STATE OF MONTANA 457(b) DEFERRED COMPENSATION 2020 SALARY DEFERRAL AGREEMENT457(b) Deferred Compensation Agreement • March 18th, 2020
Contract Type FiledMarch 18th, 2020About You Last Name First Name, MI Date of Birth/ / Last 4 of SSN Employer Employee ID # (for State Employees Only) Phone Number Payroll Choices Contribution Type (Choose One) Start/Restart Stop Change One Time Final/Retiring Military Make Up for Year(s) No. of Deferrals Per Year 12 (If you are paid Monthly) 24 (If you are paid Semi‐Monthly or Biweekly and do not want your deferral to come out of a third paycheck) 26+ (If you are paid Biweekly and want your deferral from all checks) Contribution Amount(s) (amount per paycheck) Pre Tax $ or % Post Tax (ROTH) $ or % Deferral Effective Pay Date (Choose One) Next Eligible Pay Date or Beginning on Pay Date / / Note: changes to the dollar amount contributed to the Plan must be made in the month prior to when it will take effect. Deferral Type Basic Deferral/Age 50 Catch‐Up ‐ I understand that I will be enrolled in the appropriate deferral‐limit provision based on my age. My total annual pre‐tax contributions and Designated Roth Contri