HomeMy WebLinkAboutCity Council Resolutions (R-90-644-D)-12/18/1990
EREAS, the establishment of a deferred compensation plan for
such employees will serve the interests of the Employer
by enabling it to provide reasonable retirement security
for its employees, by providing increased flexibility in
its personnel management system, and by assisting in the
attraction and retention of competent personnel; and
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RESOLUTION NO.
R-90-644 - d
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the City of Colleyville, hereinafter "Employer" has
employees rendering valuable services; and
the Employer has determined that the establishment of a
deferred compensation plan to be administered by the
ICMA Retirement corporation will serve the above
objectives, and
the Employer desires that the investment of funds held
under its deferred compensation plan be administered by
the ICMA Retirement Corporation, as Trustee, with the
understanding that such funds will be held by the ICMA
Retirement Trust, a trust established by public
.employers for the purpose of representing the interests
of such employers with respect to the collective
investment of funds held under their deferred
compensation plans:
I OW THEREFORE, BE IT RESOLVED
16 ,ICOLLEYVILLE, TEXAS:
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BY THE CITY COUNCIL OF THE CITY OF
That the Employer adopts the deferred compensation plan,
attached hereto as Appendix A, and appoints the lCMA
Retirement Corporation to serve as Administrator
thereunder; and
That the Employer hereby executes the leMA Retirement
Trust, attached hereto as Appendix B; and
That the City Manager shall be the coordinator for this
program and shall receive necessary reports, notices,
etc., from the ICMA Retirement Corporation as
Administrator, and shall cast, on behalf of the
Employer, any required votes under the program.
Administrative duties to carry out the plan may be
assigned to the appropriate departments.
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That C. Robert Stripling is hereby designated as an
eligible employee under the ICMA Retirement Plan adopted
by the city.
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AND IT IS SO RESOLVED.
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Passed by a vote of
Cb~Jr ~
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on this
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, 1990.
8 .ATTEST:
1::1 ~j~, U
,~a JOhnSona
11 :pity Secretary
CITY OF COLLEYVILLE
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APPROVED AS TO LEGAL FORM:
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Ro s T. Fos er
15 City Attorney
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APPBNDIX A
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("Employer")
Deferred Compensation Plan
Artfde 1.INTRODucnON
The Employer hereby establishes the Employers Deferred Compensa-
tion Plan, hereinatter referred to as the "Plan." The Plan consists of the
provisions set forth in this document
The primary purpose of this Plan is to provide retirement Income and
other deferred benefits to the Employees of the employer in accordance
with the provisions of Section 457 of the Internal Revenue Code of 1986. as
amended (the "Code").
This Plan shall be an agreement solely belween the Employer and
participating Employees.
Artic:Je II. DEAN mONS
Section 2.01 Account: The bookkeeping account maintained for each
Partlcipant reflecting the cumulatlve amount of the Participant's Deferred
Compensation. including any Income. gains, loases. or increases or
decreases in market value attributable to the EmpjOyer's investment of the
Participant's Deferred Compensatlon, and further reflecting any distri-
butions to the Participant or the Participant's Beneficiary and any fees or
expenses charged against such Participant's Defemtd Compensatlon.
Sectlon 2.02 Administrator: The person or persona named to carry out
certain nondlscnttionary administrallve functlons under the Plan. as
hereinafter described. The Employer may remove any person as Admin-
istrator upon 60 days' advance nollce in wrillng to sucl1 person, in which
case the Employer shall name another person or persons to act as
Administrator. The Administrator may resign upon 60 days' advance
notice in writing to the Empfoyer. in which case the Employer shall name
another peraon or persons to act as Administrator.
Sectlon 2.03 Beneficlary: The person or persons designated by the
Participant in his JOinder Agreement who shall receive any benefits
payable hereunder in the event of the Participant's death. In the event
that the Participant names two or more Beneficiaries. each Beneficiary
shall be entitled to equal shares of the benefits paYable at the Partici-
pant's death. unlesa otherwise provided in the Participant's Joinder
Agreement. If no Beneficiary is designated in the Joinder Agreement. if
the Designated Beneficiary Predeceases the Participant, or if the deSIg-
nated Beneficiary does not survive the Participant tor a period ot fifteen
(15) days, then the estate of the PartiCIpant shall be the Beneficiary.
Section 2.04 Defwr.d Compenution: The amount of Normal Compen-
sation othelWlse payable to the Participant which the Participant and
the Employer mutually agree to defer hereunder, any amount credited
to a Participant's Account by reason of a transfer under Sectlon 6.03.
or any other amount which the Employer agrees to credit to a Partici-
pant's Account
. Section 2.05 Empk)yee; Any individual who provides services for the
Employer, whether as an employee of the Employer or as an independ-
ent contractor. and who has been deSIgnated by the Employer as
eligible to participate in the Plan.
Section 2.06 Includible ComP8nAtion: The amount of an Employee's
compensation from the Employer tor a taxable year that is attributable to
S8fVices performed for the Employer and that is includible in the employ-
ee's gross income tor the taxable year for federal income lax purposes;
such term does not include any amount excludable from gross income
under this Plan or any other plan described in Section 4S7(b) of the
-:ode or any other amount excludable from grosa income tor federal
Income tax purposes. Includible Compensatlon shall be determined
without regard to any community property laws..
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Section 2.07 Jofnder AgrMment: An agreement entered into between an
Employee and tha Employer. including any amandments or modiftca-
tlons thereof. Such agreement shall fix the amount of Deferred Compan-
satlon, speCify a preference among the investmant alternallves
deelgnated by the Employer, designate the Employee's BenefiCiary or
Beneficiaries. and incorporate the terms, COnditions. and proVisions of
the Plan by referenca.
Section 2.08 Normel Compensation: The amount of compensetion which
would be payable to a Participant by the Employer for a taxable year if no
Joinder Agreement were in effect to deter compensation under this Plan.
Section 2.09 NomuIl Retirement Age: Age 7011.1, unless the Participant has
elected an alternate Normal Retirement Age by written instrument deliv-
ered to the Administrator prior to Separation from Service. A Partic;-
panrs Normal Retirement Age determines the periOd during which a
Partlcipant may utilize the catch-up limitation of SectIon 5.02 hereun-
der. Once a Participant has to any extent utlllzed the catch-up Iimltallon
of Section 5.02. his Nonnal Retirement Age may not be changed.
