SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • October 29th, 2008
Employee Information Employee Name Social Security No. Date of Birth Date of Hire Home Address City State Zip California Home Phone Work Phone SchoolsFirst Federal Credit Union Acct No. (Optional) School District Name: School/Location Name (Select One)Classified Certificated Agent/Financial Advisor Name: Phone Number Number of Voluntary Deductions Per Year (Select one)9 10 12 Other ---------------Action to be taken---------------(This request must be submitted 30 days prior to the effective date) Effective Date: Next available pay cycle Later Pay Cycle Check One: ⇒Begin or Resume Contributions (If you have NO current contributions)Change Future Contribution Amounts (Please list ALL future contributions below) Change Future Contribution Companies (Please list ALL future contributions below)Change Future Contribution Amounts and Companies (Please list ALL future contributions below) Terminate participation (If you are not terminating ALL providers, please choose one of the options ab
Oral Roberts University Retirement Plan (ORU) Salary Reduction Agreement (SRA)Salary Reduction Agreement (Sra) • November 8th, 2021
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • February 17th, 2009
Employee Information Employee Name Social Security No. Date of Birth Date of Hire Home Address City State Zip Home Phone Work Phone SchoolsFirst Federal Credit Union Acct No. (Optional) School District Name: School/Location Name (Select One) Classified Certificated Agent/Financial Advisor Name: Phone Number Number of Payroll Deductions Per Year (Select one)9 10 12 Other ---------------Action to be taken---------------(This request must be submitted 30 days prior to the effective date) Effective Date: Effective Pay Cycle Terminate participation (Use this form if you are terminating all Roth 403b deductions) Note: Please list ALL 403(b)deductions and ALL providers. ---------------Disclosure--------------- I understand and agree to the following:a. This Salary Reduction Agreement is legally binding and irrevocable with respect to amounts paid or available while this agreement is in effect; andb. This Salary Reduction Agreement may be terminated at any time for amounts not yet paid or
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • October 29th, 2008
Employee Information Employee Name Social Security No. Date of Birth Date of Hire Home Address City State Zip California Home Phone Work Phone SchoolsFirst Federal Credit Union Acct No. (Optional) School District Name: School/Location Name (Select One) Classified Certificated Agent/Financial Advisor Name: Phone Number Number of Voluntary Deductions Per Year (Select one)9 10 12 Other ---------------Action to be taken---------------(This request must be submitted 30 days prior to the effective date) Effective Date: Next available pay cycle Later Pay Cycle Check One: ⇒Begin or Resume Contributions (If you have NO current contributions)Change Future Contribution Amounts (Please list ALL future contributions below) Change Future Contribution Companies (Please list ALL future contributions below)Change Future Contribution Amounts and Companies (Please list ALL future contributions below) Terminate participation (If you are not terminating ALL providers, please choose one of the option
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • July 18th, 2011
Agents: Complete information below only if the participant is not currently contributing to the company(ies) that he or she has selected. You are signing to the fact that the employee has completed all documentation necessary to open an account with the company.
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • July 31st, 2018
*Splitting contributions among multiple vendors: If you want to contribute to m ore than one company, the dollar amount will be split
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • April 16th, 2008
Employee Information Employee Name Social Security No. Date of Birth Date of Hire Home Address City StateCalifornia Zip Home Phone Work Phone SchoolsFirst Federal Credit Union Acct No. (Optional) School District Name: School/Location Name (Select One) Classified Certificated Agent/Financial Advisor Name: Phone Number Number of Voluntary Deductions Per Year (Select one)9 10 12 Other ---------------Action to be taken---------------(This request must be submitted 30 days prior to the effective date) Effective Date: Next available pay cycle Later Pay Cycle Check One: ⇒Begin or Resume Contributions (If you have NO current contributions)Change Future Contribution Amounts (Please list ALL future contributions below) Change Future Contribution Companies (Please list ALL future contributions below)Change Future Contribution Amounts and Companies (Please list ALL future contributions below) Terminate participation (If you are not terminating ALL providers, please choose one of the options above
For new accounts you must complete the Employer Match Form – please print off the Employer Match form (available on the USD 489 website), complete the top portion and send it to the Payroll Office. NOTE: DO NOT add the employer match amount on Omni as...Salary Reduction Agreement (Sra) • July 7th, 2022
ContractSalary Reduction Agreement (Sra) • March 18th, 2010
