Meredith College
Employee Name: ________________________________ ID#: ________________
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􀂉 New / Change Enrollment:
I authorize Meredith College to withhold the amount indicated below from my current gross pay
as my pre-tax contribution to the Plan. This election replaces any previous elections that I may
have made.
PreTax: $_________________ per pay cycle Effective Date: ___________
PreTax: %________________ per pay cycle Effective Date: ___________
I understand this election will begin on the next available payroll following the effective date
indicated. I also understand that the election will remain in effect until I request a change in
writing. However, I acknowledge and agree that my employer may reduce or suspend my
contributions if it is determined that the legal limit has been reached. I understand it is my sole
responsibility to establish a contribution amount within legal limits, to establish an account and
monitor investment performance, fees and expenses associated with the account. I understand that
participation in the Plan requires that account information be coordinated between TIAA and
Meredith College.
2020 Annual Employee Contribution Limits: 403(b) - $19,500 / Catch-Up - $6,500 I understand
that contribution limits may change from year to year, and that my contribution amount under this
will not
automatically adjust each year due to changes in the applicable limits. Any changes
to my contribution deduction amounts require that I complete a new authorization form.
􀂉 Cancellation / Non-election:
I do not wish to make any contributions to the Plan at this time. Please stop my current 403(b)
salary reduction contributions on the next available payroll following the effective date given.
Cancellation Effective Date: ________________
Employee Signature: _______________________________ Date: _____________
Received By HR: __________________________________ Date: ______________
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