a collective
bargaining agreement between the Employer and
Employee Representatives, if retirement
benefits were the subject of good faith
bargaining. For this purpose, the term
"Employee Representative" does not include any
organization more than half of whose members
are Employees who are owners, officers, or
executives of the Employer.
[x] (iii) The Plan shall exclude Employees who are
nonresident aliens and who receive no earned
income from the Employer which constitutes
income from sources within the United States.
[ ] (iv) The Plan shall exclude from participation any
nondiscriminatory classification of Employees
determined as follows:
_______________________________________
NOTE: Employees, if otherwise permitted under law and
regulations, may waive out from all or a portion of this
Plan if the Employer so provides above and the Plan
continues to meet the requirements of Code Sections
401(a)(26) and 410(b). In addition, eliminating part-time
employees, as announced by several Key Districts, is not
acceptable since the IRS considers that to be
discriminatory classification.
(d) Employees on Effective Date:
[x] (i) Not Applicable. All Employees will be
required to satisfy both the age and Service
requirements specified above.
Page 8 of Exhibit 4
[ ] (ii) Employees employed on the Plan's Effective Date
do not have to satisfy the Service requirements
specified above.
[ ] (iii) Employees employed on the Plan's Effective Date
do not have to satisfy the age requirements
specified above.
5. RETIREMENT AGES
(a) Normal Retirement Age:
If the Employer imposes a requirement that Employees retire upon
reaching a specified age, the Normal Retirement Age selected below
may not exceed the Employer imposed mandatory retirement age.
[x] (i) Normal Retirement Age shall be 60 (not to exceed
age 65).
[ ] (ii) Normal Retirement Age shall be the later
of attaining age (not to exceed age 65) or the
____ (not to exceed the 5th) anniversary of the
first day of the first Plan Year in which the
Participant commenced participation in the
Plan.
(b) Early Retirement Age:
[x] (i) Not Applicable.
[ ] (ii) The Plan shall have an Early Retirement Age of __
(not less than 55) and completion of ____ Years
of Service.
6. EMPLOYEE CONTRIBUTIONS
[x] (a) Participants shall be permitted to make
Elective Deferrals in any amount from 0.1% up
to 20 % of their Compensation.
If (a) is applicable, Participants shall be
permitted to amend their Salary Savings
Agreements to change the contribution
percentage as provided below:
[ ] (i) On the Anniversary Date of the
Plan,
[ ] (ii) On the Anniversary Date of the
Plan and on the first day of
the seventh month of the Plan
Year,
[ ] (iii) On the Anniversary Date of the
Plan and on the first day
following any Valuation Date,
Page 9 of Exhibit 4
[x] (iv) On the Anniversary Date of the
Plan and on the first day of
the fourth, seventh and tenth
months of the Plan Year, or
[ ] (v) Upon 30 days' notice to the
Employer.
[ ] (b) Participants shall be permitted to make after tax
Voluntary Contributions up to ___% of
Compensation.
[ ] (c) Participants shall be required to make after tax
Voluntary Contributions as follows (Thrift
Savings Plan):
[ ] (i) ____% of Compensation.
[ ] (ii) A percentage determined by
the Employee on his or her
enrollment form.
NOTE: If Employee after-tax Voluntary Contributions are required
for the Employee to participate in the Plan, the Employer
Contribution shall be deemed Employer Matching
Contributions subject to the Average Contribution
Percentage [401(m)] Test.
[x] (d) If necessary to pass the Average Deferral
Percentage Test, Participants [ ] may [x] may
not have Elective Deferrals recharacterized as
Voluntary Contributions.
NOTE: The Average Deferral Percentage Test will apply
to contributions under (a) above. The Average
Contribution Percentage Test will apply to
contributions under (b) and (c) above, and may
apply to (a).
7. EMPLOYER CONTRIBUTIONS AND ALLOCATION THEREOF
NOTE: The Employer shall make contributions to the Plan in
accordance with the formula or formulas selected below. The
Employer's contribution shall be subject to the limitations
contained in Articles III and X. For this purpose, a
contribution for a Plan Year shall be limited for the
Limitation Year which ends with or within such Plan Year.
Also, the integrated allocation formulas below are for Plan
Years beginning in 1989 and later. The Employer's
allocation for earlier years shall be as specified in its
Plan prior to amendment for the Tax Reform Act of 1986.
Page 10 of Exhibit 4
(a) Profits Requirement:
(i) Current or Accumulated Net Profits are required for:
[ ] (A) Matching Contributions.
[ ] (B) Qualified Non-Elective Contributions.
[ ] (C) discretionary contributions.
(ii) No Net Profits are required for:
[x] (A) Matching Contributions.
[x] (B) Qualified Non-Elective Contributions.
[x] (C) discretionary contributions.
NOTE: Elective Deferrals can always be contributed regardless
of profits.
