Agreement For Salary Reduction Under The Colgate University Defined Contribution Retirement Plan Form - Human Resources Department

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COLGATE UNIVERSITY
Human Resources Department
Agreement for Salary Reduction Under the Colgate University Defined Contribution Retirement Plan
BY THIS AGREEMENT, made between ______________________________________ (the Employee) and Colgate
University (the University), we agree as follows:
Effective for amounts paid to the Employee by the University on or after _________________, 20____, which date is
subsequent to the execution of this Agreement, the Employee’s salary will be reduced by the amount or percentage indicated
below. The University will contribute the indicated amount or percentage to the Colgate University Defined Contribution
Retirement Plan (the Plan) and direct that amount to the investment provider (currently, TIAA-CREF and Fidelity
Investments) designated by the Employee below. As provided in the Plan, the Employee may then allocate the contributed
amounts among the mutual funds, annuity contracts, or any other investments made available under the Plan. If the
Employee fails to affirmatively allocate contributions, contributions will be directed to the Plan’s default investment
alternative, which currently is an age-appropriate lifecycle or target date mutual fund. (More information regarding Plan
investment options is available from the University’s Human Resources Department and from the investment providers.)
Subject to the foregoing, and subject to all of the terms and conditions of the Plan, the Employee hereby elects to reduce the
Employee’s “regular” gross salary (as further defined in the Plan) as follows:
DIRECT TO TIAA-CREF
DIRECT TO FIDELITY
Pre-Tax Election: Enter a dollar amount or a percentage
Pre-Tax Election: Enter a dollar amount or a percentage
of “regular” gross salary to be deducted on a pre-tax basis.
of “regular” gross salary to be deducted on a pre-tax basis.
$_________ per pay period
$_________ per pay period
______% per pay period
______% per pay period
Roth (After-Tax) Election: Enter a dollar amount or a
Roth (After-Tax) Election: Enter a dollar amount or a
percentage of “regular” gross salary to be deducted on an
percentage of “regular” gross salary to be deducted on an
after-tax basis.
after-tax basis.
$_________ per pay period
$_________ per pay period
______% per pay period
______% per pay period
If the Employee is or becomes eligible for University non-elective or matching contributions to the Plan, those University
contributions shall be directed for investment to (check one):
TIAA-CREF OR
Fidelity
This Agreement shall be legally binding and irrevocable for both the University and the Employee while the Employee’s
employment continues. However, either party may terminate or otherwise modify the Agreement as of the end of any pay
period by giving prior written notice, with implementation as soon as practicable, so that this Agreement will not apply to
salary subsequently paid. This Agreement will terminate automatically when the Employee’s employment ends. If the
Employee is rehired and wishes to make contributions to the Plan, a new agreement must be executed.
_______________________________
______________________________
Employee Signature
Date
Colgate University
Employing University
FOR HUMAN RESOURCES USE:
By__________________________________________________
(Name)
2104517.3 4/23/2013

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