SALARY REDUCTION AGREEMENTSalary Reduction Agreement • February 18th, 2009
Contract Type FiledFebruary 18th, 2009Please read information on reverse side before completing Effective As soon as possible Date: Later: _ See #7, p. 2 (Paycheck date) mm/dd/yyyy PART I: Employee Information Name Last First Middle Employee ID or last 4 digits of SSN University of Wisconsin InstitutionUW- Work phone number Number of Pay Periods per Year9* 12 26 E-mail Address Date of Birth/ / I am age 50 or older this year.Yes No This year I contributed to another employer's voluntary retirement plan.Yes No