THE COLLEGE OF WOOSTER
SALARY REDUCTION AUTHORIZATON UNDER SECTION 403(b)
Employee Data:
____________________________________________________________ _____________________________________
Print your full name above (last, first, middle initial) Date of Birth
_____________________________________________________________________________________________________________________
Street Address City State Zip
________________________________ Check the payroll on which you are paid: Bi-Weekly/Hourly _____
Social Security Number Monthly/Salaried _____
1. BY THIS AGREEMENT, made between the above-named employee (“Employee”) and The College of Wooster, the parties agree as
follows:
2. Effective with respect to amounts earned on and after the Employee’s “Date of Commencement of Salary Reduction”, the Employee’s
periodic “Plan Compensation” will be reduced by an amount calculated using the percentage or dollar amount indicated in the first sentence
of paragraph 4 below and allocated between a Regular Retirement Annuity and/or a Group Supplemental Retirement Annuity as indicated
in subparagraphs (a) and (b) of paragraph 4 and allocated between TIAA and/or CREF as authorized by the Employee. At the same time
The College of Wooster’s contribution to the Employee’s annuity contract will be increased by a corresponding amount allocated to the
Regular Retirement Annuity and allocated between TIAA and/or CREF as authorized by the Employee.
3. This Agreement will be legally binding and irrevocable as to each of the parties hereto while employment continues; provided, however,
that either party may terminate this Agreement as of the last day of any pay period that coincides with, immediately precedes, or
immediately follows the last day of a month, so that this Agreement will not apply to “Plan Compensation” subsequently earned, by giving
at least 15 days written notice of the date of termination; and provided, further, that no more than four agreements for salary reduction may
be made within any taxable year by the Employee.
4. The Employee authorizes and agrees to a salary reduction equal to ________ percent of the Employee’s periodic “Plan Compensation” or
$___________ per pay period, which will produce a total contribution by the Employee and The College of Wooster for each calendar year
that does not exceed the Employee’s statutory limitation under IRC Section 415 or Section 402(g), whichever is less. The total salary
reduction specified in the preceding sentence will be allocated and paid as follows:
(a) ________ percent of “Plan Compensation” or $__________ per pay period will be paid as premiums to the Employee’s TIAA-
CREF Regular Retirement Annuity; and /or
(b) ________ percent of “Plan Compensation” or $__________ per pay period will be paid as premiums to the Employee’s TIAA-
CREF Group Supplemental Retirement Annuity.
(c) For employees age 50 and over, an additional catch-up contribution of $___________ shall be contributed. This amount must
not exceed the statutory limitation under IRC Section 414(v).
Please note that only salary reduction contributions to TIAA and/or CREF Regular Retirement Annuities will qualify for College matching
contributions and that the sum of the percentages or dollar amounts specified in subparagraphs (a) and (b) above must equal the total salary
reduction percentage or dollar amount specified in the first sentence of this paragraph 4. If you elect not to make salary reduction
contributions at this time, please leave the lines provided in paragraph 4 blank and enter a checkmark below on the line directly to the left
of the statement, “WAIVER: I CHOOSE NOT TO MAKE SALARY REDUCTION CONTRIBUTIONS AT THIS TIME”.
5. The “Date of Commencement of Salary Reduction” for an Employee who completes this Agreement and submits it to the Department of
Human Resources before his or her “Date of Hire” will be the first day of the month following the “Date of Hire” (i.e. the first date on
which the Employee performs services for the College). The “Date of Commencement of Salary Reduction” for an Employee who
completes this Agreement and submits it to the Department of Human Resources after his or her “Date of Hire” will be the first day of the
month following the date on which the employee has submitted this Agreement to the Department of Human Resources.
6. As used in this Agreement, the term “Plan Compensation” will be defined in the plan documents for The College of Wooster Defined
Contribution Plan.
(______) WAIVER: I CHOOSE NOT TO MAKE SALARY REDUCTION CONTRIBUTIONS AT THIS TIME (please leave the line to the
left of this “WAIVER” blank if you have elected to make salary reduction contributions.
Employee’s Signature Department of Human Resources Use Only:
____________________________________________ Date of Hire/Change ______________
Employee Date Date of Commencement of Salary Reduction ______________
Salary Reduction Percentage ______________
The College of Wooster College Contribution Percentage ______________
Weekly Hours of Service ______________
____________________________________________ Date of Completion of 2 Years of Service ______________
Name Title Date
PLEASE SEE INFORMATION ON REVERSE SIDE
Salary Reduction Agreement, 12/09