A Participanfs alternate Nonnal Retirement Age may not be earlier
than the eat1lest date that the Participant win become eligible to retire
and receive unreduced retirement benefits under the Employers baSIC
reIlt8ment plan covering the Participant and may not be 'aler than the
date the Participant WIll attain age 7011.1. If a PartICIpant contlnue8 emplOy-
ment after attaining age 7011.1, not having previously elected an alternate
Normal Retirement Age, the Participanfs alternate Nonnal Retirement
Age shall not be later than the mandatory retirement age. if any. estab-
D8hec:1 by the Employer, or the age at which the PartIcipant actually
aeparatea from service if the Employer has no mandatory retirement
age. If the Participant will not become eligible to receive benefits under a
buic: retirement plan maintained by the Employer. the Participant's
a/tamate Nonnal Ratlrement Age may not be earlier than age 55 and
may not be later than age 7011.1.
Section 2.10 PlIrtlc:ip8nt: Any Employee who has joined the Plan pursuant
to the requirements of Article IV.
Section 2.11 PI.... Veer: The calendar year.
Section 2.12 Retirement: The first date upon which both of the follOWing
shall have occurred WIth respect to a participant: Separation from
SefVice and attainment of age 65.
Section 2.13 Sep.1'IItion from SeMce: Severance of the PartiCipant's
employment WIth the Employer which constitutes a "separation from
Mrvlce" within the meaning ot Section 402(e)(4)lA)IIIi) of the Code. In
general, a Participant shan be deemed to have severed his employment
with the Employer for purposes ot this Plan when, in accordance with
the established practices of the Employer, the employment relationship Is considered to have actually terminated. In the case of a Participant
who is an independent contractor of the Employer. Separation from
Service shan be deemed to have occurred when the Participant's con-
tract under which services are performed has completely expired and
tenninated. there is no foreseeable possibility that the Employer will
renew the contract or enter into a new contract for the Participant's
services, and it is not anticipated that the Participant WIll become an
EmployeeoftheEmploye~
AttIde II. ADMINlSTRAnoH
Section 3.01 DutIee of EmIHoyer: The Employer shall have the authority to
make all dlscrellonary decisions atf8ctlng the nghts or benefits of
PartlcJpanta which may be required In the administration of thle Plan.
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Section 3.02 Dutla of Adminmrator. The Administrator, as agent for the
Employer, shail perform nondiscretionary administrative functions in
connection with the Plan, including the maintenance ot Participants'
Accounts, the provision ot penodic reports of the status ot each Account,
and rhe disbursement 01 benelits on behalf ot the Employer in accor-
dance with the prOvisions 01 this Plan.
AIticl. IV. PARTlCIPATlON IN THE PLAN
Section 4.01InitJ.1 ParticiPlltion: An Employee may become a Participant
by entering into a Joinder Agreement prior to the beginning 01 the
calendar month In which the JOinder Agreement is to become effective
to deler compensation not yet earned.
Section 4.02 Amendment of Joinder Ag~t: A Participant may amend
an executed Joinder Agreement to change the amount otcompensation
not yet earned which is 10 be aelerred (including the reduction 01 such
future deferrals to zero) or to Change hiS investment preference (subject
to such restrictions as may result Irom the nature or terms ot any
investment made by the Employer). Such amendment shall become
effective as of Ihe beginning 01 the calendar month commencing after
the date the amendment is executed. A Participant may at eny time
amend his Joinder Agreement to change the designated Beneficiary,
and such amendment shall become effective immediately.
Articte V. UMfTATlONS ON DEFERRALS
Section 5.01 NonNII Umitation: EJ!cept as provided in SectIon 5.02, the
maximum amount ot Deterred Comoensation lor any Participant tor any
taxable year shall not exceed the lesser ot $7.500.00 or 33~ percent
ot the Participant'S Includible Compensation lor the taxable year. This
limitation will Ordinarily be equivalent to the lesser ot $7.500.00 01' 25
percent ot the Partlcipanfs Normal Compensation.
Section 5.02 Catdt-Up Umitation: For each ot the lsat three (3) taxable years
'l' a Participant ending before his attainment 01 Normal Retirement Age,
,1e m81umum amount 01 Deferred Compensation shall be the lesser ot:
(1) $15,000 or (2) the sum of (i) the Normal Limitation for the taxable
year, and (ii) the Normal Umitation 'or eech pnor taxable year of the
Participant commencing atter 1978 less the amount ot the Participanfs
Deferred Compensation lor such prior taxable years. A prior taxable
year shall be taken Into account under the preceding sentence only it (i)
the Participant was eligible to participate in Ihe Plan for such year (or in
any other eligible delerred compensation plan established under Sec-
tion 457 01 the Code which is properly taken into account pursuant to
regulations under section 457), and (ii) compensation (if any) delerrlld
under the Plan (or SUCh other plan) was sublect to the deferral limita-
tions set forth in Section 5.01.
s.ctlon 5.03 oth... Plan.: The amount excludable from a Participant's
gross income under this Plan or any other eligible deterred compensa-
tion plan under section 457 at the COde Shall not exceed $7,500.00 (or
such greater amount allowed under Section 5.02 of the Plan), less any
amount excluded trom gross income undar section 403(b). 402(a)(8),
or 402(h)(1)(B) 01 the Code, or any amount WIth respect to which a
deduction is allowable by reason of a contnbution to an organization
described in section 501(c)(181 of the Code.
Artide VI. INVESTMENTS AND ACCOUNT VAlUES
Section 6.01 Iml8Stment of Defen-ed Compensation: All investments of
Participants' Deferred Compensation made by the Employer, including
all property and rights purchased with such amounts and all income
attributable thereto, shall be Ihe sole property of the Employer and shall
not be held in trust for Participants or as collateral security lor the
fulfillment of the Employer'S Obligations under the Plan. Such property
~aJl be subject 10 the claims 01 general creditors at the Employer, and
Parocipant or Beneficiary shall have any vested interest or secured
preterred position with respect to such property or have any claim
against the Employer except as a general creditor.
Section 6.02 Crediting of Acc:ountll: The Participanfs Account Shall renect
the amount and value of the investments or other property obtained by
the Employer through the Investment ot the Partidpanfs Delerred Com-
pensation. It is anticlpaled that the employer'S investments with respect
to a Participant WIll conform to the investment prelerence specified in
the PartiCipant's Joinder Agreement, but nothing herein shall be con-
strued to require the Employer to make any particular Investment of a
Participant's Deferred Compensation. Each Participant shall receive
periodic reports. not less frequently than annually. Showing the Ihen-
current value 01 his Account.