[x] (b) Salary Savings Agreement:
The Employer shall contribute and allocate to each Participant's
account an amount equal to the amount withheld from the
Compensation of such Participant pursuant to his or her Salary
Savings Agreement. If applicable, the maximum percentage is
specified in Section 6 above. An Employee who has terminated his
or her election under the Salary Savings Agreement other than for
hardship reasons may not make another Elective Deferral:
[ ] (i) until the first day of the next Plan Year.
[ ] (ii) until the next Valuation Date.
[ ] (iii) until the first day of the next Plan
Year or, if earlier, on the first day of the
seventh month of the current Plan Year.
[x] (iv) until the first day of the next Plan Year
or, if earlier, on the first day of the fourth,
seventh and tenth months of the current Plan
Year.
[ ] (v) for a period of _____ month(s) (not to exceed 12
months).
Page 11 of Exhibit 4
[x] (c) Matching Employer Contribution [See paragraphs (h) and (i)]:
[ ] (i) Percentage Match: The Employer shall contribute
and allocate to each eligible Participant's
account an amount equal to ____% of the amount
contributed and allocated in accordance with
paragraph 7(b) above and (if checked) ____% of
[ ] the amount of Voluntary Contributions made in
accordance with paragraph 4.1 of the Basic Plan
Document #04. The Employer shall not match
Participant Elective Deferrals as provided above
in excess of $________ or in excess of ______% of
the Participant's Compensation or if applicable,
Voluntary Contributions in excess of $______ or
in excess of ____% of the Participant's
Compensation. In no event will the match on both
Elective Deferrals and Voluntary Contributions
exceed a combined amount of $_____ or ___%.
[x] (ii) Discretionary Match: The Employer shall
contribute and allocate to each eligible
Participant's account a percentage of the
Participant's Elective Deferral contributed and
allocated in accordance with paragraph 7(b)
above. The Employer may set such percentage
prior to the end of the Plan Year. The Employer
shall not match Participant Elective Deferrals
in excess of $________ or in excess of ______%
of the Participant's Compensation.
[ ] (iii) Tiered Match: The Employer shall contribute and
allocate to each Participant's account an amount
equal to ____% of the first ____% of the
Participant's Compensation, to the extent
deferred.
_____% of the next ____% of the Participant's
Compensation, to the extent deferred.
_____% of the next ____% of the Participant's
Compensation, to the extent deferred.
NOTE: Percentages specified in (iii) above may not increase as the
percentage of Participant's contribution increases.
[ ] (iv) Flat Dollar Match: The Employer shall contribute
and allocate to each Participant's account
$_______ if the Participant defers at least 1% of
Compensation.
[ ] (v) Percentage of Compensation Match: The Employer
shall contribute and allocate to each
Participant's account _____% of Compensation if
the Participant defers at least 1% of
Compensation.
Page 12 of Exhibit 4
NOTE: Matching options (iv) or (v) may violate the Code Section
401(a) regulations by failure to make the match effectively
available to all Participants.
[ ] (vi) Proportionate Compensation Match: The
Employer shall contribute and allocate to each
Participant who defers at least 1% of
Compensation, an amount determined by
multiplying such Employer Matching Contribution
by a fraction the numerator of which is the
Participant's Compensation and the denominator
of which is the Compensation of all
Participants eligible to receive such an
allocation. The Employer shall set such
discretionary contribution prior to the end of
the Plan Year.
[x] (vii) Qualified Match: Employer Matching Contributions
will be treated as Qualified Matching
Contributions to the extent specified below:
[ ] (A) All Matching Contributions.
[x] (B) None.
[ ] (C) ____% of the Employer's Matching
Contribution.
[ ] (D) Up to ____% of each Participant's
Compensation.
[ ] (E) The amount necessary to meet the
[ ] Average Deferral Percentage
(ADP) Test, [ ] Average
Contribution Percentage (ACP) Test,
[ ] Both the ADP and ACP Tests.
(viii) Matching Contribution Computation Period: The
time period upon which matching contributions
will be based shall be:
[ ] (A) weekly
[ ] (B) biweekly
[ ] (C) semimonthly
[ ] (D) monthly
[ ] (E) quarterly
[ ] (F) semiannually
Page 13 of Exhibit 4
[x] (G) annually
[ ] (H) the Participant's payroll period
(ix) Eligibility for Match: Employer Matching
Contributions, whether or not Qualified, will
only be made on Employee Contributions not
withdrawn prior to the end of the [ ] valuation
period [ ] Plan Year.
NOTE: This Eligibility for Match shall override any conflicting
Employer contribution requirements in the Basic Plan
Document since the Employee Elective Deferrals and/or
Contributions shall be deemed not made if withdrawn.
[x] (d) Qualified Non-Elective Employer Contribution - [See paragraphs
(h) and (i)] These contributions are fully vested when
contributed.
The Employer shall have the right to make an additional
discretionary contribution which shall be allocated to each
eligible Employee in proportion to his or her Compensation as a
percentage of the Compensation of all eligible Employees. This
part of the Employer's contribution and the allocation thereof
shall be unrelated to any Employee contributions made hereunder.
