Common Contracts
2 similar 403(b) Salary Reduction Agreement contracts
Contract403(b) Salary Reduction Agreement • July 31st, 2017
Retirement Plan Administration 403(b) Salary Reduction Agreement (SRA) FAX COMPLETED FORMS TO: 714.258.4262 1. Participant Information First Name Last Name Social Security Number (REQUIRED) Date of Birth Date of Hire Street Address City State Zip CodeSB Phone NumberCertificated Classified School District County Employee ID (Required for LA Districts Only) Participant Email Address 2. Action This agreement supersedes all prior 403(b) Salary Reduction Agreements (SRA) on file, only the instructions identified below will be completed. SRAs must be submitted at least 30 days, but not more than 90 days, prior to the effective date. For your convenience, you may also make your deferral change online at pa.schoolsfirstfcu.org. Effective date: ■ Next Available Pay Date Future Pay Date Type of Deferral Requested Action Investment Provider Name Pre-Tax Roth403(b) 403(b) Amount ■ Begin Resume Change Cancel ■ $ Begin Resume Change Cancel $
Contract403(b) Salary Reduction Agreement • April 14th, 2017
Retirement Plan Administration 403(b) Salary Reduction Agreement (SRA) FAX COMPLETED FORMS TO: 714.258.4262 1. Participant Information First Name Last Name Social Security Number (REQUIRED) Date of Birth Date of Hire Street Address City State Zip Code Phone NumberCertificated Classified School District County Employee ID (Required for LA Districts Only) Participant Email Address 2. Action This agreement supersedes all prior 403(b) Salary Reduction Agreements (SRA) on file, only the instructions identified below will be completed. SRAs must be submitted at least 30 days, but not more than 90 days, prior to the effective date. For your convenience, you may also make your deferral change online at pa.schoolsfirstfcu.org. Effective date: Next Available Pay Date Future Pay Date Type of Deferral Requested Action Investment Provider Name Pre-Tax Roth403(b) 403(b) Amount Begin Resume Change Cancel $ Begin Resume Change Cancel $ Begin
