EXHIBIT 10.14
PRINTED -- 8/26/03
SCUDDER
INVESTMENTS
================================================================================
SCUDDER TRUST COMPANY
PROTOTYPE DEFINED CONTRIBUTION PLAN
FULL-FLEX PROFIT SHARING PLAN (With 401(k) Option)
Non-Standardized (003)
ADOPTION AGREEMENT
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AMENDED FOR THE URUGUAY ROUND AGREEMENTS ACT ("GATT"), THE UNIFORM SERVICES
EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT ("USERRA"), THE SMALL BUSINESS JOB
PROTECTION ACT OF 1996 ("SBJPA"), THE TAXPAYER RELIEF ACT OF 1997 ("TRA '97"),
THE INTERNAL REVENUE SERVICE RESTRUCTURING AND REFORM ACT OF 1998 AND THE
COMMUNITY RENEWAL TAX RELIEF ACT OF 2000 (COLLECTIVELY REFERRED TO AS "GUST").
NATIONAL OFFICE LETTER
DATE: __________
SERIAL NUMBER: __________
SCUDDER TRUST COMPANY
PROTOTYPE DEFINED CONTRIBUTION PLAN
TABLE OF CONTENTS
A. PREAMBLE................................................... 1
B. LEAD AND PARTICIPATING EMPLOYER INFORMATION................ 1
Lead Employer: [Plan Sec. 2.40]............................ 1
Participating Employers: [Plan Secs. 2.50 and 15.1]........ 1
C. PLAN INFORMATION........................................... 1
Plan: [Plan Sec. 1.1]...................................... 1
Plan Year: [Plan Sec. 2.58]................................ 2
Plan Administrator: [Plan Secs. 2.54 and 14.1]............. 2
Funding Vehicle: [Plan Secs. 1.3 and 2.32]................. 2
Controlling Law State: [Plan Sec. 1.4]..................... 2
D. ELIGIBILITY AND SERVICE REQUIREMENTS....................... 3
Excluded Employment Categories: [Plan Sec. 2.14(a)]........ 3
Age and Service Requirements: [Plan Sec. 3.1(a)]........... 4
Entry: [Plan Secs. 2.27 and 3.1(a)]........................ 4
Hours of Service: [Plan Sec. 2.64]......................... 4
Method to Determine Service for Eligibility Purposes:
[Plan Sec. 2.64]........................................ 4
Method to Determine Service for Vesting Purposes:
[Plan Sec. 2.64]........................................ 5
Break in Service Rules for Eligibility and Vesting:
[Plan Secs. 2.8, 3.3 and 10.2(m)]....................... 6
Predecessor Employer Credit: [Plan Secs. 2.59 and 2.64(c)]. 7
Waiver of Entry Requirements: [Plan Sec. 3.1(f)]........... 7
Election Not to Participate: [Plan Sec. 3.5]............... 8
E. PLAN COMPENSATION.......................................... 8
Plan Compensation: [Plan Sec. 2.56]........................ 8
Plan Compensation for the Plan Year: [Plan Sec. 2.57]...... 10
Imputed Earnings While Disabled: [Plan Sec. 2.56(e)]....... 10
F. EMPLOYEE PRE-TAX COMPONENT................................. 10
Employee Pre-Tax Contributions: [Plan Sec. 4.1]............ 10
Age and Service Requirements: [Plan Sec. 3.1(a)]........... 10
Entry: [Plan Secs. 2.27 and 3.1(a)]........................ 11
Pay Reduction Contributions - Minimums/Maximums:
[Plan Sec. 4.1(a)]...................................... 11
Pay Reduction Agreements: [Plan Sec. 4.1(a)]............... 13
Cash or Deferred Contributions: [Plan Sec. 4.1(c)]......... 13
In-Service Withdrawals: [Plan Sec. 11.2]................... 14
G. EMPLOYER AFTER-TAX COMPONENT............................... 14
Employer After-Tax Contributions: [Plan Sec. 4.2].......... 14
Age and Service Requirements/Entry:
[Plan Secs. 2.27 and 3.1(a)] ........................... 14
Payroll Withholding Contributions: [Plan Sec. 4.2(a)]...... 14
Direct Contributions: [Plan Sec. 4.2(c)]................... 15
Required Contributions - Thrift Plan: [Plan Sec. 4.2(b)]... 15
In-Service Withdrawals: [Plan Sec. 11.2]................... 16
H. EMPLOYER SAFE-HARBOR COMPONENT............................. 16
Employer Safe-Harbor Contributions [Plan Secs. 5.1 and 6.1] 16
Age and Service Requirements: [Plan Sec. 3.1(a)]........... 17
Employer Safe-Harbor Contributions [Plan Sec. 5.1]......... 17
In-Service Withdrawals: [Plan Sec. 11.2]................... 18
I. EMPLOYER REGULAR MATCHING COMPONENT........................ 19
Employer Regular Matching Contributions: [Plan Sec. 5.2]... 19
Excluded Employment Categories: [Plan Sec. 2.14(a)]........ 19
Age and Service Requirements: [Plan Sec. 3.1(a)]........... 19
Entry: [Plan Secs. 2.27 and 3.1(a)]........................ 19
Requirements to Receive an Employer Regular Matching
Contribution: [Plan Sec. 5.2(a) or (b)]................. 20
Matching Formula: [Plan Sec. 5.2(a) or (b)]................ 21
Minimums and Maximums: [Plan Sec. 5.2(d)].................. 27
Vesting Schedule for Employer Regular Matching
Component: [Plan Sec. 10.2(e)].......................... 27
Treatment of Forfeitures: [Plan Sec. 5.2(g)]............... 28
In-Service Withdrawals: [Plan Sec. 11.2]................... 29
J. EMPLOYER REGULAR PROFIT SHARING COMPONENT.................. 30
Profit Sharing Contributions: [Plan Sec. 6.2].............. 30
Excluded Employment Categories: [Plan Sec. 2.14(a)]........ 30
Age and Service Requirements: [Plan Sec. 3.1(a)]........... 30
Entry: [Plan Secs. 2.27 and 3.1(a)]........................ 30
Requirements to Share in the Employer Regular Profit
Sharing Contribution: [Plan Sec. 6.2(a) or (b)]......... 31
Contribution/Allocation Formula: [Plan Sec. 6.2(a) or (b)]. 32
Vesting Schedule for Employer Regular Profit Sharing
Component: [Plan Sec. 10.2(e)].......................... 37
Treatment of Forfeitures: [Plan Sec. 6.2(d)]............... 37
In-Service Withdrawals: [Plan Sec. 11.2]................... 38
K. EMPLOYER QUALIFIED MATCHING AND PROFIT SHARING COMPONENT... 39
Employer Qualified Contributions: [Plan Secs. 5.3 and 6.3]. 39
Employer Qualified Matching Contributions (QMACs):
[Plan Sec. 5.3]......................................... 39
Employer Qualified Profit Sharing Contributions (QNECs):
[Plan Sec. 6.3]......................................... 40
In-Service Withdrawals: [Plan Sec. 11.2]................... 41
L. EMPLOYEE ROLLOVER COMPONENT................................ 42
Employee Rollover Contributions: [Plan Sec. 4.5]........... 42
In-Service Withdrawals: [Plan Sec. 11.2]................... 42
M. RETIREMENT, DISABILITY AND HARDSHIP........................ 42
Retirement Age: [Plan Secs. 2.19 and 2.47]................. 42
Disability: [Plan Sec. 2.18]............................... 42
Hardship: [Plan Sec. 2.33]................................. 43
N. SPECIAL VESTING RULES...................................... 43
Vesting Schedule: [Plan Sec. 10.2(e)]...................... 43
Service Disregarded for Vesting: [Plan Sec. 10.2(f)]....... 43
Special Vesting Events: [Plan Sec. 10.2(b)]................ 44
Forfeitures: [Plan Sec. 10.2(g)]........................... 44
Vesting Formula for Partially Vested:
[Plan Sec. 10.2(c) and (g)]............................. 44
Reinstatement upon Return to Service: [Plan Sec. 10.2(h)].. 45
Special Vesting Rules for Life Insurance: [Plan Sec. 10.3]. 45
O. EMPLOYER SECURITIES........................................ 45
Employer Securities: [Plan Sec. 14.15 and 14.16]........... 45
Voting Provisions: [Plan Secs. 14.15(d) and 14.16]......... 45
Tender Provisions: [Plan Secs. 14.15(e) and 14.16]......... 46
In-Kind Distribution Option: [Plan Sec. 12.3(c)]........... 46
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P. PAYMENT OF BENEFITS........................................ 47
Balances Less Than Cash-Out Amount: [Plan Sec. 12.4]....... 47
Balances More Than Cash-Out Amount: [Plan Sec. 12.3(a)].... 47
Payment Forms: [Plan Secs. 12.3(b) and 12.6]............... 48
Payment Medium: [Plan Sec. 12.3(c)]........................ 49
Beneficiary: [Plan Secs. 13.1 and 13.3].................... 49
Minimum Distributions: [Plan Secs. 2.62 and 12.7].......... 49
Q. TOP-HEAVY PROVISIONS....................................... 51
Top-Heavy Eligible Participant: [Plan Sec. 17.4(k)]........ 51
Top-Heavy Contribution Requirement: [Plan Sec. 17.1]....... 51
Top-Heavy Vesting Schedule: [Plan Sec. 17.2]............... 51
Coordination With Other Qualified Plans: [Plan Sec. 17.1].. 51
R. CODE SECTION 415 COORDINATION.............................. 52
415 Compensation: [Plan Sec. 18.4(b)]...................... 52
Limitation Year: [Plan Sec. 18.4(h)]....................... 52
Correction Method: [Plan Sec. 18.1(b)]..................... 52
Coordination With Other Plans: [Plan Sec. 18.2 and 18.3]... 53
S. SPECIAL TESTING RULES...................................... 53
Highly Compensated Employees: [Plan Sec. 2.35]............. 53
ADP/ACP Testing Method: [Plan Sec. 19.2 and 19.3].......... 54
Other Elections Regarding ADP/ACP Testing:
[Plan Sec. 19.2, 19.3 and 19.4]......................... 54
Gain or Loss on Excess Contributions: [Plan Sec. 19.1(d),
19.2(d) and 19.3(d)].................................... 55
T. SPECIAL EFFECTIVE DATE RULES............................... 55
U. FROZEN CONTRIBUTIONS ACCOUNTS.............................. 56
V. OTHER INFORMATION FOR THE PARTICIPATING EMPLOYERS.......... 56
W. SPONSOR OF THE PROTOTYPE................................... 57
X. RELIANCE ON IRS OPINION LETTER............................. 58
Y. LEAD EMPLOYER SIGNATURE.................................... 58
Z. TRUSTEE OR CUSTODIAN SIGNATURE............................. 59
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SCUDDER
INVESTMENTS
SCUDDER TRUST COMPANY
PROTOTYPE DEFINED CONTRIBUTION PLAN
FULL-FLEX PROFIT SHARING PLAN (With 401(k) Option)
Non-Standardized (003)
ADOPTION AGREEMENT
A. PREAMBLE
A.1. BY THIS AGREEMENT, THE LEAD EMPLOYER HEREBY ... [CHECK ONE]:
a. [ ] adopts a new profit sharing plan as of ... [complete]:
1. Original Effective Date: __ [month day, year].
b. [X] amends/restates its existing profit sharing plan effective as of ... [complete 1. and 2.]:
1. Amendment Effective Date: January 1, 2003 [month day, year].
2. Original Effective Date: January 1, 1989 [month day, year]. [NOTE: INSERT THE ORIGINAL
EFFECTIVE DATE OF THIS PLAN, WHETHER AS THIS PROTOTYPE, ANOTHER
PROTOTYPE, OR IN ANY OTHER FORM. IF TWO OR MORE PLANS HAVE BEEN
MERGED OR CONSOLIDATED, INSERT THE ORIGINAL EFFECTIVE DATE OF THE
PLAN SHOWN AS THE SURVIVING PLAN FOR GOVERNMENT FILING PURPOSES
(E.G., FORM 5500).]
B. LEAD AND PARTICIPATING EMPLOYER INFORMATION
LEAD EMPLOYER: B.1. Lead Employer Name: Range Resources Corporation.
[PLAN SEC. 2.40]
B.2. Lead Employer EIN: 34-1312571.
PARTICIPATING EMPLOYERS: B.3. The Participating Employers are the ... [check each that applies]: [NOTE: IF
[PLAN SECS. 2.50 AND 15.1] THERE ARE MORE THAN THREE PARTICIPATING EMPLOYERS, ATTACH THE PARTICIPATING
EMPLOYER ADDENDUM.]
a. [X] Lead Employer.
b. [ ] following Controlled Group Members ... [complete]:
1. Participating Employer:
Name: ____.
Employer EIN: ____.
2. Participating Employer:
Name: ____.
Employer EIN: ____.
3. Participating Employer:
Name: ____.
Employer EIN: ____.
[NOTE: A CONTROLLED GROUP MEMBER WILL IMMEDIATELY CEASE TO BE A PARTICIPATING
EMPLOYER AS OF THE DATE IT CEASES TO BE A CONTROLLED GROUP MEMBER.]
C. PLAN INFORMATION
PLAN: C.1. Plan Name: Range Resources Corporation 401(k) Plan.
[PLAN SEC. 1.1]
C.2. Plan Number: 002. [NOTE: THIS IS THE THREE-DIGIT IDENTIFYING NUMBER (E.G.,
001) THAT THE EMPLOYER ASSIGNS FOR GOVERNMENT FILING PURPOSES (E.G., FORM
5500).]
PLAN YEAR: C.3. The Plan Year is the twelve-consecutive-month period ending each December 31
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[PLAN SEC. 2.58] [month day] [check each that applies]:
a. [ ] The first Plan Year is a short year that began on the Original Effective
Date and ended ___ [month day, year].
b. [ ] The Plan Year has been amended. The last Plan Year before the amendment
ended ___ [month day, year], and the short Plan Year resulting from the
amendment began the next day and ended ___ [month day, year].
PLAN ADMINISTRATOR: C.4. The Plan Administrator is the ... [check one]:
[PLAN SECS. 2.54 AND 14.1]
a. [X] Lead Employer. [NOTE: THE LEAD EMPLOYER MAY DELEGATE ADMINISTRATIVE
AUTHORITY TO AN INDIVIDUAL OR COMMITTEE.]
b. [ ] following individual or entity ... [complete]:
Name: ____.
c. [ ] following committee of individuals ... [check one]: [NOTE: EITHER THE NAME
OF THE COMMITTEE OR THE INDIVIDUAL COMMITTEE MEMBERS MUST BE SPECIFIED.]
1. [ ] Name of committee: ____.
2. [ ] Committee members ... [complete]:
Name: ____.
Name: ____.
Name: ____.
Name: ____.
Name: ____.
Name: ____.
Name: ____.
FUNDING VEHICLE: C.5. The Funding Vehicle(s) for the Plan include ... [check each that applies]:
[PLAN SECS. 1.3 AND 2.32]
a. [X] a Trust Fund with ... [check each that applies]:
1. [ ] individual trustee(s). [NOTE: INDIVIDUAL TRUSTEE(S) MAY SERVE ON
A DISCRETIONARY OR DIRECTED BASIS PURSUANT TO THE TRUST AGREEMENT.]
2. [X] a financial organization serving pursuant to the Trust Agreement
... [check one]:
a. [X] for a Directed Trustee.
b. [ ] with a Discretionary Trustee Option.
b. [ ] a Custodial Account. [NOTE: THIS OPTION IS APPROPRIATE ONLY FOR A PLAN
MAINTAINED BY AN UNINCORPORATED BUSINESS AND THAT COVERS SELF-EMPLOYED
INDIVIDUALS. ALSO, THE CUSTODIAN MUST BE A BANK OR OTHER ORGANIZATION
AUTHORIZED TO ACT AS A CUSTODIAN WITH RESPECT TO QUALIFIED PLANS.]
c. [ ] Annuity Funding Contract(s).
CONTROLLING LAW STATE: C.6. The Plan will be construed and administered in accordance with the laws of the
[PLAN SEC. 1.4] State or Commonwealth of New Hampshire to the extent that such laws are not
preempted by the laws of the United States of America.
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D. ELIGIBILITY AND SERVICE REQUIREMENTS
EXCLUDED EMPLOYMENT CATEGORIES: D.1. Covered Employment does not include employment as ... [check each of a. through
[PLAN SEC. 2.14(a)] l. that applies, or check m. or n.]: [NOTE: COVERED EMPLOYMENT ONLY INCLUDES
EMPLOYMENT WITH A PARTICIPATING EMPLOYER. HOWEVER, IT DOES NOT INCLUDE EMPLOYMENT
AS A COLLECTIVE BARGAINING EMPLOYEE UNLESS THE COLLECTIVE BARGAINING AGREEMENT
PROVIDES FOR PARTICIPATION IN THE PLAN UNDER THE TERMS SET FORTH IN THIS ADOPTION
AGREEMENT.]
a. [ ] a non-resident alien who receives no earned income (within the meaning of Code
Section 911(d)(2)) from a Participating Employer which constitutes income from
sources within the United States (within the meaning of Code Section 861(a)(3)),
or who receives such earned income but it is all exempt from income tax in the
United States under the terms of an income tax convention.
b. [ ] a Highly Compensated Employee.
[NOTE: EXCLUDING ANY OF THE FOLLOWING CATEGORIES MAY RESULT IN FAILURE TO SATISFY
THE COVERAGE REQUIREMENTS OF CODE SECTION 410(b).]
c. [ ] a Key Employee.
d. [X] a Leased Employee.
e. [ ] a Self-Employed Individual (that is, a sole proprietor or partner with respect
to a Participating Employer).
f. [ ] a salaried Employee.
g. [ ] an hourly-wage Employee.
h. [X] an Employee paid primarily on a commission basis.
i. [ ] an Employee working outside the United States.
j. [ ] a citizen or resident of a foreign country, except those who work in the United
States under the following VISA or NAFTA categories ... [check one]:
1. [ ] All categories are excluded except as expressly required by United
States Immigration Law.
2. [ ] The following categories are included [specify]: ____.
k. [ ] an Employee in any of the following units or locations [specify]: ___ [NOTE: TO
EXCLUDE ALL EMPLOYEES OF A CONTROLLED GROUP MEMBER, DO NOT DESIGNATE THAT
CONTROLLED GROUP MEMBER AS A PARTICIPATING EMPLOYER.]
l. [X] other [specify]: Temporary employees, Reclassified employees.
m. [ ] The Plan is exclusively a collective bargaining plan - thus, the only Employees
Collective in Covered Employment are those Collective Bargaining Employees who are covered
Bargaining Only Plan by the following collective bargaining agreement(s) that provides for
participation in the Plan ... [complete]: [NOTE: ALL OTHER EMPLOYEES ARE EXCLUDED
FROM ALL COMPONENTS.]
1. ____.
2. ____.
3. ____.
4. ____.
5. ____.
n. [ ] The Plan is exclusively a "prevailing wage" plan - thus, the only Employees in
Prevailing Wage Only Covered Employment are those who are employed on prevailing wage projects
Plan specified in J.8.f. or on the Prevailing Wage Addendum. [NOTE: ALL OTHER EMPLOYEES
ARE EXCLUDED FROM ALL COMPONENTS.]
D.2. Covered Employment ... [check one]:
a. [X] does not include employment during the transition period following a stock or
asset acquisition described in Code Section 410(b)(6)(C) ... [check if applicable]:
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1. [ ] subject to the following exceptions [complete]: [NOTE: FOR EACH LISTED
ACQUISITION, EMPLOYMENT BECOMES COVERED EMPLOYMENT AS OF THE EFFECTIVE
DATE LISTED FOR THAT ACQUISITION (UNLESS THE EMPLOYMENT IS EXCLUDED
UNDER D.1.).]
Acquisition: _____.
Effective Date: _____.
Acquisition: _____.
Effective Date: _____.
Acquisition: _____.
Effective Date: _____.
b. [ ] includes employment during the transition period following a stock or asset
acquisition described in Code Section 410(b)(6)(C) (unless the employment is
excluded under D.1.).
[NOTE: THIS PROVISION APPLIES ONLY TO AN INDIVIDUAL WHO BECOMES AN EMPLOYEE
AS A RESULT OF THE ACQUISITION. THE "TRANSITION PERIOD" BEGINS ON THE DATE OF
SUCH ACQUISITION AND ENDS ON THE LAST DAY OF THE FIRST PLAN YEAR BEGINNING
AFTER THE DATE OF SUCH ACQUISITION (OR, IF EARLIER, UPON ANY SIGNIFICANT CHANGE
IN COVERAGE OF THE PLAN OTHER THAN AS A RESULT OF SUBSEQUENT ACQUISITION).]
AGE AND SERVICE REQUIREMENTS: D.3. The age requirement for participation will be determined separately for each
[PLAN SEC. 3.1(a)] Component, as specified in F.2., G.2., H.2., I.3. and J.3.
D.4. The service requirement for participation will be determined separately for
each Component, as specified in F.3., G.2., H.2., I.4. and J.4.
ENTRY: D.5. An Employee in Covered Employment will become an Active Participant in a
[PLAN SECS. 2.27 AND 3.1(a)] Component on the Entry Date that coincides with or next follows the date
he/she satisfies the age and service requirements for such Component, except
as otherwise provided in J.5. with respect to the Employer Regular Profit
Sharing Component.
D.6. The Entry Dates will be determined separately for each Component, as specified
in F.5., G.2., H.2., I.6. and J.6.
HOURS OF SERVICE: D.7. An Employee for whom a record of actual hours is not maintained or available
[PLAN SEC. 2.64] (e.g., salaried employees) will be credited with ... [check one]:
[COMPLETE IF HOURS ARE a. [ ] 190 Hours of Service for each month
USED FOR ANY PURPOSE - b. [ ] 95 Hours of Service for each semi-monthly payroll period
E.G., ELIGIBILITY, c. [X] 45 Hours of Service for each week
VESTING OR ALLOCATIONS] d. [ ] 10 Hours of Service for each day
... in which he/she has one or more Hours of Service.
D.8. An Employee for whom a record of actual hours is maintained and available will
be credited with ... [check one]:
a. [X] actual Hours of Service.
b. [ ] the same equivalency as specified in D.7.
METHOD TO DETERMINE SERVICE D.9. Service will be determined for eligibility purposes using the ... [check one]:
FOR ELIGIBILITY PURPOSES:
[PLAN SEC. 2.64] a. [ ] hour count method ... [complete as necessary] [NOTE: THIS OPTION SHOULD BE
ELECTED IF THE HOUR COUNT METHOD IS USED TO DETERMINE SERVICE UNDER ANY
[COMPLETE ONLY IF A COMPONENT.]
SERVICE REQUIREMENT IS
IMPOSED ON PARTICIPATION 1. An Employee must complete at least ___ [1,000 or less] Hours of
IN ONE OR MORE COMPONENTS] Service during an eligibility computation period for it to count as
a year of Service.
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2. The eligibility computation period is the twelve-consecutive-month period
beginning on the Service Commencement Date and each ... [check one]:
a. [ ] Plan Year beginning after the Service Commencement Date.
b. [ ] anniversary of the Service Commencement Date.
3. An Employee will have satisfied the service requirement as of the ...
[check one]:
a. [ ] end of the eligibility computation period during which
b. [ ] date during the eligibility computation period as of which
... he/she has completed the required Hours of Service.
4. The hour count method applies to ... [check one]:
a. [ ] all Employees.
b. [ ] Employees who are ... [check each that applies]:
1. [ ] classified as "full-time"
2. [ ] classified as "part-time"
3. [ ] classified as "temporary" or "seasonal"
4. [ ] paid on an hourly-wage basis
5. [ ] paid on a salaried basis
6. [ ] employed with the following Participating Employers
[specify]: _____,
... and the elapsed time method applies to all other Employees.
b. [ ] elapsed time method.
METHOD TO DETERMINE SERVICE D.10. Service will be determined for vesting purposes using the ... [check one]:
FOR VESTING PURPOSES:
[PLAN SEC. 2.64] a. [X] hour count method ... [complete as necessary]
[COMPLETE ONLY IF A 1. An Employee must complete at least 1000 [1,000 or less] Hours of
VESTING SCHEDULE APPLIES Service during a vesting computation period for it to count as a
WITH RESPECT TO THE year of Service.
EMPLOYER REGULAR MATCHING
OR REGULAR PROFIT SHARING 2. The vesting computation period is the ... [check one of a. through c.,
COMPONENT] and check d. if it applies]:
a. [X] Plan Year.
b. [ ] twelve-consecutive-month period ending each ____ [month day].
c. [ ] twelve-consecutive-month period beginning on the Service
Commencement Date and each anniversary of the Service
Commencement Date.
[check d. if the vesting computation period has been amended]
d. [ ] The vesting computation period has been amended. The
last vesting computation period before the amendment ended
____ [month day, year], the special vesting computation
period resulting from the amendment began ____ [month day,
year] and ended ____ [month day, year], and the vesting
computation period after the amendment is specified above
beginning ____ [month day, year]. [NOTE: THE SPECIAL
VESTING COMPUTATION PERIOD MUST BE TWELVE MONTHS IN LENGTH.]
3. A Break in Service will occur if the Employee has 500 [500 or less] or
fewer Hours of Service during a vesting computation period.
4. The hour count method applies to ... [check one]:
5
a. [ ] all Participants.
b. [ ] Participants who are ... [check each that applies]:
1. [ ] classified as "full-time"
2. [ ] classified as "part-time"
3. [ ] classified as "temporary" or "seasonal"
4. [ ] paid on an hourly-wage basis
5. [ ] paid on a salaried basis
6. [ ] employed with the following Participating Employers
[specify]: ____,
... and the elapsed time method applies to all other
Participants, with Service calculated based on completed years
of Service (disregarding fractional years).
b. [ ] elapsed time method, with Service for vesting purposes being calculated at
Termination of Service based on ... [check one]:
1. [ ] completed years of Service (disregarding fractional years).
2. [ ] completed and fractional years of Service, with fractional years
calculated based on completed ... [check one]:
a. [ ] days (365 completed days equals one year).
b. [ ] months (12 completed months equals one year).
BREAK IN SERVICE RULES FOR D.11. Service prior to a Break in Service of one year or more ... [check one]:
ELIGIBILITY AND VESTING:
[PLAN SECS. 2.8, 3.3 AND a. [X] will be taken into account for eligibility and vesting purposes
10.2(m)] immediately upon a subsequent return to employment under all Components
(unless disregarded under D.12.).
b. [ ] will not be taken into account for eligibility or vesting purposes under
the ... [check each that applies]:
1. [ ] Employer Regular Matching Component
2. [ ] Employer Regular Profit Sharing Component
... until the Employee completes one year of Service after the Break in
Service (in which case Service will be retroactively restored to the
Employee). However, such Service will be taken into account immediately
upon a subsequent return to employment under each other Component
(unless otherwise disregarded under D.12). [NOTE: USE OF THIS OPTION b.
MAY REQUIRE THAT RETROACTIVE EMPLOYER REGULAR MATCHING OR REGULAR PROFIT
SHARING CONTRIBUTIONS BE MADE ON BEHALF OF THE PARTICIPANT.]
