457(b) Salary Reduction Agreement Sample Contracts

Participant Instructions
457(b) Salary Reduction Agreement • February 6th, 2020

The Salary Reduction Agreement (SRA) is to be utilized to establish, change, or cancel salary reductions withheld from your paycheck and contributed to the 457(b) plan on your behalf. The SRA is also used to change the investment providers that receive your contributions. Upon completion, fax or mail a copy of the form to National Benefit Services, LLC. Please note that this form is not valid unless all applicable sections are completed and you have signed the form.

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Contract
457(b) Salary Reduction Agreement • December 8th, 2015

*Last Name *First Name *MI *Date of Birth *Street Address *City *State *Zip Code *Social Security Number *Date of Hire *Annual Salary *Contact Number I Am Paid: 🞏 Monthly *Email Address 🞏 Semi-monthly 🞏 Bi-weekly

Contract
457(b) Salary Reduction Agreement • December 4th, 2019
Participant Instructions
457(b) Salary Reduction Agreement • February 6th, 2020

The Salary Reduction Agreement (SRA) is to be utilized to establish, change, or cancel salary reductions withheld from your paycheck and contributed to the 457(b) plan on your behalf. The SRA is also used to change the investment providers that receive your contributions. Upon completion, fax or mail a copy of the form to National Benefit Services, LLC. Please note that this form is not valid unless all applicable sections are completed and you have signed the form.

Contract
457(b) Salary Reduction Agreement • September 27th, 2017
Participant Instructions
457(b) Salary Reduction Agreement • October 28th, 2022

The Salary Reduction Agreement (SRA) is utilized to establish, change, or cancel salary reductions withheld from your paycheck and contributed to the 457(b) Plan on your behalf. The SRA is also used to change the investment providers that receive your contributions. Upon completion, fax or mail a copy of the form to National Benefit Services, LLC. Please note that this form is not valid unless all applicable sections are completed and you have signed the form. If you have questions regarding this form, please call 1-800-274-0503 ext 5.

Participant Instructions
457(b) Salary Reduction Agreement • March 16th, 2018

The Salary Reduction Agreement (SRA) is utilized to establish, change, or cancel salary reductions withheld from your paycheck and contributed to the 457(b) plan on your behalf. The SRA is also used to change the investment providers that receive your contributions. Upon completion, fax or mail a copy of the form to National Benefit Services, LLC. Please note that this form is not valid unless all applicable sections are completed and you have signed the form.

Participant Instructions
457(b) Salary Reduction Agreement • March 21st, 2016

The Salary Reduction Agreement (SRA) is to be used to establish, change, or cancel salary reductions withheld from your paycheck and contributed to the 457(b) plan on your behalf. The SRA is also used to change the investment providers that receive your contributions. Upon completion, fax or mail a copy of the form to National Benefit Services, LLC. Please note that this form is not valid unless all applicable sections are completed and you have signed the form.

Contract
457(b) Salary Reduction Agreement • November 16th, 2021
Contract
457(b) Salary Reduction Agreement • December 8th, 2015

*Last Name *First Name *MI *Date of Birth *Street Address *City *State *Zip Code *Social Security Number *Date of Hire *Annual Salary *Contact Number I Am Paid: □ Monthly *Email Address □ Semi-monthly □ Bi-weekly

Contract
457(b) Salary Reduction Agreement • September 27th, 2017
Contract
457(b) Salary Reduction Agreement • November 22nd, 2021
Contract
457(b) Salary Reduction Agreement • October 13th, 2016

This Agreement is legally binding and irrevocable for both the Institution and the Employee with respect to amounts earned while the Agreement is in effect.

Contract
457(b) Salary Reduction Agreement • November 16th, 2021
Contract
457(b) Salary Reduction Agreement • May 24th, 2022

Your contributions, and the College’s contributions, are subject to IRS regulations. Your salary reduction amount cannot exceed the lesser of the dollar limits in the chart below or 100% of your pay.

Contract
457(b) Salary Reduction Agreement • March 9th, 2022
Contract
457(b) Salary Reduction Agreement • January 26th, 2016

This Salary Reduction Agreement will continue to be in effect until you notify the Benefits & Data Management Office in Human Resources in writing that you wish to cancel or change the agreement. Either employee or the employer may terminate this Salary Reduction Agreement at any time.

Contract
457(b) Salary Reduction Agreement • July 31st, 2018
Contract
457(b) Salary Reduction Agreement • July 18th, 2019
UNIVERSITY SYSTEM OFFICE (USO) 457(B) SALARY REDUCTION AGREEMENT
457(b) Salary Reduction Agreement • December 8th, 2014

This Agreement shall be legally binding and irrevocable for both the Employer and Employee with respect to amounts paid or otherwise made available while this agreement is in effect. Either party may modify or otherwise terminate this Agreement as of the first pay period commencing with or during the first month following receipt of satisfactory written notice of such modification or termination by giving at least a 30 day written notice so that this Agreement will not apply to the amounts subsequently paid or otherwise made available.

SCHOOL DISTRICT OF KETTLE MORAINE 457(b) SALARY REDUCTION AGREEMENT
457(b) Salary Reduction Agreement • January 23rd, 2013

This salary reduction agreement does not establish a tax deferred annuity with a specific vendor but only authorizes the withholding of funds from your paycheck. Allow three weeks for processing.

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WASHTENAW COMMUNITY COLLEGE
457(b) Salary Reduction Agreement • December 5th, 2017

By this agreement, made between (employee’s name), Employee ID number @ , and Washtenaw Community College, the parties hereto agree as follows:

SCHOOL DISTRICT OF ATHENS 457(b) SALARY REDUCTION AGREEMENT
457(b) Salary Reduction Agreement • December 22nd, 2015
Salary Reduction Agreement
457(b) Salary Reduction Agreement • November 3rd, 2020

A 457(b) plan is a tax-deferred retirement plan, which allows employees to defer income on retirement savings into future years.

Participant Instructions
457(b) Salary Reduction Agreement • February 6th, 2020

The Salary Reduction Agreement (SRA) is to be utilized to establish, change, or cancel salary reductions withheld from your paycheck and contributed to the 457(b) plan on your behalf. The SRA is also used to change the investment providers that receive your contributions. Upon completion, fax or mail a copy of the form to National Benefit Services, LLC. Please note that this form is not valid unless all applicable sections are completed and you have signed the form.

Contract
457(b) Salary Reduction Agreement • June 1st, 2016
Contract
457(b) Salary Reduction Agreement • June 5th, 2020
Simi Valley Unified School District 457(b) Salary Reduction Agreement
457(b) Salary Reduction Agreement • June 15th, 2022

To complete this form, enter the correct information into each designated field within the 'Employee Information' section. Please ensure all spelling and numbers which are entered are accurate.

Contract
457(b) Salary Reduction Agreement • February 6th, 2020
Salary Reduction Agreement Company Distribution Cancellation
457(b) Salary Reduction Agreement • April 27th, 2007
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