SectIon 8.03 li'an.1....:
(a) Incoming Transfers: A transler may be accepted trom an eligible
delerred compensation plan maintained by another employer and cred-
ited to a Participanrs Account under this Plan If (i) the PartiCipant has
separaled lrom service WIth Ihal employer and become an Employee of
the Employer, and (ii) the other employer's plan provides that such
transfer will be made. The EmPloyer may requare such documentation
from the predecessor plan as it deems necessary to effectuate the
transfer, to confirm that such plan is an eligible deferred compensallon
plan within Ihe meaning 01 Section 457 01 the Code, and to assure that
transfers are provided for under such plan. The Employer may refuse to
accept a transfer in the form of assets other than cash, unless the
Employer and the Administrator agree to hold such other assets under
the Plan. Any such transferred amount Shall not be treated as a detErral
subject to the limitations ot Article V, except that, for purposes ot
apptying the limitations of Sections 5.01 and 5.02. an amount deterred
during any taxable year under the plan from which the lrensler is
accepted shall be treated as it it has been deferred under thiS Plan
during such taxable year and compensation paid by the transferor
employer ShaJl be treated as if it had been paid by the Employer.
(b) Outgoing Transfers: An amount may be transferred to an eligible
deterred compensation plan maintained by another employer, and
ctulrged to a Participant's Account under thl. Plan, if (i) the Participant
haa separated from sarvlce with the Employer and become an employee
0' the other employer, (ii) the other employer's plan provides thaI such
transfer will be accepted, and (iii) the Participant and the employers
have signed SUCh agreements as are necessary to assure that the
Employer's liability to pay benefits to the Participant has been dis-
charged and assumed by the other employer. The Employer may reqUIre
SUCh documentation from the other plan as it deems necessery to
effectuate the transler, to confirm that such plan is an eligible deterred
compensation plan within Ihe meaning of section 457 of the Code. and
to assure that translers are prOVided for under such plan, Such trans-
fers shall be made only under such circumstances as are perm,ned
under section 457 01 the COde and the regulations thereunOer.
Section 8.04 Employer Liability: In no event shall the Employer'S liability to
pay benefits to a PartiCipant under Article VI exceed the value 01 the
amounts credited to the PartiCipant's Account; the Employer shall not
be liable lor losses arising lrom depreciation or shrinkage in the value of
any investments acqUIred under this Plan.
Artlde VI. SENERTS
SectIon 7.01 Retirement Benefits and Election on Separation from
Senice: EJ!cept as otherwise provided in this Article VII. the distribution
ot a Participant's Account shall commence as of April 1 of the calenaar
year alter the Plan Year of the Participant's Retirement, and the distribu-
tion of such Retirement benefits Shall be made in accordance With one
of the payment options described in Section 7,02. Notwithstanding the
foregoing, the Participant may irrevocably elect within 60 days 'ollowlng
Separation tram Sennce to have the distnbution of benefits commence
on a fixed or determinable date other than that described in the preced-
ing sentence which IS at least 60 days after the date such eiectlon is
delivered in wntlng to the Employer and forwarded to the Administrator.
but not later than April 1 of the year follOWing the year ot lJ'Ie Participant's
ReUrement or attainment of age 701;. whichever is later.
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Section 7.02 Payment Option.: As provided in Sections 7.01, 7.04, and
7.05. a Participant or Beneficiary may elect to have the value 01 the
PartIcipant's Account distnbuted in accordance WIth one 01 the lollow-
ing payment options, provided that SUCh optioo is conSistent with the
IImltallons set forth in Section 7.03:
(a) Equal monthly, Quarterly, semi-annual or annual payments in an
amount chosen by the Participant, continuing until his Account is
exhausted;
(b) One lump-sum payment:
(c) Approximately equal monthly, quarterly, semi-annual or annual
payments. calculated 10 continue for a period certain chosen by the
Participant
(d) Annual Payments equal to the minimum distributions required
under Section 401 (a)(9) at the Code over the lite expectancy of the
Participant or over the lite expectancies of the Participant and his
Beneficiary.
(e) Payments equal to payments made by the issuer at a retirement
annuity policy acquired by the Employer.
(I) Any other payment option elected by the Participant and agreed to
by tha Employer and Administrator, provided that SUCh option must
provide lor substantially nonincreasing payments for any period aner
the latest benefit commencement date under Section 7.01.
A Partlcipanrs or Beneficiary's election of a payment option must be
made at least 30 days before1he payment 01 benefits is to commence. If
a Participant or Beneficiary lails to make a timely election of a payment
option. benefits shall be paid monthly under option (C) above tor a
period ot five years.
Section 1.03 Umitatlon on Optiona: No payment option may be selected
by a Participant or Beneficiary under Sections 7.02, 7.04, or 7.05 unless
it satisfies the requirements 01 Sections 401 (a)(9) and 457(d)(2) 01 the
Code, including that payments commencing before the death of the
Participant shall satlsly the inCidental death benefits requirement under
section 457(d)(2)(B)(i)(l). Unless otherwise elected by the Partlclpant,
aU determinations under Section 401(a)(9) shall be made Without recaI-
culatlon at life expectancies.
Section 1.04 Post-nltirement Death Benefits:
(a) Should the Participant die after he has begun to receive benefits
under a payment option, the remaining payments, if any, under the
payment option shall be payable to the Participant's Beneficiary com-
mencmg Within the 30-day period commencmg with the 61st day after
the Participant's dealh, unless the BenefiCiary elects payment under a
diNerent payment option that IS available under Section 7.02 within 60
dayS of the Participant's death. Any different payment option elected by
a Beneficiary under this section must provide for payments at a rate that
is at least as rapid as under the payment option that was appliceble to
the Participant. In no event shall the Employer or Admimstrator be liable
to the Beneficiary for the amount of any payment made in the name of
the ParticIpant before the Administrator receives proof at death at the
Participant
(b) If the designated Beneficiary does not continue to live lor the remain-
ing penod of payments under the payment option, then the commuted
value 01 any remaining payments under the payment option shall be
paid in a lump sum to the estate of the Beneficiary. In the event that the
PartiClpanfs estate IS the Beneticiary, the commuted value of any remain-
ing payments under the payment option shall be paid to the estate in a
lump sum.
Section 7.05 Pre-nttirement DelIth Benefits:
(a) Should the Participant die before he has begun to receive the
. benefits prOVIded by Section 7.0 I, the value at the Partic,panrs Account
'latl be payable to the Beneficiary commencing WIthin the 30-day
'nod commencing on the 9 t st day aner the PartiClpanfs death, unless
the Beneficiary irrevocably elects a different fixed or determinable
benefit commencement date within 90 days 01 the Participant's death.