D.12. In the case of a Participant who had no vested interest in his/her Account
prior to a period of five or more consecutive one-year Breaks in Service (other
than a vested interest in an Employee After-Tax, Deductible, Forfeiture
Restoration or Rollover Contribution Account), Service prior to such period ...
[check one]:
a. [X] will not
b. [ ] will
... be taken into account for eligibility or vesting purposes after a subsequent
return to employment. [NOTE: IN ALL OTHER CASES AND FOR ALL PARTICIPANTS WITH A
VESTED INTEREST IN THEIR ACCOUNTS, SERVICE PRIOR TO A BREAK IN SERVICE WILL BE
COUNTED AFTER A SUBSEQUENT RETURN TO EMPLOYMENT (SUBJECT TO ANY RESTRICTIONS
SPECIFIED IN D.11).]
PREDECESSOR EMPLOYER CREDIT: D.13. Employment with the following Predecessor Employer(s) which did not maintain
[PLAN SECS. 2.59 AND 2.64(c)] the Plan ... [complete as appropriate]: [NOTE: CODE SECTION 414(a) REQUIRES THAT
SERVICE WITH A PREDECESSOR EMPLOYER BE TAKEN INTO ACCOUNT IF A PLAN OF THE
PREDECESSOR EMPLOYER IS MAINTAINED BY A CONTROLLED GROUP MEMBER. THE SERVICE
CREDIT UNDER THIS D.13. IS IN ADDITION TO THAT REQUIRED UNDER CODE SECTION
414(a).] [NOTE: IF THERE IS MORE THAN ONE PREDECESSOR EMPLOYER, ATTACH THE
PREDECESSOR EMPLOYER ADDENDUM.]
Name: Range Energy Ventures Corporation.
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Employer Identification Number: 76-0520793.
... counts as Service for ... [check each that applies]:
1. [X] eligibility purposes, with Service with the Predecessor Employer
calculated based on ... [check one]:
a. [X] Hours of Service from ... [check one]:
1. [X] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]: ____.
b. [ ] elapsed time from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]: ____.
2. [X] vesting purposes, with Service with the Predecessor Employer
calculated based on ... [check one]:
a. [X] Hours of Service from ... [check one]:
1. [X] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]: ____.
b. [ ] elapsed time from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]: ____.
However, prior service credit for vesting purposes will be limited
to ____ years. [complete if desired.]
3. [X] determining whether the Participant is entitled to share in the
Employer Regular Matching or Regular Profit Sharing Contribution.
For such Participant, the compensation paid by the Predecessor
Employer ... [check one]:
a. [X] is not
b. [ ] is
... counted as Plan Compensation for purposes of determining or
allocating the Employer Regular Matching or Regular Profit Sharing
Contribution for the first year of participation under this Plan.
WAIVER OF ENTRY REQUIREMENTS: D.14. An Employee in Covered Employment ... [check one]:
[PLAN SEC. 3.1(f)]
a. [X] must always satisfy the age and/or service requirements to become an Active
Participant.
b. [ ] will become an Active Participant on the ... [check one]:
1. [ ] Original Effective Date
2. [ ] following date: ____ [month day, year]
... even if he/she has not satisfied the ... [check each that applies]:
3. [ ] age
4. [ ] service
... requirement for participation in the Component.
7
This age and/or service waiver applies with respect to ... [check 5., or check
each of 6. through 8. that applies]:
5. [ ] all Components.
6. [ ] the Employee Pre-Tax Component (and those Components with
eligibility and entry tied to such Component).
7. [ ] the Employer Regular Matching Component.
8. [ ] the Employer Regular Profit Sharing Component.
[NOTE: THE WAIVER ALSO APPLIES WITH RESPECT TO THE EMPLOYEE
AFTER-TAX COMPONENT, IF ANY, IF ELIGIBILITY AND ENTRY IS TIED TO
THAT COMPONENT UNDER G.2.]
ELECTION NOT TO PARTICIPATE: D.15. May an Employee elect not to participate in the Plan? [check one]:
[PLAN SEC. 3.5]
a. [X] No. [Skip to Section E.]
b. [ ] Yes ... [check one]: [NOTE: THIS OPTION MAY RESULT IN FAILURE TO SATISFY
THE COVERAGE REQUIREMENTS OF CODE SECTION 410(b) UNLESS IT IS LIMITED TO
HIGHLY COMPENSATED EMPLOYEES.]
1. [ ] if he/she has a religious objection to participation in the
Plan.
2. [ ] for any reason ... [check if applicable]:
a. [ ] but only if he/she is a Highly Compensated Employee.
E. PLAN COMPENSATION
[NOTE: PLAN COMPENSATION WILL BE USED FOR NONDISCRIMINATION TESTING UNLESS THE
PLAN ADMINISTRATOR EXPRESSLY DIRECTS THAT A DIFFERENT DEFINITION OF COMPENSATION
BE USED FOR SUCH TESTING FOR A PARTICULAR PLAN YEAR. TESTING COMPENSATION MAY BE
USED TO DETERMINE AN EMPLOYER QUALIFIED PROFIT SHARING CONTRIBUTION IF SO
ELECTED IN K.5. NOTWITHSTANDING THE ELECTIONS IN THIS ITEM E.]
PLAN COMPENSATION: E.1. Plan Compensation means ... [check one]:
[PLAN SEC. 2.56]
a. [ ] earnings required to be reported in the Wages, Tips and Other Compensation
box of Form W-2.
b. [X] earnings for purposes of Code Section 415(c)(3).
c. [ ] earnings for purposes of federal income tax withholding.
[NOTE: UNLESS SPECIFICALLY EXCLUDED BELOW, PLAN COMPENSATION INCLUDES EMPLOYEE
PRE-TAX CONTRIBUTIONS, OTHER ELECTIVE DEFERRALS AND AMOUNTS THAT ARE EXCLUDED
FROM INCOME UNDER CODE SECTION 125.]
8
E.2. Plan Compensation does not include ... [check each that applies]:
With respect to With respect to
the Employer the Employer
Safe-Harbor, Safe-Harbor,
Regular or Regular or
Qualified Qualified*
Matching Profit Sharing
Component Component
--------- ----------
a. [ ] [ ] Employee Pre-Tax Contributions and other
Elective Deferrals.
b. [ ] [ ] amounts that are excluded from income
under Code Section 125 (cafeteria plan).
c. [ ] [ ] reimbursements or other expense
allowances, fringe benefits (cash and
non-cash), moving expenses, deferred
compensation and welfare benefits.
* EXCEPT AS OTHERWISE ELECTED IN K.5. WITH RESPECT TO THE EMPLOYER QUALIFIED
PROFIT SHARING COMPONENT.
[NOTE: THE FOLLOWING EXCLUSIONS (d. THROUGH k.) DO NOT APPLY FOR PURPOSES OF THE
EMPLOYER SAFE-HARBOR MATCHING OR SAFE-HARBOR PROFIT SHARING COMPONENT.[NOTE:
EXCLUDING ANY OF THE FOLLOWING ITEMS WILL REQUIRE THE DEFINITION OF PLAN
COMPENSATION TO BE TESTED FOR DISCRIMINATION UNDER CODE SECTION 414(s).]
d. [ ] [ ] amounts in excess of $___. [NOTE: THE
AMOUNT THAT MAY BE TAKEN INTO ACCOUNT FOR
A PLAN YEAR IS ALREADY LIMITED UNDER CODE
SECTION 401(a)(17). INCLUDE AN AMOUNT HERE
ONLY IF A LIMIT LESS THAN THE OTHERWISE
APPLICABLE LIMIT IS INTENDED.]
e. [X] [X] severance pay paid at or prior to Termination
of Service. [NOTE: SEVERANCE PAY OR OTHER
AMOUNTS PAID AFTER TERMINATION OF SERVICE ARE
AUTOMATICALLY EXCLUDED.]
f. [X] [X] bonuses.
g. [ ] [ ] commissions.
h. [ ] [ ] overtime. [NOTE: EXCLUDING OVERTIME PAYMENTS
WITH RESPECT TO CERTAIN CONTRIBUTION TYPES MAY
RAISE ISSUES UNDER FEDERAL AND/OR STATE WAGE
AND HOUR LAWS.]
i. [ ] [ ] amounts paid in any form other than cash.
j. [X] [X] amounts contributed under the following
incentive, bonus or equity plan(s)
[specify]: stock bonus; moving allowance,
stock purchase plan, ISO Exercise, Note
Receivable, Deferred Stock Bonus.
[NOTE: AMOUNTS PAID AFTER AN EMPLOYEE CEASES TO BE AN ACTIVE PARTICIPANT IN ANY
COMPONENT ARE AUTOMATICALLY EXCLUDED FROM PLAN COMPENSATION FOR THAT COMPONENT.]
9
PLAN COMPENSATION FOR THE PLAN E.3. Plan Compensation for the Plan Year means the Plan Compensation paid within the Plan
YEAR: Year ... [check if applicable]:
[PLAN SEC. 2.57]
a. [ ] except for purposes of the ... [check each that applies]:
[COMPLETE ONLY IF THE 1. [ ] Employer Regular Matching Component,
PLAN INCLUDES AN EMPLOYER 2. [ ] Employer Regular Profit Sharing Component,
REGULAR MATCHING OR
REGULAR PROFIT SHARING
COMPONENT] ... where Plan Compensation for the Plan Year means Plan Compensation paid within
the twelve-consecutive-month period that ends each _______ [month day] within the
Plan Year.
In the case of a Participant hired during such twelve-consecutive-month period, Plan
Compensation for the Plan Year means Plan Compensation paid within ... [check one]:
3. [ ] such twelve-consecutive-month period.
4. [ ] the Plan Year.
E.4. Plan Compensation for the Plan Year does not include amounts paid prior to the Entry
Date ... [check if applicable]:
a. [X] except for purposes of the ... [check one or both of 1. and 2., or check 3.]
1. [ ] Employer Regular Matching Component,
2. [ ] Employer Regular Profit Sharing Component,
3. [X] Employer Contribution Components (Employer Safe-Harbor, Regular and
Qualified Matching Components, and Employer Safe-Harbor, Regular and
Qualified Profit Sharing Components, as applicable)
... where Plan Compensation for the Plan Year includes amounts paid during the
determination period in E.3., but prior to the Entry Date.
IMPUTED EARNINGS WHILE E.5. Plan Compensation ... [check one]:
DISABLED:
[PLAN SEC. 2.56(e)] a. [X] will not
b. [ ] will
... be imputed to a Participant during periods of total disability (as defined in
[COMPLETE ONLY IF THE Code Section 22(e)(3)) for purposes of determining or allocating Employer Regular Profit
PLAN INCLUDES AN EMPLOYER Sharing Contributions.
REGULAR PROFIT SHARING
COMPONENT]
F. EMPLOYEE PRE-TAX COMPONENT
EMPLOYEE PRE-TAX CONTRIBUTIONS: F.1. Employee Pre-Tax Contributions ... [check one]:
[PLAN SEC. 4.1]
a. [ ] will not [Skip to Section G.]
b. [X] will
... be allowed under the Plan.
AGE AND SERVICE REQUIREMENTS: F.2. For an Employee to participate in the Employee Pre-Tax Component, he/she must have
[PLAN SEC. 3.1(a)] attained age ... [check one]:
a. [X] 18 [21 or less].
b. [ ] N/A - there is no age requirement.
10
F.3. For an Employee to participate in the Employee Pre-Tax Component, he/she must have
completed ... [check one]:
a. [ ] one year of Service (determined under D.9.).
b. [ ] ______ [12 or less] months of Service determined using the elapsed time method
(irrespective of the election in D.9.).
c. [X] N/A - there is no service requirement.
ENTRY: F.4. An Employee in Covered Employment will become an Active Participant in the
[PLAN SECS. 2.27 AND 3.1(a)] Employee Pre-Tax Component on the Entry Date that coincides with or next
follows the date he/she satisfies the age and service requirements for such Component.
F.5. The Entry Dates for the Employee Pre-Tax Component are the ... [check one]:
a. [ ] first day of each Plan Year and the first day of the seventh month of each Plan Year.
b. [ ] first day of each quarter of each Plan Year.
c. [ ] first day of each month.
d. [ ] first day of each payroll period.
e. [X] day on which the age and service requirements are satisfied.
f. [ ] first day of each Plan Year. [NOTE: THIS OPTION IS PERMITTED ONLY IF (i) THERE IS NO
AGE REQUIREMENT OR THE AGE REQUIREMENT SPECIFIED IN F.2.a. DOES NOT EXCEED 20 1/2,
AND (ii) THERE IS NO SERVICE REQUIREMENT OR THE SERVICE REQUIREMENT SPECIFIED IN
F.3.b. OR c. DOES NOT EXCEED 6 MONTHS.]
g. [ ] other [specify]: ____. [NOTE: THE ENTRY DATES SPECIFIED MUST BE AT LEAST AS FAVORABLE
AS ONE OF THE CHOICES IN a. - f.]
PAY REDUCTION CONTRIBUTIONS F.6. Employee Pre-Tax Contributions are permitted by means of pay reduction in any whole ...
- - MINIMUMS/MAXIMUMS: [check one or both of a. and b., and check c. if it applies]:
[PLAN SEC. 4.1(a)]
a. [X] percentage, subject to the following minimum and maximum per payroll period ...
[check each of 1. and 2. that applies, or check 3.]:
1. [X] Minimum: 1% of Plan Compensation.
2. [X] Maximum [complete]:
a. 50% of Plan Compensation with respect to any Non-Highly
Compensated Employee, and
b. 50% [not to exceed the percentage in a.] of Plan Compensation with
respect to any Highly Compensated Employee.
3. [ ] such minimum and maximum as the Lead Employer may specify in written
action taken prior to the first day of the Plan Year.
b. [ ] dollar amount, subject to the following minimum and maximum per payroll period ...
[check each of 1. and 2. that applies, or check 3.]:
1. [ ] Minimum ... [check one]:
a. [ ] $_____.
b. [ ] ______% of Plan Compensation.
2. [ ] Maximum: $ ______.
3. [ ] such minimum and maximum as the Lead Employer may specify in written
action taken prior to the first day of the Plan Year.
[check c. only if an annual maximum is desired that is less than the limit under
Code Section 402(g)].
c. [ ] provided that the aggregate Employee Pre-Tax Contributions of a Participant for the
Plan Year may not exceed ... [check one]:
1. [ ] $ _______.
2. [ ] _________% of Plan Compensation for the Plan Year.
11
3. [ ] the lesser of $_____ or _____% of Plan Compensation for the Plan Year.
4. [ ] such maximum as the Lead Employer may specify in written action taken
prior to the first day of the Plan Year.
[NOTE: EMPLOYEE PRE-TAX CONTRIBUTIONS ARE LIMITED BY CODE SECTION 402(g).]
[NOTE: IF THE PLAN PROVIDES FOR EMPLOYER SAFE-HARBOR MATCHING CONTRIBUTIONS, THE MAXIMUM
UNDER a., b. AND c., ABOVE, FOR A NON-HIGHLY COMPENSATED EMPLOYEE MUST BE AT LEAST
SUFFICIENT TO ALLOW THE PARTICIPANT TO RECEIVE THE MAXIMUM EMPLOYER SAFE-HARBOR MATCHING
CONTRIBUTION.]
Catch-Up Election F.7. If a Participant has contributed less than the maximum amount for prior payroll periods
within the Plan Year, he/she ... [check one]:
a. [X] may not
b. [ ] may ... [check one]:
1. [ ] at any time
2. [ ] at any time during the final month of the Plan Year
3. [ ] at any time during the final quarter of the Plan Year
4. [ ] at any time during the Plan Year in which the Employee Pre-Tax Component
becomes effective (but not later Plan Years)
... increase his/her pay reductions above the maximum in subsequent payroll periods to
account for no prior pay reductions, or pay reductions at less than the maximum. [NOTE:
IN SUCH CASE, THE TOTAL PAY REDUCTIONS FOR THE PLAN YEAR MAY NOT EXCEED THE MAXIMUM(S)
SPECIFIED ABOVE APPLIED BY REFERENCE TO PLAN COMPENSATION FOR THE PLAN YEAR.]
Automatic Enrollment F.8. Upon initial entry into the Employee Pre-Tax Component, a Participant will be deemed to
have elected a pay reduction of ... [check one]: [NOTE: SOME STATE LAWS MAY PROHIBIT OR
LIMIT AUTOMATIC ENROLLMENTS.]
a. [X] N/A - the automatic enrollment provision does not apply.
b. [ ] ____% [5% or less] of Plan Compensation per payroll period unless he/she
affirmatively elects a different percentage or amount or elects not to receive
Employee Pre-Tax Contributions.
Special Effective Date [complete if desired]:
This provision will be effective as of _______ [month day, year] with respect to
individuals who become ... [check one of 1. or 2., and check 3. if it applies]
1. [ ] Employees
2. [ ] Active Participants in the Employee Pre-Tax Component
... on or after that date....
3. [ ] This provision will also apply effective as of that date to each then
current Active Participant in the Employee Pre-Tax Component who ...
[check one]:
a. [ ] does not then have a pay reduction agreement in effect ...
[check if applicable]:
1. [ ] and who has not revoked such an agreement in the
last ______ [specify number] months.
b. [ ] does not then have a pay reduction agreement in effect, or who
has a pay reduction agreement in effect of less than the
automatic enrollment percentage above.
PAY REDUCTION AGREEMENTS: F.9. The initial pay reduction agreement made by a Participant may be effective as soon as
[PLAN SEC. 4.1(a)] administratively practicable after his/her initial Entry Date. Thereafter, if a
Participant does not have a pay reduction agreement in effect (because he/she has not
previously filed one, or because it has been revoked), a pay reduction agreement may be
effective
12
as soon as administratively practicable on or after ... [check one]:
a. [ ] any Entry Date.
b. [ ] the first day of any Plan Year or the first day of the seventh month of any Plan
Year.
c. [ ] the first day of any Plan Year.
d. [ ] the first day of any quarter of any Plan Year.
e. [ ] the first day of any month.
f. [X] the date the election is made.
F.10. A pay reduction agreement may be modified effective as soon as administratively
practicable on or after ... [check one]:
a. [ ] any Entry Date.
b. [ ] the first day of any Plan Year or the first day of the seventh month of any Plan
Year.
c. [ ] the first day of any Plan Year.
d. [ ] the first day of any quarter of any Plan Year.
e. [ ] the first day of any month.
f. [X] the date the election is made.
F.11. A pay reduction agreement may be revoked effective as soon as administratively
practicable on or after ... [check one]:
a. [ ] any Entry Date.
b. [ ] the first day of any Plan Year or the first day of the seventh month of any Plan
Year.
c. [ ] the first day of any Plan Year.
d. [ ] the first day of any quarter of any Plan Year.
e. [ ] the first day of any month.
f. [X] the date the election is made.
CASH OR DEFERRED CONTRIBUTIONS: F.12. A cash or deferred option is available with respect to ... [check one]: [NOTE: IF A CASH
[PLAN SEC. 4.1(c)] OR DEFERRED OPTION IS AVAILABLE WITH RESPECT TO AN ITEM OF COMPENSATION, A GENERAL PAY
REDUCTION AGREEMENT WILL NOT APPLY TO THAT ITEM.]
a. [X] N/A - a cash or deferred option is not available. [Skip to F.15.]
b. [ ] bonuses paid during the Plan Year and designated as eligible for this option by the
Lead Employer.
c. [ ] payments in lieu of a cash distribution of accrued but unused vacation time.
d. [ ] employer credits under a cafeteria plan that are otherwise made available under such
plan as a cash distribution to the Participant.
e. [ ] the following incentive, bonus or equity plan(s) [specify]: _______.
F.13. The contributions made pursuant to this cash or deferred option may not exceed ... [check
one]:
a. [ ] _____% of the designated payments subject to the cash or deferred option.
b. [ ] $_____ per Plan Year.
13
F.14. The contributions made pursuant to this cash or deferred option ... [check one]:
a. [ ] are
b. [ ] are not
... eligible for Employer Regular Matching Contributions. [NOTE: IF THE PLAN PROVIDES FOR
EMPLOYER SAFE-HARBOR MATCHING CONTRIBUTIONS, THE CONTRIBUTIONS MADE PURSUANT TO THIS CASH
OR DEFERRED OPTION ARE ELIGIBLE FOR SUCH EMPLOYER SAFE-HARBOR MATCHING CONTRIBUTIONS.]
IN-SERVICE WITHDRAWALS: F.15. Withdrawals are allowed from Employee Pre-Tax Contribution Accounts ... [check a., or
[PLAN SEC. 11.2] check each of b. and c. that applies]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [X] for any reason after ... [check one]:
1. [ ] Normal Retirement Age (or age 59 1/2, if later).
2. [X] age 59 1/2.
3. [ ] age _______ [60 or more].
c. [X] at any age on account of Hardship.
G. EMPLOYEE AFTER-TAX COMPONENT
EMPLOYEE AFTER-TAX G.1. Employee After-Tax Contributions ... [check one]:
CONTRIBUTIONS:
[PLAN SEC. 4.2] a. [X] will not [Skip to Section H.]
b. [ ] will
... be allowed under the Plan.
AGE AND SERVICE G.2. The eligibility and entry requirements for the Employee After-Tax Component are the same
REQUIREMENTS/ENTRY: as for the ... [check one]:
[PLAN SECS. 2.27 AND 3.1(a)]
a. [ ] Employee Pre-Tax Component.
b. [ ] Employer Regular Matching Component.
c. [ ] Employer Regular Profit Sharing Component.
PAYROLL WITHHOLDING G.3. Employee After-Tax Contributions ... [check one]:
CONTRIBUTIONS:
[PLAN SEC. 4.2(a)] a. [ ] will not be allowed by means of payroll withholding.
b. [ ] will be allowed by means of payroll withholding in any whole ... [check one or both
of 1. and 2., and check 3. if it applies]:
1. [ ] percentage, subject to the following minimum and maximum per payroll
period ... [check each of a. and b. that applies, or check c.]:
a. [ ] Minimum: _______% of Plan Compensation.
b. [ ] Maximum [complete 1., and complete 2. if it applies]:
1. Maximum ... [complete]:
a. _____% of Plan Compensation with respect to any
Non-Highly Compensated Employee, and
b. _____% [not to exceed the percentage in a.] of
Plan Compensation with respect to any Highly
Compensated Employee.
2. Combined Maximum [complete if desired]: The Employee Pre-Tax
and After-Tax Contributions of a Participant in combination
may not exceed ______% of Plan Compensation per payroll
period (other than as a result of a catch-up election under
F.7.).
14
c. [ ] such minimum and maximum as the Lead Employer may specify in
written action taken prior to the first day of the Plan Year.
2. [ ] dollar amount, subject to the following minimum and maximum per payroll
period ... [check each a. and b. that applies, or check c.]:
a. [ ] Minimum ... [check one]:
1. [ ] $______.
2. [ ] _______% of Plan Compensation.
b. [ ] Maximum [complete 1., and complete 2. if it applies]:
1. Maximum: $____.
2. Combined Maximum [complete if desired]: The Employee
Pre-Tax and After-Tax Contributions of a Participant in
combination may not exceed $____ per payroll period
(other than as a result of a catch-up election under
F.7.).
c. [ ] such minimum and maximum as the Lead Employer may specify in
written action taken prior to the first day of the Plan Year.
[check 3. only if an annual maximum is desired]
3. [ ] provided that the aggregate Employee After-Tax Contributions of a
Participant for the Plan Year may not exceed ... [check one]:
a. [ ] $____.
b. [ ] _____% of Plan Compensation for the Plan Year.
c. [ ] the lesser of $____ or ____% of Plan Compensation for the
Plan Year.
d. [ ] such maximum as the Lead Employer may specify in written action
taken prior to the first day of the Plan Year.
DIRECT CONTRIBUTIONS: G.4. Employee After-Tax Contributions ... [check one]:
[PLAN SEC. 4.2(c)]
a. [ ] will not be allowed by means other than payroll withholding.
b. [ ] will be allowed by such means (other than payroll withholding) as may be prescribed
from time to time by the Lead Employer (e.g., personal checks) .... [check if
applicable]:
1. [ ] The maximum amount of the Employee After-Tax Contributions allowed in any
Plan Year (including by payroll withholding, if allowed) is ... [check
one]:
a. [ ] $____.
b. [ ] _____% of Plan Compensation for the Plan Year.
REQUIRED CONTRIBUTIONS - G.5. An Active Participant will be required to make Employee After-Tax Contributions equal
THRIFT PLAN: to ... [check one]:
[PLAN SEC. 4.2(b)]
a. [ ] N/A - such contributions will not be required.
b. [ ] ______% of Plan Compensation per payroll period.
c. [ ] the percentage, not less than ____%, of Plan Compensation per payroll period that
is selected by the Participant upon his/her enrollment in the Employee After-Tax
Component.
IN-SERVICE WITHDRAWALS: G.6. Withdrawals are allowed from Employee After-Tax Contribution Accounts ... [check one]:
[PLAN SEC. 11.2]
15
a. [ ] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason and at any time .... [check if applicable]:
1. [ ] Employee After-Tax Contributions will be suspended for ____ [not more
than 12] months after such a withdrawal.
c. [ ] for any reason after ... [check one]:
1 [ ] Normal Retirement Age.
2. [ ] age 59 1/2.
3. [ ] age ____.
H. EMPLOYER SAFE-HARBOR COMPONENT
EMPLOYER SAFE-HARBOR H.1. This Plan ... [check one]:
CONTRIBUTIONS:
[PLAN SECS. 5.1 AND 6.1] a. [X] is not intended to be a Safe-Harbor Plan. [Skip to Section I.]
b. [ ] is intended to be a Safe-Harbor Plan, and safe-harbor contributions will be made
under ... [check one]:
1. [ ] this Plan.
2. [ ] the following defined contribution plan [specify]: . [Skip to Section I.]
[NOTE: THE OTHER PLAN MUST HAVE THE SAME PLAN YEAR AS THIS PLAN.]
[NOTE: EMPLOYEE AFTER-TAX CONTRIBUTIONS (IF ANY) WILL REMAIN SUBJECT TO THE ACTUAL
CONTRIBUTION PERCENTAGE TEST OF CODE SECTION 401(m) REGARDLESS OF WHETHER THIS PLAN
IS A SAFE-HARBOR PLAN. FURTHER, EMPLOYER SAFE-HARBOR AND REGULAR MATCHING
CONTRIBUTIONS WILL REMAIN SUBJECT TO THE ACTUAL CONTRIBUTION PERCENTAGE TEST OF
CODE SECTION 401(m) IF ANY SUCH CONTRIBUTION IS MADE BASED ON EMPLOYEE PRE-TAX
AND/OR AFTER-TAX CONTRIBUTIONS IN EXCESS OF 6% OF PLAN COMPENSATION OR THE PLAN
OTHERWISE FAILS TO SATISFY THE REQUIREMENTS OF CODE SECTION 401(m)(11)(B).]
