For Benefits Office Use Only 4/2008 TX Salary Deferral Agreement Approved:__________________ TC: D R OF University of Michigan 457(b) Deferred Compensation Plan Date:______________________ Fid: D R OF On this form, you authorize the amount(s) to be contributed from your salary to a tax-deferred Pay:______________________ 457(b) deferred compensation plan on your behalf. Please print all information in black ink. 1. Faculty or Staff Member Information Name (Last, First, Middle Initial) UMID Number US Social Security Number E-mail Daytime Phone Number Daytime FAX Number Monthly paid Bi-weekly paid 2. Effective Date (Check one) 4. Salary Deferral Agreement and Signature I understand and agree to the following terms and conditions: FIRST AVAILABLE PAY PERIOD: Elections to enroll, cancel, or change your salary deferral contribution shall be effective no 1. This Agreement is legally binding and irrevocable between the earlier than the month following the date your Agreement is filed University of Michigan and myself. with the Benefits Office. For bi-weekly paid staff, Agreements filed 2. The Internal Revenue Code (IRC) limits the aggregate amount an on or after the 15th day of any month are generally made effective individual taxpayer can tax-defer. During the year, the Benefits no earlier than the second pay period of the following month. Office will lower or suspend my salary deferral contribution if it will cause me to exceed the IRC 457(b)(2), 457(b)(3), or 414(v) limits. If my contribution is lowered or suspended during the year to keep FUTURE PAY DATE: _________________________________ me within IRC limits, my elected amount will generally resume the following year. If I participate in a 457(b) plan outside of the University of Michigan, I may need to consult with a tax advisor to ensure I do not exceed IRC limits. 3a. Salary Deferral Amount 3. I agree to hold harmless and indemnify the University of Michigan for any and all liability and expenses by it as the result of any Enroll Change Amount Cancel No Change misstatement or omission made by me in this Agreement. 4. This Agreement revokes any previously signed Agreement. 1. Enter the amount of compensation you wish to defer per pay 5. This Agreement shall become effective as soon as period. If you are paid bi-weekly, this amount will be deferred from administratively feasible, with respect to University of Michigan each paycheck, not as a monthly total. compensation not yet earned, but not earlier than the first day of 2. This amount will remain in effect until you submit another form to the month following the date this Agreement is filed with the change or cancel it. Benefits Office. 3. If you already defer compensation and are changing the amount, 6. This salary reduction agreement is covered under and shall be indicate the new total amount of the deferral, not just the amount interpreted consistent with U.S. Treasury Regulations. of the change. 7. If the University of Michigan modifies future versions of this Agreement to comply with federal law or regulations, I agree that I request to defer my eligible U-M compensation per pay period into this Agreement shall be administered according to such modified the U-M 457(b) deferred compensation plan by the amount indicated Agreements. below. (Enter whole dollar amounts only) 8. I understand my deferred compensation and earnings cannot be withdrawn until I have terminated employment, or as an employee, I am age 70½ or older, or elect a one-time withdrawal AMOUNT PER PAY PERIOD $ pursuant to IRC Section 457(e)(9)(A). 9. I understand this form does not enroll me in the University of Michigan Basic Retirement Plan or change any elections I have made with regards to the University of Michigan Basic Retirement Plan or Supplemental (SRA) Retirement Plan. 3b. Investment Company Enroll Change Investment Company No Change Signature I request to allocate the deferral amount indicated in Section 3a to the investment company(ies) as indicated below. (Check one) 100% TIAA-CREF Date 100% Fidelity Investments 50% TIAA-CREF & 50% Fidelity Investments Benefits Office – Retirement Plan Area Other: ________% TIAA-CREF & ________% Fidelity Wolverine Tower Low Rise G405 3003 S. State Street Ann Arbor, MI 48109-1278 Phone: (734) 615-2000 • FAX: (734) 936-8835 Salary Deferral Agreement Your TIAA-CREF and/or Fidelity Account(s) Changing Your Contribution There are no applications for you to complete to open your Elections to cancel, reduce, or increase your contribution shall account with TIAA-CREF and/or Fidelity. The Benefits Office be effective no earlier than the month following the date your will send an enrollment notice to your chosen investment Agreement is filed with the Benefits Office. company to create your account once your properly completed and signed Salary Deferral Agreement has been received. TIAA-CREF and/or Fidelity will then mail you with information Salary Deferral Amount on how to change your investment fund and how to designate Enter the amount of compensation you wish to defer per pay your beneficiary. Be sure to designate your beneficiary as period. If you are paid bi-weekly, this amount will be deferred soon as possible. from each paycheck, not as a monthly total. This amount will remain in effect until you submit another form to change or The investment fund will automatically be an age-appropriate cancel it. If you already defer compensation and are changing Lifecycle Fund if you select TIAA-CREF or a Freedom Fund if the amount, indicate the new total amount of the deferral, not you select Fidelity. A TIAA-CREF Lifecycle or Fidelity just the amount of the change. Freedom Fund is a mutual fund that is a diversified portfolio of other mutual funds offered by that company. This includes domestic and international stock and bond funds, as well as Investment Company money market funds. Each fund automatically selects the Indicate the investment company you want to receive your allocation of stock, bond, and money market funds that are salary deferral contributions. List whole percentages only. The appropriate for a target retirement date of approximately age total must equal 100%, for example: 50% to TIAA-CREF and 65. The fund will adjusts its holdings periodically to maintain 50% to Fidelity. an asset allocation appropriate for its target retirement date to maximize returns