The amount of Qualified non-Elective Contributions taken into
account for purposes of meeting the ADP or ACP test requirements
is:
[ ] (i) All such Qualified non-Elective Contributions.
[x] (ii) The amount necessary to meet [ ] the ADP
test, [ ] the ACP test, [x] Both the ADP and
ACP tests.
Qualified non-Elective Contributions will be made to:
[ ] (iii) All Employees eligible to participate.
[x] (iv) Only non-Highly Compensated Employees eligible to
participate.
[ ] (e) Additional Employer Contribution Other Than Qualified Non-Elective
Contributions - Non-Integrated [See paragraphs (h) and (i)]
The Employer shall have the right to make an additional
discretionary contribution which shall be allocated to each
eligible Employee in proportion to his or her Compensation as a
percentage of the Compensation of all eligible Employees. This
Page 14 of Exhibit 4
part of the Employer's contribution and the allocation thereof
shall be unrelated to any Employee contributions made hereunder.
[x] (f) Additional Employer Contribution - Integrated Allocation Formula
[See paragraphs (h) and (i)]
The Employer shall have the right to make an additional
discretionary contribution. The Employer's contribution for the
Plan Year plus any forfeitures shall be allocated to the accounts
of eligible Participants as follows:
(i) First, to the extent contributions and forfeitures are
sufficient, all Participants will receive an allocation
equal to 3% of their Compensation.
(ii) Next, any remaining Employer Contributions and forfeitures
will be allocated to Participants who have Compensation in
excess of the Taxable Wage Base (excess Compensation).
Each such Participant will receive an allocation in the
ratio that his or her excess compensation bears to the
excess Compensation of all Participants. Participants may
only receive an allocation of 3% of excess Compensation.
(iii) Next, any remaining Employer contributions and forfeitures
will be allocated to all Participants in the ratio that
their Compensation plus excess Compensation bears to the
total Compensation plus excess Compensation of all
Participants. Participants may only receive an allocation
of up to 2.7% of their Compensation plus excess
Compensation, under this allocation method. If the Taxable
Wage Base defined at Section 3(j) is less than or equal to
the greater of $10,000 or 20% of the maximum, the 2.7%
need not be reduced. If the amount specified is greater
than the greater of $10,000 or 20% of the maximum Taxable
Wage Base, but not more than 80%, 2.7% must be reduced to
1.3%. If the amount specified is greater than 80% but less
than 100% of the maximum Taxable Wage Base, the 2.7% must
be reduced to 2.4%.
NOTE: If the Plan is not Top-Heavy or if the Top-Heavy minimum
contribution or benefit is provided under another Plan
[see Section 11(c)(ii)] covering the same Employees,
sub-paragraphs (i) and (ii) above may be disregarded and
5.7%, 4.3% or 5.4% may be substituted for 2.7%, 1.3% or
2.4% where it appears in (iii) above.
(iv) Next, any remaining Employer contributions and forfeitures
will be allocated to all Participants (whether or not they
received an allocation under the preceding paragraphs) in
the ratio that each Participant's Compensation bears to
all Participants' Compensation.
Page 15 of Exhibit 4
[ ] (g) Additional Employer Contribution-Alternative Integrated Allocation
Formula. [See paragraph (h) and (i)].
The Employer shall have the right to make an additional
discretionary contribution. To the extent that such contributions
are sufficient, they shall be allocated as follows:
___% of each eligible Participant's Compensation plus ____% of
Compensation in excess of the Taxable Wage Base defined at Section
3(j) hereof. The percentage on excess compensation may not exceed
the lesser of (i) the amount first specified in this paragraph or
(ii) the greater of 5.7% or the percentage rate of tax under Code
Section 3111(a) as in effect on the first day of the Plan Year
attributable to the Old Age (OA) portion of the OASDI provisions
of the Social Security Act. If the Employer specifies a Taxable
Wage Base in Section 3(j) which is lower than the Taxable Wage
Base for Social Security purposes (SSTWB) in effect as of the
first day of the Plan Year, the percentage contributed with
respect to excess Compensation must be adjusted. If the Plan's
Taxable Wage Base is greater than the larger of $10,000 or 20% of
the SSTWB but not more than 80% of the SSTWB, the excess
percentage is 4.3%. If the Plan's Taxable Wage Base is greater
than 80% of the SSTWB but less than 100% of the SSTWB, the excess
percentage is 5.4%.
NOTE: Only one plan maintained by the Employer may be
integrated with Social Security.
(h) Allocation of Excess Amounts (Annual Additions)
In the event that the allocation formula above results in an
Excess Amount, such excess shall be:
[ ] (i) placed in a suspense account accruing no gains or
losses for the benefit of the Participant.
[x] (ii) reallocated as additional Employer contributions
to all other Participants to the extent that they
do not have any Excess Amount.