Special Effective Date [complete if applicable]:
The designation as a Safe-Harbor Plan is effective as of ____[month day, year] [no
earlier than the first day of the first Plan Year beginning on or after January 1,
1999]. [NOTE: A DESIGNATION AS A SAFE-HARBOR PLAN CAN BE EFFECTIVE ONLY AS OF THE
FIRST DAY OF A PLAN YEAR (INCLUDING A SHORT FIRST PLAN YEAR) OR AS OF THE DATE ON
WHICH THE EMPLOYEE PRE-TAX COMPONENT IS FIRST EFFECTIVE UNDER THE PLAN. THE
ADOPTION AGREEMENT ADDING AN EMPLOYER SAFE-HARBOR MATCHING COMPONENT TO THIS PLAN
MUST BE EXECUTED BEFORE THE COMPONENT BECOMES EFFECTIVE. THE ADOPTION AGREEMENT
ADDING AN EMPLOYER SAFE-HARBOR PROFIT SHARING COMPONENT TO THIS PLAN MUST BE
EXECUTED AT LEAST 30 DAYS BEFORE THE END OF THE PLAN YEAR IN WHICH THE COMPONENT
BECOMES EFFECTIVE.]
AGE AND SERVICE REQUIREMENTS: H.2. For an Employee to participate in the Employer Safe-Harbor Matching or Safe-Harbor Profit
[PLAN SEC. 3.1(a)] Sharing Component, he/she must have ... [check one]:
a. [ ] attained age 21 and completed one year of Service (determined under D.9.). [NOTE: IF
THIS OPTION IS ELECTED, THE PORTION OF THE EMPLOYEE PRE-TAX COMPONENT COVERING
PARTICIPANTS WHO HAVE NOT SATISFIED THESE AGE AND SERVICE REQUIREMENTS MUST BE
DISAGGREGATED, AND MUST SEPARATELY SATISFY CODE SECTION 410(b) AND THE AVERAGE
DEFERRAL PERCENTAGE TEST OF CODE SECTION 401(k).] [NOTE: IF THIS OPTION IS ELECTED,
THE ENTRY DATES FOR THE EMPLOYER SAFE-HARBOR MATCHING OR SAFE-HARBOR PROFIT SHARING
COMPONENT ARE THE FIRST DAY OF THE PLAN YEAR AND THE FIRST DAY OF THE SEVENTH MONTH
OF THE PLAN YEAR.]
b. [ ] satisfied the same age and service requirements as for the Employee Pre-Tax
Component.
16
EMPLOYER SAFE-HARBOR H.3. The Employer Safe-Harbor Contribution will be an ... [check one]:
CONTRIBUTIONS:
[PLAN SEC. 5.1] a. [ ] Employer Safe-Harbor Matching Contribution made in accordance with ... [check
1. or 2., and complete 3. and 4.]:
1. [ ] the following schedule ... [complete schedule]:
Basic Matching
Formula
THE EMPLOYER OF MATCH
SAFE-HARBOR MATCHING ELIGIBLE
CONTRIBUTION WILL BE: CONTRIBUTIONS*:
--------------------- ---------------
A B
- -------------------------------------------------------------------
1 100% of the first: 3%
2 ___% [50% or more, but of the next: 2%
not more than 1A%]
3 ___% [not more than 2A%] of the next: 1%
[NOTE: IF THE FOLLOWING ARE USED, THE PLAN WILL SATISFY
THE 401(k) SAFE-HARBOR BUT NOT THE 401(m) SAFE-HARBOR.]
4 ___% [not more than 3A%] of the next: ___%
5 ___% [not more than 4A%] of the next: ___%
6 ___% [not more than 5A%] of the next: ___%
*OF MATCH ELIGIBLE CONTRIBUTIONS (EXPRESSED AS A
PERCENTAGE OF PLAN COMPENSATION) FOR PAYROLL PERIODS
ENDING WITHIN THE MATCHING CONTRIBUTION PERIOD.
[NOTE: TO SATISFY THE MINIMUM REQUIREMENTS FOR AN
EMPLOYER SAFE-HARBOR MATCHING CONTRIBUTION, 2.A. MUST BE
COMPLETED.]
2. [ ] the following schedule ... [complete schedule]:
Enhanced Matching
Formula
THE EMPLOYER OF MATCH
SAFE-HARBOR MATCHING ELIGIBLE
CONTRIBUTION WILL BE: CONTRIBUTIONS*:
--------------------- ---------------
A B
- ------------------------------------------------------------------
1 100% of the first: 4%
2 ___% [not more than 1A%] of the next: 1%
3 ___% [not more than 2A%] of the next: 1%
[NOTE: IF THE FOLLOWING ARE USED, THE PLAN WILL SATISFY
THE 401(k) SAFE-HARBOR BUT NOT THE 401(m) SAFE-HARBOR.]
4 ___% [not more than 3A%] of the next: ___%
5 ___% [not more than 4A%] of the next: ___%
6 ___% [not more than 5A%] of the next: ___%
17
*OF MATCH ELIGIBLE CONTRIBUTIONS (EXPRESSED AS A
PERCENTAGE OF PLAN COMPENSATION) FOR PAYROLL PERIODS
ENDING WITHIN THE MATCHING CONTRIBUTION PERIOD.
[NOTE: TO SATISFY THE MINIMUM REQUIREMENTS FOR AN
EMPLOYER SAFE-HARBOR MATCHING CONTRIBUTION, NO ITEMS
NEED TO BE COMPLETED.]
3. The Match Eligible Contributions are the Employee Pre-Tax Contributions ...
[check if applicable]:
a. [ ] and Employee After-Tax Contributions.
4. The Matching Contribution Period is ... [check one]:
a. [ ] each Plan Year.
b. [ ] each payroll period.
c. [ ] each month.
d. [ ] each quarter of each Plan Year.
[NOTE: EMPLOYER SAFE-HARBOR MATCHING CONTRIBUTIONS WILL BE CALCULATED BASED ON
THE MATCH ELIGIBLE CONTRIBUTIONS AND PLAN COMPENSATION FOR EACH MATCHING
CONTRIBUTION PERIOD. HOWEVER, IF H.2.a. IS ELECTED, MATCH ELIGIBLE
CONTRIBUTIONS AND PLAN COMPENSATION PRIOR TO THE ENTRY DATE FOR THE EMPLOYER
SAFE-HARBOR MATCHING COMPONENT WILL BE DISREGARDED IN CALCULATING THE EMPLOYER
SAFE-HARBOR MATCHING CONTRIBUTIONS UNLESS OTHERWISE SPECIFIED IN E.4. WITH
RESPECT TO PLAN COMPENSATION.]
[NOTE: EMPLOYER SAFE-HARBOR MATCHING CONTRIBUTIONS SHOULD NOT BE DEPOSITED OR
ALLOCATED UNTIL THE END OF THE MATCHING CONTRIBUTION PERIOD.]
Profit Sharing b. [ ] Employer Safe-Harbor Profit Sharing Contribution in the amount of ____% [3% or more]
Formula of the Participant's Plan Compensation for the Plan Year. [NOTE: IF THE PLAN IS
TOP-HEAVY, THE CONTRIBUTION FORMULA FOR THE EMPLOYER SAFE-HARBOR PROFIT SHARING
CONTRIBUTIONS WILL BE APPLIED WITH THE APPLICABLE MODIFICATIONS DESCRIBED IN PLAN
SEC. 17.1(b) UNLESS AN ADDITIONAL CONTRIBUTION IS ELECTED IN Q.2.]
[NOTE: IF H.2.a. IS ELECTED, PLAN COMPENSATION PRIOR TO THE ENTRY DATE FOR THE
EMPLOYER SAFE-HARBOR PROFIT SHARING COMPONENT WILL BE DISREGARDED IN CALCULATING THE
EMPLOYER SAFE-HARBOR PROFIT SHARING CONTRIBUTIONS UNLESS OTHERWISE SPECIFIED IN E.4.]
IN-SERVICE WITHDRAWALS: H.4. Withdrawals are allowed from Employer Safe-Harbor Matching and/or Safe-Harbor Profit
[PLAN SEC. 11.2] Sharing Contribution Accounts ... [check one]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason after ... [check one]:
1. [ ] Normal Retirement Age (or age 59 1/2 if later).
2. [ ] age 59 1/2.
3. [ ] age ____[60 or more]:
c. [ ] for Hardship after age 59 1/2.
18
I. EMPLOYER REGULAR MATCHING COMPONENT
EMPLOYER REGULAR MATCHING I.1. Employer Regular Matching Contributions ... [check one]:
CONTRIBUTIONS:
[PLAN SEC. 5.2] a. [X] will not [Skip to Section J.]
b. [ ] will
... be made under the Plan.
EXCLUDED EMPLOYMENT CATEGORIES: I.2. Covered Employment with respect to the Employer Regular Matching Component does not
[PLAN SEC. 2.14(a)] include ... [check one]: [NOTE: ANY EXCLUSIONS BELOW ARE IN ADDITION TO ANY EXCLUSIONS IN
D.1.]
a. [ ] N/A - there are no additional exclusions.
b. [ ] employment ... [check each that applies]:
1. [ ] as a Highly Compensated Employee.
2. [ ] as a Key Employee.
3. [ ] on prevailing wage projects covered by J.8.f.
4. [ ] other [specify]: _______ . [NOTE: Specify a group whose exclusion will not
result in discrimination in favor of Highly Compensated Employees.]
AGE AND SERVICE REQUIREMENTS: I.3. For an Employee to participate in the Employer Regular Matching Component, he/she must
[PLAN SEC. 3.1(a)] have attained age ... [check one]:
a. [ ] _____ [21 or less].
b. [ ] N/A - there is no age requirement.
I.4. For an Employee to participate in the Employer Regular Matching Component, he/she must
have completed ... [check one]: [NOTE: IF MORE THAN ONE YEAR OF SERVICE (12 MONTHS OF
ELAPSED TIME SERVICE) IS REQUIRED FOR ELIGIBILITY, THE PLAN MUST PROVIDE FOR FULL AND
IMMEDIATE VESTING OF EMPLOYER REGULAR MATCHING CONTRIBUTION ACCOUNTS.]
a. [ ] one year of Service (determined under D.9.).
b. [ ] two years of Service (determined under D.9.).
c. [ ] _____ [24 or less] months of Service determined using the elapsed time method
(irrespective of the election in D.9.).
d. [ ] N/A - there is no service requirement.
ENTRY: I.5. An Employee in Covered Employment will become an Active Participant in the Employer
[PLAN SECS. 2.27 AND 3.1(a)] Regular Matching Component on the Entry Date that coincides with or next follows the date
he/she satisfies the age and service requirements for such Component.
I.6. The Entry Dates for the Employer Regular Matching Component are the ... [check one]:
a. [ ] first day of each Plan Year and the first day of the seventh month of each Plan Year.
b. [ ] first day of each quarter of each Plan Year.
c. [ ] first day of each month.
d. [ ] first day of each payroll period.
e. [ ] day on which the age and service requirements are satisfied.
f. [ ] first day of each Plan Year. [NOTE: THIS OPTION IS PERMITTED ONLY IF (i) THERE IS NO
AGE REQUIREMENT OR THE AGE REQUIREMENT SPECIFIED IN I.3.A. DOES NOT EXCEED 20 1/2,
AND (II) THERE IS NO SERVICE REQUIREMENT OR THE SERVICE REQUIREMENT SPECIFIED IN
I.4.C. OR D. DOES NOT EXCEED 6 MONTHS, OR 18 MONTHS IF FULL AND IMMEDIATE VESTING.]
g. [ ] other [specify]: _________ . [NOTE: THE ENTRY DATES SPECIFIED MUST BE AT LEAST AS
FAVORABLE AS ONE OF THE CHOICES IN A. - F.]
REQUIREMENTS TO RECEIVE AN I.7. To receive an Employer Regular Matching Contribution for a Plan Year, a Participant must
EMPLOYER REGULAR MATCHING be an Active Participant in the Employer Regular Matching Component at some time during
CONTRIBUTION: the Plan Year ... [check one]: [NOTE: EMPLOYER REGULAR MATCHING
19
[PLAN SEC. 5.2(a) OR (b)] CONTRIBUTIONS SHOULD NOT BE MADE ON BEHALF OF ANY PARTICIPANT UNTIL HE/SHE HAS SATISFIED
THE CONDITIONS IMPOSED ON THE RECEIPT OF SUCH CONTRIBUTIONS.]
a. [ ] but need not be an Employee on the last day of the Plan Year or have completed any
specified number of Hours of Service.
b. [ ] and must either be an Employee on the last day of the Plan Year or must have
completed at least ______ [1,000 or less] Hours of Service during the Plan Year.
However, these requirements do not apply if the Participant's Termination of Service
occurred during the Plan Year because he/she ... [check each that applies]:
1. [ ] died.
2. [ ] became Disabled.
3. [ ] retired after ... [check each that applies]:
a. [ ] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]: _______ .
c. [ ] and must both be an Employee on the last day of the Plan Year and must have completed
at least 1000 [1,000 or less] Hours of Service during the Plan Year.
However, ... [check one]:
1. [ ] these requirements do not apply
2. [ ] the last day requirement does not apply
... if the Participant's Termination of Service occurred during the Plan Year because
he/she ... [check each that applies]:
3. [ ] died.
4. [ ] became Disabled.
5. [ ] retired after ... [check each that applies]:
a. [ ] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]: _______ .
d. [ ] and must be an Employee on the last day of the Plan Year. However, this requirement
does not apply if the Participant's Termination of Service occurred during the Plan
Year because he/she ... [check each that applies]:
1. [ ] died.
2. [ ] became Disabled.
3. [ ] retired after ... [check each that applies]:
a. [ ] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]: ________ .
e. [ ] and must have completed at least [1,000 or less] Hours of Service during the Plan
Year. However, this requirement does not apply if the Participant's Termination of
Service occurred during the Plan Year because he/she ... [check each that applies]:
1. [ ] died.
2. [ ] became Disabled.
3. [ ] retired after ... [check each that applies]:
a. [ ] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]: ________ .
20
MATCHING FORMULA: I.8. Employer Regular Matching Contributions will be ... [check one]:
[PLAN SEC. 5.2(a) OR (b)]
Fixed Contributions a. [ ] determined under the following schedule ... [complete schedule and the items that
- based on follow]:
Percentage of Match
Eligible
Contributions to
Plan Compensation
Optional:
- Profits
Contingency
- Discretionary
Contributions
THE EMPLOYER REGULAR OF THE MATCH
MATCHING ELIGIBLE
CONTRIBUTION WILL BE: CONTRIBUTIONS*:
-------------------- ---------------
A B
1 ___% of the first: ___%
2 ___% [less than 1A%] of the next: ___%
3 ___% [less than 2A%] of the next: ___%
4 ___% [less than 3A%] of the next: ___%
5 ___% [less than 4A%] of the next: ___%
*OF MATCH ELIGIBLE CONTRIBUTIONS (EXPRESSED AS A PERCENTAGE OF PLAN
COMPENSATION) FOR PAYROLL PERIODS ENDING WITHIN THE MATCHING CONTRIBUTION
PERIOD.
1. The Match Eligible Contributions are the ... [check each that applies]:
a. [ ] Employee Pre-Tax Contributions (except as provided in F.14.).
b. [ ] Employee After-Tax Contributions. ... [check if applicable]:
1. [ ] except that the Employer Regular Matching Contributions
made on Employee After-Tax Contributions will be a
discretionary amount determined by the Lead Employer.
[NOTE: THE LEAD EMPLOYER MAY SPECIFY IN A WRITTEN ACTION
TAKEN PRIOR TO THE FIRST DAY OF THE PLAN YEAR THAT THE
EMPLOYER REGULAR MATCHING CONTRIBUTIONS WILL BE MADE ON
EMPLOYEE AFTER-TAX CONTRIBUTIONS IN ACCORDANCE WITH A
SCHEDULE THAT CONFORMS WITH A SCHEDULE IN A., B. OR C.
OTHERWISE, THE EMPLOYER REGULAR MATCHING CONTRIBUTIONS MADE
FOR A PLAN YEAR ON EMPLOYEE AFTER-TAX CONTRIBUTIONS WILL BE
ALLOCATED IN PROPORTION OF THE EMPLOYEE AFTER-TAX
CONTRIBUTIONS FOR PAYROLL PERIODS ENDING WITHIN THE PLAN
YEAR.]
2. The Matching Contribution Period is ... [check one]:
a. [ ] each Plan Year.
b. [ ] each payroll period.
c. [ ] each month.
d. [ ] each quarter of each Plan Year.
e. [ ] each half of each Plan Year.
f. [ ] other [specify]: ______ . [Note: Specify a period longer than a
Plan Year.]
[NOTE: EMPLOYER REGULAR MATCHING CONTRIBUTIONS WILL BE CALCULATED BASED ON THE
MATCH ELIGIBLE CONTRIBUTIONS AND PLAN COMPENSATION FOR EACH MATCHING
CONTRIBUTION PERIOD -"TRUE-UP" CONTRIBUTIONS MAY BE ELECTED UNDER 3.]
[NOTE: EMPLOYER REGULAR MATCHING CONTRIBUTIONS SHOULD NOT BE DEPOSITED OR
ALLOCATED UNTIL THE END OF THE MATCHING CONTRIBUTION PERIOD.]
21
3. The Employer Regular Matching Contributions will be calculated separately for
each Matching Contribution Period and ... [check one]:
a. [ ] N/A - the Matching Contribution Period is the Plan Year.
b. [ ] "true-up" contributions will not be made.
c. [ ] then will be recalculated based on the Match Eligible
Contributions and Plan Compensation for the Plan Year, and
"true-up" contributions will be made accordingly, with respect to
each eligible Participant described in I.7 ... [check if
applicable]:
1. [ ] who is an Employee on the last day of the Plan Year.
However, this requirement does not apply if the
Participant's Termination of Service occurred during
the Plan Year because he/she ... [check each that
applies]:
1. [ ] died.
2. [ ] became Disabled.
3. [ ] retired after... [check each that applies]:
a. [ ] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]: _______ .
4. The Employer Regular Matching Contribution is ... [check one]: [NOTE: IF
EMPLOYER REGULAR MATCHING CONTRIBUTIONS ARE CONTINGENT ON NET PROFITS, THE
MATCHING CONTRIBUTION PERIOD MUST BE THE PLAN YEAR AND THE CONTRIBUTIONS
SHOULD NOT BE DEPOSITED OR ALLOCATED UNTIL AFTER THE END OF THE PLAN YEAR.]
a. [ ] not contingent on Net Profits.
b. [ ] contingent on ... [check one]:
1. [ ] current (for the fiscal year ending with or within the
Plan Year)
2. [ ] accumulated
... Net Profits of the Participating Employers, determined under ...
[check one]:
3. [ ] GAAP [ ] before [ ] after the payment of discretionary
bonuses.
4. [ ] other [specify]: _______ .
5. The Lead Employer may direct that an additional Employer Regular Matching
Contribution be made for a Plan Year which, if made, will be allocated in
proportion to the ... [check one]:
a. [ ] N/A - such contributions will not be made.
b. [ ] Employer Regular Matching Contributions received under the above
schedule for the Plan Year. The allocation will be made among all
eligible Participants described in I.7 ... [check if applicable]:
1. [ ] who are Non-Highly Compensated Employees.
c. [ ] Match Eligible Contributions of each eligible Participant that do
not exceed _______ % of his/her Plan Compensation for the Plan
Year. The allocation will be made among all eligible Participants
described in I.7 ... [check if applicable]:
1. [ ] who are Non-Highly Compensated Employees.
22
Fixed Contributions b. [ ] determined under the following schedule ... [complete schedule and the items that follow]:
- - based on Dollar
Amount of Match
Eligible
Contributions
Optional:
- - Profits
Contingency
- - Discretionary
Contributions
THE EMPLOYER REGULAR
MATCHING OF THE MATCH ELIGIBLE
CONTRIBUTION WILL BE: CONTRIBUTIONS*:
-------------------- ---------------------
A B
1 ______% of the first: $ _____.
2 ______% [less than 1A%] of the next: $ _____.
3 ______% [less than 2A%] of the next: $ _____.
4 ______% [less than 3A%] of the next: $ _____.
5 ______% [less than 4A%] of the next: $ _____.
*OF MATCH ELIGIBLE CONTRIBUTIONS (EXPRESSED AS A DOLLAR AMOUNT) FOR PAYROLL
PERIODS ENDING WITHIN THE MATCHING CONTRIBUTION PERIOD.
1. The Match Eligible Contributions are the ... [check each that applies]:
a. [ ] Employee Pre-Tax Contributions (except as provided in F.14.).
b. [ ] Employee After-Tax Contributions.... [check if applicable]:
1. [ ] except that the Employer Regular Matching Contributions made on
Employee After-Tax Contributions will be a discretionary amount
determined by the Lead Employer. [NOTE: THE LEAD EMPLOYER MAY HAVE
SPECIFIED IN A WRITTEN ACTION TAKEN PRIOR TO THE FIRST DAY OF THE
PLAN YEAR THAT THE EMPLOYER REGULAR MATCHING CONTRIBUTIONS WILL BE
MADE ON EMPLOYEE AFTER-TAX CONTRIBUTIONS IN ACCORDANCE WITH A
SCHEDULE THAT CONFORMS WITH A SCHEDULE IN a., b. OR c. OTHERWISE,
THE EMPLOYER REGULAR MATCHING CONTRIBUTIONS MADE FOR A PLAN YEAR ON
EMPLOYEE AFTER-TAX CONTRIBUTIONS WILL BE ALLOCATED IN PROPORTION OF
THE EMPLOYEE AFTER-TAX CONTRIBUTIONS FOR PAYROLL PERIODS ENDING
WITHIN THE PLAN YEAR.]
2. The Matching Contribution Period is ... [check one]:
a. [ ] each Plan Year.
b. [ ] each payroll period.
c. [ ] each month.
d. [ ] each quarter of each Plan Year.
e. [ ] each half of each Plan Year.
f. [ ] other [specify]: ______. [Note: Specify a period longer than a Plan Year.]
[NOTE: EMPLOYER REGULAR MATCHING CONTRIBUTIONS WILL BE CALCULATED BASED ON THE MATCHING
ELIGIBLE CONTRIBUTIONS AND PLAN COMPENSATION FOR EACH MATCHING CONTRIBUTION PERIOD
-"TRUE-UP" CONTRIBUTIONS MAY BE ELECTED UNDER 3.]
[NOTE: EMPLOYER REGULAR MATCHING CONTRIBUTIONS SHOULD NOT BE DEPOSITED OR ALLOCATED UNTIL
THE END OF THE MATCHING CONTRIBUTION PERIOD.]
3. The Employer Regular Matching Contribution will be calculated separately for each
Matching Contribution Period and ... [check one]:
23
a. [ ] N/A - the Matching Contribution Period is the Plan Year.
b. [ ] "true-up" contributions will not be made.
c. [ ] then will be recalculated based on the Match Eligible Contributions and
Plan Compensation for the Plan Year, and "true-up" contributions will be
made accordingly, with respect to each eligible Participant described in
I.7. ... [check if applicable]:
1. [ ] who is an Employee on the last day of the Plan Year. However, this
requirement does not apply if the Participant's Termination of
Service occurred during the Plan Year because he/she ... [check
each that applies]:
1 [ ] died.
2. [ ] became Disabled.
3. [ ] retired after ... [check each that applies]:
a. [ ] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]:____.
4. The Employer Regular Matching Contribution is ... [check one]: [NOTE: IF EMPLOYER REGULAR
MATCHING CONTRIBUTIONS ARE CONTINGENT ON NET PROFITS, THE MATCHING CONTRIBUTION PERIOD
MUST BE THE PLAN YEAR AND THE CONTRIBUTIONS SHOULD NOT BE DEPOSITED OR ALLOCATED
UNTIL AFTER THE END OF THE PLAN YEAR.]
a. [ ] not contingent on Net Profits.
b. [ ] contingent on ... [check one]:
1. [ ] current (for the fiscal year ending with or within the Plan
Year)
2. [ ] accumulated
... Net Profits of the Participating Employers, determined under ...
[check one]:
3. [ ] GAAP [ ] before [ ] after the payment of discretionary
bonuses.
4. [ ] other [specify]: ______.
5. The Lead Employer may direct that an additional Employer Regular Matching Contribution be
made for a Plan Year which, if made, will be allocated in proportion to the ...
[check one]:
a. [ ] N/A - such contributions will not be made.
b. [ ] Employer Regular Matching Contributions received under the above schedule for
the Plan Year. The allocation will be made among all eligible Participants
described in I.7 ... [check if applicable]:
1. [ ] who are Non-Highly Compensated Employees.
c. [ ] Match Eligible Contributions of each eligible Participant that do not exceed
$____ for the Plan Year. The allocation will be made among all eligible
Participants described in I.7 ... [check if applicable]:
1. [ ] who are Non-Highly Compensated Employees.
Fixed Contributions c. [ ] determined under the following schedule ... [complete schedule and the items that follow]:
- - based on Years of [NOTE: USE OF THIS OPTION WILL REQUIRE BENEFITS, RIGHTS AND FEATURES TESTING UNDER
Credited Service: CODE SECTION 401(a)(4).] [NOTE: IF THIS OPTION IS ELECTED, THE MATCHING CONTRIBUTION PERIOD
IS THE PLAN YEAR AND CONTRIBUTIONS SHOULD NOT BE DEPOSITED OR ALLOCATED UNTIL AFTER THE END
OF THE PLAN YEAR.]
24
Optional:
- - Profits Contingency
- - Discretionary
Contributions
OF MATCH ELIGIBLE CONTRIBUTIONS
THE EMPLOYER REGULAR FOR PARTICIPANTS WITH AT LEAST THE
MATCHING FOLLOWING NUMBER OF
CONTRIBUTION WILL BE: YEARS OF CREDITED SERVICE:
--------------------- ----------------------------------
A B
1 ______% 1 yr. [NOTE: IF MORE THAN ONE YEAR OF SERVICE IS REQUIRED
TO PARTICIPATE IN THE EMPLOYER REGULAR MATCHING COMPONENT,
THAT SERVICE REQUIREMENT MUST BE SATISFIED TO RECEIVE A
CONTRIBUTION.]
2 ______% [more than 1A%] ______yrs. [more than 1B]
3 ______% [more than 2A%] ______yrs. [more than 2B]
4 ______% [more than 3A%] ______yrs. [more than 3B]
5 ______% [more than 4A%] ______yrs. [more than 4B]
1. The Match Eligible Contributions are the ... [check each that applies]:
a. [ ] Employee Pre-Tax Contributions (except as provided in F.14.).
b. [ ] Employee After-Tax Contributions .... [check if applicable]:
1. [ ] except that the Employer Regular Matching Contributions made on
Employee After-Tax Contributions will be a discretionary amount
determined by the Lead Employer. [NOTE: THE LEAD EMPLOYER MAY
SPECIFY IN A WRITTEN ACTION TAKEN PRIOR TO THE FIRST DAY OF THE PLAN
YEAR THAT THE EMPLOYER REGULAR MATCHING CONTRIBUTIONS WILL BE MADE
ON EMPLOYEE AFTER-TAX CONTRIBUTIONS IN ACCORDANCE WITH A SCHEDULE
THAT CONFORMS WITH A SCHEDULE IN a., b. OR c. OTHERWISE, THE
EMPLOYER REGULAR MATCHING CONTRIBUTIONS MADE FOR A PLAN YEAR ON
EMPLOYEE AFTER-TAX CONTRIBUTIONS WILL BE ALLOCATED IN PROPORTION OF
THE EMPLOYEE AFTER-TAX CONTRIBUTIONS FOR PAYROLL PERIODS ENDING
WITHIN THE PLAN YEAR.]