and minimize risks. Both TIAA-CREF and Fidelity offer a wide selection of stock, bond, money market, and real estate mutual funds. If you do not want your Limits on Cash Withdrawals and Rollovers investment fund to be a Lifecycle or Freedom Fund, you may Cash withdrawals and rollovers are permitted: change this by contacting TIAA-CREF or Fidelity. Upon termination of employment at any age. At age 70 ½ or older if you are a current faculty or staff Effective Date member at U-M. The Salary Deferral Agreement shall become effective as As a one-time withdrawal if you are a current faculty or staff soon as administratively feasible with respect to member at U-M and 1) the total account balance (not compensation not yet earned, but not earlier than the first attributable to rollovers you made into the plan) is no more day of the month following the date this Agreement is filed than $5,000; and 2) no amount has been deferred under with the Benefits Office. the plan during the two-year period that ends on the date of Agreements filed on the first day of the month or later are distribution; and 3) no previous distribution was taken made effective no earlier than the following month. under this provision. By checking “First Available Pay Period” elections shall take effect the month following the date the Agreement is filed with the Benefits Office. For bi-weekly paid staff, U-M Retirement Plan th Enrolling and contributing to the U-M 457(b) Deferred Agreements filed on or after the 15 day of any month are generally made effective no earlier than the second pay Compensation Plan does not enroll you in or affect any period of the following month. elections you have with respect to the U-M Basic Retirement Plan or Supplemental (SRA) Plan. The U-M Retirement Plan You may list a future pay date as your effective date if you is a separate plan from the U-M 457(b) Plan. want to target a specific future payroll period instead of your first available pay period. If you check no box, the default will be First Available Pay Period. Questions? Visit the U-M 457(b) Deferred Compensation Plan section of the Benefits Office Web site at www.umich.edu/~benefits/plans/457b, or call the HR/Payroll Service Center at 734-615-2000 or 866-647-7657 (toll free for off-campus long-distance within the U.S.) How to Return Your Signed and Completed Form Keep a copy for your records and a copy of the fax transmission report, if you return this form by fax. By FAX (for fastest service) By Mail Drop It Off In Person 734-936-8835 Benefits Office – Retirement Plan Area HR/Payroll Service Center Wolverine Tower – Low Rise G405 Wolverine Tower – Low Rise G250 3003 South State Street 3003 South State Street Ann Arbor, MI 48109-1278 Ann Arbor, MI 48109-1278 Enrolling with TIAA-CREF and Fidelity Investments What forms do I complete to open my What is a Lifecycle or Freedom Fund? account with TIAA-CREF and/or Fidelity? A TIAA-CREF Lifecycle or Fidelity Freedom Fund is There are no paper forms to complete to open your a mutual fund that is a diversified portfolio of other account with TIAA-CREF and/or Fidelity. mutual funds offered by that company. This includes domestic and international stock funds, bond funds, and money market funds. How is my account established? Each Lifecycle or Freedom fund automatically The Benefits Office will send an enrollment notice selects the allocation of stock, bond, and money to your chosen investment company to create your market funds that are appropriate for a target account once your properly completed and signed retirement date of approximately age 65. The fund Salary Deferral Agreement has been received. will adjusts its holdings periodically to maintain an Notifications are sent to Fidelity on a weekly basis. asset allocation appropriate for its target retirement Notifications to TIAA-CREF are sent with your first date to maximize returns and minimize risks. contribution; this is the first business day of the month after your first deduction. Your date of birth will be included in the enrollment notice sent to your chosen investment company. This will determine into which specific Lifecycle or Freedom Fund you will be enrolled. What should I do next? Lifecycle and Freedom Funds provide a simple 1) Designate Your Beneficiary solution if you lack the time, confidence, or The investment company you selected will send investment knowledge to create and manage a you a welcome packet with information on how to well-diversified portfolio. Each fund is how to designate your beneficiary. professionally managed and provides you with a simple, single investment fund. Fidelity will include a beneficiary designation form in the packet. Contact TIAA-CREF at 800-842-2776 to request a beneficiary designation form or What are my other investment choices? update it online at: www.tiaa-cref.org. Both TIAA-CREF and Fidelity offer a wide selection of stock, bond, money market, and real estate Complete the form and return it to the investment funds. If you do not want your investment fund to company as soon as possible. be a Lifecycle or Freedom Fund, contact TIAA- CREF or Fidelity to designate a different fund. 2) Choose Your Investment Funds Fidelity: 1-800-343-0860 The investment fund will automatically be an age- appropriate Lifecycle Fund if you select TIAA-CREF TIAA-CREF: 1-800-842-2776 or a Freedom Fund if you select Fidelity. You may You may also create your account online at change this by contacting TIAA-CREF or Fidelity. www.tiaa-cref.org/enroll by entering in all caps access code: UM457B Benefits Office - Retirement Plan Area Wolverine Tower – Low Rise G405 3003 South State Street Ann Arbor, MI 48109-1278 Phone (734) 615-2000 Fax (734) 936-8835 4/2008 How to Complete the Salary Deferral Agreement Fill in your name, UMID, Social Security Number, pay frequency, and contact information. Indicate when you wish your salary deferral to begin. Enrollments and elections are effective no earlier than the first of the month after your forms are filed with the Benefits Office. Indicate a fixed, whole dollar amount to be contributed with each pay period. Indicate the percent of your contribution that is to be directed to TIAA- CREF and/or Fidelity. Your signature is Return this form to the Benefits required; be sure Office. For fastest service, FAX forms to sign and date to: 734-936-8835. the form here.