(i) Minimum Employer Contribution Under Top-Heavy Plans:
For any Plan Year during which the Plan is Top-Heavy, the sum of
the contributions and forfeitures as allocated to eligible
Employees under paragraphs 7(d), 7(e), 7(f), 7(g) and 9 of this
Adoption Agreement shall not be less than the amount required
under paragraph 14.2 of the Basic Plan document #04. Top-Heavy
minimums will be allocated to:
[x] (i) all eligible Participants.
Page 16 of Exhibit 4
[ ] (ii) only eligible non-Key Employees who are
Participants.
(j) Return of Excess Contributions and/or Excess Aggregate
Contributions:
In the event that one or more Highly Compensated Employees is
subject to both the ADP and ACP tests and the sum of such tests
exceeds the Aggregate Limit, the limit will be satisfied by
reducing the:
[ ] (i) the ADP of the affected Highly Compensated
Employees.
[ ] (ii) the ACP of the affected Highly Compensated
Employees.
[x] (iii) a combination of the ADP and ACP of the affected
Highly Compensated Employees.
8. ALLOCATIONS TO TERMINATED EMPLOYEES
[ ] (a) The Employer will not allocate Employer related
contributions to Employees who terminate during a Plan
Year, unless required to satisfy the requirements of Code
Section 401(a)(26) and 410(b). (These requirements are
effective for 1989 and subsequent Plan Years.)
[x] (b) The Employer will allocate Employer matching and other
related contributions as indicated below to Employees who
terminate during the Plan Year as a result of:
Matching Other
-------- -----
[x] [x] (i) Retirement.
[x] [x] (ii) Disability.
[x] [x] (iii) Death.
[ ] [ ] (iv) Other termination of employment
provided that the Participant has
completed a Year of Service as
defined for Allocation Accrual
Purposes.
[ ] [ ] (v) Other termination of employment even
though the Participant has not
completed a Year of Service.
Page 17 of Exhibit 4
[ ] [ ] (vi) Termination of employment (for any
reason) provided that the
Participant had completed a Year of
Service for Allocation Accrual
Purposes.
9. ALLOCATION OF FORFEITURES
NOTE: Subsections (a), (b) and (c) below apply to forfeitures of
amounts other than Excess Aggregate Contributions.
(a) Allocation Alternatives:
If forfeitures are allocated to Participants, such
allocation shall be done in the same manner as the
Employer's contribution.
[ ] (i) Not Applicable. All contributions are
always fully vested.
[ ] (ii) Forfeitures shall be allocated to
Participants in the same manner as
the Employer's contribution.
If allocation to other Participants
is selected, the allocation shall be
as follows:
[1] Amount attributable to Employer
discretionary contributions and
Top-Heavy minimums will be allocated
to:
[ ] all eligible Participants under the
Plan.
[ ] only those Participants eligible
for an allocation of Employer
contributions in the current year.
[ ] only those Participants eligible
for an allocation of matching
contributions in the current year.
[2] Amounts attributable to Employer
Matching contributions will be
allocated to:
[ ] all eligible Participants.
[ ] only those Participants eligible
for allocations of matching
contributions in the current year.
[x] (iii) Forfeitures shall be applied to reduce the
Employer's contribution for such Plan Year.
Page 18 of Exhibit 4
[ ] (iv) Forfeitures shall be applied to offset
administrative expenses of the Plan. If
forfeitures exceed these expenses, (iii)
above shall apply.
(b) Date for Forfeitures:
NOTE: If no distribution has been made to a former Participant,
sub-section (i) below will apply to such Participant even
if the Employer elects (ii), (iii), (iv) or (v) below as
its normal administrative policy.
[ ] (i) Forfeitures shall be applied
pursuant to the selection in (a)
above at the end of the Plan Year
during which the former Participant
incurs his or her fifth consecutive
one year Break In Service.
[ ] (ii) Forfeitures shall be applied pursuant to
the selection in (a) above immediately as
of the beginning of the next month.
[ ] (iii) Forfeitures shall be applied pursuant to
the selection in (a) above immediately as
of the beginning of the next quarter.
[ ] (iv) Forfeitures shall be applied pursuant to
the selection in (a) above at the end of
the Plan Year during which the former
Employee incurs his or her _____ (1st, 2nd,
3rd, or 4th) consecutive one year Break In
Service.
[x] (v) Forfeitures shall be applied pursuant to
the selection in (a) above immediately as
of the Plan Year end.
(c) Restoration of Forfeitures:
If amounts are forfeited prior to five consecutive 1-year
Breaks in Service, the Funds for restoration of account
balances will be obtained from the following resources in
the order indicated (fill in the appropriate number):
[1] (i) Current year's forfeitures.
[2] (ii) Additional Employer contribution.
[ ] (iii) Income or gain to the Plan.