2. The Participant's years of credited service for this purpose means ... [check one]:
a. [ ] the number of Plan Years in which the Participant had ___ [1,000 or less] or
more Hours of Service.
b. [ ] the number of years of elapsed time Service of the Participant as of the
last day of the Plan Year.
3. The Employer Regular Matching Contribution is ... [check one]:
a. [ ] not contingent on Net Profits.
b. [ ] contingent on ... [check one]:
1. [ ] current (for the fiscal year ending with or within the Plan Year)
2. [ ] accumulated
... Net Profits of the Participating Employers, determined under ...
[check one]:
3. [ ] GAAP [ ] before [ ] after the payment of discretionary bonuses.
4. [ ] other [specify]: ______.
25
4. The Lead Employer may direct that an additional Employer Regular Matching Contribution be
made for a Plan Year which, if made, will be allocated in proportion to the ...
[check one]:
a. [ ] N/A - such contributions will not be made.
b. [ ] Employer Regular Matching Contributions received under the above schedule for
the Plan Year. The allocation will be made among all eligible Participants
described in I.7 ... [check if applicable]:
1. [ ] who are Non-Highly Compensated Employees.
c. [ ] Match Eligible Contributions of each eligible Participant that do not exceed
____% of his/her Plan Compensation for the Plan Year. The allocation will be
made among all eligible Participants described in I.7 ... [check if
applicable]:
1. [ ] who are Non-Highly Compensated Employees.
Discretionary d. [ ] a discretionary amount determined by the Lead Employer.
Contributions
The Lead Employer may specify in a written action taken prior to the first day of the Plan Year
that Employer Regular Matching Contributions will be made for such Plan Year in accordance with
a schedule that conforms with a schedule specified in a., b. or c., above. A separate schedule
may apply to Employee Pre-Tax Contributions and Employee After-Tax Contributions.
If such written action is not taken prior to the first day of the Plan Year, then any Employer
Regular Matching Contribution made for the Plan Year on Employee Pre-Tax Contributions will be
allocated ... [check one]:
1. [ ] in proportion to Employee Pre-Tax Contributions (except as provided in F.14.) for
payroll periods ending within the Plan Year that do not exceed ... [check one]:
a. [ ] N/A - no limit.
b. [ ] $___.
c. [ ] ____% of Plan Compensation for the Plan Year.
d. [ ] the lesser of $_____ or _____% of Plan Compensation for the Plan Year.
2. [ ] under the following schedule ... [complete]:
WILL BE ALLOCATED IN
PROPORTION TO EMPLOYEE
PRE-TAX CONTRIBUTIONS
THE FOLLOWING (EXCEPT AS PROVIDED IN
PERCENT OF THE EMPLOYER F.14.) THAT DO NOT EXCEED
REGULAR MATCHING THE FOLLOWING PERCENT OF
CONTRIBUTION FOR PLAN COMPENSATION FOR
THE PLAN YEAR: THE PLAN YEAR:
----------------------- ------------------------
A B
1 ______% ______%
2 ______% ______% [less than 1B%]
3 ______% ______% [less than 2B%]
Total = 100%
[NOTE: THE STEPS IN THE ALLOCATION FORMULA PROVIDE CUMULATIVE
CONTRIBUTIONS AT LOWER DEFERRAL LEVELS.]
26
3. [ ] under the following schedule ... [complete]:
WILL BE ALLOCATED IN
PROPORTION TO EMPLOYEE
PRE-TAX CONTRIBUTIONS
THE FOLLOWING DOLLAR (EXCEPT AS PROVIDED IN
AMOUNT OF THE EMPLOYER F.14.) THAT DO NOT EXCEED
REGULAR MATCHING THE FOLLOWING PERCENT OF
CONTRIBUTION FOR PLAN COMPENSATION FOR
THE PLAN YEAR: THE PLAN YEAR:
---------------------- -------------------------
A B
1 The first: $_____. ______%
2 The next: $_____. ______% [less than 1B%]
3 The remainder: ______% [less than 2B%]
[NOTE: THE STEPS IN THE ALLOCATION FORMULA PROVIDE
CUMULATIVE CONTRIBUTIONS AT LOWER DEFERRAL LEVELS.]
Any Employer Regular Matching Contribution made for the Plan Year on Employee After-Tax
Contributions will be allocated in proportion of Employee After-Tax Contributions for payroll
periods ending within the Plan Year.
[NOTE: IF THE PLAN PROVIDES FOR DISCRETIONARY EMPLOYER SAFE-HARBOR MATCHING CONTRIBUTIONS, EMPLOYER
SAFE-HARBOR MATCHING AND REGULAR MATCHING CONTRIBUTIONS WILL REMAIN SUBJECT TO THE ACTUAL
CONTRIBUTION PERCENTAGE TEST OF CODE SECTION 401(m) IF DISCRETIONARY CONTRIBUTIONS MADE ON BEHALF
OF ANY PARTICIPANT EXCEED 4% OF HIS/HER PLAN COMPENSATION FOR THE PLAN YEAR.]
MINIMUMS AND MAXIMUMS: I.9. The minimum Employer Regular Matching Contribution that any Participant who has Match Eligible
[PLAN SEC. 5.2(d)] Contributions can receive for any Plan Year is ... [check one]:
a. [ ] N/A - no minimum (except as results from the matching schedule).
b. [ ] $____.
c. [ ] %____ of Plan Compensation for the Plan Year.
I.10. The maximum Employer Regular Matching Contribution that any Participant can receive for any Plan
Year is ... [check one]: [NOTE: A SEPARATE MAXIMUM NEEDS TO BE SPECIFIED ONLY IF THE MATCH IS
DISCRETIONARY AND A MAXIMUM IS DESIRED, OR IF A MATCHING SCHEDULE APPLIES AND A MAXIMUM IS DESIRED
THAT IS LESS THAN THE MAXIMUM OTHERWISE RESULTING FROM THE MATCHING SCHEDULE.]
a. [ ] N/A - no maximum (except as results from the matching schedule).
b. [ ] $_____.
c. [ ] _____% of Plan Compensation for the Plan Year.
d. [ ] the lesser of $____ or _____% of Plan Compensation for the Plan Year.
VESTING SCHEDULE FOR I.11. A Participant's vested percentage in his/her Employer Regular Matching Contribution Account
EMPLOYER REGULAR will be ... [check one]:
MATCHING COMPONENT:
[PLAN SEC. 10.2(e)] a. [ ] 100% at all times.
b. [ ] determined under the following schedule ... [complete as desired]:
27
YEARS OF VESTED
SERVICE PERCENTAGE
- -------- ----------
0 0%
1 40%
2 80%
3 100% [20% or more]
4 100% [40% or more]
5 100% [60% or more]
6 100% [80% or more]
7 or more 100%
c. [ ] determined under the following schedule ... [complete as desired]:
YEARS OF VESTED
SERVICE PERCENTAGE
- --------- ----------
0 0%
1 ______%
2 ______%
3 ______%
4 ______%
5 or more 100%
[NOTE: IF THE PLAN IS TOP-HEAVY, AND IF THE VESTING SCHEDULE SPECIFIED ABOVE DOES NOT
SATISFY THE VESTING REQUIREMENTS APPROPRIATE FOR A TOP-HEAVY PLAN UNDER PLAN SEC. 17.2,
THE VESTED PERCENTAGE OF THE PARTICIPANT WILL BE THE GREATER OF THE VESTED PERCENTAGE
DETERMINED UNDER THE VESTING SCHEDULE SPECIFIED ABOVE OR THE APPLICABLE VESTING SCHEDULE
SPECIFIED IN PLAN SEC. 17.2. IF THE PLAN WAS, BUT HAS CEASED TO BE TOP-HEAVY, THE
APPROPRIATE VESTING SCHEDULE WILL BE DETERMINED UNDER Q.3.]
I.12. The vesting schedule specified above applies to the Employer Regular Matching
Contribution Accounts ... [check one]: [NOTE: IF THE VESTING SCHEDULE IS AMENDED,
SPECIAL RULES (INCLUDING A PARTICIPANT ELECTION) MAY APPLY UNDER PLAN SEC. 10.2(k).]
a. [ ] of all Participants.
b. [ ] of Participants who become ... [check one]:
1. [ ] Employees
2. [ ] Active Participants in the Employer Regular Matching Component
... on or after [month day, year] (and the vesting schedule in effect
prior to such date will apply to all other Participants).
c. [ ] reflecting Employer Regular Matching Contributions made for periods on or after
__ [month day, year] (and the vesting schedule in effect prior to such date will apply
to all Employer Regular Matching Contributions made for periods prior to such date).
TREATMENT OF I.13. A Pending Allocation Account that reflects Forfeitures from Employer Regular
FORFEITURES: Matching Contribution Accounts ... [check one]:
[PLAN SEC. 5.2(g)]
[COMPLETE ONLY IF A a. [ ] can
VESTING SCHEDULE b. [ ] cannot
APPLIES WITH RESPECT
TO ANY PART OR ALL ... be applied to pay administrative expenses of the Plan if so directed by the Plan
OF THE EMPLOYER Administrator.
REGULAR MATCHING
CONTRIBUTION ACCOUNT]
28
I.14. A Pending Allocation Account that reflects Forfeitures from Employer Regular Matching
Contribution Accounts (to the extent not applied to pay administrative expenses if
permitted in I.13.) will be ... [check one]:
a. [ ] applied as a credit against ... [check each that applies]:
1. [ ] Employer Safe-Harbor and/or Regular Matching Contributions
2. [ ] Employer Safe-Harbor and/or Regular Profit Sharing Contributions
... that are made under the Plan, as and when directed by the Lead Employer.
b. [ ] allocated as of the last day of the Plan Year as an additional ... [check one]:
1. [ ] Employer Regular Matching Contribution.
2. [ ] Employer Regular Profit Sharing Contribution. [NOTE: IF THE PLAN PROVIDES FOR A
FIXED CONTRIBUTION DETERMINED UNDER AN INTEGRATED FORMULA, THE ALLOCATION WILL
BE MADE IN PROPORTION TO PLAN COMPENSATION FOR THE PLAN YEAR.]
The allocation will be made in the same manner as (and as part of) any variable
contribution, or in proportion to any fixed contribution, under the Plan. [NOTE: IF THE
PLAN PROVIDES FOR A VARIABLE CONTRIBUTION (e.g., A DISCRETIONARY CONTRIBUTION), AND A
CONTRIBUTION IS NOT MADE FOR A PLAN YEAR, THE ALLOCATION WILL BE MADE IN THE SAME MANNER
AS THE VARIABLE CONTRIBUTION WOULD HAVE BEEN ALLOCATED.]
c. [ ] allocated as of the last day of the Plan Year in proportion to Plan Compensation for
the Plan Year. The allocation will be among all eligible Participants described in
I.7.
IN-SERVICE WITHDRAWALS: I.15. Withdrawals are allowed from Employer Regular Matching Contribution Accounts...[check a.,
[PLAN SEC. 11.2] or check each of b. through d. that applies]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason after...[check one]:
1. [ ] Normal Retirement Age.
2. [ ] age 59 1/2.
3. [ ] age____[check each that applies]:
a. [ ] and completion of _____ years of ... [check one]:
1. [ ] vesting Service.
2. [ ] participation in the Plan. [NOTE: PARTICIPATION IS
MEASURED ON AN ELAPSED TIME BASIS FROM THE ENTRY DATE.]
b. [ ] but only if at the time of the withdrawal the Participant is ...
[check one]:
1. [ ] fully vested
2. [ ] at least ______% vested
... in his/her Employer Regular Matching Contribution Account.
4. [ ] completion of _____ years of ... [check one]:
a. [ ] vesting Service.
b. [ ] participation in the Plan. [NOTE: PARTICIPATION IS MEASURED ON AN
ELAPSED TIME BASIS FROM THE ENTRY DATE.]
c. [ ] at any age on account of Hardship ... [check if applicable]:
1. [ ] but only if at the time of the withdrawal the Participant is ... [check
29
one]:
a. [ ] fully vested
b. [ ] at least______% vested
... in his/her Employer Regular Matching Contribution Account.
d. [ ] for any reason, but only if at the time of the withdrawal the Participant is fully vested in
his/her Employer Regular Matching Contribution Account, and provided the withdrawal may not
include amounts allocated to the Contribution Account within two years prior to the withdrawal
... [check if applicable]: [NOTE: THE CALCULATION OF THE MAXIMUM AMOUNT AVAILABLE FOR WITHDRAWAL
IS SET FORTH IN PLAN SEC. 11.2(a).]
1. [ ] unless the Participant has completed five years of participation in the Plan.
[NOTE: PARTICIPATION IS MEASURED ON AN ELAPSED TIME BASIS FROM THE ENTRY DATE.]
J. EMPLOYER REGULAR PROFIT SHARING COMPONENT
PROFIT SHARING J.1. Employer Regular Profit Sharing Contributions ... [check one]:
CONTRIBUTIONS:
[PLAN SEC. 6.2]
a. [X] will
b. [ ] will not [Skip to Section K.]
... be made under the Plan.
EXCLUDED EMPLOYMENT J.2. Covered Employment with respect to the Employer Regular Profit Sharing Component does not include
CATEGORIES: ... [check one]: [NOTE: ANY EXCLUSIONS BELOW ARE IN ADDITION TO ANY EXCLUSIONS IN D.1.]
[PLAN SEC. 2.14(a)]
a. [X] N/A - there are no additional exclusions.
b. [ ] employment ... [check each that applies]:
1. [ ] as a Highly Compensated Employee.
2. [ ] as a Key Employee.
3. [ ] other [specify]:_______. [Note: Specify a group whose exclusion will not result in
discrimination in favor of Highly Compensated Employees.]
AGE AND SERVICE J.3. For an Employee to participate in the Employer Regular Profit Sharing Component, he/she must have
REQUIREMENTS: attained age ... [check one]:
[PLAN SEC. 3.1(a)]
a. [X] 18 [21 or less].
b. [ ] N/A - there is no age requirement.
J.4. For an Employee to participate in the Employer Regular Profit Sharing Component, he/she must have
completed ... [check one]: [NOTE: IF MORE THAN ONE YEAR OF SERVICE (12 MONTHS OF ELAPSED TIME
SERVICE) IS REQUIRED FOR ELIGIBILITY, THE PLAN MUST PROVIDE FOR FULL AND IMMEDIATE VESTING OF
EMPLOYER REGULAR PROFIT SHARING CONTRIBUTION ACCOUNTS.]
a. [ ] one year of Service (determined under D.9.).
b. [ ] two years of Service (determined under D.9.).
c. [ ] _____[24 or less] months of Service determined using the elapsed time method (irrespective of the
election in D.9.).
d. [X] N/A - there is no service requirement.
ENTRY: J.5. An Employee in Covered Employment will become an Active Participant in the Employer Regular Profit
[PLAN SECS. 2.27 Sharing Component on the Entry Date that ... [check one]:
AND 3.1(a)]
a. [X] coincides with or next follows
b. [ ] coincides with or next precedes
c. [ ] is nearest to
30
... the date he/she satisfies the age and service requirements for such Component.
J.6. The Entry Dates for the Employer Regular Profit Sharing Component are the ... [check one]:
a. [ ] first day of each Plan Year and the first day of the seventh month of each Plan Year.
b. [ ] first day of each quarter of each Plan Year.
c. [ ] first day of each month.
d. [ ] first day of each payroll period.
e. [X] day on which the age and service requirements are satisfied.
f. [ ] first day of each Plan Year. [NOTE: THIS OPTION IS PERMITTED ONLY IF (i) THERE IS NO AGE
REQUIREMENT OR THE AGE REQUIREMENT SPECIFIED IN J.3.a. DOES NOT EXCEED 20 1/2, AND (ii) THERE IS
NO SERVICE REQUIREMENT OR THE SERVICE REQUIREMENT SPECIFIED IN J.4.c. OR d. DOES NOT EXCEED 6
MONTHS, OR 18 MONTHS IF FULL AND IMMEDIATE VESTING.]
g. [ ] other [specify]:_____. [NOTE: THE ENTRY DATES SPECIFIED MUST BE AT LEAST AS FAVORABLE AS ONE OF
THE CHOICES IN a. - f.]
REQUIREMENTS TO SHARE J.7. To share in the Employer Regular Profit Sharing Contribution for a Plan Year, a Participant must be
IN THE EMPLOYER an Active Participant in the Employer Regular Profit Sharing Component at some time during the Plan
REGULAR PROFIT SHARING Year ... [check one]:
CONTRIBUTION:
[PLAN SEC. 6.2(a)
OR (b)]
a. [ ] but need not be an Employee on the last day of the Plan Year or have completed any specified
number of Hours of Service.
b. [ ] and must either be an Employee on the last day of the Plan Year or must have completed at least
______[1,000 or less] Hours of Service during the Plan Year. However, these requirements do not
apply if the Participant's Termination of Service occurred during the Plan Year because he/she
... [check each that applies]:
1. [ ] died.
2. [ ] became Disabled.
3. [ ] retired after ... [check each that applies]:
a. [ ] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]:_______.
c. [X] and must both be an Employee on the last day of the Plan Year and must have completed at least
1000 [1,000 or less] Hours of Service during the Plan Year. However, ... [check one]:
1. [X] these requirements do not apply
2. [ ] the last day requirement does not apply
... if the Participant's Termination of Service occurred during the Plan Year because he/she ...
[check each that applies]:
3. [X] died.
4. [X] became Disabled.
5. [X] retired after ... [check each that applies]:
a. [X] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]:______.
d. [ ] and must be an Employee on the last day of the Plan Year. However, this requirement does not
apply if the Participant's Termination of Service occurred during the Plan Year because
he/she ... [check each that applies]:
1. [ ] died.
2. [ ] became Disabled.
3. [ ] retired after ... [check each that applies]:
31
a. [ ] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]:______.
e. [ ] and must have completed at least _____[1,000 or less] Hours of Service during the Plan Year.
However, this requirement does not apply if the Participant's Termination of Service occurred
during the Plan Year because he/she ... [check each that applies]:
1. [ ] died.
2. [ ] became Disabled.
3. [ ] retired after ... [check each that applies]:
a. [ ] Normal Retirement Age.
b. [ ] Early Retirement Age.
c. [ ] age [specify]:______.
CONTRIBUTION/ALLOCATION J.8. The Employer Regular Profit Sharing Contribution for each Plan Year will ... [check one of a.
FORMULA: through e., and check f. if it applies. Do not check b. or d. if any Controlled Group Member
[PLAN SEC. 6.2(a) maintains any other plan that is integrated and that covers any of the same Participants]: [NOTE:
OR (b)] IF THE PLAN IS TOP-HEAVY, THE CONTRIBUTION FORMULA OR ALLOCATION METHOD FOR THE EMPLOYER REGULAR
PROFIT SHARING CONTRIBUTIONS WILL BE APPLIED WITH THE APPLICABLE MODIFICATIONS DESCRIBED IN PLAN
SEC. 17.1(b) UNLESS AN ADDITIONAL CONTRIBUTION IS ELECTED IN Q.2.]
32
Non-Integrated a. [ ] be allocated among the eligible Participants ... [check one]:
Variable Formula -
Discretionary or 1. [ ] in proportion to Plan Compensation for the Plan Year
Non-Discretionary 2. [ ] as an equal dollar amount (subject to the limits of Code Section 415)
with Profits
Contingency ... using the nonintegrated allocation formula in Plan Sec. 6.2(a)(1). The amount of the
contribution will be ... [check one]:
3. [ ] a discretionary amount determined by the Lead Employer (not contingent on Net
Profits).
4. [ ] ______% of ... [check one]:
a. [ ] current (for the fiscal year ending with or within the Plan Year)
b. [ ] accumulated
... Net Profits of the Participating Employers, determined under ... [check one]:
c. [ ] GAAP [ ] before [ ] after the payment of discretionary bonuses,
d. [ ] other [specify]:______.
Integrated b. [X] be allocated among the eligible Participants using an integrated allocation formula in Plan Sec.
Variable Formula - 6.2(a)(2). The amount of the contribution will be ... [check 1., 2. or 3., and complete 4. and 5.
Discretionary or below]:
Non-Discretionary
with Profits 1. [X] a discretionary amount determined by the Lead Employer (not contingent on Net
Contingency Profits).
2. [ ] ____% of ... [check one]:
a. [ ] current (for the fiscal year ending with or within the Plan Year)
b. [ ] accumulated
... Net Profits of the Participating Employers, determined under ... [check one]:
c. [ ] GAAP [ ] before [ ] after the payment of discretionary bonuses,
d. [ ] other [specify]:______
... but not to exceed the maximum amount deductible under the Code (or such other limits
as may be imposed under the Plan).
3. [ ] _____% [15% or less] of the aggregate Plan Compensation for the Plan Year of all
eligible Participants.
________________________________________________________________________________________________
4. The Integration Level is ... [check one]:
a. [X] the Taxable Wage Base in effect at the beginning of the Plan Year.
b. [ ] $____[not more than the Taxable Wage Base in effect at the beginning of the
Plan Year in which this dollar amount is first effective].
c. [ ] ____% [less than 100%] of the Taxable Wage Base in effect at the beginning of
the Plan Year ... [check if desired]:
1. [ ] increased to the next highest whole dollar.
5. The integrated allocation formula used is the ... [check one]:
a. [ ] Two-step formula.
b. [ ] Three-step formula.
c. [X] Four-step formula.
33
Non-Integrated c. [ ] equal a fixed amount for each eligible Participant. The amount of the contribution will
Fixed Formula - be ... [check one of 1., 2. or 3., and complete 4. and 5. below]:
Non-Discretionary
with Optional
Profits Contingency 1. [ ] $______ for the Plan Year.
2. [ ] $______ for each ... [check one]:
a. [ ] Hour of Service
b. [ ] day
c. [ ] week
... as an Active Participant in the Employer Profit Sharing Component during the Plan
Year.
3. [ ] ______% [not to exceed 15%] of Plan Compensation for the Plan Year.
_________________________________________________________________________________________________
4. The Employer Regular Profit Sharing Contribution is ... [check one]:
a. [ ] not contingent on Net Profits.
b. [ ] contingent on ... [check one]:
1. [ ] current (for the fiscal year ending with or within the Plan Year)
2. [ ] accumulated
... Net Profits of the Participating Employers, determined under ...
[check one]:
3. [ ] GAAP [ ] before [ ] after the payment of discretionary bonuses.
4. [ ] other [specify]: ______.
5. The Lead Employer ... [check one]:
a. [ ] does not
b. [ ] does
... have the discretion to direct that an additional Employer Regular Profit Sharing
Contribution be made for a Plan Year which, if made, will be allocated among the eligible
Participants described in J.7. ... [check if applicable]:
c. [ ] who are Non-Highly Compensated Employees
... in proportion to the Plan Compensation for the Plan Year of each eligible
Participant.
Integrated d. [ ] equal a fixed amount for each eligible Participant. The amount of the contribution will
Fixed Formula - be ... [complete 1. through 5. below]:
Non-Discretionary
with Optional 1. ________ % of Plan Compensation for the Plan Year, plus
Profits Contingency 2. ________ % of Plan Compensation for the Plan Year in excess of the Integration Level
[the percentage in 2. may not exceed the lesser of the percentage in 1. or the percentage
in the table below]:
34
TABLE
IF THE INTEGRATION LEVEL IS: THE MAXIMUM PERCENTAGE IS:
The Taxable Wage Base for the current 5.7%
year ("TWB")
More than 80% of the TWB but less than 5.4%
100% of the TWB
More than the greater of 20% of the 4.3%
TWB or $10,000 but not more than
80% of the TWB
Less than or equal to the greater of 5.7%
$10,000 or 20% of the TWB
3. The Integration Level is ... [check one]:
a. [ ] the Taxable Wage Base in effect at the beginning of the Plan Year.
b. [ ] ________% [less than 100%] of the Taxable Wage Base in effect at the beginning
of the Plan Year ... [check if desired]:
1. [ ] increased to the next highest whole dollar.
4. The Employer Regular Profit Sharing Contribution is ... [check one]:
a. [ ] not contingent on Net Profits.
b. [ ] contingent on ... [check one]:
1. [ ] current (for the fiscal year ending with or within the Plan Year)
2. [ ] accumulated
... Net Profits of the Participating Employers, determined under ...
[check one]:
3. [ ] GAAP [ ] before [ ] after the payment of discretionary bonuses.
4. [ ] other [specify]: ______.
5. The Lead Employer ... [check one]:
a. [ ] does not
b. [ ] does
... have the discretion to direct that an additional Employer Regular Profit
Sharing Contribution be made for a Plan Year which, if made, will be allocated
among the eligible Participants described in J.7. ... [check if applicable]:
c. [ ] who are Non-Highly Compensated Employees
... in proportion to the Plan Compensation for the Plan Year of each eligible Participant.
Uniform Point e. [ ] be allocated among the eligible Participants in proportion to the "points" of each eligible
Formula Participant. An eligible Participant will be awarded ... [check one or both of 1. and 2., and
check 3. if it applies]
1. [ ] _______[specify a whole number] points for each year of age he/she has attained by
the last day of the Plan Year.
2. [ ] _______ [specify a whole number] points for each year of credited service he/she
has completed by the last day of the Plan Year. ... [complete]
35
a. The Participant's years of credited service for this purpose means ...
[check one]:
1. [ ] the number of Plan Years in which the Participant had ______
[1,000 or less] or more Hours of Service.
2. [ ] the number of years of elapsed time Service of the Participant
as of the last day of the Plan Year.
b. The Participant's years of credited service taken into account will not
exceed ... [check one]:
1. [ ] N/A - there is no limit.
2. [ ] ________years.
[check 3. if points are awarded based on compensation]
3. [ ] _______[specify a whole number] points for each $_________ [not more than $200] of
Plan Compensation for the Plan Year.
Prevailing Wage f. [ ] equal a fixed amount for each hour working on a project and in a job category covered by the
Formula Prevailing Wage Laws. The amount of the contribution will be determined ... [check one of 1. or
2., and complete 3. and 4.]:
1. [ ] as specified on the Prevailing Wage Addendum. [NOTE: A CONTRIBUTION WILL BE MADE ONLY
WITH RESPECT TO PROJECTS AND JOB CATEGORIES LISTED ON THE PREVAILING WAGE ADDENDUM.]
2. [ ] as follows ... [complete]:
For contracts classified as ... The contribution amount will be ...
___________________ [ ] $______ per hour
[ ] ______% of the prevailing wage.
___________________ [ ] $______ per hour
[ ] ______% of the prevailing wage.
___________________ [ ] $______ per hour
[ ] ______% of the prevailing wage.
________________________________________________________________________________________________
3. The contribution will be made on behalf of each Active Participant in the Prevailing
Wage Component ... [check if applicable]:
a. [ ] who is a Non-Highly Compensated Employee.
4. If such a Participant also is eligible for an Employer Regular Profit Sharing Contribution
for a Plan Year, such contribution ... [check one]:
a. [ ] N/A - such Participants will not be eligible for Employer Regular
Profit Sharing Contributions.
b. [ ] will not
c. [ ] will
... be offset by the Prevailing Wage Contribution.
