DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENT FOR JEFFREY J. DEUELDeferred Compensation Plan Participation Agreement • September 7th, 2012 • Heritage Financial Corp /Wa/ • Savings institutions, not federally chartered
This Participation Agreement (“Participation Agreement”) is entered into as of July 1, 2012 (the “Award Date”) by and between HERITAGE FINANCIAL CORPORATION (the “Company”) and JEFFREY J. DEUEL, an employee of the Company (the “Participant”). Except for terms defined herein, any capitalized term in this Participation Agreement has the meaning ascribed to that term under the Heritage Financial Corporation Deferred Compensation Plan (the “Plan”).
Participant InformationDeferred Compensation Plan Participation Agreement • January 2nd, 2019
Plan Name: Kent County Deferred Compensation Plan Plan ID: 0039275001 Name: Social Security Number: Date of Birth: Gender: c Male c Female Address: City, State, & ZIP: Home Phone Number: Work Phone Number: Email Address:
DEFERRED COMPENSATION PLANDeferred Compensation Plan Participation Agreement • December 19th, 2011
SEND COMPLETED FORM TO:Deferred Compensation Plan Participation Agreement • December 3rd, 2021
Please read the reverse side of this form and Plan Highlights document carefully before completing this agreement. If you are a new participant, you must also complete the ICMA-RC 457 enrollment form. Please type or print clearly in ink. Human Resources must approve all requests before they become final.
PARTICIPANT INFORMATIONDeferred Compensation Plan Participation Agreement • April 21st, 2014
Effective Date: This agreement will be effective the first available pay date of the month following the month this form is completed.
Oklahoma City, OK Deferred Compensation Plan Participation Agreement and Service RequestDeferred Compensation Plan Participation Agreement • January 3rd, 2012
Deferrals can start, increase or decrease no earlier than the first day of the month following the month this application is signed.
Deferred Compensation PlanDeferred Compensation Plan Participation Agreement • June 24th, 2015
Plan Name: Snohomish County, WA Plan ID: 0037208001 Name: SSN: Date of Birth: Gender: c Male c Female Address: City, State, & ZIP: Home Phone Number: Work Phone Number: Email Address:
Participant Information Plan Name: Kent County Deferred Compensation Plan Plan ID: 0039275001 Name: SSN: Date of Birth: Primary Phone: Street Address: City: State: ZIP: Email: How would you like to be contacted if additional information is required? ⬜...Deferred Compensation Plan Participation Agreement • July 27th, 2022
Paperless Delivery: By providing your email address you are consenting to electronic (paperless) delivery of documents related to your retirement plan, e.g. - statements, confirmations, terms, agreements, etc. Check the box below if you would prefer to receive paper copies of the documents via US Mail to the address provided above.
Form of 2006 Participant Agreement under Deferred Compensation Plan for Directors of Entercom Communications Corp.Deferred Compensation Plan Participation Agreement • December 19th, 2005 • Entercom Communications Corp • Radio broadcasting stations
To enroll in the Entercom Deferred Compensation Plan for Directors, you must complete Sections A-E of this form. After completing all sections that apply, please return this form to our corporate office by December 27, 2005.
City of Tampa Deferred Compensation Plan Participation Agreement and Service RequestDeferred Compensation Plan Participation Agreement • January 6th, 2012
Deferrals can start or increase no earlier than the first day of the month following the month this application is signed.
Personal Information Plan Name: OCFA Deferred Compensation Plan Plan ID: 0038488001 Name: Date of Birth: SSN: Gender: ⬜ Male ⬜ Female Street Address: City: State: ZIP: Home Phone: Work Phone: Email:Deferred Compensation Plan Participation Agreement • October 4th, 2019
Paperless Delivery: By providing your email address you are consenting to receive statements, confirmations, terms, agreements and other information provided in connection with your retirement plan electronically. Unless you choose to have statements, account documents and other documents sent in connection with your retirement plan delivered via US Mail to the mailing address of record by checking the box below, these documents will be made available to you electronically.
City of Orlando, FL Deferred Compensation Plan Participation Agreement and Service RequestDeferred Compensation Plan Participation Agreement • April 9th, 2012
Deferrals can start, increase or decrease no earlier than the first day of the month following the month this application is signed.