Instructions The Salary Reduction Agreement (SRA) is to be used to establish, change, or cancel salary reductions withheld from your paycheck and contributed to the 403(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.NBS Mailing Address: National Benefit Services, LLC NBS Fax Number: (800) 597-8206 8523 S. Redwood RoadWest Jordan, UT 84088 NBS Phone Number: (800) 274-0503 ext. 5 EmployeeInformation Employee Name Social Security Number Employer Name Home Phone Number Employee Mailing Address (Street) (City, ST ZIP) E-mail Address Date of Birth Number of Pay Periods Per Year RequestedAction Check only one box. SRA is not valid without an Effective Date.I want to STOP all contributions to all providers Effective Date:I want to BEGI
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • October 29th, 2008
Employee Information Employee Name Social Security No. Date of Birth Date of Hire Home Address City State Zip California Home Phone Work Phone SchoolsFirst Federal Credit Union Acct No.(Optional) School District Name: School/Location Name (Select One) Classified Certificated Agent/Financial Advisor Name: Phone Number Number of Voluntary Deductions Per Year (Select one)9 10 12 Other --------------- Effective Date: Next available pay cycle Later Pay Cycle Check One: ⇒Begin or Resume Contributions (If you have NO current contributions)Change Future Contribution Amounts (Please list ALL future contributions below) Change Future Contribution Companies (Please list ALL future contributions below)Change Future Contribution Amounts and Companies (Please list ALL future contributions below) Terminate participation (If you are not terminating ALL providers, please choose one of the options above)403bcompare.com Dollar Amount -OR- Percentage** **Percentage of gross pay. Vendor Vendor ID #{Pe
Independent School District #728 Salary Reduction Agreement (SRA)Salary Reduction Agreement (Sra) • December 31st, 2015
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • February 12th, 2020
ContractSalary Reduction Agreement (Sra) • January 28th, 2009
Instructions The Salary Reduction Agreement (SRA) is to be used to establish, change, or cancel salary reductions withheld from your paycheck and contributed to the 403(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. NBS Mailing Address: National Benefit Services, LLC NBS Fax Number: (800) 597-8206 8523 S. Redwood Road West Jordan, UT 84088 NBS Phone Number: (800) 274-0503 ext. 5 EmployeeInformation Employee Name Social Security Number Employer Name Home Phone Number Employee Mailing Address E-mail Address (Street) (City, ST ZIP) Date of Birth Number of Pay Periods Per Year RequestedAction Check only one box. SRA is not valid without an Effective Date.
OMNI Online SRA Completion InstructionsSalary Reduction Agreement (Sra) • April 16th, 2020
The Omni Salary Reduction Agreement (SRA) form must be completed by the last day of the month prior to the month you wish the change to take effect. For example, there is a July 31st deadline for changes to be effective on your August paycheck. This process is only necessary for 403b, 403b Roth and 457 Tax Shelters, if you wish to contribute to the Persi Choice 401K, please complete the Persi Choice form available on the Employee Online website and submit it directly to the Payroll Department at the Boise School District Services Center. Please contact the payroll department at 208-854-4025 with any 401K questions.
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • October 29th, 2008
Employee Information Employee Name Social Security No. Date of Birth Date of Hire Home Address City State Zip California Home Phone Work Phone SchoolsFirst Federal Credit Union Acct No. (Optional) School District Name: School/Location Name (Select One)Classified □ Certificated □ Agent/Financial Advisor Name: Phone Number Number of Voluntary Deductions Per Year (Select one)9 □ 10 □ 12 □ Other ---------------Action to be taken---------------(This request must be submitted 30 days prior to the effective date) Effective Date: □ Next available pay cycle □ Later Pay Cycle Check One: ⇒□ Begin or Resume Contributions (If you have NO current contributions)□ Change Future Contribution Amounts (Please list ALL future contributions below)□ Change Future Contribution Companies (Please list ALL future contributions below)□ Change Future Contribution Amounts and Companies (Please list ALL future contributions below)□ Terminate participation (If you are not terminating ALL providers, please choose
Salary Reduction Agreement (SRA) steps to make a change to a current contribution or to set up a new contribution:Salary Reduction Agreement (Sra) • November 9th, 2020
Pick the 2nd option and follow the directions. You will need to fill out each of the 4 sections – Employer Information, Employee Information and Agreements and Acknowledgements. The next section can’t be accessed until the previous one is completed.
ContractSalary Reduction Agreement (Sra) • November 8th, 2024
Important This Salary Reduction Agreement (SRA) REPLACES AND CANCELS ALL PREVIOUS AGREEMENTS ON FILE. Only the contributions to the companies listed below will continue after the effective date of this agreement.
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • March 8th, 2021
This agreement terminates any prior salary reduction agreement executed by me and submitted to the District with respect to the 457(b) Plan. This agreement shall continue indefinitely until amended or terminated by either party by giving at least thirty (30) days advance written notice. I acknowledge that my participation in the 457(b) Plan will terminate upon my separation from service with the District.
SALARY REDUCTION AGREEMENT (SRA)Salary Reduction Agreement (Sra) • December 3rd, 2018