[NOTE: EMPLOYER REGULAR PROFIT SHARING CONTRIBUTIONS SHOULD NOT BE DEPOSITED OR ALLOCATED UNTIL THE
END OF THE PLAN YEAR (EXCEPT UNDER A PREVAILING WAGE COMPONENT).]
VESTING SCHEDULE J.9. A Participant's vested percentage in his/her Employer Regular Profit Sharing Contribution Account
FOR EMPLOYER will be ... [check one]:
REGULAR PROFIT
SHARING COMPONENT:
a. [ ] 100% at all times.
36
[PLAN SEC. 10.2(e)] b. [X] determined under the following schedule ... [complete as desired]:
YEARS OF VESTED
SERVICE PERCENTAGE
-------- ----------
0 0%
1 40%
---
2 80%
---
3 100% [20% or more]
---
4 100% [40% or more]
---
5 100% [60% or more]
---
6 100% [80% or more]
---
7 or more 100%
c. [ ] determined under the following schedule ... [complete as desired]:
YEARS OF VESTED
SERVICE PERCENTAGE
-------- ----------
0 0%
1 ___%
2 ___%
3 ___%
4 ___%
5 or more 100%
[NOTE: IF THE PLAN IS TOP-HEAVY, AND IF THE VESTING SCHEDULE SPECIFIED ABOVE DOES NOT SATISFY THE
VESTING REQUIREMENTS APPROPRIATE FOR A TOP-HEAVY PLAN UNDER PLAN SEC. 17.2, THE VESTED PERCENTAGE OF
THE PARTICIPANT WILL BE THE GREATER OF THE VESTED PERCENTAGE DETERMINED UNDER THE VESTING SCHEDULE
SPECIFIED ABOVE OR THE APPLICABLE VESTING SCHEDULE SPECIFIED IN PLAN SEC. 17.2. IF THE PLAN WAS, BUT
HAS CEASED TO BE TOP-HEAVY, THE APPROPRIATE VESTING SCHEDULE WILL BE DETERMINED UNDER Q.3.]
J.10. The vesting schedule specified above applies to the Employer Regular Profit Sharing Contribution
Accounts ... [check one]: [NOTE: IF THE VESTING SCHEDULE IS AMENDED, SPECIAL RULES (INCLUDING A
PARTICIPANT ELECTION) MAY APPLY UNDER PLAN SEC. 10.2(k).]
a. [X] of all Participants.
b. [ ] of Participants who become ... [check one]:
1. [ ] Employees
2. [ ] Active Participants in the Employer Regular Profit Sharing Component
... on or after ____ [month day, year] (and the vesting schedule in effect prior to such date
will apply to all other Participants).
c. [ ] reflecting Employer Regular Profit Sharing Contributions made for periods on or after ____
[month day, year] (and the vesting schedule in effect prior to such date will apply to all
Employer Regular Profit Sharing Contributions made for periods prior to such date).
TREATMENT OF J.11. A Pending Allocation Account that reflects Forfeitures from Employer Regular Profit Sharing
FORFEITURES: Contribution Accounts ... [check one]:
[PLAN SEC. 6.2(d)]
[COMPLETE ONLY IF a. [X] can
A VESTING SCHEDULE b. [ ] cannot
APPLIES WITH
RESPECT TO ANY ... be applied to pay administrative expenses of the Plan if so directed by the Plan Administrator.
PART OR ALL OF THE
EMPLOYER REGULAR J.12. A Pending Allocation Account that reflects Forfeitures from Employer Regular Profit Sharing
PROFIT SHARING Contribution Accounts (to the extent not applied to pay administrative expenses if permitted in J.11)
CONTRIBUTION will be ... [check one]:
ACCOUNT]
37
a. [ ] applied as a credit against ... [check each that applies]:
1. [ ] Employer Safe-Harbor and/or Regular Matching Contributions
2. [ ] Employer Safe-Harbor and/or Regular Profit Sharing Contributions
... that are made under the Plan, as and when directed by the Lead Employer.
b. [X] allocated as of the last day of the Plan Year as an additional Employer Regular
Profit Sharing Contribution. The allocation will be made in the same manner as (and
as part of) any variable contribution, or in proportion to any fixed contribution
(disregarding any contribution under a prevailing wage formula), under the Plan.
[NOTE: IF THE PLAN PROVIDES FOR A VARIABLE CONTRIBUTION (e.g., A DISCRETIONARY
CONTRIBUTION), AND A CONTRIBUTION IS NOT MADE FOR A PLAN YEAR, THE ALLOCATION WILL BE
MADE IN THE SAME MANNER AS THE VARIABLE CONTRIBUTION WOULD HAVE BEEN ALLOCATED.]
[NOTE: IF THE PLAN PROVIDES FOR A FIXED CONTRIBUTION UNDER AN INTEGRATED FORMULA, THE
ALLOCATION WILL BE MADE IN PROPORTION TO PLAN COMPENSATION FOR THE PLAN YEAR.]
c. [ ] allocated as of the last day of the Plan Year in proportion to Plan Compensation for
the Plan Year. The allocation will be among all eligible Participants described in
J.7.
IN-SERVICE WITHDRAWALS: J.13. Withdrawals are allowed from Employer Regular Profit Sharing Contribution Accounts
[PLAN SEC. 11.2] ... [check a., or check each of b. through d. that applies]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [X] for any reason after ... [check one]:
1. [ ] Normal Retirement Age.
2. [X] age 59 1/2.
3. [ ] age _____ ... [check each that applies]:
a. [ ] and completion of ______ years of ... [check one]:
1. [ ] vesting Service.
2. [ ] participation in the Plan. [NOTE: PARTICIPATION IS
MEASURED ON AN ELAPSED TIME BASIS FROM THE ENTRY
DATE.]
b. [ ] but only if at the time of the withdrawal the Participant is
... [check one]:
1. [ ] fully vested
2. [ ] at least ______ % vested
... in his/her Employer Regular Profit Sharing Contribution
Account.
4. [ ] completion of ______ years of ... [check one]:
a. [ ] vesting Service.
b. [ ] participation in the Plan. [NOTE: PARTICIPATION IS MEASURED ON
AN ELAPSED TIME BASIS FROM THE ENTRY DATE.]
c. [ ] at any age on account of Hardship ... [check if applicable]:
1. [ ] but only if at the time of the withdrawal the Participant is ... [check
one]:
a. [ ] fully vested
b. [ ] at least _____ % vested
... in his/her Employer Regular Profit Sharing Contribution Account.
d. [ ] for any reason, but only if at the time of the withdrawal the Participant is fully
vested in his/her Employer Regular Profit Sharing Contribution Account, and
38
provided the withdrawal may not include amounts allocated to the Contribution Account
within two years prior to the withdrawal ... [check if applicable]:
[NOTE: THE CALCULATION OF THE MAXIMUM AMOUNT AVAILABLE FOR WITHDRAWAL IS SET FORTH IN
PLAN SEC. 11.2(a).]
1. [ ] unless the Participant has completed five years of participation in the
Plan. [NOTE: PARTICIPATION IS MEASURED ON AN ELAPSED TIME BASIS FROM THE
ENTRY DATE.]
K. EMPLOYER QUALIFIED MATCHING AND PROFIT SHARING COMPONENT
[NOTE: CONTRIBUTIONS ELECTED UNDER THIS SECTION K. ARE IN ADDITION TO ANY
EMPLOYER SAFE-HARBOR MATCHING, REGULAR MATCHING, SAFE-HARBOR PROFIT SHARING OR
REGULAR PROFIT SHARING CONTRIBUTIONS.]
EMPLOYER QUALIFIED K.1. Employer Qualified Matching and/or Qualified Profit Sharing Contributions ... [check
CONTRIBUTIONS: one]:
[PLAN SECS. 5.3 AND 6.3]
a. [X] will
b. [ ] will not [Skip to Section L.]
... be made under the Plan.
[NOTE: EMPLOYER QUALIFIED MATCHING AND/OR QUALIFIED PROFIT SHARING CONTRIBUTIONS MUST BE
MADE WITHIN TWELVE MONTHS FOLLOWING THE CLOSE OF THE APPLICABLE PLAN YEAR. HOWEVER,
CONTRIBUTIONS MADE LATER THAN 30 DAYS AFTER THE EMPLOYER'S TAX FILING DEADLINE MUST BE
TREATED AS ANNUAL ADDITIONS IN THE LIMITATION YEAR MADE FOR PURPOSES OF CODE SECTION
415.]
[NOTE: THE "APPLICABLE" PLAN YEAR IS THE CURRENT PLAN YEAR IF THE CURRENT YEAR TESTING
METHOD IS USED, OR THE PRIOR PLAN YEAR IF THE PRIOR YEAR TESTING METHOD IS USED.]
EMPLOYER QUALIFIED K.2. Employer Qualified Matching Contributions (QMACs) will be allocated among the ...
MATCHING CONTRIBUTIONS [check one of a. or b., and check one of c. - e.]:
(QMACs):
[PLAN SEC. 5.3] a. [X] Non-Highly Compensated Employees
b. [ ] Highly and Non-Highly Compensated Employees [NOTE: THIS OPTION IS NOT APPROPRIATE IF
THE "PRIOR YEAR" TESTING METHOD IS USED.]
... who ... [check one]:
c. [X] are eligible Participants described in I.7 (relating to the Employer Regular Matching
Component) with respect to the applicable Plan Year. [NOTE: THIS OPTION IS
APPROPRIATE ONLY IF THE PLAN INCLUDES AN EMPLOYER REGULAR MATCHING COMPONENT.]
d. [ ] benefit under the applicable Component for the applicable Plan Year. [NOTE: THE
"APPLICABLE" COMPONENT IS THE EMPLOYEE PRE-TAX COMPONENT IN THE CASE OF A
CONTRIBUTION MADE TO SATISFY THE ACTUAL DEFERRAL PERCENTAGE (ADP) TEST OF
CODE SECTION 401(k); OR THE EMPLOYER REGULAR MATCHING COMPONENT IN THE CASE OF A
CONTRIBUTION MADE TO SATISFY THE ACTUAL CONTRIBUTION PERCENTAGE (ACP) TEST OF CODE
SECTION 401(m).] [NOTE: IF A COMPONENT IS DISAGGREGATED INTO TWO OR MORE SEPARATE
COMPONENTS FOR PURPOSES OF THE COVERAGE REQUIREMENTS OF CODE SECTION 410(b), ANY
DISCRETIONARY CONTRIBUTION WILL BE DETERMINED SEPARATELY FOR EACH DISAGGREGATED
COMPONENT.]
[NOTE: AN EMPLOYEE "BENEFITS" UNDER THE EMPLOYEE PRE-TAX COMPONENT IF HE/SHE IS
ELIGIBLE TO MAKE EMPLOYEE PRE-TAX CONTRIBUTIONS DURING THE APPLICABLE PLAN YEAR. AN
EMPLOYEE "BENEFITS" UNDER THE EMPLOYER REGULAR MATCHING COMPONENT IF HE/SHE SATISFIES
THE REQUIREMENTS IN I.7. FOR THE APPLICABLE PLAN YEAR.]
e. [ ] are Active Participants in the Employee Pre-Tax Component ... [check one]:
1. [ ] at some time during
2. [ ] on the last day of
39
3. [ ] throughout
... the applicable Plan Year.
K.3. Employer Qualified Matching Contributions (QMACs) will be a discretionary amount
determined by the Lead Employer. The contribution will be allocated ... [check one]:
a. [X] in proportion to the Employee Pre-Tax Contributions of each eligible Participant that
do not exceed ... [check one]:
1 [X] N/A - no limit.
2. [ ] ______ % of his/her Plan Compensation for the Plan Year. [NOTE: IF THE PLAN
INCLUDES AN EMPLOYER SAFE-HARBOR COMPONENT, INCLUDE A PERCENTAGE NO GREATER
THAN 6%.]
3. [ ] $ ______ .
b. [ ] as an equal dollar amount to each eligible Participant who has Employee Pre-Tax
Contributions.
c. [ ] in proportion to the Employer Regular Matching Contributions of each eligible
Participant.
EMPLOYER QUALIFIED PROFIT K.4. Employer Qualified Profit Sharing Contributions (QNECs) will be allocated among the ...
SHARING CONTRIBUTIONS [check one of a. or b., and check one of c. - e.]:
(QNECs):
[PLAN SEC. 6.3] a. [X] Non-Highly Compensated Employees
b. [ ] Highly and Non-Highly Compensated Employees [NOTE: THIS OPTION IS NOT APPROPRIATE IF
THE "PRIOR YEAR" TESTING METHOD IS USED.]
... who ... [check one]:
c. [X] are eligible Participants described in J.7 (relating to the Employer Regular Profit
Sharing Component) with respect to the applicable Plan Year. [NOTE: THIS OPTION IS
APPROPRIATE ONLY IF THE PLAN INCLUDES AN EMPLOYER REGULAR PROFIT SHARING COMPONENT.]
d. [ ] benefit under the applicable Component for the applicable Plan Year. [NOTE: THE
"APPLICABLE" COMPONENT IS THE EMPLOYEE PRE-TAX COMPONENT IN THE CASE OF A
CONTRIBUTION MADE TO SATISFY THE ACTUAL DEFERRAL PERCENTAGE (ADP) TEST OF
CODE SECTION 401(k); OR THE EMPLOYER REGULAR MATCHING COMPONENT IN THE CASE OF A
CONTRIBUTION MADE TO SATISFY THE ACTUAL CONTRIBUTION PERCENTAGE (ACP) TEST OF
CODE SECTION 401(m).] [NOTE: IF A COMPONENT IS DISAGGREGATED INTO TWO OR MORE
SEPARATE COMPONENTS FOR PURPOSES OF THE COVERAGE REQUIREMENTS OF CODE SECTION
410(b), ANY DISCRETIONARY CONTRIBUTION WILL BE DETERMINED SEPARATELY FOR EACH
DISAGGREGATED COMPONENT.]
[NOTE: AN EMPLOYEE "BENEFITS" UNDER THE EMPLOYEE PRE-TAX COMPONENT IF HE/SHE IS
ELIGIBLE TO MAKE EMPLOYEE PRE-TAX CONTRIBUTIONS DURING THE APPLICABLE PLAN YEAR. AN
EMPLOYEE "BENEFITS" UNDER THE EMPLOYER REGULAR MATCHING COMPONENT IF HE/SHE SATISFIES
THE REQUIREMENTS IN I.7. FOR THE APPLICABLE PLAN YEAR.]
e. [ ] are Active Participants in the Employee Pre-Tax Component ... [check one]:
1. [ ] at some time during
2. [ ] on the last day of
3. [ ] throughout
... the applicable Plan Year.
K.5. Employer Qualified Profit Sharing Contributions (QNECs) will be a discretionary amount
determined by the Lead Employer. The contribution will be allocated ... [check one]:
a. [X] as a uniform percentage of Plan Compensation for the Plan Year ... [check each that
applies]:
40
1. [ ] using testing compensation as the definition of Plan Compensation for the
Plan Year instead of the definition in Item E. [NOTE: FOR THIS PURPOSE,
"TESTING COMPENSATION" MEANS THE DEFINITION OF COMPENSATION USED FOR
PURPOSES OF APPLYING THE ACTUAL DEFERRAL PERCENTAGE (ADP) TEST OR ACTUAL
CONTRIBUTION PERCENTAGE (ACP) TEST FOR THE APPLICABLE PLAN YEAR.]
2. [ ] disregarding Plan Compensation for the Plan Year in excess of $ ______
[specify a dollar amount less than the compensation limit in effect
under Code Section 401(a)(17)].
b. [ ] as an equal dollar amount.
c. [ ] first to the eligible Participant with the lowest Plan Compensation for the Plan
Year, then to the eligible Participant with the next lowest Plan Compensation for the
Plan Year, etc. until the applicable test is met, with the allocation to each
eligible Participant limited to the amount permitted under Code Section 415. [NOTE:
THIS OPTION IS NOT APPROPRIATE IF THE ALLOCATION WILL BE MADE TO HIGHLY COMPENSATED
EMPLOYEES.]
[NOTE: IF A COMPONENT IS DISAGGREGATED INTO TWO OR MORE SEPARATE COMPONENTS FOR PURPOSES
OF THE COVERAGE REQUIREMENTS OF CODE SECTION 410(b), ANY DISCRETIONARY CONTRIBUTION WILL
BE DETERMINED SEPARATELY FOR EACH DISAGGREGATED COMPONENT.]
IN-SERVICE WITHDRAWALS: K.6. Withdrawals are allowed from Employer Qualified Matching and/or Qualified Profit Sharing
[PLAN SEC. 11.2] Contribution Accounts ... [check one]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [X] for any reason after ... [check one]:
1. [ ] Normal Retirement Age (or age 59 1/2, if later).
2. [X] age 59 1/2.
3. [ ] age ______ [60 or more].
c. [ ] for Hardship after age 59 1/2.
L. EMPLOYEE ROLLOVER COMPONENT
EMPLOYEE ROLLOVER L.1. Employee Rollover Contributions are ... [check one]
CONTRIBUTIONS:
[PLAN SEC. 4.5] a. [ ] not allowed. [Skip to Section M.]
b. [X] allowed if the Employee is ... [check one]:
1. [X] in Covered Employment (but regardless of whether he/she is an Active
Participant).
2. [ ] an Active Participant in any Component of the Plan.
L.2. Employee Rollover Contributions will be allowed in ... [check one]:
a. [X] cash only ... [check if applicable]:
1. [ ] except that an outstanding loan made under a prior employer's plan will be
accepted if the loan is not in default and the transfer satisfies such
requirements as may be imposed under the participant loan program (if any)
of the Plan.
b. [ ] cash or in kind (to the extent not prohibited by the Funding Agent), except that an
outstanding loan made under a prior employer]'s plan ... [check one]:
1. [ ] will not be accepted.
2. [ ] will be accepted only if the loan is not in default and the transfer
satisfies such requirements as may be imposed under the participant loan
program (if any) of the Plan.
IN-SERVICE WITHDRAWALS: L.3. Withdrawals are allowed from Employee Rollover Contribution Accounts ... [check
41
[PLAN SEC. 11.2] one]:
a. [X] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason and at any time.
c. [ ] for any reason after ... [check one]:
1. [ ] Normal Retirement Age.
2. [ ] age 59 1/2.
3. [ ] age ______ .
M. RETIREMENT, DISABILITY AND HARDSHIP
RETIREMENT AGE: M.1. The Normal Retirement Age is ... [check one]:
[PLAN SECS. 2.19 AND 2.47]
a. [X] age 55 [65 or less].
b. [ ] the later of age _______ [65 or less] or the _______ [5th or less] anniversary of the
first day of the Plan Year in which the Participant commenced participation in the
Plan.
M.2. The Early Retirement Age is ... [check one]:
a. [X] N/A - early retirement is not recognized under the Plan.
b. [ ] age ______ [less than Normal Retirement Age].
c. [ ] the later of age _______ [less than Normal Retirement Age] or the
date on which the Participant completes ______ years of vesting Service.
DISABILITY: M.3. A Participant will be deemed to be Disabled for purposes of the Plan if he/she ... [check
[PLAN SEC. 2.18] one]:
a. [X] has a physical or mental condition that makes him/her unable to engage in any
substantial gainful activity and that can be expected to result in death or has
lasted or can be expected to last for at least a twelve-consecutive-month period.
b. [ ] meets the standard for long-term disability benefits under any disability plan
maintained by a Controlled Group Member.
c. [ ] has been determined to be disabled for purposes of Social Security.
d. [ ] has a physical or mental condition that makes him/her permanently unable to perform
the normal duties of his/her job with the Participating Employer.
e. [ ] has a physical or mental condition that makes him/her permanently unable to engage in
any occupation for wage or profit for which he/she is reasonably fitted by training,
education or experience.
HARDSHIP: M.4. A Participant will be deemed to be under a Hardship for purposes of the Plan if he/she
[PLAN SEC. 2.33] has a financial need resulting from ... [check each that applies]:
a. [X] expenses for medical care described in Code Section 213(d) incurred by the
Participant, his/her spouse, or his/her dependents (as defined in Code Section 152),
or necessary for any of those persons to obtain such medical care.
b. [X] costs directly related to the purchase of the Participant's principal residence
(excluding mortgage payments).
c. [X] payment of tuition and related educational fees for the next 12 months of
post-secondary education for the Participant, his/her spouse, children, or
dependents.
d. [X] the need to prevent the eviction of the Participant from the Participant's principal
residence or foreclosure on the mortgage of the Participant's principal residence.
e. [ ] other [specify in a manner that prevents employer discretion]: _______ . [NOTE: THIS
HARDSHIP STANDARD DOES NOT APPLY TO HARDSHIP WITHDRAWALS FROM EMPLOYEE PRE-TAX
CONTRIBUTION ACCOUNTS PRIOR TO AGE 59 1/2.]
M.5. The Hardship amount ... [check one]:
a. [X] may
b. [ ] may not
... include any amount necessary to pay any federal, state or local income taxes or
penalties reasonably expected to result from the distribution.
42
N. SPECIAL VESTING RULES
[NOTE: DO NOT COMPLETE IF THE PLAN PROVIDES FOR FULL AND IMMEDIATE VESTING OF
ALL CONTRIBUTION ACCOUNTS. SKIP TO SECTION O.]
VESTING: N.1. A Participant's vested percentage in his/her Employee Pre-Tax, After-Tax, Deductible,
[PLAN SEC. 10.2(e)] Forfeiture Restoration and Rollover Contribution Accounts, and in his/her Employer
Safe-Harbor Matching, Qualified Matching, Safe-Harbor Profit Sharing and Qualified Profit
Sharing Contribution Accounts, will be 100% at all times.
A Participant's vested percentage in his/her Employer Regular Matching Contribution
Account will be determined under I.11.
A Participant's vested percentage in his/her Employer Regular Profit Sharing Contribution
Account will be determined under J.9.
SERVICE DISREGARDED FOR N.2. To determine the vested percentage of a Participant in his/her Employer Regular Matching
VESTING: or Regular Profit Sharing Contribution Account, Service ... [check each that applies]:
[PLAN SEC. 10.2(f)]
a. [ ] before the Participant attained the age of ______ [18 or less]
b. [ ] before any Controlled Group Member first maintained this Plan (or a predecessor plan)
... will be disregarded. ...
c. [ ] Such Service also will be disregarded for purposes of determining ... [check each
that applies]:
1. [ ] Early Retirement Age.
2. [ ] whether a Participant has satisfied the requirements to receive an
in-service withdrawal that is conditioned on vesting Service.
SPECIAL VESTING EVENTS: N.3. A Participant will be fully vested in an Employer Regular Matching and/or Regular Profit
[PLAN SEC. 10.2(b)] Sharing Contribution Account if he/she ... [check each that applies]:
a. [X] dies
b. [X] becomes Disabled
c. [ ] attains age ______ [less than Normal Retirement Age]
d. [ ] attains Early Retirement Age
... while employed with a Controlled Group Member. [NOTE: A PARTICIPANT WILL IN ALL
EVENTS BE FULLY VESTED UPON ATTAINMENT OF NORMAL RETIREMENT AGE WHILE EMPLOYED WITH A
CONTROLLED GROUP MEMBER.]
FORFEITURES: N.4. The portion of an Employer Regular Matching or Regular Profit Sharing Contribution
[PLAN SEC. 10.2(g)] Account in which a Participant is not vested will become a Forfeiture on the earlier of
the date the Participant incurs a period of five consecutive one year Breaks in Service
or the ... [check one]:
a. [ ] first day of the Plan Year after the Plan Year in which
b. [ ] last day of the Plan Year in which
c. [X] date on which
d. [ ] last day of the ... [check one]:
1. [ ] first
2. [ ] second
3. [ ] third
4. [ ] fourth
5. [ ] fifth
... Plan Year after the Plan Year in which
... the Participant receives a full distribution of the vested portion of the
Contribution
43
Account (or immediately upon Termination of Service if the Participant is not vested in
the Contribution Account).
VESTING FORMULA FOR PARTIALLY N.5. If a Participant receives a distribution after his/her Termination of Service of less
VESTED: than the full vested balance of a partially vested Employer Regular Matching or Regular
[PLAN SEC. 10.2(c) AND (g)] Profit Sharing Account ... [check one]:
a. [X] the following formula will apply after the distribution to determine the vested
portion of the Contribution Account ... [check one]: [NOTE: UNDER THIS OPTION, A
PARTIAL DISTRIBUTION WILL NOT RESULT IN AN IMMEDIATE FORFEITURE.] [NOTE: THIS FORMULA
WILL ALSO APPLY IF A PARTICIPANT IS ELIGIBLE TO AND DOES RECEIVE AN IN-SERVICE
WITHDRAWAL (INCLUDING THOSE FOR HARDSHIP) FROM A PARTIALLY VESTED EMPLOYER REGULAR
MATCHING AND REGULAR PROFIT SHARING ACCOUNT.]
1. [ ] P(AB+D)-D
2. [X] P[AB+(RxD)]-(RxD)
b. [ ] a proportionate share of the remaining balance of the Contribution Account will
immediately become a Forfeiture. [NOTE: UNDER THIS OPTION, THE FORFEITURE WILL BE
IMMEDIATELY TAKEN FROM THE CONTRIBUTION ACCOUNT AND CREDITED TO THE PENDING
ALLOCATION ACCOUNT REFLECTING FORFEITURES.]
If a Participant makes a withdrawal (including those for Hardship) before his/her
Termination of Service from a partially vested Employer Regular Matching or Regular
Profit Sharing Contribution Account, the formula that will apply to determine the
vested portion of such Contribution Account after the in-service withdrawal is ...
[check one]: [NOTE: THE VARIABLES USED IN THE FOLLOWING FORMULAS ARE DESCRIBED IN
PLAN SEC. 10.2(c).]
1. [ ] N/A - In-service withdrawals are not permitted from partially vested
Accounts.
2. [ ] P(AB+D)-D
3. [ ] P[AB+(RxD)]-(RxD)
REINSTATEMENT UPON RETURN TO N.6. A Participant who has a Termination of Service, receives a distribution of the vested
SERVICE: portion of an Employee Regular Matching or Regular Profit Sharing Contribution Account
[PLAN SEC. 10.2(h)] and returns to Covered Employment ... [check one]:
a. [X] will
b. [ ] will not
... be required to repay the prior distribution in order to have the amount of a prior
Forfeiture reinstated to such Contribution Account.
SPECIAL VESTING RULES FOR LIFE N.7. The value attributable to a life insurance policy held for the Contribution Account of
INSURANCE: the Participant will be ... [check one]:
[PLAN SEC. 10.3]
a. [X] N/A - life insurance is not available from a partially vested Contribution Account.
b. [ ] fully vested notwithstanding the normal vesting rules applicable to the Contribution
Account.
c. [ ] subject to the normal vesting rules applicable to the Contribution Account ... [check
if applicable]:
1. [ ] and all premiums paid on a term life policy (other than unearned premiums
returned by the insurance company to the Trustee or Custodian) and, in the
case of a cash value policy ... [check one]:
a. [ ] the excess of the premium paid over the cash surrender value of
the policy
b. [ ] the PS-58 cost charged to the Participant as a result of the
Trustee or Custodian holding the policy
... will be treated as a withdrawal for purposes of applying the formula
specified in N.5.