HERITAGE FINANCIAL CORPORATION DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENTDeferred Compensation Plan Participation Agreement • November 6th, 2019 • Heritage Financial Corp /Wa/ • Savings institutions, not federally chartered
This Participation Agreement (“Participation Agreement”) is entered into as of November 4, 2019 (the “Award Date”) by and between HERITAGE FINANCIAL CORPORATION (the “Company”) and CINDY HUNTLEY, an employee of the Company (the “Participant”). Except for terms defined herein, any capitalized term in this Participation Agreement has the meaning ascribed to that term under the Heritage Financial Corporation Deferred Compensation Plan, as amended (the “Plan”).
Deferred Compensation PlanDeferred Compensation Plan Participation Agreement • June 22nd, 2015
Plan Name: Oklahoma City, OK Plan ID: 0038678001 Name: Social Security Number: Date of Birth: Gender: c Male c Female Address: City, State, & ZIP: Home Phone Number: Work Phone Number: Email Address:
CITY OF EUGENE DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENTDeferred Compensation Plan Participation Agreement • January 17th, 2012
(A meeting with ING is required to begin participation, or to add a new Pre-tax Option or Roth Option if fund choices have not previously been selected.)
Personal InformationDeferred Compensation Plan Participation Agreement • August 30th, 2019
Select Action: ⬜ New Enrollment ⬜ Re-Enrollment ⬜ Change of Address ⬜ Beneficiary Change ⬜ Name Change Employer Name: Town of Rowe Employer ID: 0059288-001 Name: SSN: Date of Birth: Gender: ⬜ Male ⬜ Female Address: City, State, & ZIP: Home Phone Number: Work Phone Number: Email Address:
CLACKAMAS COUNTY DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENT(Revised 9/2009)Deferred Compensation Plan Participation Agreement • September 24th, 2009
NEW PARTICIPATION Name(Last)Address (Street) (City)Department /Division Name RESTART PAYROLL DEDUCTION (First) (State) INCREASE PAYROLL DEDUCTIONPARTICIPANT INFORMATIO (Middle Initial) (ZIP Code) DEFERRAL ELECTION DECREASE PAYROLL DEDUCTIONN Social Security # Date of Birth:Work Phone ( Home Phone ( STOP PAYROLL DEDUCTION Employee ID ) )
HERITAGE FINANCIAL CORPORATION DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENTDeferred Compensation Plan Participation Agreement • March 11th, 2015 • Heritage Financial Corp /Wa/ • Savings institutions, not federally chartered
This Participation Agreement (“Participation Agreement”) is effective as of January 1, 2015 (the “Award Date”) by and between HERITAGE FINANCIAL CORPORATION (the “Company”) and Bryan D. McDonald, an employee of the Company (the “Participant”). Except for terms defined herein, any capitalized term in this Participation Agreement has the meaning ascribed to that term under the Heritage Financial Corporation Deferred Compensation Plan, as amended (the “Plan”).
Deferred Compensation PlanDeferred Compensation Plan Participation Agreement • September 10th, 2015
Plan Name: County of Fresno, CA Deferred Compensation Plan ID: 0051910001 Name: Social Security Number: Date of Birth: Gender: ⬜ Male ⬜ Female Address: City, State, & ZIP: Home Phone Number: Work Phone Number: Email Address:
HERITAGE FINANCIAL CORPORATION DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENTDeferred Compensation Plan Participation Agreement • June 28th, 2012 • Heritage Financial Corp /Wa/ • Savings institutions, not federally chartered
This Participation Agreement (“Participation Agreement”) is entered into as of July 1, 2012 (the “Award Date”) by and between HERITAGE FINANCIAL CORPORATION (the “Company”) and BRIAN L. VANCE, an employee of the Company (the “Participant”). Except for terms defined herein, any capitalized term in this Participation Agreement has the meaning ascribed to that term under the Heritage Financial Corporation Deferred Compensation Plan (the “Plan”).
Personal InformationDeferred Compensation Plan Participation Agreement • February 9th, 2016
Plan Name: Kansas City, MO Deferred Compensation Plan Plan ID: 0038754001 Name: SSN: Date of Birth: Gender: c Male c Female Address: City, State, & ZIP: Home Phone Number: Work Phone Number: Email Address:
COUNTY OF SAN JOAQUIN DEFERRED COMPENSATION PLAN EZ ENROLLMENT/PARTICIPATION AGREEMENTDeferred Compensation Plan Participation Agreement • January 7th, 2015
County of San Joaquin (the ‘employer’) has established an Internal Revenue Code Section 457(b) Deferred Compensation Plan (the ‘Plan’) for the benefit of its employees. The Plan provides that eligible employees may elect to join and become participants in the Plan (subject to the limitations established in the Plan) upon executing and filing a Participant Agreement with the employer.