SUCh benefit commencement date shall be not later than the later 01 Ii)
December 31 of the year following the year of the PartiCipant's death, or
(Ii) If the Beneficiary is the Partlcipanrs spouse, December 31 of the year
In which the Participant would have attained age 70\2.
(b) Unless a Beneficiary elects a different payment option prior to the
benefit commencement date, death benefits under this Section shall be
paid In approximately equal annual installments over five years, or over
such shorter periOd as may be necessary to assure that the amount of
any annual installment is not less Ihan $3,500. A Beneficiary shall be
treated as il he were a Participant lor purposea of determining the
payment options available under Section 7.02, prOVided. however, that
the payment option chosen by the Benetlciary must provide lor pay_
ments to the Benellciary over a period no longer than the life expac-
tancy 01 the Beneficiary, and provided that such period may not exceed
fifteen (15) years if the Beneficiary is not the Partlcipanfs spouse.
(c) In the event that the Beneficiary dies belore the payment of death
benefits has commenced or been completed. the remaining value 01 the
Participant's Account shall be paid to the estate 01 the Beneficiary in a
lump sum. In the event that the Partlclpanrs estate is the Beneticiary,
payment shall be made to the estate in a lump sum.
SectIon 7.06 Unror.MebIe Emergenc:iec
(a) In the event an unforeseeable emergency occurs, a Participant may
apply to tha Employer to receive that part 01 the value of his Account that
Is reasonably needed to satisfy the emergency need. If such an applica-
Uon is approved by the Employer. the PartiCipant shall be paid only such
amount as the Employer deems necessary to meet the emergency
need. but payment shall not be made 10 the extent that the financial
h8ldahip may be relieved through ceaaatlon of deferral under the Plan.
insurance or other reimbursement, or liquidation 01 other assets to the
extent such liQuidaUon would not Itself ceuse severe finanCial hlUdship.
(b) An unforeseeable emergency shall be deemed to Involve only cir-
cumstances 01 severe finanCIal hlUdahip to the Participant resulting
from e sudden unexpected illness, accident, or disability 01 the Partici-
pant or of a dependent (as defined in Section 152(al of the Codel 01 the
Particlpant, loss of the Partlcipanrs property due to casualty, or other
similar and extraordinary unforeseeable clrcumatances arising as a
result of events beyond the control of the PartiCipant. The need to send a
Partlcipanfs child to college or to purchase a new home shall not be
considered unforeseeable emergencies. The determination as to
whether such an unforeseeable emergency eXIsts shall be based on the
merita of each individual case.
Section 7.07lhtnaitio.... Rule for Pre-1989 Benefit Election.: In the event
that, prior to January I, 1989, a Participant or BenefiCiary has com-
menced recalving benefits under a payment option or has irrevocably
elected a payment option or benefit commencement date, then that
payment option or election shall remain in effect notwithstanding any
other provision 01 this Plan.
AItlcle YJll NON-ASSIGNA8lUTY
Section 8.01 In G..,..: Except as provided in Section 8.02. no Partici-
pant or Beneficiary shall have any nght to commute, sell. assign, pledge,
lransler or otherwise conveyor encumber the right to receive any
payments hereunder. which payments and rights are expressly declared
to be non-assignable and non-transferable.
Section 8.02 Domestic Relation. Ora...:
(a) Allowance of Transfers: To the extent required under a tinal jUdg-
ment, decree, or order (including approval of a property settlement
agreement' made pursuant to a state domestic relations law. any portion
of a Participanfs Account may be paid or set aside for payment to a
spouse, former spouse. or child 01 the Participant. Where necessary
to carry out the terms of such an order. a separate Account Shall be
established with respect to the spouse. tonner spouse, or child who
shall be entiUed to make Investmenl selections WIth respect thereto in
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ttle same manner as the Participant; any amount so set aside for a
spouse, former spouse, or child shall be paid out In a lump sum at ttle
earliest date that benefits may be paid to the Participant, unless the
order directs a different time or form of payment Nottling in this Section
shall be construed to authorize any amount to be distributed under ltIe
Plan at a time or in a form that Is not penmtted under Section 457 of the
Code. Any payment made to a person other than the Participant pursu-
ant to this Section shall be reduced by required income tax withholding;
ltIe fact that payment is made to a person other than the Participant may
not prevent such payment from being includible in the gross income of
the Participant for WithhOlding and income tax reporting purposes.
(b) Release from Uability to Participant: The Employer's liability to pay
benefits to a Participant shall be reduced to the extent that amounts
have been paid or set aside for payment to a spouse, former spouse. or
child pursuant to paragraph (a) of this Section. No such transfer shall be
effectuated unless the Employer or Administrator has been Provided
With satisfactory eVidence that the Employer and the Admlnlstrato{ are
released tram any further claim by the Participant With respect to such
amounts. The Participant shall be deemed to have released the Employer
and the Administrator from any claim With respect to such amounts, in
any case In which (i) the Employer or Administrator has been served
with legal process or otherwise joined in a prOCeeding relating to such
transfer, (ii) the Participant has been notified of ttle pendency of such
proceeding in ttle manner prescribed by the law of the jUrisdiction in
which ttle proceeding is pending for servtce of process in such action or
by mail from the Employer or Administrator to the Participant's last
known mailing address. and (iii) the Participant tails to obtain an order of
ttle court in the Proceeding relieving the Employer or Administrator from
ttle obligation to comply with the judgment, decree, or order.
(c) Participation in Legal PrOCeedings; The Employer and Administrator
shall not be obligated to defend against or set aside any judgment,
decr&.!, or order described in paragraph (a) or any legal order relating to
the garnishment of a Participant's benefits, unless the full expense of
such legat action is borne by the Participant In the event that the
ParUcipant's action (or inaction) nonetheless causes the Employer or
. Administrator to incur such expense, the amount of the expense may be
charged against the Participant's Account and thereby reduce the
Employer's Obligation to pay benefits to ltIe PartiCipant. In the course at
any proceeding relating to divorce, separation, or child suPPOrt, the
Employer and Administrator shall be authorized to disclose information
relating to the PartIcipant's Account to ltIe Participant's spouse. former
spouse. or child (including the legal representatives of the spouse,
former spouse, or child), or to a court.