44
O. EMPLOYER SECURITIES
EMPLOYER SECURITIES: O.1. The Plan ... [check one]:
[PLAN SEC. 14.15 AND 14.16]
a. [ ] may not [Skip to Section P.]
b. [X] may
... hold Qualifying Employer Securities or Predecessor Employer Securities.
VOTING PROVISIONS: O.2. A Participant will be allowed to direct the vote on Qualifying Employer Securities
[PLAN SECS. 14.15(d) AND credited to his/her Account on ... [check one]: [NOTE: A PARTICIPANT IS NOT ALLOWED TO
14.16] VOTE WITH RESPECT TO PREDECESSOR EMPLOYER SECURITIES.]
a. [X] any matter put to the vote of shareholders. Qualifying Employer Securities for which
Participants fail to provide timely direction will be voted ... [check one]:
1. [ ] in the same proportion as the votes cast on securities for which other
Participants provide timely direction.
2. [X] at the discretion of the Lead Employer, or a Named Fiduciary or Investment
Manager designated by the Lead Employer.
3. [ ] at the discretion of the Trustee.
b. [ ] any significant corporate event (as defined in Plan Sec. 14.15(e)). ... [complete 1.
and 2.]:
1. Qualifying Employer Securities for which Participants fail to provide timely
direction will be voted ... [check one]:
a. [ ] in the same proportion as the votes cast on securities for which
other Participants provide timely direction.
b. [ ] at the discretion of the Lead Employer, or a Named Fiduciary or
Investment Manager designated by the Lead Employer.
c. [ ] at the discretion of the Trustee.
2. With respect to any matter other than a significant corporate event,
Qualifying Employer Securities will be voted ... [check one]:
a. [ ] at the discretion of the Lead Employer, or a Named Fiduciary or
Investment Manager designated by the Lead Employer.
b. [ ] at the discretion of the Trustee.
c. [ ] N/A - not allowed to direct any vote. Qualifying Employer Securities will be
voted ... [check one]:
1. [ ] at the discretion of the Lead Employer, or a Named Fiduciary or Investment
Manager designated by the Lead Employer.
2. [ ] at the discretion of the Trustee.
TENDER PROVISIONS: O.3. A Participant will be allowed to direct the hold or sell/exchange decision on Qualifying
[PLAN SECS. 14.15(e) Employer Securities or Predecessor Employer Securities credited to his/her Account in
AND 14.16] ... [check one]:
a. [X] any ... [check one or both]:
1. [X] tender or exchange offer.
2. [X] cash or stock offer made in connection with a merger or other corporate
transaction.
Qualifying Employer Securities or Predecessor Employer Securities for which
Participants fail to provide timely direction will be held or sold/exchanged ...
[check one]:
3. [ ] in the same proportion as the securities for which other Participants
45
provide timely direction.
4. [X] at the discretion of the Lead Employer, or a Named Fiduciary or Investment
Manager designated by the Lead Employer.
5. [ ] at the discretion of the Trustee.
b. [ ] N/A - not allowed to direct the hold or sell/exchange decision in any corporate
transaction. Qualifying Employer Securities or Predecessor Employer Securities will
be held or sold/exchanged ... [check one]:
1. [ ] at the discretion of the Lead Employer, or a Named Fiduciary or Investment
Manager designated by the Lead Employer.
2. [ ] at the discretion of the Trustee.
IN-KIND DISTRIBUTION OPTION: O.4. A Participant ... [check one]:
[PLAN SEC. 12.3(c)]
a. [X] may not take an in-service withdrawal (including those for Hardship) or a
distribution following Termination of Service in the form of Qualifying Employer
Securities or Predecessor Employer Securities.
b. [ ] may take ... [check each that applies]:
1. [ ] an in-service withdrawal (if otherwise available) ... [check one]:
a. [ ] including
b. [ ] excluding
... those for Hardship.
2. [ ] a distribution following Termination of Service
... in the form of Qualifying Employer Securities or Predecessor Employer Securities
(to the extent the applicable Contribution Account is then invested in such
securities).
P. PAYMENT OF BENEFITS
BALANCES LESS THAN CASH- P.1. The Benefit subject to involuntary cash-out is ... [check one]:
OUT AMOUNT:
[PLAN SEC. 12.4] a. [X] $5000.00 [$5,000 or less].
b. [ ] N/A - involuntary cash-out distributions will not be made. [Skip to P.3.]
P.2. If a Benefit is subject to involuntary cash-out, the payment will be made to the
Participant or Beneficiary as soon as administratively practicable after ... [check one]:
[NOTE: THE TIMING OF DISTRIBUTIONS SHOULD BE COORDINATED WITH THE VALUATION DATE(s),
WHICH ARE THE DATE(s) ON WHICH ASSETS ARE VALUED UNDER THE PLAN.]
a. [X] Termination of Service.
b. [ ] the first day of the ... [check one]:
1. [ ] month
2. [ ] Plan Year quarter
3. [ ] Plan Year
... following Termination of Service.
c. [ ] other [specify]: ______ . [at least as soon as b.3]
BALANCES MORE THAN CASH- P.3. If a Benefit is not subject to involuntary cash-out, the earliest that the Participant
OUT AMOUNT: or Beneficiary may elect to receive payment is as soon as administratively practicable
[PLAN SEC. 12.3(a)] after ... [check one]: [NOTE: THE TIMING OF DISTRIBUTIONS SHOULD BE COORDINATED WITH THE
VALUATION DATES, WHICH ARE THE DATE(s) ON WHICH ASSETS ARE VALUED UNDER THE PLAN.]
a. [X] Termination of Service.
b. [ ] the first day of the ... [check one]:
46
1. [ ] month
2. [ ] Plan Year quarter
3. [ ] Plan Year
... following Termination of Service.
c. [ ] the later of Termination of Service or attainment of ... [check one]:
1. [ ] Normal Retirement Age.
2. [ ] age ___ [less than Normal Retirement Age].
d. [ ] a Break in Service of ______ years has occurred following Termination of Service.
e. [ ] other [specify]: ____. [no later than Normal Retirement Age]
P.4. A Benefit may be paid after Termination of Service and prior to the earliest payment
date specified above if ... [check a., or each of b. through d. that applies]:
a. [X] N/A - earlier payment is not permitted.
b. [ ] Termination of Service occurs because the Participant ... [check each that applies]:
1. [ ] died.
2. [ ] became Disabled.
3. [ ] retired after ... [check one]:
a. [ ] Early Retirement Age.
b. [ ] age ____ [less than Normal Retirement Age].
c. [ ] the Benefit does not exceed $____ [specify dollar amount].
d. [ ] the Participant is under a Hardship.
P.5. A Benefit must be paid (or must commence) to a Participant or Beneficiary ... [check
one]:
a. [X] by the date distributions are required to commence under Code Section 401(a)(9).
b. [ ] on or as soon as administratively practicable after the Participant's Normal
Retirement Age (or age 62, if later) ... [check if applicable]:
1. [ ] even if the Participant then remains employed with a Controlled Group
Member.
[NOTE: IF A BENEFIT IS PAID (OR COMMENCES) AND ALLOCATIONS ARE SUBSEQUENTLY MADE TO THE
ACCOUNT, THE ADDITIONAL BENEFIT RESULTING FROM SUCH ALLOCATIONS WILL BE PAID IN THE SAME
FORM AS SOON AS ADMINISTRATIVELY PRACTICABLE FOLLOWING THE CLOSE OF EACH PLAN YEAR OR
FOLLOWING TERMINATION OF SERVICE.]
PAYMENT FORMS: P.6. The methods of payment permitted under the Plan (for Benefits in excess of the cash-out
[PLAN SECS. 12.3(b) AND 12.6] amount) include ... [check each that applies]: [NOTE: MINIMUM DISTRIBUTIONS WILL IN ALL
EVENTS BE MADE IN ACCORDANCE WITH CODE SECTION 401(a)(9).]
a. [X] a lump sum payment ... [check if applicable]:
1. [ ] including partial payments made at the request of the Participant or
Beneficiary.
b. [X] installments ... [check each that applies]:
1. [X] over a fixed period that does not exceed ... [check each that applies]:
a. [X] a number of years equal to the life expectancy of the
Participant, as determined under Table V in Treas. Reg.
Section 1.72-9.
b. [X] a number of years equal to the joint life and last survivor
expectancy of the Participant and his/her Beneficiary, as
determined under Table VI in Treas. Reg. Section 1.72-9.
47
c. [ ] ______ years.
d. [ ] the shorter of _____ months or the applicable life expectancy
under Code Section 401(a)(9).
e. [ ] other [specify]: _____ .
2. [ ] of a fixed amount, as directed by the Participant or Beneficiary.
c. [ ] purchase of a period-certain annuity contract.
d. [ ] purchase of any type of annuity contract (including a life annuity), in which case,
the qualified annuity requirements of the Plan apply ... [check 1. or 2., and
complete 3. and 4.]:
1. [ ] to all Participants
2. [ ] only to a Participant who elects a life annuity form of payment.
3. The Qualified Joint and Survivor Annuity is a joint and survivor annuity with
a survivor percentage of _______ [not less than 50% or more than 100%].
4. The Qualified Preretirement Survivor Annuity is the life annuity that can be
purchased with ... [check one]:
a. [ ] 100%
b. [ ] 50%
... of the Participant's Benefit.
P.7. The payment options specified above apply to ... [check one]:
a. [X] all Contribution Accounts.
b. [ ] Contribution Accounts (or subaccounts thereunder) reflecting contributions made after
______ [month day, year], and the payment options in effect under the Plan prior to
such date will apply to all other Contribution Accounts (or subaccounts thereunder).
[NOTE: PAYMENT OPTIONS THAT WERE AVAILABLE UNDER THE PLAN PRIOR TO THE LATER OF THE
EFFECTIVE DATE OR ADOPTION DATE OF AN AMENDMENT TO THE PLAN GENERALLY CANNOT BE
ELIMINATED. IF THE PAYMENT OPTIONS ARE CHANGED TO BE MORE RESTRICTIVE, SEPARATE
SUBACCOUNTS MUST BE MAINTAINED TO REFLECT THE PORTION OF EACH CONTRIBUTION ACCOUNT
SUBJECT TO THE PRIOR PAYMENT OPTIONS WHICH CANNOT BE ELIMINATED.]
PAYMENT MEDIUM: P.8. The medium of payment permitted with respect to a non-annuity distribution under the Plan
[PLAN SEC. 12.3(c)] is ... [check one]:
a. [X] cash only.
b. [ ] cash or in-kind.
[NOTE: DISTRIBUTION OF QUALIFYING EMPLOYER SECURITIES OR PREDECESSOR EMPLOYER SECURITIES
IS GOVERNED BY O.4.]
BENEFICIARY: P.9. If a designation of Beneficiary is not on file, or if all designated Beneficiaries
[PLAN SECS. 13.1 AND 13.3] predecease the Participant, the Beneficiary will be the ... [check one]:
a. [X] Participant's Spouse, or if no Surviving Spouse, the Participant's estate.
b. [ ] person or persons surviving in the first of the following classes in which there is a
survivor, share and share alike:
1. Participant's Spouse.
2. Participant's children, except that if any of those children predeceases the
Participant but leaves issue surviving, such issue will take by right of
representation the share their parent would have taken if living.
3. Participant's parents.
4. Participant's brothers and sisters.
5. Participant's estate.
48
c. [ ] other [specify]:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
[NOTE: THE PARTICIPANT'S SPOUSE MUST BE THE FIRST PRIMARY BENEFICIARY.]
P.10. The Spouse of a Participant must consent to a designation of another or different primary
Beneficiary ... [check one]:
a. [X] under all circumstances.
b. [ ] only if the Participant and Spouse have been married for one year. [NOTE: A
DESIGNATION WILL CEASE TO BE EFFECTIVE AFTER ONE YEAR WITHOUT CONSENT.]
P.11. A Beneficiary ... [check one]:
a. [X] may not
b. [ ] may
... designate a successor beneficiary to take upon the death of the first Beneficiary.
[NOTE: THIS DESIGNATION WILL NOT OPERATE TO CHANGE ANY DESIGNATION MADE BY THE
PARTICIPANT. THUS, A BENEFICIARY MAY DESIGNATE A SUCCESSOR ONLY IF SUCH DESIGNATION IS
NOT INCONSISTENT WITH A DESIGNATION MADE BY THE PARTICIPANT.]
MINIMUM DISTRIBUTIONS: P.12. The Required Beginning Date of a Participant will be ... [check one]:
[PLAN SECS. 2.62 AND 12.7]
a. [X] the April 1 of the calendar year after the later of the calendar year in which the
Participant attains age 70 1/2, or (except in the case of a Participant who is a more
than five-percent owner in the Plan Year ending in the calendar year in which he/she
attains age 70 1/2), the calendar year of Termination of Service.
Special Effective Date [complete only if this Adoption Agreement implements a change
in the Required Beginning Date from b. to a. after the Plan has been amended for
GUST]:
The above date will be treated as the Required Beginning Date effective ____ [month
day, year]. A Participant who attained age 70 1/2 prior to this date and who has not
had a Termination of Service ... [check one]:
1. [ ] may not elect to stop minimum distributions.
2. [ ] may elect to stop minimum distributions and recommence such distributions
by the April 1 of the calendar year after the calendar year of his/her
Termination of Service, and the new commencement date ... [check one]:
a. [ ] will
b. [ ] will not
... be treated as a new Benefit Starting Date for purposes of the Plan.
[NOTE: THE OPTION TO STOP MINIMUM DISTRIBUTIONS DOES NOT APPLY TO A
PARTICIPANT WHO IS A MORE THAN FIVE-PERCENT OWNER IN THE PLAN YEAR ENDING
IN THE CALENDAR YEAR IN WHICH HE/SHE ATTAINS AGE 70 1/2.]
b. [ ] the April 1 of the calendar year after the Participant attains age 70 1/2. [NOTE:
THIS OPTION IS NOT APPROPRIATE FOR A NEW PLAN WITH AN ORIGINAL EFFECTIVE DATE ON OR
AFTER JANUARY 1, 1997.]
P.13. To determine the minimum distribution required to be made to a Participant prior to
death, ... [check one]: [NOTE: ONLY THE LIFE EXPECTANCY OF THE PARTICIPANT AND HIS/HER
SPOUSE BENEFICIARY ARE ELIGIBLE FOR RECALCULATION.]
a. [ ] the Participant can elect the life expectancies to be recalculated. In the absence of
an election, ... [check one]:
1. [ ] the life expectancy of the Participant will be recalculated annually, and
the life expectancy of his/her Spouse Beneficiary ... [check one]:
49
a. [ ] also will be recalculated annually.
b. [ ] will not be recalculated.
2. [ ] life expectancies will not be recalculated.
b. [X] the life expectancy of the Participant will be recalculated annually, and
the life expectancy of his/her Spouse Beneficiary ... [check one]:
1. [X] also will be recalculated annually.
2. [ ] will not be recalculated.
c. [ ] life expectancies will not be recalculated.
P.14. To determine the minimum distribution required to be made to a Beneficiary when
the Participant dies prior to the Required Beginning Date (and prior to
commencement of an irrevocable annuity), the 5-year rule ... [check one]:
a. [X] applies in all cases. [Skip to Section Q.]
b. [ ] applies, except that ... [check each that applies]:
1. [ ] a Spouse Beneficiary
2. [ ] any Beneficiary
... may elect to have minimum distributions commence by December 31 of the
year following the year of the Participant's death, and such minimum
distributions may continue beyond the 5-year limit. ... [check if
applicable]:
3. [ ] A Spouse Beneficiary may further elect to have minimum distributions
commence at any time prior to December 31 of the calendar year in which the
Participant would have reached age 70 1/2.
P.15. To determine the minimum distribution required to be made to a Spouse
Beneficiary when the Participant dies prior to the Required Beginning Date (and
prior to commencement of an irrevocable annuity), ... [check one]:
a. [ ] the Spouse Beneficiary can elect whether his/her life expectancy is
to be recalculated. In the absence of an election, life expectancy ...
[check one]:
1. [ ] will be recalculated annually.
2. [ ] will not be recalculated.
b. [ ] the life expectancy of the Spouse Beneficiary will be recalculated annually.
c. [ ] the life expectancy of the Spouse Beneficiary will not be recalculated.
Q. TOP-HEAVY PROVISIONS
TOP-HEAVY ELIGIBLE Q.1. A Top-Heavy Eligible Participant is an Active Participant at some time during the Plan
PARTICIPANT: Year who is an Employee on the last day of the Plan Year and who is a Non-Key Employee
[PLAN SEC. 17.4(k)] ... [check if applicable]:
a. [ ] or a Key Employee
... with respect to the Plan Year.
TOP-HEAVY CONTRIBUTION Q.2. If the Plan is Top-Heavy and a defined contribution minimum must be provided
REQUIREMENT: under this Plan, the minimum contribution requirement will be satisfied ...
[PLAN SEC. 17.1] [check one]:
a. [X] by means of an additional contribution made solely on behalf of the Top-Heavy
Eligible Participants. [NOTE: UNDER THIS OPTION, THE EMPLOYER SAFE-HARBOR AND/OR REGULAR
PROFIT SHARING CONTRIBUTION WILL BE DETERMINED OR ALLOCATED AS PROVIDED IN SECTION H.
AND/OR J, AND ADDITIONAL CONTRIBUTIONS WILL BE MADE AS NECESSARY TO SATISFY PLAN SEC.
17.1(a).]
50
b. [ ] by modification of the otherwise applicable contribution formula or allocation
method for the Employer Safe-Harbor or Regular Profit Sharing Contributions in
accordance with Plan Sec. 17.1(b). [NOTE: THIS OPTION IS NOT APPROPRIATE IF THE PLAN
DOES NOT OTHERWISE PROVIDE FOR AN EMPLOYER SAFE-HARBOR OR REGULAR PROFIT SHARING
CONTRIBUTION. UNDER THIS OPTION, THE EMPLOYER SAFE-HARBOR AND/OR REGULAR PROFIT SHARING
CONTRIBUTIONS WILL NOT BE DETERMINED OR ALLOCATED AS PROVIDED IN SECTION H. AND/OR J.,
BUT WILL INSTEAD BE DETERMINED OR ALLOCATED AS PROVIDED IN PLAN SEC. 17.1(b).]
TOP-HEAVY VESTING SCHEDULE: Q.3. If the Plan was, but has ceased to be, Top-Heavy, the applicable vesting schedule specified
[PLAN SEC. 17.2] in Plan Sec. 17.2 will ... [check one]:
a. [ ] cease to apply. [NOTE: THIS WILL BE TREATED AS AN AMENDMENT TO THE VESTING SCHEDULE
THAT IS SUBJECT TO THE PARTICIPANT ELECTION SPECIFIED IN PLAN SEC. 10.2(k).]
b. [X] continue to apply to all Participants.
c. [ ] continue to apply to any Participant who has three or more years of vesting Service
as of the last day the Plan is Top-Heavy (but not any other Participant).
[NOTE: IF THE VESTING SCHEDULE SPECIFIED IN PLAN SEC. 17.2 CONTINUES TO APPLY, A
PARTICIPANT'S VESTED PERCENTAGE WILL BE THE GREATER OF THE VESTED PERCENTAGE UNDER SUCH
SCHEDULE OR THE VESTING SCHEDULE THAT OTHERWISE APPLIES UNDER THE PLAN.]
COORDINATION WITH OTHER Q.4. Does any Controlled Group Member maintain another qualified plan? [check one]:
QUALIFIED PLANS:
[PLAN SEC. 17.1] a. [X] No. [Skip to Section R.]
b. [ ] Yes.
Q.5. If this Plan is Top-Heavy, and if a Participant also is covered under another qualified
defined contribution plan, the defined contribution minimum will be provided under ...
[check one]:
a. [ ] N/A - no such plan exists.
b. [ ] the following plan [specify name]:___.
c. [ ] this Plan.
Q.6. If this Plan is Top-Heavy, and if a Participant also is covered under a qualified defined
benefit plan, ... [check one]:
a. [ ] N/A - no such plan exists. [Skip to Section R.]
b. [ ] a defined benefit minimum of 2% per year of service (up to 20%) will be provided under
the defined benefit plan.
c. [ ] a defined contribution minimum of 5% will be provided under the defined contribution
plan designated in Q.5. (or if there is no other defined contribution plan, or if
another defined contribution plan is designated in Q.5. but the Participant is not
covered under such plan, then under this Plan).
d. [ ] other [specify manner in which top-heavy benefit will be provided; attach addendum
if necessary]:___.
Q.7. The Top-Heavy Ratio will be determined using the following interest rate and mortality
assumptions to value accrued benefits under defined benefit plans [complete]:
Interest: ______%
Mortality: ______.
R. CODE SECTION 415 COORDINATION
415 COMPENSATION: R.1. The 415 Compensation of a Participant is his/her ... [check one]:
[PLAN SEC. 18.4(b)]
a. [X] Plan Compensation determined without regard to any exclusions elected in E.2. and
without regard to the compensation limit imposed under Code Section 401(a)(17).
b. [ ] earnings required to be reported in the Wages, Tips and other Compensation box of
Form W-2.
c. [ ] earnings for purposes of Code Section 415(c)(3).
d. [ ] earnings for purposes of federal income for withholding.
51
[NOTE: FOR LIMITATION YEARS BEGINNING ON OR AFTER JANUARY 1, 1998, 415 COMPENSATION INCLUDES
ELECTIVE DEFERRALS AND ANY CONTRIBUTIONS MADE AT THE ELECTION OF THE PARTICIPANT TO A
CAFETERIA PLAN THAT IS EXCLUDED FROM GROSS INCOME UNDER CODE SECTION. 125.]
LIMITATION YEAR: R.2. The Limitation Year with respect to the Plan is the ... [check one of a. or b., and check
[PLAN SEC. 18.4(h)] c. if it applies]:
a. [X] Plan Year.
b. [ ] twelve-consecutive-month period ending each ______ [month day].
[check c. if the Limitation Year has been amended]
c. [ ] The Limitation Year has been amended. The last Limitation Year before the amendment
ended ____ [month day, year], and the short Limitation Year resulting from the amendment
began on the next day and ended ____ [month day, year].
CORRECTION METHOD: R.3 If Excess Annual Additions have been made under the Plan, the correction will be made using
[PLAN SEC. 18.1(b)] the ... [check one]: [NOTE: THE FOLLOWING CORRECTION METHOD APPLIES ONLY AFTER EMPLOYEE
PRE-TAX AND AFTER-TAX CONTRIBUTIONS FOR THE LIMITATION YEAR HAVE BEEN REFUNDED TO THE
PARTICIPANT.]
a. [ ] individual reduction method - that is, the Excess Annual Additions will remain in
the Participant's Account (so long as he/she remains an Active Participant) and will
reduce Employer Contributions made on behalf of such Participant in future Limitation
Years.
b. [X] suspense account method - that is, the Excess Annual Additions will be placed in the
Pending Allocation Account and will reduce Employer Contributions of all Participants in
future Limitation Years.
c. [ ] current allocation method - that is, the Excess Annual Additions will be reallocated
among other Active Participants as of the last day of the current Limitation Year in
proportion to Plan Compensation.
R.4. If a Pending Allocation Account is ever maintained to hold Excess Annual Additions, such
Account ... [check one]: [NOTE: AN ELECTION MUST BE MADE EVEN IF THE INDIVIDUAL REDUCTION
METHOD IS USED TO CORRECT EXCESS ANNUAL ADDITIONS, BECAUSE EXCESS ANNUAL ADDITIONS THAT
REMAIN IN A PARTICIPANT'S CONTRIBUTION ACCOUNTS AT TERMINATION OF SERVICE MUST THEN BE
CREDITED TO A PENDING ALLOCATION ACCOUNT.]
a. [X] will
b. [ ] will not
... share in investment gains and losses under the Plan.
COORDINATION WITH OTHER PLANS: R.5. Does any Controlled Group Member maintain (i) another qualified defined contribution plan
[PLAN SEC. 18.2 AND 18.3] (other than another master or prototype plan), (ii) a simplified employee pension as defined
in Code Section 408(a), (iii) a welfare benefit fund as defined in Code Section 419(e), or
(iv) an individual medical account as defined in Code Section 415(1)(2), under which amounts
are treated as Annual Additions with respect to any Participant in this Plan? [check one]:
a. [X] No. [Skip to Section S.]
b. [ ] Yes.
52
R.6. If a Participant is covered under another qualified defined contribution plan (other than a
master or prototype plan) or under a simplified employee pension, welfare benefit fund or
individual medical account of a Controlled Group Member, ... [check one]:
a. [ ] the method used to coordinate the limit on Annual Additions will be the same method
that would be used for a master or prototype plan under Plan Sec. 18.2(a).
b. [ ] the Excess Annual Additions will be attributed ... [check one]:
1. [ ] last
2. [ ] first
... to this Plan.
c. [ ] other [specify the method that will be used to coordinate the annual addition limits
in a manner that precludes discretion; attach addendum if necessary]: _____ .
S. SPECIAL TESTING RULES
[NOTE: IF THIS ADOPTION AGREEMENT AMENDS THE PLAN TO RETROACTIVELY COMPLY WITH
THE SMALL BUSINESS JOB PROTECTION ACT OF 1996 AND THE TAXPAYER RELIEF ACT OF
1997, COMPLETE AND ATTACH THE "SPECIAL TESTING RULES ADDENDUM".]
HIGHLY COMPENSATED EMPLOYEES: S.1. An Employee will be a Highly Compensated Employee if he/she is a more than five-percent
[PLAN SEC. 2.35] owner at any time during the current Plan Year or the twelve-consecutive-month period
immediately preceding the current Plan Year. [NOTE: THE CONSTRUCTIVE OWNERSHIP RULES UNDER
CODE SECTION 318 APPLY FOR DETERMINING WHO IS A MORE THAN FIVE-PERCENT OWNER.]
An Employee also will be a Highly Compensated Employee if his/her Compensation during the
look-back period exceeded the limit in effect under Code Section 414(q)(1)(b) ... [check if
applicable]: [NOTE: THE FOLLOWING ELECTION CAN ONLY BE MADE IF IT IS MADE IN ALL PLANS OF
ALL CONTROLLED GROUP MEMBERS.]
a. [ ] and the Employee was in the top-paid group for the look-back period.
S.2. The look-back period is the ... [check one]:
a. [X] twelve-consecutive-month period immediately preceding the current Plan Year.
b. [ ] calendar year ending within the current Plan Year. [NOTE: THIS ELECTION IS NOT
APPROPRIATE IF THE PLAN YEAR IS THE CALENDAR YEAR, AND CAN ONLY BE MADE IF IT IS MADE IN
ALL PLANS (OTHER THAN CALENDAR YEAR PLANS) OF ALL CONTROLLED GROUP MEMBERS.]
[NOTE: COMPLETE S.3. THROUGH S.10. ONLY IF THE PLAN HAS AN EMPLOYEE PRE-TAX OR AFTER-TAX COMPONENT.]