Page 19 of Exhibit 4
(d) Forfeitures of Excess Aggregate Contributions shall be:
[x] (i) Applied to reduce Employer contributions
for the Plan Year in which the excess
arose, but allocated under (ii) below to
the extent the excess exceeds the Employer
contribution or the Employer has already
contributed for such Plan Year.
[ ] (ii) Allocated, after all other forfeitures
under the Plan, to the Matching
Contribution account of each non-highly
compensated Participant who made Elective
Deferrals or Voluntary Contributions
in the ratio which each such Participant's
Compensation for the Plan Year bears to the
total Compensation of all Participants for
such Plan Year. Such forfeitures cannot be
allocated to the account of any Highly
Compensated Employee.
NOTE: If (ii) is selected, amounts allocated
thereunder must be included in the ACP Test
for the Plan Year in which allocated to the
Participant.
Forfeitures of Excess Aggregate Contributions will be so
applied at the end of the Plan Year in which they occur.
10. CASH OPTION
[x] (a) The Employer may permit a Participant to elect to defer to
the Plan, an amount not to exceed 100% of any Employer paid
cash bonus made for such Participant for any year. A
Participant must file an election to defer such contribution
at least fifteen (15) days prior to the end of the Plan
Year. If the Employee fails to make such an election, the
entire Employer paid cash bonus to which the Participant
would be entitled shall be paid as cash and not to the Plan.
Amounts deferred under this section shall be treated for all
purposes as Elective Deferrals. Notwithstanding the above,
the election to defer must be made before the bonus is made
available to the Participant.
[ ] (b) Not Applicable.
11. LIMITATIONS ON ALLOCATIONS
[x] This is the only Plan the Employer maintains or ever maintained,
therefore, this section is not applicable.
Page 20 of Exhibit 4
[ ] The Employer does maintain or has maintained another Plan
(including a Welfare Benefit Fund or an individual medical account
(as defined in Code Section 415(l)(2)), under which amounts are
treated as Annual Additions) and has completed the proper sections
below. Complete (a), (b) and (c) only if the Employer maintains or
ever maintained another qualified plan, including a Welfare
Benefit Fund or an individual medical account [as defined in Code
Section 415(l)(2)] in which any Participant in this Plan is (or
was) a participant or could possibly become a participant.
(a) If the Participant is covered under another qualified Defined
Contribution Plan maintained by the Employer, other than a Master
or Prototype Plan:
[ ] (i) the provisions of Article X of the Basic
Plan Document #04 will apply, as if the other
plan were a Master or Prototype Plan.
[ ] (ii) Attach provisions stating 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.
(b) If a Participant is or ever has been a participant in a Defined
Benefit Plan maintained by the Employer:
Attach provisions which will satisfy the 1.0 limitation of Code
Section 415(e). Such language must preclude Employer discretion.
The Employer must also specify the interest and mortality
assumptions used in determining Present Value in the Defined
Benefit Plan.
(c) The minimum contribution or benefit required under Code Section
416 relating to Top-Heavy Plans shall be satisfied by:
[ ] (i) this Plan.
[ ] (ii) ______________________________________
(Name of other qualified plan of the Employer).
[ ] (iii) Attach provisions stating the method
under which the minimum contribution and
benefit provisions of Code Section 416 will
be satisfied. If a Defined Benefit Plan is or
was maintained, an attachment must be
provided showing interest and mortality
assumptions used in the Top-Heavy Ratio.
Page 21 of Exhibit 4
12. VESTING
Employees shall have a fully vested and nonforfeitable interest in any
Employer contribution and the investment earnings thereon made in
accordance with paragraphs (select one or more options) [ ] 7(c), [ ]
7(e), [ ] 7(f), [ ] 7(g) and [ ] 7(i) hereof. Contributions under
paragraph 7(b), 7(c)(vii) and 7(d) are always fully vested. If one or more
of the foregoing options are not selected, such Employer contributions
shall be subject to the vesting table selected by the Employer.
Each Participant shall acquire a vested and nonforfeitable percentage in
his or her account balance attributable to Employer contributions and the
earnings thereon under the procedures selected below except with respect
to any Plan Year during which the Plan is Top-Heavy, in which case the
Two-twenty vesting schedule [Option (b)(iv)] shall automatically apply
unless the Employer has already elected a faster vesting schedule. If the
Plan is switched to option (b)(iv), because of its Top-Heavy status, that
vesting schedule will remain in effect even if the Plan later becomes
non-Top-Heavy until the Employer executes an amendment of this Adoption
Agreement indicating otherwise.
(a) Computation Period:
The computation period for purposes of determining Years of
Service and Breaks in Service for purposes of computing a
Participant's nonforfeitable right to his or her account balance
derived from Employer contributions:
[ ] (i) shall not be applicable since Participants are
always fully vested,
[ ] (ii) shall commence on the date on which an Employee
first performs an Hour of Service for the
Employer and each subsequent 12-consecutive month
period shall commence on the anniversary thereof,
or
[x] (iii) shall commence on the first day of the
Plan Year during which an Employee first
performs an Hour of Service for the Employer
and each subsequent 12-consecutive month
period shall commence on the anniversary
thereof.