Artide IX. RElATIONSHIP TO OTHER PUNS AND EMPlOYMENT
AGREEMENTS
This Plan serves in addition to any other retirement, penSion. or
benefit plan or system presently in existence or hereinafter established
lor the benefit of the Employer's employees, and participation hereun-
der shall not affect benefits receiYable under any such plan or system.
Nothing contained in this Plan shall be deemed to constitute an employ-
ment contract or agreement between any Participant and the Employer
or to give any Participant the nght to be retained In the employ of the
Employer. Nor shall anything herein be construed to modify the terms of
any employment Contract or agreement between a ParticIpant and the
Employer.
Artide X. AMENDMENT OR TERMINATION OF PlAN
The Employer may at any time amend this Plan provided that it
transmits such amendment in wnting to the Administrator at least 30
days prior to the effective date of the amendment. The consent of the
Administrator shall not be reqUITed in order tor such amendment to
become effective, but the Administrator shall be under no obligation to
continue acting as Administrator hereunder if it disapproves of suCh
amendment. The Employer may at any lime terminate this Plan.
The Administrator may at any lime propose an amendment to lhe Plan
by an instrument in wnting transmitted to the Employer at least 30 days
before the effective date of the amendment. Such amendment shall
become effective unless. WIthin such 30-day period. ltIe Employer
notifies the Administrator in writing ltIat it disapproves such amend-
ment, In which case such amendment shall not become effective. In the
event of such disapproval, the Administrator shall be under no obllga-
lion to continue acting as Administrator hereunder. It this Plan docu-
ment constitutes an amendment and restatement of the Plan as
previously adopted by the Employer. the amendments contained herein
shall become effective on January 1, 1989, and the terms of the preced-
ing Plan document shall remain in effect through December 31,1988.
Except as may be required to maintain the status of the Plan as an
eligible deterred compensation plan under section 457 of the Code or
to comply with other applicable laws, no amendment or termination of
the Plan shall divest any Participant of any rights with respect 10 com-
pensation deterred before the date of the amendment or termination.
ArtIcle XL APPUCA8I..e LAW
Thl. Plan shall be construed under the laws of the state where the
Employer IS located and is established WIth the intent that it meet the
requirements of an "eligible deterred compensation plan" under Sec-
tion 457 of the Code, as amended. The provisions of this Plan shall be
Interpreted wherever possible in conformity with the reqUirements at
that section.
AItide XJL GENDER AND NUMBER
The masculine pronoun, whenever used hereIn, shall include the
leminine pronoun, and ltIe singular shall InClude the plural. except
where the context requires otherwIse.
4
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'. ". , .' .;:.:Y" : ;',' ".,' ''''k'i'' "'.,',.--::';' AppendlJtB.", ,";..; "
. ',. - ";'.-', "" '~.;.., 'f"'", ':", -'l'.. ..', '.,<,t:~.. '. . ,.'. ',- .i.'.;,.:,:.:...,,:..;'. 1';~~./:'..-:...~_.. '.'. ':.1Il:~.:"~;..\!;:.,
DECLARATION OF TRUST
OF ICMA RETIREMENT CORPORATION
ARTICLE L NAME DEFINITIONS
Section 1.1 Name: The Name of the Trust, as amended and
restated hereby, is the ICMA Retirement Trust.
Section 1.2 Definitions: Wherever they are used herein,
the following terms shall have the following respective
meanings:
(a) Bylaws. The bylaws referred to in Section 4.1
hereof, as amended from time to time.
(b) Deferred Compensation Plan. A deferred
compensation plan established and maintained, by
a Public Employer for the purpose of prOViding
retirement income and other deferred benefits to
its employees in accordance with the provision of
section 457 of the Internal Revenue Code of 1954,
as amended.
(c) Employees. Those employees who participate in
Qualified Plans.
(d) Employer Trust. A trust created pursuant to
an agreement between RC and a Public Employer
for the purpose of investing and administering the
funds set aside by such Employer in connection
with its Deferred Compensation agreements ~Ith
its employees or In connection With Its Quallhed
Plan.
(8) Guaranteed Investment Contract. A contract
entered into by the Rehrem ent Trust with insurance
companies that provides for a guaranteed rate 01
return on investments made pursuant to such
contract.
(f) ICMA. The International City Management
Association.
(g) ICMAlRC Trustees. Those Trustees elected by
the Public Employers who, in accordance with the
provisions of Section 3.1 (a) hereof, are also
members, or lormer mel)1bers, 01 the Board 01
Directors of ICMA or RC_ .
(h) Investment Adviser. The Investment Adviserthat
enters Into a contract with the Retirement Trust to
provide advice with respect to investment of the
Trust Property.
(i) Portfolios. The Portfolios 01 investment established
by the Investment Adviser to the Retirement Trust,
under the supervision of the Trustees, for the
purpose 01 providing investments for the Trust
Property.
(j) Public Employee Trustees. Those Trustees
elected by the Public Employers who, in accordance
with the provision of Seclion 3.1 (a) hereof. are lull-
time employees of Public Employers.
(k) Public Employer Trustees. Public Employers who
serve as trustees of the Qualilied Plans.
(I) Public Employer. A unit 01 state or local
government, or any agency or instrumentality
thereof, that has adopted a Deferred Compensation
Plan or a Qualilied Plan and has executed this
Declaration of Trust.
(m) Qualified Plan. A plan sponsored by a Public
Employer for the purpose of providing retirement
Income to its employees which satislies the
qualification requirements 01 Section 401 01 the
Internal Revenue Code, as amended.
(n) RC. The International City Management
Association Retirement Corporation.
(0) Retirement Trust. The Trust created by tho
Declaration of Trust.
(p) Trust Property. The amounts held in the
Retirement Trust on behalf of the PubliC
Employers in connection with Deferred
Compensation Plans and on behalf of the Public
Employer Trustees for the exclusive benefit of
Employees pursuant to Qualified Plans. The Trusl
Property shalt include any income resulting from
the investment 10 the amounts so held.
{q} Trustees. The Public Employee Trustees and
ICMAlRC Trustees elected by the Public Employers
to serve as members of the Board of Trustees of
the Retirement Trust.
ARTICLE II. CREATION AND PURPOSE OF THE TRUST;
OWNERSHIP OF TRUST PROPERTY
Section 2.1 Creation: The Retirement Trust is created and
established by the execution 01 this Declaration ot
Trust by the Truslees and the Public Employers.