ADP/ACP TESTING METHOD: S.3. The Actual Deferral Percentage Test and the Actual Contribution Percentage Test will be
[PLAN SEC. 19.2 AND 19.3] applied using the ... [select the method being used for the Plan Year for which this
Adoption Agreement is effective]: [NOTE: IF THE PLAN IS DESIGNATED AS A SAFE-HARBOR
PLAN, IT WILL BE DEEMED TO BE USING THE CURRENT YEAR TESTING METHOD - THUS, B. MUST BE
ELECTED BELOW.]
a. [X] prior year testing method. [NOTE: IF THE PLAN FIRST IS REQUIRED TO APPLY THE ACTUAL
DEFERRAL PERCENTAGE TEST OR ACTUAL CONTRIBUTION PERCENTAGE TEST IN A PLAN YEAR BEGINNING
ON OR AFTER JANUARY 1, 1997 (AND THE PLAN IS NOT A SUCCESSOR PLAN), AND THE PRIOR YEAR
TESTING METHOD IS USED FOR SUCH PLAN YEAR, THEN THE TEST WILL BE APPLIED FOR SUCH PLAN
YEAR USING THE GREATER OF (i) 3%, OR (ii) THE ACTUAL DEFERRAL PERCENTAGE OR ACTUAL
CONTRIBUTION PERCENTAGE, AS APPROPRIATE, OF THE NON-HIGHLY COMPENSATED EMPLOYEES FOR
SUCH PLAN YEAR.]
b. [ ] current year testing method. [NOTE: THE CURRENT YEAR TESTING ELECTION CAN BE CHANGED
ONLY UNDER CIRCUMSTANCES PRESCRIBED BY THE IRS.]
OTHER ELECTIONS REGARDING S.4. In applying the Actual Deferral Percentage Test, ... [check each that applies]:
ADP/ACP TESTING:
a. [X] Employer Regular Matching Contributions (to the extent such contributions satisfy the
requirements to be Employer Qualified Matching Contributions (QMACs))
53
[PLAN SEC. 19.2, 19.3 AND 19.4] b. [X] Employer Regular Profit Sharing Contributions (to the extent such contributions satisfy
the requirements to be Employer Qualified Profit Sharing Contributions (QNECs))
... may be taken into account under such test at the discretion of the Plan
Administrator.
S.5. In applying the Actual Contribution Percentage Test, ... [check each that applies]:
a. [X] Employee Pre-Tax Contributions
b. [X] Employer Regular Profit Sharing Contributions (to the extent such contributions
satisfy the requirements to be Employer Qualified Profit Sharing Contributions (QNECs))
... may be taken into account under such test at the discretion of the Plan
Administrator.
[NOTE: EMPLOYER QUALIFIED MATCHING (QMACs) AND QUALIFIED PROFIT SHARING (QNECs)
CONTRIBUTIONS (IF PERMITTED UNDER THE PLAN) MAY IN ALL CASES BE TAKEN INTO ACCOUNT IN
APPLYING THE ACTUAL DEFERRAL PERCENTAGE TEST AND ACTUAL CONTRIBUTION PERCENTAGE TEST. ALSO,
EMPLOYER SAFE-HARBOR PROFIT SHARING CONTRIBUTIONS MAY BE TAKEN INTO ACCOUNT IN APPLYING THE
ACTUAL CONTRIBUTION PERCENTAGE TEST, BUT ONLY TO THE EXTENT THEY EXCEED THE MINIMUM
CONTRIBUTION REQUIRED TO QUALIFY AS SAFE-HARBOR CONTRIBUTIONS UNDER CODE SECTION 401(k).]
S.6. If Employee After-Tax Contributions are allowed under the Plan, Employee Pre-Tax
Contributions ... [check one]:
a. [X] N/A - Employee After-Tax Contributions are not allowed under the Plan.
b. [ ] may not
c. [ ] may at the discretion of the ... [check one]:
1. [ ] Plan Administrator
2. [ ] affected Participant
... be recharacterized as Employee After-Tax Contributions to the extent necessary to
satisfy the Actual Deferral Percentage Test.
[NOTE: RECHARACTERIZATION IS PERMISSIBLE ONLY IF THE PLAN USES THE CURRENT YEAR TESTING
METHOD AND THE PLAN CURRENTLY ALLOWS EMPLOYEE AFTER-TAX CONTRIBUTIONS, AND THEN ONLY IF THE
RECHARACTERIZED AMOUNT, IN COMBINATION WITH EMPLOYEE AFTER-TAX CONTRIBUTIONS, DOES NOT
EXCEED ANY LIMITS OTHERWISE IMPOSED UNDER THE PLAN ON EMPLOYEE AFTER-TAX CONTRIBUTIONS.]
S.7. If Employer Regular Matching Contributions are forfeited as Excess Aggregate Contributions,
such forfeited amounts will be ... [check a., or check one of b. through d.]:
a. [ ] N/A - the Plan provides for full and immediate vesting of Employer Regular Matching
Contribution Accounts.
b. [X] applied in the same manner as any other Forfeiture from an Employer Regular Matching
Contribution Account.
c. [ ] allocated as of the last day of the Plan Year to which such Employer Regular Matching
Contributions relate among the Non-Highly Compensated Employees with respect to such
Plan Year who are Active Participants in the ... [check one]:
1. [ ] Employee Pre-Tax Component
2. [ ] Employer Regular Matching Component
3. [ ] Employer Regular Profit Sharing Component
... during such Plan Year and who have otherwise satisfied the requirements to receive a
contribution under such Component for such Plan Year. The allocation will be made in
proportion to the Plan Compensation for the Plan Year of each eligible Participant.
d. [ ] applied as a credit against Employer Safe-Harbor and/or Regular Matching
54
Contributions that are made under the Plan, as and when directed by the Lead Employer.
S.8. If the multiple use test is failed for a Plan Year (after corrective contributions or
distributions, if any), ... [check one]:
a. [X] the Actual Contribution Percentage
b. [ ] the Actual Deferral Percentage
c. [ ] the Actual Contribution Percentage and Actual Deferral Percentage (proportionately)
... will be reduced as necessary to satisfy such test. [NOTE: IF CONTRIBUTIONS OF THE SAME
TYPE ARE MADE UNDER MORE THAN ONE PLAN, THE CORRECTION WILL BE MADE UNDER THE PLAN
DESIGNATED BY THE PLAN ADMINISTRATOR.]
GAIN OR LOSS ON EXCESS S.9. The gain or loss allocable to Excess Elective Deferrals that are refunded to a Participant,
CONTRIBUTIONS: or allocable to Excess Contributions or Excess Aggregate Contributions distributed to
[PLAN SEC. 19.1(d), 19.2(d) satisfy the Actual Deferral Percentage Test, Actual Contribution Percentage Test, or
AND 19.3(d)] multiple use test, will be determined using ... [check one]:
a. [X] the safe harbor method specified in the Plan.
b. [ ] a method established by the Plan Administrator that reasonably reflects the manner in
which gain or loss is allocated under the Plan.
S.10. The gain or loss allocated ... [check one]:
a. [X] does not
b. [ ] does
... include gain or loss for the "gap period" - that is, the period from the end of the year
to the date of distribution.
T. SPECIAL EFFECTIVE DATE RULES
T.1. The following Components are added and effective after the Original Effective Date or
Amendment Effective Date specified in Section A ... [check each that applies]:
a. [ ] Employee Pre-Tax Component
Effective Date:_____.
b. [ ] Employee After-Tax Component
Effective Date:_____.
c. [ ] Employer Regular Matching Component
Effective Date:_____[must be the first day of a Matching Contribution Period].
d. [ ] Employer Regular Profit Sharing Component
Effective Date:_____.
e. [ ] Employer Qualified Matching and Qualified Profit Sharing Component
Effective Date:_____.
f. [ ] Employer Prevailing Wage Component
Effective Date:_____.
T.2. The effective date for the following provisions is different than the Original Effective
Date or Amendment Effective Date specified in Section A ... [complete as appropriate]:
a. [X] The Trust Agreement incorporated by reference into this Agreement as it pertains to
those assets contributed for the 2002 profit sharing contribution.
Effective Date: December 15, 2002.
b. [ ] _____.
55
Effective Date:_____.
c. [ ] _____.
Effective Date:_____.
d. [ ] _____.
Effective Date:_____.
U. FROZEN CONTRIBUTIONS ACCOUNTS
U.1. The following Components have been removed, but Contribution Accounts still exist under the
Plan for contributions made under the Component (these are referred to as "Frozen"
Contribution Accounts) ... [check each that applies]: [NOTE: COMPLETE THE FROZEN
CONTRIBUTION ACCOUNT ADDENDUM.]
a. [X] Employee Rollover Component
b. [ ] Employee After-Tax Component
c. [ ] Employee Deductible Component
d. [ ] Employee Safe-Harbor Matching and/or Safe-Harbor Profit Sharing Component
e. [X] Employer Regular Matching Component
f. [ ] Employer Regular Profit Sharing Component (including Prevailing Wage Component)
g. [ ] Employer Qualified Matching and/or Qualified Profit Sharing Component
h. [ ] Employer Pension Component
V. OTHER INFORMATION FOR THE PARTICIPATING EMPLOYERS
Failure to fill out this Adoption Agreement completely and correctly may result in failure of the
Plan to qualify under Code Section 401(a).
The Plan Administrator is responsible for administration of the Plan, including the filing of the
annual report on Form 5500 and the preparation and delivery of summary plan descriptions, summaries
of material modifications and summary annual reports. The Lead Employer and other fiduciaries agree
to obtain bonds as required by law. [ERISA Section 412.]
Inquiries regarding the adoption of the Plan, the meaning of its provisions or the effect of the
opinion letter should be directed to the financial organization or other entity from which the Lead
Employer obtained the Plan or to the Sponsor of the Prototype.
W. SPONSOR OF THE PROTOTYPE
The Sponsor of the Prototype is Scudder Trust Company
Scudder Trust Company
11 Northeastern Boulevard
Salem, NH 03079-1953
Phone Number: (617) 295-1000
The Sponsor of the Prototype (or its authorized representative) will inform the Lead Employer if
any amendments are made to the Prototype Defined Contribution Plan, or if the Prototype Defined
Contribution Plan is discontinued or abandoned.
[The remaining portion of the page is intentionally blank]
56
X. RELIANCE ON IRS OPINION LETTER
The Participating Employers may rely on an opinion letter issued by the Internal Revenue Service
("IRS") as evidence that the Plan is qualified under Code Section 401(a) only to the extent
provided in Announcement 2001-77, 2001-30 I.R.B.
The Participating Employers may not rely on the opinion letter in certain other circumstances or
with respect to certain qualification requirements, which are specified in the opinion letter
issued with respect to the Plan and in Announcement 2001-77.
In order to have reliance in such circumstances or with respect to such qualification requirements,
application for a determination letter must be made to Employee Plans Determinations of the
Internal Revenue Service.
This Adoption Agreement may be used only in conjunction with Basic Plan Document #03.
Y. LEAD EMPLOYER SIGNATURE
IN WITNESS WHEREOF, the Lead Employer has caused this Adoption Agreement to be
adopted effective as of the Original Effective Date or Amendment Effective Date
(in Section A. Preamble).
YOU SHOULD CONSULT WITH AN ATTORNEY OR OTHER INDEPENDENT QUALIFIED ADVISOR AS TO
THE LEGAL AND TAX EFFECT OF ADOPTING THE PLAN.
Date signed: _______________________ Lead Employer: Range Resources Corporation
By: ______________________________________
Name [print]: ________________________
Its [title]: ________________________
57
Z. TRUSTEE OR CUSTODIAN SIGNATURE
FOR TRUST AGREEMENT
The Trustee(s) hereby accepts appointment as such in accordance with the
Prototype Trust Agreement.
FOR INDIVIDUAL TRUSTEE(S) SERVING PURSUANT TO THE "TRUST AGREEMENT FOR
INDIVIDUAL TRUSTEES" (ATTACH ADDITIONAL SHEETS IF NECESSARY)
Date signed:_______________________________
Effective:_________________________________
Trustee (1):______
___________________________________________
Signature
Trustee (2):______
___________________________________________
Signature
Trustee (3):______
___________________________________________
Signature
Trustee (4):______
___________________________________________
Signature
FOR A FINANCIAL ORGANIZATION SERVING PURSUANT TO THE "TRUST AGREEMENT FOR
DIRECTED TRUSTEE" OR THE "TRUST AGREEMENT WITH DISCRETIONARY TRUSTEE OPTION"
Date signed:_______________________________
Effective:_________________________________
Trustee: Scudder Trust Company
By: _______________________________________
Name [print]:__________________________
Its [title]:___________________________
[additional signature is optional]
And: ______________________________________
Name [print]:_________________________
Its [title]:__________________________
OR
FOR CUSTODIAL AGREEMENT
The Custodian hereby accepts its appointment as such in accordance with the
Custodial Agreement.
Date signed:________________________ Custodian: _________________________
Effective:__________________________
By: ________________________________
Name [print]:___________________
Its [title]:____________________
58
SCUDDER TRUST COMPANY
PROTOTYPE DEFINED CONTRIBUTION PLAN
PREDECESSOR EMPLOYER ADDENDUM
The following Predecessor Employers are covered by Section D.13. of the Adoption
Agreement (in addition to those listed in Section D.13. of the Adoption
Agreement):
Employment with the following Predecessor Employer(s) which did not maintain the
Plan ... [complete as appropriate]: [NOTE: CODE SECTION 414(a) REQUIRES THAT
SERVICE WITH A PREDECESSOR EMPLOYER BE TAKEN INTO ACCOUNT IF A PLAN OF THE
PREDECESSOR EMPLOYER IS MAINTAINED BY A CONTROLLED GROUP MEMBER. THE SERVICE
CREDIT IS IN ADDITION TO THAT REQUIRED UNDER CODE SECTION 414(a).]
Name:_____.
Employer Identification Number:.
.... counts as Service for ... [check each that applies]:
1. [ ] eligibility purposes, with Service with the Predecessor Employer
calculated based on ... [check one]:
a. [ ] Hours of Service from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]:_______.
b. [ ] elapsed time from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]:_______.
2. [ ] vesting purposes, with Service with the Predecessor Employer
calculated based on ... [check one]:
a. [ ] Hours of Service from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]:_______.
b. [ ] elapsed time from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]:_______.
However, prior service credit for vesting purposes will be limited to
________ years. [complete if desired.]
3. [ ] determining whether the Participant is entitled to share in the
Employer Regular Matching or Regular Profit Sharing Contribution. For
such Participant, the compensation paid by the Predecessor
Employer ... [check one]:
a. [ ] is not
b. [ ] is
... counted as Plan Compensation for purposes of determining or
allocating the Employer Regular Matching or Regular Profit Sharing
Contribution for the first year of participation under this Plan.
Name:______.
Employer Identification Number:______.
.... counts as Service for ... [check each that applies]:
1. [ ] eligibility purposes, with Service with the Predecessor Employer
calculated based on ... [check one]:
a. [ ] Hours of Service from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]:_______.
b. [ ] elapsed time from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]:_______.
2. [ ] vesting purposes, with Service with the Predecessor Employer
calculated based on ... [check one]:
a. [ ] Hours of Service from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]:_______.
b. [ ] elapsed time from ... [check one]:
1. [ ] last date of hire.
2. [ ] original date of hire.
3. [ ] other [specify]:_______.
However, prior service credit for vesting purposes will be limited
to__________years. [complete if desired.]
3. [ ] determining whether the Participant is entitled to share in the
Employer Regular Matching or Regular Profit Sharing Contribution. For
such Participant, the compensation paid by the Predecessor
Employer ... [check one]:
a. [ ] is not
b. [ ] is
... counted as Plan Compensation for purposes of determining or
allocating the Employer Regular Matching or Regular Profit Sharing
Contribution for the first year of participation under this Plan.
ATTACH ADDITIONAL SHEETS IF NECESSARY.
SCUDDER TRUST COMPANY
PROTOTYPE DEFINED CONTRIBUTION PLAN
PARTICIPATING EMPLOYER ADDENDUM
The following Controlled Group Members are Participating Employers in the Plan
(in addition to those listed in Section B.3. of the Adoption Agreement):
Participating Employer:
Name: _____.
EIN:____.
Participating Employer:
Name: _____.
EIN:____.
Participating Employer:
Name: _____.
EIN:____.
Participating Employer:
Name: _____.
EIN:____.
Participating Employer:
Name: _____.
EIN:____.
Participating Employer:
Name: _____.
EIN:____.
Participating Employer:
Name: _____.
EIN:____.
Participating Employer:
Name: _____.
EIN:____.
Participating Employer:
Name: _____.
EIN:____.
Participating Employer:
Name: _____.
EIN:____.
ATTACH ADDITIONAL SHEETS IF NECESSARY.
SCUDDER
INVESTMENTS
SCUDDER TRUST COMPANY
PROTOTYPE DEFINED CONTRIBUTION PLAN
SUPPLEMENTAL INFORMATION - LEAD EMPLOYER
LEAD EMPLOYER INFORMATION
LEAD EMPLOYER: B.1 a. Lead Employer Name: Range Resources Corporation
[B.1]
B.2. Complete the following information about the Lead Employer ... [complete]:
a. Address ... [complete]:
1. Lead Employer EIN: 34-1312571
2. SIC Code: 324110
3. Address: 777 Main Street Suite 800
4. City: Fort Worth
5. State: Texas
6. Zip Code: 76102
7. Phone Number: 817-870-2601
b. Fiscal year end ... [check one]:
1. [X] December 31 ____________ [month year]
2. [ ] 52/53 week year: [describe]: ______________________________________
c. Type of business entity ... [check one]:
1. [X] C Corporation
2. [ ] S Corporation
3. [ ] Limited Liability Corporation
4. [ ] Partnership
5. [ ] Limited Liability Partnership
6. [ ] Sole Proprietorship
7. [ ] other [specify]: ______
d. Is the Lead Employer a Participating Employer in the Plan?
1. [X] Yes
2. [ ] No
e. Contact person for Lead Employer ... [complete]:
1. Name: Carol Culpepper
2. Phone Number: 817-870-2601
3. E-mail: _________________________________
B.2.1. Are there other business entities that are part of the controlled (or affiliated service)
group of the Lead Employer? ...
a. [ ] Yes [NOTE: FOR EACH CONTROLLED (OR AFFILIATED SERVICE) GROUP MEMBER,
COMPLETE THE SHEET LABELED SUPPLEMENTAL INFORMATION - CONTROLLED GROUP
MEMBERS]
b. [X] No
SCUDDER
INVESTMENTS
SCUDDER TRUST COMPANY
PROTOTYPE DEFINED CONTRIBUTION PLAN
SUPPLEMENTAL INFORMATION - FUNDING VEHICLE
FUNDING INFORMATION
[INSTRUCTION: COMPLETE THE FOLLOWING IF AN INDIVIDUAL OR A COMMITTEE OF
INDIVIDUALS IS A "TRUSTEE" OF ALL OR ANY PORTION OF THE PLAN ASSETS.]
FUNDING VEHICLE: C.5. The Trustee is the following individual or committee of individuals ...
[C.5] [complete]:
1. individual trustee(s) ... [complete]:
a. List the trustee(s)
1. Name: __________________________________________________________________
2. Name: __________________________________________________________________
3. Name: __________________________________________________________________
4. Name: __________________________________________________________________
5. Name: __________________________________________________________________
6. Name: __________________________________________________________________
7. Name: __________________________________________________________________
8. Name: __________________________________________________________________
b. Trustee contact ... [complete]:
1. Name: __________________________________________________________________
2. Address: _______________________________________________________________
3. City: __________________________________________________________________
4. State: _________________________________________________________________
5. Zip Code: ______________________________________________________________
6. Phone Number: __________________________________________________________
7. E-mail: ________________________________________________________________
[INSTRUCTION: COMPLETE THE FOLLOWING IF A FINANCIAL ORGANIZATION IS A "TRUSTEE"
OF ALL OR ANY PORTION OF THE PLAN ASSETS.]
FUNDING VEHICLE: C.5. The Trustee is the following financial organization ... [complete]:
[C.5]
2. a financial organization serving pursuant to the Trust Agreement ... [check one]:
c. [X] Scudder Trust Company
11 Northeastern Boulevard
Salem, N.H. 03079
EIN: 02-0443137
d. [ ] Trustee information ... [complete]:
1. Name: _____________________________________________________________
2. EIN: ______________________________________________________________
3. Address: __________________________________________________________
4. City: _____________________________________________________________
5. State: ____________________________________________________________
6. Zip Code: _________________________________________________________
Trustee contact ... [complete]:
7. Name: _____________________________________________________________
8. Phone Number: _____________________________________________________
9. E-mail: ___________________________________________________________
[INSTRUCTION: COMPLETE THE FOLLOWING IF A FINANCIAL ORGANIZATION IS A
"CUSTODIAN" OF ALL OR ANY PORTION OF THE PLAN ASSETS.]
FUNDING VEHICLE: C.5. The Custodian is the following financial organization ... [complete]:
[C.5]
1. Custodian information ... [complete]:
a. Name: __________________________________________________________________
b. EIN: ___________________________________________________________________
c. Address: _______________________________________________________________
d. City: __________________________________________________________________
e. State: _________________________________________________________________
f. Zip Code: ______________________________________________________________
2. Custodian contact ... [complete]:
a. Name: __________________________________________________________________
b. Phone Number: __________________________________________________________
c. E-mail: ________________________________________________________________
[INSTRUCTION: COMPLETE THE FOLLOWING IF THE PLAN IS FUNDED IN WHOLE OR IN PART
THROUGH A GROUP ANNUITY CONTRACT WITH AN INSURANCE COMPANY (OTHER THAN A GROUP
ANNUITY CONTRACT HELD AS AN ASSET OF A TRUST).]
FUNDING VEHICLE: C.5. The Annuity Funding Contract is with the following insurance company ... [complete]:
[C.5]
1. Insurance company information ... [complete]:
a. Name: __________________________________________________________________
b. EIN: ___________________________________________________________________
c. Address: _______________________________________________________________
d. City: __________________________________________________________________
e. State: _________________________________________________________________
f. Zip Code: ______________________________________________________________
g. Phone Number: __________________________________________________________
2. The contact person is ... [complete]:
a. Name: __________________________________________________________________
b. Phone Number: __________________________________________________________
c. E-mail: ________________________________________________________________
SCUDDER
INVESTMENTS
SCUDDER TRUST COMPANY
PROTOTYPE DEFINED CONTRIBUTION PLAN
SUPPLEMENTAL INFORMATION - PLAN FEATURES
PLAN FEATURE INFORMATION
AGENT FOR LEGAL PROCESS: C.2.1 Who will be the agent for service of legal process? ... [check one]:
a. [X] The contact person for the Lead Employer
b. [ ] The following person ... [complete]:
1. Name: ___________________________________________________________
2. Address: ________________________________________________________
3. City: ___________________________________________________________
4. State: __________________________________________________________
5. Zip Code: _______________________________________________________
6. Phone Number: ___________________________________________________
RELATING TO PARTICIPANT C.7. Participant elections ... be changed by electronic media
ELECTIONS: (e.g., voice response unit or intranet)
a. [X] can
b. [ ] cannot
C.8 The administrative forms used for this Plan ... require approval by the Plan
Administrator ... [check one]:
a. [X] will
b. [ ] will not
C.10 Is the Plan Administrator responsible for processing address changes? ... [check one]:
a. [X] Yes
b. [ ] No, address changes are done via telephone with the recordkeeper ... [complete]:
1. The phone number is: _____________________________________
RELATING TO INVESTMENTS: C.11 Are participants allowed to self-direct the investment of any of their accounts? ...
[check one]:
a. [X] Yes ... [complete the following]:
1. In what percentage increments can participant investment changes be made? ...
[check one]:
a. [ ] 5%
b. [ ] 10%
c. [X] other [specify]: 1 %
2. Can a participant rebalance the investment of his/her current account when
he/she files investment directions for new contributions? ... [check one]:
a. [ ] Yes
b. [X] No
b. [ ] No
C.11.1 Does the Plan have an Investment Policy? ... [check one]:
a. [X] Yes. [NOTE: COMPLETE THE PARTICIPANT INVESTMENT POLICY QUESTIONNAIRE]
b. [ ] No
C.12 Are participant loans allowed from the plan? ... [check one]:
a. [X] Yes. [NOTE: COMPLETE THE PARTICIPANT LOAN POLICY QUESTIONNAIRE]
b. [ ] No
RELATING TO COLLECTIVE C.9 Are members of any collective bargaining units eligible to participate in the Plan? ...
BARGAINING EMPLOYEES: [check one]:
a. [ ] No
b. [X] Yes, members of the following collective bargaining units are eligible to
participate in the plan ... [specify]:
1. ______________________________________________________________
2. ______________________________________________________________
3. ______________________________________________________________
4. ______________________________________________________________
5. ______________________________________________________________
6. ______________________________________________________________
7. ______________________________________________________________
8. ______________________________________________________________
9. ______________________________________________________________
RELATING TO DEFERRAL F.16 Are deferral elections (changes in enrollment percentage, etc.) - other than the initial
CHANGES: election - required to be done electronically (that is, by voice response or web)? ...
[check one]:
a. [ ] Yes
b. [X] No, a participant can make changes via paper form ... .[complete]:
1. Can a participant elect a deferred date on which a change in his/her deferral
percentage will take effect? ... [check one]:
a. [X] No, all changes are effective as soon as administratively
practicable after the form is filed.
b. [ ] Yes, a participant can specify a later date on which a change will
take effect.
F.17 The initial deferral election can be made ... [check each that applies]:
a. [X] on a paper enrollment form.
b. [X] electronically (that is, by voice response or web).
RELATING TO ROLLOVER L.4 Will the Plan accept a personal check for rollovers? ... [check one]:
CONTRIBUTIONS:
a. [ ] Yes
b. [X] No, only cashier's checks or money orders will be accepted.
RELATING TO DISTRIBUTIONS: P.16 Is a Participant allowed to specify the Contribution Account from which a withdrawal
or distribution is to be made? ... [check one]:
a. [ ] N/A [NOTE: THIS OPTION IS APPROPRIATE ONLY IF THERE IS ONLY ONE CONTRIBUTION
ACCOUNT OR IF WITHDRAWALS OR DISTRIBUTIONS CAN NEVER BE MADE FROM MORE THAN
ONE CONTRIBUTION ACCOUNT.]
b. [ ] Yes
c. [X] No
P.17 Does the plan allow rollover checks to be sent directly to the rollover plan or IRA? ...
[check one]:
a. [ ] Yes
b. [X] No, a check will be sent (made payable to the rollover plan or IRA) to the
Participant.
P.18. Will a rollover option to a specific financial organization be available on the rollover
forms? ... [check one]:
a. [X] Yes, the following financial organization ... [specify]:
Scudder Investments
b. [ ] No, a check will be sent (made payable to the rollover plan or IRA) to the
Participant.
SCUDDER TRUST COMPANY
PROTOTYPE DEFINED CONTRIBUTION PLAN
FROZEN ACCOUNT ADDENDUM
The following vesting and withdrawal rules apply to frozen accounts under this
Plan.
A. FROZEN EMPLOYEE ROLLOVER COMPONENT
VESTING: A.1. A Participant's vested percentage in his/her Frozen Employee Rollover Contribution
[PLAN SEC. 10.2(e)] Account will be 100% at all times.
IN-SERVICE WITHDRAWALS: A.2. Withdrawals are allowed from Frozen Employee Pre-Tax Contribution Accounts...
[PLAN SEC. 11.2] [check a., or check each of b. and c. that applies]:
a. [X] for any reason and at any time.
b. [ ] for any reason after ... [check one]:
1. [ ] Normal Retirement Age (or age 59 1/2, if later).
