TIAA Salary Deferral Form

Salary Deferral Form Buckingham Browne & Nichols DC Retirement Plan Complete this form and return to the School. Do not send this form to TIAA. Use this form to authorize the School to establish, change, or cancel the amount you wish to have withheld from your paycheck and contributed to your Plan account. EMPLOYEE INFORMATION Employee First Name Middle Initial Last Name ELECTIVE DEFERRAL AMOUNT Insert the percentage (whole number) of your basic pay to be withheld from your paycheck each pay period. For payroll periods ending after June 1, 2022, we will not deduct from overtime, bonuses or other amounts in excess of your basic pay. We do not deduct from stipends except for employees (such as seasonal coaches) whose stipends are the sole or primary source of compensation. Deferrals do not take precedence over legally mandated withholdings and may not exceed IRS limits. _________% 1. SIGNATURE • My deferrals are subject to Social Security tax in the year I understand and accept that: when earned. • This deferral election remains in effect for this year and • Amounts in my Plan account are subject to gain or loss in following years until I cancel or change it by submitting a accordance with my selected investments and Plan rules. new Form to the School. The School will process this Form and any changes or cancellations after receipt, subject to • Amounts may be paid from the Plan only according to its reasonable processing time. rules. • My deferrals are not subject to federal or state income tax • If this is my first election, I must complete enrollment until distributed from my Plan account (or from a rollover materials before this election can be processed. account if I have rolled over a distribution). Employee Signature Date IRS ANNUAL ELECTIVE DEFERRAL LIMIT This chart shows the IRS annual Limits for deferrals and catch-up limits. You must be at least 50 years old in the calendar year for the catch-up limit to apply. These limits are reduced by any 403(b) or 401(k) salary deferrals you make in the same year to the plan of another employer. To avoid tax penalties, you must promptly notify the School if you have over-contributed so that the excess can be withdrawn. It is your responsibility to know and monitor the limit if you contribute to other plans in the same year as this Plan. Year Deferral Limit Catch-up Limit Total Deferral 2023 $22,500 $7,500 $30,000 $23,000 $7,500 $30,500 2024