Section 2.2 Purpose: The purpose 01 the Retirement Trust
is to provide tor lhe commingled investment of funds
held by lhe Public Employers in connection wllh their
Deferred Compensation and Qualified Plans. The
Trust Properly shall be invested in the Portfolios, in
Guaranteed Inveslment Contracts, and in other in-
vestments recommended by the lovestmenl Adviser
under the supervision 01 the Board 01 Trustees. No
part 01 the Trust Property will be invested in securities
Issued by Public Employers.
Section 2.3 Ownership 01 Trust Property: The Truslees
shall have legal htle to the Trust Property, The Public
Employers shall be the beneficial owners of the por-
tion of the Trust Property allocable to the Deferred
Compensation Plans. The portion of the Trust Prop-
erty allocable to the Qualified Plans shall be held lor
lhe Public Employer Trustees lorthe exclusive benefit
of the Employees.
ARTICLE III. TRUSTEES
Section 3.1 Number and Qualification of Trustees:
(a)The Board of Trustees shall consist of nine Trust-
ees. Five of the Trustees shalt be full-time employees
of a Public Employer (the Public Employee Trustees)
who are authorized by such Public Employer to serve
as Trustee. The remaining four Trustees shall consist
of two persons who, at the time 01 election to the Board
of Trustees, are members 01 the Board of Directors of
ICMA and two persons who, at the time of election, are
members of the Board of Directors 01 RC (the ICMAI
RC Truslees. One 01 the Trustees who is a director of
ICMA, and one of the Trustees who is adirectorof RC,
shall, at the time 01 election, be lull'lime employees ot
a Public Employer.
(b) No person may serve as a Trustee for more than
one term in any ten.year period.
Section 3.2 Election and Term: (a) Except for the Trust-
ees appointed to fill vacancies pursuanlto Section 3,5
hereol, the Truslees shall be elected by a vole of a
majority of the Public Employers in accordance with
the procedures set forth in tha By-laws. (b) At the first
election of Trustees, three Trustees shall be elected
for a term of three years, lhree Trustees shall btl
elected for a term of two years and three Trustees
shalt be elected for a term of one year. At each
subsequent election, three Trustees shall be elected
tor a term of three years and until his or her successor
is elected and qualified.
Section 3.3 Nominations: The Trustees who are full-time
employetJs of Public Employers shall serve as thQ
Nominating Committee for the Public Employee
Trustees. The Nominating Committee shall choose
candidates for Public Employee Trustees in accor-
dance with the procedures set forth in the By-laws.
Section 3.4 Resignation and Removal: (a) Any Trustee
may resign as Trustee (without need for prior or
subsequent accounting) by an instrument in writing
signed by the Trustee and delivered to the other
Trustees and such resignation shall be effective upon
such delivery, or at a later date according to the terms
of the instrument. Any at the Trustees may be re-
moved for cause, by a vote of a majority at the Public
Employers. (b) Each Public Employee Trustee shall
resign his or her position as Trustee within sixty days
of the date on which he or she ceases to be a tull-time
employee of a Public Employer.
Section 3.5 Vacancies: The term at office of a Trustee
shall terminate and a vacancy shall occur in the event
of the death. resi~nation, removal, adjudicated incom-
petence or other Incapacity to perform the duties of the
office at a Trustee. In the case of a vacancy, the
remaining Trustees shall appoint such person as they
in their discretion shall see tit (subject to the limitations
set forth in this Section), to serve for the unexpired
portion ot the term at the Trustee who has resi\Jned or
otherwise ceased to be a Trustee. The appointment
shall be made by a written instrument si~ned by a
majority of the Trustees. The person apPOinted must
be the same type of Trustee (i.e., Public Employee
Trustee or ICMA/RC Trustee) as the person who has
ceased to be a Trustee. An appointment of a Trustee
may be made in anticipation at a vacancy to occur at
a later date by reason of retirement or resignation,
provided that such appointment shall not become
effective prior to such retirement or resignation.
Whenever a vacancy in the number of Trustees shall
occur, until such vacancy is filled as provided in this
Section 3.5, the Trustees in office, regardless of their
number, shall have all the powers granted to the
Trustees and shall discharge all the dutIes imposed
upon the Trustees by this Declaration. A written
instrument certifying the existence of such vacancy
signed by a majority of the Trustees shall be conclu.
sive evidence at the existence of such vacaocy.
Section 3.6 Trustees Serve In Representative Capacity:
By executing this Declaration, each Public Employer
agrees that the Public Employee Trustees elected by
the Public Employers are authorized to act as agents
and representatives at the Public Employers collec-
tively.
ARTICLE IV. POWERS OF TRUSTEES
Section 4.1 General Powers: The Trustees shall have the
power to conduct the business at the Trust and to carry
on its operations. Such power shall include, but shall
not be limited to, the power to:
(a) receive the Trust Property from the Public
Employers, Public Employer Trustees or other
Trustee of any Employer Trust;
(b) enter into a contract with an Investment Adviser
providing, among other things, tor the
establishment and operation of the Portfolios,
selection of the Guaranteed Investment Contracts
in which the Trust Property may be invested,
selection of the other investments for the Trust
Property and the payment at reasonable fees to
the Investment Adviser and to any sub-investment
adviser retained by the Investment Adviser;
(c) review annually the performance 01 the Investment
Adviser and approve annually the contract With
such Investment AdViser;
(d) invest and reinvest the Trust Propeny in the
Portfolios, the Guaranteed Interest COnlraClS and
in any other investment recommended by the
Investment Adviser, but not including sGcuritit.ls
issued by Public Employers, provided that if a
Public Employer has directed that its monies be
invested in specified Portfolios or in a Guaranteed
Investment Contract, the Trustees of the
Retirement Trust shall invest such munies in
accordance with such directions;
(e) keep such portion at the Trust Propeny in c.:asn or
cash balances as the Trustees, tram tnne to tllne,
may deem to be in the best interest of the
Retirement Trust created hereby without liability
for interest thereon;
(t) accept and retain for such time as tney may aetlm
advisable any securities or other propeny roceilloo
or acquired by them as Trustees hereundtH,
whether or not such securities or other properly
would normally be purchased as invastment
hereunder;
(g) cause any securities or other propeny heid as part
of the Trust Propeny to be registered In tne name
of the Retirement Trust or in the name of a nominee,
and to hold any investments in bearer tram, butthe
books and records ot the Truslees shall at all times
show that all such investments are a part of the
Trust Property;
(h) make, execute, acknowledge, and deliver any and
all documents at transter and conveyance and any
and all other instruments that may be necessary or
appropriale to carry oul the powers herein granted;
(I) vote upon any slOck, bonds, or other seCUrities;