A Participant shall receive credit for a Year of Service if he or she
completes at least 1,000 Hours of Service [or if lesser, the number of
hours specified at 3(l)(iii) of this Adoption Agreement] at any time
during the 12-consecutive month computation period. Consequently, a Year
of Service may be earned prior to the end of the 12-consecutive month
computation period and the Participant need not be employed at the end of
the 12-consecutive month computation period to receive credit for a Year
of Service.
Page 22 of Exhibit 4
(b) Vesting Schedules:
NOTE: The vesting schedules below only apply to a Participant
who has at least one Hour of Service during or after the
1989 Plan Year. If applicable, Participants who separated
from Service prior to the 1989 Plan Year will remain under
the vesting schedule as in effect in the Plan prior to
amendment for the Tax Reform Act of 1986.
(i) Full and immediate vesting.
Years of Service
----------------
1 2 3 4 5 6 7
- - - - - - -
(ii) ___% 100%
(iii) ___% ___% 100%
(iv) ___% 20% 40% 60% 80% 100%
(v) 0% 0% 20% 40% 60% 80% 100%
(vi) 10% 20% 30% 40% 60% 80%
(vii) ___% ___% ___% ___% 100% 100%
(viii) ___% ___% ___% ___% ___% ___% 100%
NOTE: The percentages selected for schedule (viii) may not be less
for any year than the percentages shown at schedule (v).
[x] All contributions other than those which are fully vested
when contributed will vest under schedule (v) above.
[ ] Contributions other than those which are fully vested
when contributed will vest as provided below:
Vesting
Option Selected Type Of Employer Contribution
--------------- -----------------------------
____ 7(c) Employer Match on Salary Savings
____ 7(c) Employer Match on Employee Voluntary
____ 7(e) Employer Discretionary
____ 7(f) & (g) Employer Discretionary -
Integrated
Page 23 of Exhibit 4
(c) Service disregarded for Vesting:
[ ] (i) Not Applicable. All Service shall be considered.
[ ] (ii) Service prior to the Effective Date of this Plan
or a predecessor plan shall be disregarded when
computing a Participant's vested and
nonforfeitable interest.
[x] (iii) Service prior to a Participant having attained
age 18 shall be disregarded when computing a
Participant's vested and nonforfeitable interest.
13. SERVICE WITH PREDECESSOR ORGANIZATION
For purposes of satisfying the Service requirements for eligibility, Hours
of Service shall include Service with the following predecessor
organization(s):
(These hours will also be used for vesting purposes.)
NOTE: Past Service credit may only be given to Employees of a
predecessor employer in situations where there was a
transaction between the predecessor employer and this
Plan's Employer in which there was a stock or asset
acquisition, a merger, or similar transaction involving a
change in the Employer of the Employees of a trade or
business.
14. ROLLOVER/TRANSFER CONTRIBUTIONS
(a) Rollover Contributions, as described at paragraph 4.3 of the Basic
Plan Document #04, [x] shall [ ] shall not be permitted. If
permitted, Employees [x] may [ ] may not make Rollover
Contributions prior to meeting the eligibility requirements for
participation in the Plan.
(b) Transfer Contributions, as described at paragraph 4.4 of the Basic
Plan Document #04, [ ] shall [x] shall not be permitted. If
permitted, Employees [ ] may [x] may not make Transfer
Contributions prior to meeting the eligibility requirements for
participation in the Plan.
NOTE: Even if available, the Employer may refuse to accept such
contributions if its Plan meets the safe-harbor rules of
paragraph 8.7 of the Basic Plan Document #04.
Page 24 of Exhibit 4
15. HARDSHIP WITHDRAWALS
Hardship withdrawals, as provided for in paragraph 6.9 of the Basic Plan
Document #04, [ ] are [x] are not permitted. Hardship withdrawals shall be
made from [ ] all eligible monies [ ] only from eligible Employee Elective
Deferrals and eligible earnings thereon.
16. PARTICIPANT LOANS
Participant loans, as provided for in paragraph 13.5 of the Basic Plan
Document #04, [x] are [ ] are not permitted. If permitted, repayments of
principal and interest shall be repaid to [x] the Participant's segregated
account or [ ] the general Fund.
17. INSURANCE POLICIES
The insurance provisions of paragraph 13.6 of the Basic Plan Document #04
[ ] shall [x] shall not be applicable.
18. EMPLOYER INVESTMENT DIRECTION
The Employer investment direction provisions, as set forth in paragraph
13.7 of the Basic Plan Document #04, [x] shall [ ] shall not be
applicable.
19. EMPLOYEE INVESTMENT DIRECTION
(a) The Employee investment direction provisions, as set forth in
paragraph 13.8 of the Basic Plan Document #04, [x] shall [ ] shall
not be applicable.
If applicable, Participants may direct their investments:
[ ] (i) among funds offered by the Trustee.
