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1 similar Participation Agreement contracts
PARTICIPATION AGREEMENT FOR SECTION 457 DEFERRED COMPENSATION PLANParticipation Agreement • July 9th, 2021
NAME (PRINT LAST, FIRST, MI) SOCIAL SECURITY NO. DATE OF BIRTH STREET ADDRESS CITY STATE ZIP CODE DEPARTMENT WK. PHONE HOME PHONE EMPLOYEE NUMBER CONTRIBUTION AMOUNTI wish to participate in the OLMSTED COUNTY Deferred Compensation Plan.I hereby agree to defer compensation each pay period in the amount of $ Pre-tax / Roth.This is to be effective on pay date . INVESTMENT SELECTIONThe compensation deferred is to be directed to Voya Life Insurance and Annuity Company and invested in accordance with my investment designation with that provider. BENEFICIARYI wish to designate the following beneficiary(ies) to receive benefits in the event of my death. I understand that each beneficiary eligible to receive benefits will receive an equal share of benefits under the Plan unless otherwise indicated.Primary Beneficiary(ies) & relationship to participant : Contingent Beneficiary(ies) & relationship to partcipant: CATCH-UP ELECTION (Select one only) Three Years Prior to Normal Retirement AgeF