Deferred Compensation PlanDeferred Compensation Plan Participation Agreement • June 22nd, 2015
Plan Name: Snohomish County, WA Plan ID: 0037208001 Name: SSN: Date of Birth: Gender: c Male c Female Address: City, State, & ZIP: Home Phone Number: Work Phone Number: Email Address:
Deferred Compensation Plan 457(b) ParticipationDeferred Compensation Plan Participation Agreement • December 29th, 2011
County of Cortland, NY Deferred Compensation PlanDeferred Compensation Plan Participation Agreement • June 22nd, 2015
Name: Social Security Number: Address: City, State, & Zip Code: Date of Birth: Home Phone Number: Department: Work Phone Number: Date of Hire: Gender: c Male c Female Email Address:
Deferred Compensation PlanDeferred Compensation Plan Participation Agreement • June 24th, 2015
Plan Name: Pierce County, WA Plan ID: 0049890001 Name: SSN: Date of Birth: Gender: c Male c Female Address: City, State, & ZIP: Home Phone Number: Work Phone Number: Email Address:
Nationwide Retirement SolutionsDeferred Compensation Plan Participation Agreement • March 18th, 2010
DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENT and DESIGNATION OF BENEFICIARYDeferred Compensation Plan Participation Agreement • April 26th, 2005
WHEREAS, the Employer has established the “Glendale Unified School District Employees Deferred Compensation Plan”, hereinafter referred to as “Plan” for the benefit of its employees, and
HERITAGE FINANCIAL CORPORATION DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENT - ADDENDUMDeferred Compensation Plan Participation Agreement • December 22nd, 2015 • Heritage Financial Corp /Wa/ • Savings institutions, not federally chartered
This Participation Agreement Addendum (“Addendum”) is hereby entered into by and between HERITAGE FINANCIAL CORPORATION (the “Company”) and DAVID A. SPURLING, an employee of the Company (the “Participant,” and together with the Company, the “Parties”).
Deferred Compensation PlanDeferred Compensation Plan Participation Agreement • November 27th, 2012
Plan ID: ⬜ Corp - 0035046001 ⬜ Pension - 0035046001 ⬜ Health - 0035046001 ⬜ Forest Preserve - 0035043001 Name: SSN: Date of Birth: Gender: ⬜ Male ⬜ Female Address: City, State, & ZIP: Home Phone Number: Work Phone Number: Work Location: Department: Department Number: Employee Number: Email Address: Includible Compensation: $
OPINION RESEARCH CORPORATION DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENTDeferred Compensation Plan Participation Agreement • December 20th, 2005 • Opinion Research Corp • Services-engineering, accounting, research, management
Subject to the provisions of the Opinion Research Corporation Deferred Compensation Plan, as amended (the “Plan”), I request that, pursuant to Section 3 of the Plan, compensation otherwise payable to me by Opinion Research Corporation (the “Company”) be paid to me on a deferred basis as indicated on this form.
Deferred Compensation PlanDeferred Compensation Plan Participation Agreement • September 20th, 2023
Paperless Delivery: By providing your email address you are consenting to electronic (paperless) delivery of documents related to your retirement plan, e.g. - statements, confirmations, terms, agreements, etc. Check the box below if you would prefer to receive paper copies of the documents via US Mail to the address provided above.
Deferred Compensation PlanDeferred Compensation Plan Participation Agreement • January 15th, 2021
Paperless Delivery: By providing your email address you are consenting to electronic (paperless) delivery of documents related to your retirement plan, e.g. - statements, confirmations, terms, agreements, etc. Check the box below if you would prefer to receive paper copies of the documents via US Mail to the address provided above.
PARTICIPANT INFORMATIONDeferred Compensation Plan Participation Agreement • February 11th, 2016
Effective Date: This agreement will be effective the first available pay date of the month following the month this form is completed.
HERITAGE FINANCIAL CORPORATION DEFERRED COMPENSATION PLAN PARTICIPATION AGREEMENTDeferred Compensation Plan Participation Agreement • January 6th, 2014 • Heritage Financial Corp /Wa/ • Savings institutions, not federally chartered
This Participation Agreement (“Participation Agreement”) is entered into as of January 2, 2014 (the “Award Date”) by and between HERITAGE FINANCIAL CORPORATION (the “Company”) and DAVID A. SPURLING, an employee of the Company (the “Participant”). Except for terms defined herein, any capitalized term in this Participation Agreement has the meaning ascribed to that term under the Heritage Financial Corporation Deferred Compensation Plan, as amended (the “Plan”).