give general or special proxies or powers 01 attorney
with or without power of substitution;exerclse any
conversion privileges. subscription rights, or OlOer
options, and make any payments incidental thereto;
oppose, or consent to, or otherwise particlpale in,
corporaie reorganizations or to other changes
affecting corporate securities, and delegate
discretionary powers and pay any assessments or
charges in connection therewith; and generally
exercise any of the powers of an owner With
respect to stocks, bonds, securities or olher
property held as part of the Trust Property;
(j) enter into coniracts or arrangements for goods or
services reqUired In connectIon With the operation
of the Retirement Trust, including, but not limited
to, contraCtS with custodians and contracts tor the
provision of administrative services;
(k) borrow or raise money for the purposes of the
Retirement Trust in such amount, and upon sUl:h
terms and conditions, as the TlUstees shall deem
advisable, provided that the aggregate amount of
such borrowings shall not exceed 30% at the
value of the Trust Property. No person lending
money to the Trustees shall be bound to see the
application of the money lent or to inqUire into Its
validity, expediency or propriety or any such
borrowing;
(I) incur reasonable expenses as required for Ins
operation of the Retirement Trust and deduct such
expenses from of the Trust Property;
(m) pay expenses properly allocable to the Trust
Property incurred in connection with the Oeieired
Compensation Plans, Qualified Plans, or the
Employer Trusts and deduct such expenses from
the portion of the Trust Property to whom such
expenses are properly allocable;
(n) payout of the Trust Properly all reai and personal
property taxes, income taxes and other taxes of
any and all kinds which, in the opinion of the
Trustees, are properly levied, or assessed under
oxisting or future laws upon, or in respect of, the
Trust Property and allocate any such taxes to the
appropriate accounts;
(0) adopt, amend and repeal the bylaws, provided
that such bylaws are at all times consistent with
the terms 0 this Declaration of Trust;
(p) employ persons to make available interests in the
Retirement Trust to employers eligible to maintain
a Deferred Compensation Plan under Section 457
or a Qualified Plan under Section 401 of the
Internal Revenue Code, as amended;
(q) issue the Annual Report of the Retirement Trust,
and the disclosure documents and other literature
used by the Retirement Trust;
(r) make loans, including the purchase of debt
obligations, provided that all such loans shall bear
interest at the current market rate;
(s) contract for, and dele~ate any powers granted
hereunder to, such officers, agents, employees,
auditors and attorneys as the Trustees may select,
provided that the Trustees may not delegate the
powers set forth in paragraphs (b), (c) and (0) of
this Section 4. 1 and may not delegate any powers
if such delegation would violate their fiduciary
duties;
(t) provide for the indemnification of the Officers and
Trustees of the Retirement Trust and purchase
fiduciary insurance;
(u) maintain books and records, including separate
accounts for each Public Employer, Public
Employer Trustee or Employer Trust and such
additional separate accounts as are required under.
and consistent with, the Deferred Compensation
or Qualified plan of each Public Employer; and
(v) do all such acts, take all such proceedings. and
exercise all such rights and privileges. although
not specifically mention herein, as the Trustees
may deem necessary or appropriate to administer
the Trust Property and to carry out the purposes of
the Retirement Trust.
Section 4.2 Distribution of Trust Property: Distributions
of the Trust property shall be made to, or on behalf of,
the Public Employer or Public Employer Trustee, in
accordance with the terms of the Deferred Compen-
sation Plans, Qualified Plans or Employer Trusts. The
Trustees of the Retirement Trust shall be fully protected
in making payments in accordance with the directions
of the Public Employers, Public Employer Trustees or
other Trustee of the Employer Trusts without ascer-
taining whether such payments are in compliance with
the provision of the Deferred Compensation or Quali-
fied Plans, or the agreements creating the Employer
Trusts.
Section 4.3 Execution of Instruments: The Trustees may
unanimously designate anyone or more of the Trust-
ees to execute any instrument or document on behalf
of all, including but not limited to the signing or en-
dorsement of any check and the signing of any appli.
cations. insurance and other contracts, and the action
of such designated Trustee or Trustees shall have the
same force and effect as if taken by all the Trustees.
ARTICLE V. DUTY OF CARE AND LIABILITY OF
TRUSTEES
Section 5.1 Duty of Care: In exercising the powers
hereinbefore granted to the Trustees. the Trustees
shall perform all acts within their authority for the
exclusive purpose of providing benefits for the Public
Employers in connection with Delerred Compensa-
tion Plans and Public Employer Trustees pursuant to
Qualified Plans, and shall perform such acts with the
care, skill, prudence and diligence in the circum-
stances then prevailing that a prudent person acting in
a like capacity and familiar with such matters would
use in the conduct of an enterprise of a like character
and with like aims.
Section 5.2 LIability: The Trustees shall not be liable for
any mistake of Judgment or other action taken in good
faith, and for any action taken or omitted in reliance in
good faith upon the books of account or other records
of the Retirement Trust, upon the opinion of counsel,
or upon reports made to the Retirement Trust by any
of its officers, employees or agents or by the Invest-
ment Adviser or any sub-investment adviser, accoun-
tants, appraisers or other experts or consultant se-
lected WIth reasonable care by the Trustees, officers
or employees of the Retirement Trust. The Trustees
shall also not be liable for any loss sustained by the
Trust Property by reason 01 any investment made in
good faith and in accordance with the standard 01 care
set forth in Section 5.1.
Section 5.3 Bond: No Trustee shall be obligated to give
any bond or other security for the performance of any
of his or her duties hereunder.
ARTICLE VI. ANNUAL REPORT TO SHAREHOLDERS
The Trustees shall annually submit to the Public Employers
and Public Employer Trustees a written report of the transac-
tions of the Retirement Trust, including financial statements
which shall be certified by independent public accountants
chosen by the Trustees.
ARTICLE VII. DURATION OR AMENDMENT OF
RETIREMENT TRUST
Section 7.1 Withdrawal: A Public Employer or Public
Employer Trustee may, at any time, withdraw from this
RetIrement Trust by delivering to the Board of Trust-
ees a wfltten statement at Withdrawal. In such state-
ment, the Public Employer or Public Employer Trustee
shall acknowledge that the Trust Property allocable to
the Public Employer is derived from compensation
deferred by employees of such Public Employer pur-
suant to its Delerred Compensation Plan or from
contributions to the accounts of Employees pursuant
to a Qualilied Plan, and shall designate the financial
institution to which such property shall be transferred
by the Trustees of the Retirement Trust or by the
Trustee of the Employer Trust.