[x] (ii) among any allowable investments.
(b) Participants may direct the following kinds of contributions and
the earnings thereon (check all applicable):
[ ] (i) All Contributions
[x] (ii) Elective Deferrals
[ ] (iii) Employee Voluntary Contributions (after-tax)
[ ] (iv) Employee Mandatory Contributions (after-tax)
Page 25 of Exhibit 4
[ ] (v) Employer Qualified Matching Contributions
[ ] (vi) Other Employer Matching Contributions
[ ] (vii) Employer Qualified Non-Elective Contributions
[ ] (viii) Employer Discretionary Contributions
[x] (ix) Rollover Contributions
[ ] (x) Transfer Contributions
NOTE: To the extent that Employee investment direction was
previously allowed, the Trustee shall have the right to
either make the assets part of the general Trust, or leave
them as separately invested subject to the rights of
paragraph 13.8.
20. EARLY PAYMENT OPTION
(a) A Participant who separates from Service prior to retirement,
death or disability [x] may [ ] may not make application to the
Employer requesting an early payment of his or her vested account
balance.
NOTE: If the above early payment of Vested Account Balances is
selected, either option 21(a)(i) or 21(a)(ii) below should
also be selected.
(b) A Participant who has attained age 59 1/2 and who has not
separated from Service [x] may [ ] may not obtain a distribution
of his or her vested Employer contributions. Distribution can only
be made if the Participant is 100% vested.
(c) A Participant who has attained the Plan's Normal Retirement Age
and who has not separated from Service [x] may [ ] may not receive
a distribution of his or her vested account balance.
NOTE: If the Participant has had the right to withdraw his or
her account balance in the past, this right may not be
taken away. Notwithstanding the above, to the contrary,
required minimum distributions will be paid. For timing of
distributions, see item 21(a) below.
Page 26 of Exhibit 4
21. DISTRIBUTION OPTIONS
(a) Timing of Distributions:
In cases of termination for other than death, disability or
retirement, benefits shall be paid:
[ ] (i) As soon as administratively feasible,
following the close of the valuation period
during which a distribution is requested or is
otherwise payable.
[ ] (ii) As soon as administratively feasible
following the close of the Plan Year during
which a distribution is requested or is
otherwise payable.
[x] (iii) As soon as administratively feasible,
following the date on which a distribution is
requested or is otherwise payable.
[ ] (iv) As soon as administratively feasible,
after the close of the Plan Year during which
the Participant incurs ___ consecutive one-year
Breaks in Service.
[ ] (v) Only after the Participant has achieved
the Plan's Normal Retirement Age, or Early
Retirement Age, if applicable.
In cases of death, disability or retirement, benefits shall be
paid:
[ ] (vi) As soon as administratively feasible,
following the close of the valuation period
during which a distribution is requested or is
otherwise payable.
[ ] (vii) As soon as administratively feasible
following the close of the Plan Year during
which a distribution is requested or is
otherwise payable.
[x] (viii) As soon as administratively feasible,
following the date on which a distribution is
requested or is otherwise payable.
NOTE: A Participant (and the Participant's spouse, if
applicable) must consent to any distribution if the
Participant's Vested Account Balance exceeds $3,500 or if
at the time of any prior distribution it exceeded $3,500.
Page 27 of Exhibit 4
(b) Optional Forms of Payment:
[x] (i) Lump Sum.
[x] (ii) Installment Payments. For Participants with
balances as of 3/31/99.
[ ] (iii) Life Annuity*.
[ ] (iv) Life Xxxxxxx Xxxx Xxxxxxx*.
Life Annuity with payments guaranteed for
___________ years (not to exceed 20 years,
specify all applicable).
[ ] (v) Joint and [ ] 50%, [ ] 66%%, [ ] 75% or [ ] 100%
survivor annuity* (specify all applicable).
[x] (vi) Other form(s) specified: See Attached Addendum
*Not available in Plan meeting provisions of paragraph 8.7 of
Basic Plan Document #04.
NOTE: Only optional Forms of Payments properly permitted under a
prior plan of the Employer or predecessor Employer may be
selected at subparagraph (b)(vi) above.
(c) Recalculation of Life Expectancy:
In determining required distributions under the Plan, Participants
and/or their Spouse (Surviving Spouse) [x] shall [ ] shall not
have the right to have their life expectancy recalculated
annually.
If "shall",
[ ] only the Participant shall be recalculated.
[ ] both the Participant and Spouse shall be recalculated.
[x] who is recalculated shall be determined by the Participant.
Page 28 of Exhibit 4
22 SPONSOR CONTACT
Employers should direct questions concerning the language contained in and
qualification of the Prototype to:
SunTrust Bank, Central Florida, N.A.
(Job Title) Trust Administrator
(Phone Number) (000) 000-0000
In the event that the Sponsor amends, discontinues or abandons this
Prototype Plan, notification will be provided to the Employer's address
provided on the first page of this Agreement.
