Common Contracts

SALARY REDUCTION AGREEMENT

February 16th, 2016

• Filed
  February 16th, 2016

Please read information on reverse side before completing Employee ID or last 4 digits of SSN Effective As soon as possibleDate: Later: See #7, p. 2 (Paycheck date) mm/dd/yyyy PART I: Employee Information Name Last First Middle Number of Pay Periods per Year9* 12 26 University of Wisconsin InstitutionUW- Work phone number This year I contributed to another employer's voluntary retirement plan.Yes No E-mail Address Date of Birth I am age 50 or older this year.Yes No I own more than 50% of a business andhave a retirement plan with that business.Yes No *For those with 9-month appointments, contributions are taken only 9 times annually; no deductions are taken during the summer. PART II: Begin/Resume/Change I authorize the University to reduce my salary to allow for the purchase of a 403(b) supplemental retirement benefit on my behalf and to remit the designated amounts each pay period to the investment company or companies indicated below. I have read and will abide by the Participa