Section 7.2 Duration: The Retirement Trust shallcontinue
until terminated by the vote of a majority of the Public
Employers, each casting one vote. Upon termination,
all 01 the Trust Property shall be paid out 10 the Public
Employers, Public Employer Trustees or the Trustees
of the Employer Trusts, as appropriate.
Section 7.3 Amendment: The Retirement Trust may be
amended by the vote 01 a majority of the public
Employers, each casting one vote.
Section 7.4 Procedure: A resolution to terminate or amend
the Retirement Trust or to remove a Trustee shall be
submitted to a voto of the Public Employers if: (i) a
majority of the Trustees so direct, or; (il) a petition
requesting a vote signed by not less that 25 percent of
the Public Employers, is submitted to the Trustees.
ARTICLE VIII. MISCELLANEOUS
Section 8.1 Governing Law: Excegt as otherwise re-
quired by state or local law, this eclaration at Trust
and the Retiremenl Trust hereby created shall be
construed and regulated by the laws 01 the District 01
Columbia.
Section 8.2 Counterparts: This Declaration may be ex-
ecuted by the Public Employers and Trustees 10 two or
more counterparts, each of which shall be deemed an
original but all of which together shall constitute one
and the same instrument.
ICMA RETIREMENT CORPORATION, CORPORATE HEADOUARTERS, n7 NORTH CAPITOL STREET, NE, WASHINGTON, DC 20002-4240
",7 DEFERRED COMPENSATION PLAN
...mployee Action Form
ICMA
RETIREMENT
CORPORATIOl'
Please read instructions before completing this form.
Coroorate Headquarters
777 North CaPItol Street. NE
Washington. DC 20002-4240
(202) 962-460
Toll Free
[BOO) 669-740:
CHECK APPROPRIATE BOX
This is a ClNew Enrollment IJoinder Agreementl
This is a 0 Change to an Existing Enrollment
IF A CHANGE. CHECK ALL APPROPRIATE
BOXES
:: Change Of Beneficiary = Change of Investment Allocation
o Change of Address C Fund Transfer
EMPLOYER NAME:
City of Colleyville
Texas
,State,
SOCIAL SECURITY 'JUMBER:
LITIJ.il I
GLGJ.GL1/
III
?I 11 ?Q
RC ACCOUNT NUMBER
:For cnanges omy I
OFRCE PHONE NUMBER: raril1J 12 18 I 1'. ~
area cooel
PART A. ESSENTIAL EMPLOYEE INFORMATION
FULLNAME is ti ri il-PTl:li In 19 o::cIhGId 11 d sl I RI ~ i I ~
LAST ,IRST ,..,IOOLE
SEX: 0 MALE D FEMALE MARITAL STATUS: D SINGLE U MARRIED DATE OF BIRTH:COI8J / [iJ]J / ~ DATE EMPLOYED: rn / [QI~llilq
moom dar yeal monm aay
HOME PHONE NUMBER: C8IJJZJ I 51 41 5 !. G::IA.I9J!)]
larea COllel
I
b ri
year
JOB TITLE 3. DEPARTMENT:
HOME ADDRESS:
City Manager
2807 Sri~phIJ~h I~np
Slreet
F111ec::c;
C,ty
Te~qes
76039
,">0
MAIUNG ADDRESS:
(I( dlfferenr lI1an atJovel NO,
lig
Street
City
3tate
Zio
PART B. DESIGNATION OF BENEFICIARY
PRIMARY BENEFICIARY: DATE OF BIRTH
Mary Ann Stripling 01/23/47
_ ., r1NGENT BENEFICIARYrlESllF ANY:
Catherine Ann Stripling 01/02/75
SSN
464-72-0161
RELATIONSHIP TO YOU
Wife
228-31-7315
Daughter
PART C. CONTRIBUTION AND ALLOCATION TO INVESTMENT FUNDS
C1. AMOUNT OF DEFERRED COMPENSATION C2. ALLOCATION TO INVESTMENT FUNDS
Effective on the payoay snown :;elOW I deSire to oe paid. In tt1e form af deferred ccmpensanon I request that the total amounts of future deferred compensation be applied to the available In'iestment
as follows: funds In the follOWing percentages:
Mernoo at CeslQnanon Oelerre1 I
ComoensaiiOn ,Use OnlY One:
111 Pettentaqe Mernoo
.21 Ootlar ~ell1OO' per ,a, penoa i ;
Fund
Whole Percentages
o "I
10 :~ i
10
'1
i
i Asset AlocaJlon Ftnl
I
I BOIl<lFunll
I Growrn SIOCll Funa
I
I Guaranleell Funa
: Inae\ Funa
i Caso Manaqemenr Funo
:'~ I
:C"',:oyees ContnOut:cn
tf1'oloyer s CGntnaullon
~Glal
! 3
""
. FQr llollar'.1ernoo please gIVe amount :1 eacn ccnu,Oulion, eer Day penoa
100
~'~ I
Payday on whiCh plan IS to begin
Novpmhpr q , lqqO
,\'10 Day
2317.46 per pay period
2 weeks
'ill
Yr,
',I
My current salary IS S
"01
I am palO f!'Jery 12 weeKS, mentn. 15 days etc.l:
Note: If you are USing catcn.up prCVISlon clease suomlt "Renrement Age' ferm found In RCs brochure.
"The Catch-UP PrOVISion.
i ~ i
I TOTAL 100'" i
I ur1llelStal1O rnalNllete Slale or local law feslnC1S ",e nature of tile :n>esrmenr " mese lunas, ,I hili be ~e-~ 10
restnct me lll\'eStmenl cmlce to !rose avallaole uncer tMe law
PARTD. FUND TRANSFER
I request that my account assets with the aoove employer. consisting of Ofeollously contnbuted amounts plus earnings. be transferred as follows:
Transter from
~<T10um 5 ':-jr.J
to
name 01 luna .1ame ot ~:.:nd
to
,lame 01 luna name CI ;...no
,0
name 01 luna 'lame or 'L;~a
to
name 01 luna ;;ame or tliiiC
T ranster trom
~.'TGL;n: ~ Gr :'J
~r from
~r."ounr .) or ~
I._~,er trom
:JT1lJunt 3 or ,,;,.~
PART E. SIGNATURES
E~c!cj'ee 2iQr.a:L:2
Sale ::<;':2ioyer SiQ!la,L;e
:~ ,'.;! A R C..G.QE.Y
uate:
6/9()