Page 29 of Exhibit 4
APPENDIX A
PRIOR PROVISIONS DIFFERENT EFFECTIVE PERIODS
Provisions of this Adoption Agreement which were effective on different dates
than this final Tax Reform Act of 1986 amended Plan are:
Adoption Agreement Section Prior Provisions Effective Periods
-------------------------- ---------------- -----------------
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
__________________________ ____________________________ ___________ to __________
NOTE: This Appendix A only may be used to reflect the periods and
provisions which are different from those selected in this
Adoption Agreement, the Adopting Employer's final Plan. For
example, this Appendix A may be used to show different vesting
schedules, different entry dates, different eligibility
requirements, etc., for any periods prior to the final
restatement for all changes required by the Tax Reform Act of
1986 and subsequent legislation requiring changes in qualified
plans by the 1994 Plan Year.
Page 30 of Exhibit 4
23. SIGNATURES:
Due to the significant tax ramifications, the Sponsor recommends that
before you execute this Adoption Agreement, you contact your attorney or
tax advisor, if any.
(a) EMPLOYER:
Name and address of Employer if different than specified in
Section 1 above.
This agreement and the corresponding provisions of the Plan and
Trust/Custodial Account Basic Plan Document #04 were adopted by
the Employer the ____ day of ___________, 19___.
Signed for the Employer by: Xxx Xxxxxxx
Title: Executive Vice President
Signature: /s/ Xxx Xxxxxxx
---------------------------------
The Employer understands that its failure to properly complete the
Adoption Agreement may result in disqualification of its Plan.
Employer's Reliance: The adopting Employer may not rely on an
opinion letter issued by the National Office of the Internal
Revenue Service as evidence that the Plan is qualified under Code
Section 401. In order to obtain reliance with respect to Plan
qualification, the Employer must apply to the appropriate Key
District Office for a determination letter.
This Adoption Agreement may only be used in conjunction with Basic
Plan Document #04.
Page 31 of Exhibit 4
24. SIGNATURES:
Due to the significant tax ramifications, the Sponsor recommends that
before you execute this Adoption Agreement, you contact your attorney or
tax advisor, if any.
(a) EMPLOYER:
Name and address of Employer if different than specified in
Section 1 above.
Prestige Home Centers, Inc.
This agreement and the corresponding provisions of the Plan and
Trust/Custodial Account Basic Plan Document #04 were adopted by
the Employer the 12 day of February, 1999.
Signed for the Employer by: Xxx Xxxxxxx
Title: President
Signature: /s/ Xxx Xxxxxxx
------------------------------
The Employer understands that its failure to properly complete the
Adoption Agreement may result in disqualification of its Plan.
Employer's Reliance: The adopting Employer may not rely on an
opinion letter issued by the National Office of the Internal
Revenue Service as evidence that the Plan is qualified under Code
Section 401. In order to obtain reliance with respect to Plan
qualification, the Employer must apply to the appropriate Key
District Office for a determination letter.
This Adoption Agreement may only be used in conjunction with Basic
Plan Document #04.
[x] (b) TRUSTEE:
Name of Trustee:
SunTrust Bank, Central Florida, N.A.
Page 32 of Exhibit 4
The assets of the Fund shall be invested in accordance with
paragraph 13.3 of the Basic Plan Document #04 as a Trust. As such,
Employer's Plan as contained herein was accepted by the Trustee
the 12 day of February, 1999
Signed for the Trustee by: Xxxx X. Xxxxx
Title: Assistant Vice President and Trust
Officer
Signature: /s/ Xxxx X. Xxxxx
------------------------------------
[ ] (c) CUSTODIAN:
Name of Custodian:
The assets of the Fund shall be invested in accordance with
paragraph 13.4 of the Basic Plan Document #04 as a Custodial
Account. As such, the Employer's Plan as contained herein was
accepted by the Custodian the ___ day of _____________, 19__
Signed for the Custodian by:
Title:
Signature: --------------------------------------
(d) SPONSOR:
The Employer's Agreement and the corresponding provisions of the
Plan and Trust/Custodial Account Basic Plan Document #04 were
accepted by the Sponsor the 12 day of February, 1999.
Signed for the Sponsor by: Xxxx X. Xxxxx
Title: Assistant Vice President and Trust
Officer
Signature: /s/ Xxxx X. Xxxxx
-------------------------------------
Page 33 of Exhibit 4
Addendum to Adoption Agreement for the
Nobility Homes, Inc. 401(k) Profit Sharing Plan
Attachment to Section 21(b)(vi)
-------------------------------
In addition to the Optional Forms of Payment permitted in Section 21(b) of the
foregoing Adoption Agreement, the following Optional Forms of Payment shall be
available under the Plan:
1. Purchase of a single premium nontransferable annuity contract; and
2. A combination of the methods specified in subparagraphs (i), (ii), and (vi)
above.
x:\nobimemo
Page 34 of Exhibit 4