2. [ ] age 59 1/2.
3. [ ] age _____ [60 or more].
c. [ ] at any age on account of Hardship.
B. FROZEN EMPLOYEE AFTER-TAX COMPONENT
VESTING: B.1. A Participant's vested percentage in his/her Frozen Employee After-Tax Contribution
[PLAN SEC. 10.2(e)] Account will be 100% at all times.
IN-SERVICE WITHDRAWALS: B.2. Withdrawals are allowed from Frozen Employee After-Tax Contribution Accounts...
[PLAN SEC. 11.2] [check one]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason and at any time.
c. [ ] for any reason after ... [check one]:
1. [ ] Normal Retirement Age.
2. [ ] age 59 1/2.
3. [ ] age______.
C. FROZEN EMPLOYEE DEDUCTIBLE COMPONENT
VESTING: C.1. A Participant's vested percentage in his/her Frozen Employee Deductible Contribution
[PLAN SEC. 10.2(e)] Account will be 100% at all times.
IN-SERVICE WITHDRAWALS: C.2. Withdrawals are allowed from Frozen Employee Deductible Contribution Accounts...
[PLAN SEC. 11.2] [check one]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason and at any time.
c. [ ] for any reason after ... [check one]:
1. [ ] Normal Retirement Age.
2. [ ] age 59 1/2.
3. [ ] age_______.
D. FROZEN EMPLOYER SAFE-HARBOR COMPONENT
VESTING: D.1. A Participant's vested percentage in his/her Frozen Employer Safe-Harbor Matching
[PLAN SEC. 10.2(e)] and/or Safe-Harbor Profit Sharing Contribution Account will be 100% at all times.
IN-SERVICE WITHDRAWALS: D.2. Withdrawals are allowed from Frozen Employer Safe-Harbor Matching and/or Safe-
[PLAN SEC. 11.2] Harbor Profit Sharing Contribution Accounts ... [check one]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason after ... [check one]:
1. [ ] Normal Retirement Age (or age 59 1/2 if later).
2. [ ] age 59 1/2.
3. [ ] age_______[60 or more].
c. [ ] for Hardship after age 59 1/2.
E. FROZEN EMPLOYER REGULAR MATCHING COMPONENT
VESTING: E.1. A Participant's vested percentage in his/her Frozen Employer Regular Matching
[PLAN SEC. 10.2(e)] Contribution Account will be ... [check one]:
a. [X] 100% at all times.
b. [ ] determined under the following schedule ... [complete as desired]:
YEARS OF VESTED
SERVICE PERCENTAGE
- -------- ----------
0 0%
1 ____%
2 ____%
3 ____% [20% or more]
4 ____% [40% or more]
5 ____% [60% or more]
6 ____% [80% or more]
7 or more 100%
c. [ ] determined under the following schedule ... [complete as desired]:
YEARS OF VESTED
SERVICE PERCENTAGE
- -------- ----------
0 0%
1 ___%
2 ___%
3 ___%
4 ___%
5 or more 100%
[NOTE: IF THE PLAN IS TOP-HEAVY, AND IF THE VESTING SCHEDULE SPECIFIED ABOVE DOES
NOT SATISFY THE VESTING REQUIREMENTS APPROPRIATE FOR A TOP-HEAVY PLAN UNDER PLAN
SEC. 17.2, THE VESTED PERCENTAGE OF THE PARTICIPANT WILL BE THE GREATER OF THE VESTED
PERCENTAGE DETERMINED UNDER THE VESTING SCHEDULE SPECIFIED ABOVE OR THE APPLICABLE
VESTING SCHEDULE SPECIFIED IN PLAN SEC. 17.2.]
TREATMENT OF FORFEITURES: E.2. A Pending Allocation Account that reflects Forfeitures from Frozen Employer Regular Matching
[PLAN SEC. 5.2(g)] Contribution Accounts ... [check one]:
a. [ ] can
b. [ ] cannot
... be applied to pay administrative expenses of the Plan if so directed by the Plan
Administrator.
E.3. A Pending Allocation Account that reflects Forfeitures from Frozen Employer Regular Matching
Contribution Accounts (to the extent not applied to pay administrative expenses if permitted
in E.2) will be ... [check one]:
a. [ ] applied as a credit against ... [check each that applies]:
1. [ ] Employer Safe-Harbor Matching Contributions
2. [ ] Employer Safe-Harbor and/or Regular Profit Sharing Contributions
... that are made under the Plan, as and when directed by the Lead Employer.
b. [ ] allocated as of the last day of the Plan Year as an additional Employer Profit Sharing
Contribution. The allocation will be made in the same manner (and as part of) any
variable contribution, or in proportion to any fixed contribution, under the Plan.
[NOTE: IF THE PLAN PROVIDES FOR A FIXED EMPLOYER REGULAR PROFIT SHARING CONTRIBUTION
DETERMINED UNDER AN INTEGRATED FORMULA, THE PENDING ALLOCATION ACCOUNT WILL BE ALLOCATED
IN PROPORTION TO PLAN COMPENSATION FOR THE PLAN YEAR.]
c. [ ] allocated as of the last day of the Plan Year in proportion to Plan Compensation for the
Plan Year. The allocation will be among all eligible Participants who are eligible to
receive any Employer Contribution for the Plan Year or, if there are no such
Participants, among all eligible Participants who are eligible to make an Employee
Contribution for the Plan Year.
IN-SERVICE WITHDRAWALS: E.4. Withdrawals are allowed from Frozen Employer Regular Matching Contribution Accounts ...
[PLAN SEC. 11.2] [check a., or check each of b. through d. that applies]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [X] for any reason after ... [check one]:
1. [ ] Normal Retirement Age.
2. [X] age 59 1/2.
3. [ ] age ______ [check each that applies]:
a. [ ] and completion of _________ years of ... [check one]:
1. [ ] vesting Service.
2. [ ] participation in the Plan. [NOTE: PARTICIPATION IS
MEASURED ON AN ELAPSED TIME BASIS FROM THE ENTRY
DATE.]
b. [ ] but only if at the time of the withdrawal the Participant is ...
[check one]:
1. [ ] fully vested
2. [ ] at least _________ % vested
... in his/her Frozen Employer Regular Matching Contribution
Account.
4. [ ] completion of _____________ years of ... [check one]:
a. [ ] vesting Service.
b. [ ] participation in the Plan. [NOTE: PARTICIPATION IS MEASURED ON AN
ELAPSED TIME BASIS FROM THE ENTRY DATE.]
c. [ ] at any age on account of Hardship ... [check if applicable]:
1. [ ] but only if at the time of the withdrawal the Participant is ... [check one]:
a. [ ] fully vested
b. [ ] at least __________ % vested
... in his/her Frozen Employer Regular Matching Contribution Account.
d. [ ] for any reason, but only if at the time of the withdrawal the Participant is fully
vested in his/her Frozen Employer Regular Matching Contribution Account, and provided
the withdrawal may not include amounts allocated to the Contribution Account within two
years prior to the withdrawal ... [check if applicable]: [NOTE: THE CALCULATION OF THE
MAXIMUM AMOUNT AVAILABLE FOR WITHDRAWAL IS SET FORTH IN PLAN SEC. 11.2(a).]
1. [ ] unless the Participant has completed five years of participation in the Plan.
[NOTE: PARTICIPATION IS MEASURED ON AN ELAPSED TIME BASIS FROM THE ENTRY
DATE.]
F. FROZEN EMPLOYER REGULAR PROFIT SHARING COMPONENT
VESTING: F.1. A Participant's vested percentage in his/her Frozen Employer Regular Profit Sharing
[PLAN SEC. 10.2(e)] Contribution Account will be ... [check one]:
a. [ ] 100% at all times. [Skip to F.4.]
b. [ ] determined under the following schedule ... [complete as desired]:
YEARS OF VESTED
SERVICE PERCENTAGE
-------- ----------
0 0%
1 _____%
2 _____%
3 _____% [20% or more]
4 _____% [40% or more]
5 _____% [60% or more]
6 _____% [80% or more]
7 or more 100%
c. [ ] determined under the following schedule ... [complete as desired]:
YEARS OF VESTED
SERVICE PERCENTAGE
-------- ----------
0 0%
1 _____%
2 _____%
3 _____%
4 _____%
5 or more 100%
[NOTE: IF THE PLAN IS TOP-HEAVY, AND IF THE VESTING SCHEDULE SPECIFIED ABOVE DOES NOT
SATISFY THE VESTING REQUIREMENTS APPROPRIATE FOR A TOP-HEAVY PLAN UNDER PLAN SEC. 17.2, THE
VESTED PERCENTAGE OF THE PARTICIPANT WILL BE THE GREATER OF THE VESTED PERCENTAGE DETERMINED
UNDER THE VESTING SCHEDULE SPECIFIED ABOVE OR THE APPLICABLE VESTING SCHEDULE SPECIFIED IN
PLAN SEC. 17.2.]
TREATMENT OF FORFEITURES: F.2. A Pending Allocation Account that reflects Forfeitures from Frozen Employer Regular Profit
[PLAN SEC. 6.2(c)] Sharing Contribution Accounts ... [check one]:
a. [ ] can
b. [ ] cannot
... be applied to pay administrative expenses of the Plan if so directed by the Plan
Administrator.
F.3. A Pending Allocation Account that reflects Forfeitures from Frozen Employer Regular Profit
Sharing Contribution Accounts (to the extent not applied to pay administrative expenses if
permitted in F.2) will be ... [check one]:
a. [ ] applied as a credit against ... [check each that applies]:
1. [ ] Employer Safe-Harbor and/or Regular Matching Contributions
2. [ ] Employer Safe-Harbor Profit Sharing Contributions
... that are made under the Plan, as and when directed by the Lead Employer.
b. [ ] allocated as of the last day of the Plan Year in proportion to Plan Compensation for the
Plan Year. The allocation will be among all eligible Participants who are eligible to
receive any Employer Contribution for the Plan Year or, if there are no such
Participants, among all eligible Participants who are eligible to make an Employee
Contribution for the Plan Year.
IN-SERVICE WITHDRAWALS: F.4. Withdrawals are allowed from Frozen Employer Regular Profit Sharing Contribution Accounts...
[PLAN SEC. 11.2] [check a., or check each of b. through d. that applies]:
a. [ ] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason after ... [check one]:
1. [ ] Normal Retirement Age.
2. [ ] age 59 1/2.
3. [ ] age ____ ... [check each that applies]:
a. [ ] and completion of ______ years of ... [check one]:
1. [ ] vesting Service.
2. [ ] participation in the Plan. [NOTE: PARTICIPATION IS
MEASURED ON AN ELAPSED TIME BASIS FROM THE ENTRY DATE.]
b. [ ] but only if at the time of the withdrawal the Participant is...
[check one]:
1. [ ] fully vested
2. [ ] at least _____ % vested
... in his/her Frozen Employer Regular Profit Sharing Contribution
Account.
4. [ ] completion of ______ years of ... [check one]:
a. [ ] vesting Service.
b. [ ] participation in the Plan. [NOTE: PARTICIPATION IS MEASURED ON AN
ELAPSED TIME BASIS FROM THE ENTRY DATE.]
c. [ ] at any age on account of Hardship ... [check if applicable]:
1. [ ] but only if at the time of the withdrawal the Participant is ... [check one]:
a. [ ] fully vested
b. [ ] at least _____ % vested
... in his/her Frozen Employer Regular Profit Sharing Contribution Account.
d. [ ] for any reason, but only if at the time of the withdrawal the Participant is fully
vested in his/her Frozen Employer Regular Profit Sharing Contribution Account, and
provided the withdrawal may not include amounts allocated to the Contribution Account
within two years prior to the withdrawal ... [check if applicable]: [NOTE: THE
CALCULATION OF THE MAXIMUM AMOUNT AVAILABLE FOR WITHDRAWAL IS SET FORTH IN PLAN SEC.
11.2(a).]
1. [ ] unless the Participant has completed five years of participation in the Plan.
[NOTE: PARTICIPATION IS MEASURED ON AN ELAPSED TIME BASIS FROM THE ENTRY
DATE.]
G. FROZEN EMPLOYER QUALIFIED MATCHING AND PROFIT SHARING COMPONENT
VESTING: G.1. A Participant's vested percentage in his/her Frozen Employer Qualified Matching and/or
[PLAN SEC. 10.2(e)] Qualified Profit Sharing Contribution Account will be 100% at all times.
G.2. Withdrawals are allowed from Frozen Employer Qualified Matching and/or Qualified Profit
IN-SERVICE WITHDRAWALS: Sharing Contribution Accounts ... [check one]:
[PLAN SEC. 11.2]
a. [ ] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason after ... [check one]:
1. [ ] Normal Retirement Age (or age 59 1/2, if later).
2. [ ] age 59 1/2.
3. [ ] age ______ [60 or more].
c. [ ] for Hardship after age 59 1/2.
H. FROZEN EMPLOYER PENSION COMPONENT
VESTING: H.1. A Participant's vested percentage in his/her Frozen Employer Pension Contribution Account
[PLAN SEC. 10.2(e)] will be ... [check one]:
a. [ ] 100% at all times. [Skip to H.4.]
b. [ ] determined under the following schedule ... [complete as desired]:
YEARS OF VESTED
SERVICE PERCENTAGE
- -------- ----------
0 0%
1 ___%
2 ___%
3 ___% [20% or more]
4 ___% [40% or more]
5 ___% [60% or more]
6 ___% [80% or more]
7 or more 100%
c. [ ] determined under the following schedule ... [complete as desired]:
YEARS OF VESTED
SERVICE PERCENTAGE
- -------- ----------
0 0%
1 ___%
2 ___%
3 ___%
4 ___%
5 or more 100%
[NOTE: IF THE PLAN IS TOP-HEAVY, AND IF THE VESTING SCHEDULE SPECIFIED ABOVE DOES NOT
SATISFY THE VESTING REQUIREMENTS APPROPRIATE FOR A TOP-HEAVY PLAN UNDER PLAN SEC. 17.2, THE
VESTED PERCENTAGE OF THE PARTICIPANT WILL BE THE GREATER OF THE VESTED PERCENTAGE
DETERMINED UNDER THE VESTING SCHEDULE SPECIFIED ABOVE OR THE APPLICABLE VESTING SCHEDULE
SPECIFIED IN PLAN SEC. 17.2.]
TREATMENT OF FORFEITURES: H.2. A Pending Allocation Account that reflects Forfeitures from Frozen Employer Pension
[PLAN SEC. 7.2] Contribution Accounts ... [check one]:
a. [ ] can
b. [ ] cannot
... be applied to pay administrative expenses of the Plan if so directed by the Plan
Administrator.
H.3. A Pending Allocation Account that reflects Forfeitures from Frozen Employer Pension
Contribution Accounts (to the extent not applied to pay administrative expenses if
permitted in H.2) will be ... [check one]:
a. [ ] applied as a credit against ... [check each that applies]:
1. [ ] Employer Safe-Harbor and/or Regular Matching Contributions
2. [ ] Employer Safe-Harbor and/or Regular Profit Sharing Contributions
... that are made under the Plan, as and when directed by the Lead Employer.
b. [ ] allocated as of the last day of the Plan Year as an additional ... [check one]:
1. [ ] Employer Regular Matching Contribution.
2. [ ] Employer Regular Profit Sharing Contribution. [NOTE: IF THE PLAN PROVIDES
FOR A FIXED CONTRIBUTION DETERMINED UNDER AN INTEGRATED FORMULA, THE
ALLOCATION WILL BE MADE IN PROPORTION TO PLAN
COMPENSATION FOR THE PLAN YEAR.]
The allocation will be made in the same manner as (and as part of) any variable
contribution, or in proportion to any fixed contribution, under the Plan. [NOTE: IF THE
PLAN PROVIDES FOR A VARIABLE CONTRIBUTION (E.G., A DISCRETIONARY CONTRIBUTION), AND A
CONTRIBUTION IS NOT MADE FOR A PLAN YEAR, THE ALLOCATION WILL BE MADE IN THE SAME
MANNER AS THE VARIABLE CONTRIBUTION WOULD HAVE BEEN ALLOCATED.]
c. [ ] allocated as of the last day of the Plan Year in proportion to Plan Compensation for
the Plan Year. The allocation will be among all eligible Participants who are eligible
to receive any Employer Contribution for the Plan Year or, if there are no such
Participants, among all eligible Participants who are eligible to make an Employee
Contribution for the Plan Year.
IN-SERVICE WITHDRAWALS: H.4. Withdrawals are allowed from Frozen Employer Pension Contribution Accounts ... [check one]:
[PLAN SEC. 11.2]
a. [ ] N/A - in-service withdrawals are not allowed.
b. [ ] for any reason after Normal Retirement Age.
SPECIAL TESTING RULES ADDENDUM
THIS SPECIAL TESTING RULES ADDENDUM MUST BE COMPLETED IF THIS AMENDMENT TO THE
PLAN IS BEING MADE IN ORDER TO RETROACTIVELY DOCUMENT THE ADMINISTRATIVE CHOICES
MADE IN RESPONSE TO CHANGES IN THE LAW RESULTING FROM THE URUGUAY ROUND
AGREEMENTS ACT ("GATT"), THE UNIFORM SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS
ACT ("USERRA"), THE SMALL BUSINESS JOB PROTECTION ACT OF 1996 ("SBJPA"), THE
TAXPAYER RELIEF ACT OF 1997 ("TRA '97"), THE INTERNAL REVENUE SERVICE
RESTRUCTURING AND REFORM ACT OF 1998 OR THE COMMUNITY RENEWAL TAX RELIEF ACT OF
2000 (COLLECTIVELY REFERRED TO AS "GUST").
THE ELECTIONS SET FORTH IN THE ADOPTION AGREEMENT WILL CONTROL FOR PLAN YEARS
BEGINNING ON AND AFTER THE AMENDMENT EFFECTIVE DATE OF THE ADOPTION AGREEMENT
THAT IMPLEMENTS THE CHANGES REQUIRED BY GUST. THE FOLLOWING ELECTIONS RELATE
ONLY TO PLAN YEARS BEGINNING PRIOR TO SUCH AMENDMENT EFFECTIVE DATE.
HIGHLY COMPENSATED EMPLOYEES
EXPLANATION: Code Section 414(q) allows two elections for purposes of
determining the Highly Compensated Employees. First, a "top-paid group" election
generally allows the Highly Compensated Employees (other than more than
five-percent owners) to be limited to the top 20% of employees when ranked by
compensation. Second, if the plan year is other than the calendar year, a
"calendar year" election generally allows the Highly Compensated Employees to be
determined based on calendar year compensation instead of plan year
compensation. These elections are first available for plan years beginning on or
after January 1, 1997.
ELECTION (1): Specify whether the "top-paid group" election did or did not apply
for the specified Plan Year ... [complete]:
For the Plan Year Did the top-paid
beginning on or after group election
January 1 of the following year: apply?
- -------------------------------- ------------------------
1997 [ ] did [X] did not ... apply
1998 [ ] did [X] did not ... apply
1999 [ ] did [X] did not ... apply
2000 [ ] did [X] did not ... apply
2001 [ ] did [X] did not ... apply
ELECTION (2): Specify whether the "calendar year" election did or did not apply
for the specified Plan Year ... [complete]: [NOTE: DO NOT COMPLETE FOR ANY YEAR
FOR WHICH THE CALENDAR YEAR WAS THE PLAN YEAR.]
For the Plan Year Did the calendar
beginning on or after year election
January 1 of the following year: apply?
- -------------------------------- ------------------------
1997 [ ] did [X] did not ... apply
1998 [ ] did [X] did not ... apply
1999 [ ] did [X] did not ... apply
2000 [ ] did [X] did not ... apply
2001 [ ] did [X] did not ... apply
[NOTE: DEPENDING ON YOUR ADOPTION AGREEMENT, THE "CALENDAR YEAR" ELECTION MAY
NOT BE AVAILABLE FOR PLAN YEARS BEGINNING ON OR AFTER THE AMENDMENT EFFECTIVE
DATE OF YOUR NEW ADOPTION AGREEMENT.]
ACTUAL DEFERRAL/CONTRIBUTION PERCENTAGE TEST
EXPLANATION: Code Section 401(k) requires that elective deferrals annually
satisfy an Actual Deferral Percentage (ADP) Test. Further, Code Section 401(m)
requires that after-tax contributions and matching contributions annually
satisfy an Actual Contribution Percentage (ACP) Test. Starting for the first
plan year beginning on or after January 1, 1997, the ADP and ACP Tests must
either be applied using a "prior year" or "current year" testing methodology.
ELECTION (1): For each specified Plan Year in which the Plan was subject to the
ADP Test, specify whether the "prior year" or "current year" testing methodology
applied for purposes of the ADP Test ... [complete]: [NOTE: IF THE PLAN WAS A
SAFE-HARBOR PLAN UNDER CODE SECTION 401(k)(12) FOR ANY PLAN YEAR BEGINNING ON OR
AFTER JANUARY 1, 1999, THE "CURRENT YEAR" METHOD MUST BE SPECIFIED FOR THAT PLAN
YEAR.]
For the Plan Year Which testing method
beginning on or after was used to apply
January 1 of the following year: the ADP Test?
- -------------------------------- ----------------------------------
1997 [X] current year [ ] prior year ... method
1998 [X] current year [ ] prior year ... method
1999 [X] current year [ ] prior year ... method
2000 [X] current year [ ] prior year ... method
2001 [X] current year [ ] prior year ... method
ELECTION (2): For each specified Plan Year in which the Plan was subject to the
ACP Test, specify whether the "prior year" or "current year" testing methodology
applied for purposes of the ACP Test ... [complete]: [NOTE: IF THE PLAN WAS A
SAFE-HARBOR PLAN UNDER CODE SECTION 401(m)(11) FOR ANY PLAN YEAR BEGINNING ON OR
AFTER JANUARY 1, 1999, THE "CURRENT YEAR" METHOD MUST BE SPECIFIED FOR THAT PLAN
YEAR.]
For the Plan Year Which testing method
beginning on or after was used to apply
January 1 of the following year: the ACP Test?
- -------------------------------- ----------------------------------
1997 [X] current year [ ] prior year ... method
1998 [X] current year [ ] prior year ... method
1999 [X] current year [ ] prior year ... method
2000 [X] current year [ ] prior year ... method
2001 [X] current year [ ] prior year ... method
FAMILY AGGREGATION RULES
EXPLANATION: Code Section 401(a)(17) previously applied certain "family
aggregation rules" to determine the annual compensation limit of A participant.
Those family aggregation rules were repealed effective as of the first plan year
beginning on or after January 1, 1997. However, the Plan voluntarily may have
continued to apply the family aggregation rules for this purpose until it is
amended for GUST.
ELECTION: The Plan discontinued the family aggregation rules as of the Plan Year
beginning on or after ... [check one]:
a. [X] January 1, 1997.
b. [ ] the Amendment Effective Date of the Adoption Agreement that implements
the changes required by GUST.
c. [ ] ________ [a date between the dates specified in a. and b.]
CASH-OUT AMOUNT
EXPLANATION: Code Section 411(a)(11) previously allowed involuntary "cash-out"
of amounts not in excess of $3,500. This limit was raiseD to $5,000 effective as
of the first plan year beginning after August 5, 1997. However, the Plan
voluntarily may have continued the $3,500 (or a lower) cash-out amount.
ELECTION: The Plan implemented the higher cash-out amount now specified in the
Adoption Agreement as of...[check one]:
a. [X] the first day of the first Plan Year beginning after August 5, 1997.
b. [ ] the Amendment Effective Date of the Adoption Agreement that implements
the changes required by GUST.
c. [ ] [a date between the dates specified in a. and b.]
d. [ ] N/A - the cash-out amount has not been increased by the Amendment
Effective Date of the Adoption Agreement that implements the changes
required by GUST.
REQUIRED BEGINNING DATE
EXPLANATION: Code Section 401(a)(9) previously required that minimum
distributions commence to any participant as of the April 1 of the calendar year
after the calendar year in which he/she attained age 70 1/2 (even if he/she
remained employed with the employer sponsoriNg the plan). This "required
beginning date" was changed for participants who are still employed after age 70
1/2 (but not for more thAn five percent owners) effective January 1, 1997.
However, the Plan voluntarily may have continued to determine the required
beginning date based on the definition in effect prior to January 1, 1997.
ELECTION (1): The Plan implemented the new required beginning date as of ...
[check one]:
a. [X] January 1, 1997.
b. [ ] the Amendment Effective Date of the Adoption Agreement that implements
the changes required by GUST.
c. [ ]_____ [a date between the dates specified in a. and b.]
d. [ ] N/A - the new required beginning date has not been implemented by the
Amendment Effective Date of the Adoption Agreement that implements the
changes required by GUST. [NOTE: THIS OPTION IS NOT APPROPRIATE FOR PLANS
ADOPTED OR ORIGINALLY EFFECTIVE ON OR AFTER JANUARY 1, 1997.]
ELECTION (2): A Participant who attained age 70 1/2 prior to the date specified
above and who has not had a Termination of Service ... [check one]: [NOTE: DO
NOT COMPLETE IF d. IS SELECTED ABOVE.]
a. [X] may not elect to stop minimum distributions.
b. [ ] may elect to stop minimum distributions and recommence such
distributions by the April 1 of the calendar year after the calendar year
of his/her Termination of Service, and the new commencement date ... [check
one]:
1. [ ] will
2. [ ] will not
... be treated as a new Benefit Starting Date for purposes of the
Plan. [NOTE: THE OPTION TO STOP MINIMUM DISTRIBUTIONS DOES NOT APPLY
TO A PARTICIPANT WHO IS A MORE THAN FIVE-PERCENT OWNER IN THE PLAN
YEAR ENDING IN THE CALENDAR YEAR IN WHICH HE/SHE ATTAINS AGE 70 1/2.]
COMBINED PLAN LIMIT
EXPLANATION: Code Section 415(e) previously imposed a "combined plan limit" if
an employer maintained both a defined contribution plan anD a defined benefit
plan. This limit was repealed effective for Limitation Years beginning on or
after January 1, 2000. However, the Plan voluntarily may have continued to apply
the limit until it is amended for GUST.
ELECTION: The Plan eliminated the combined plan limit effective as of the first
Limitation Year beginning on or after ... [check one]:
a. [X] January 1, 2000.
b. [ ] the Amendment Effective Date of the Adoption Agreement that implements
the changes required by GUST.
c. [ ] ______ [a date between the dates specified in a. and b.]
d. [ ] N/A - no Controlled Group Member has maintained a defined benefit plan
after January 1, 2000, covering any Participant in this Plan.
ECONOMIC GROWTH AND TAX RELIEF RECONCILIATION ACT OF 2001
PLAN ADDENDUM
THE ECONOMIC GROWTH AND TAX RELIEF RECONCILIATION ACT OF 2001 ("EGTRRA") MADE A
NUMBER OF CHANGES TO THE PLAN - SOME MANDATORY AND SOME OPTIONAL. THIS EGTRRA
ADDENDUM INCLUDES BOTH THE REQUIRED CHANGES TO THE PLAN AND THE ELECTIVE
PROVISIONS.
USE OF THIS ADDENDUM: For a Plan with an Original Effective Date prior to
January 1, 2002, use this Addendum to amend the Plan for the provisions of
EGTRRA. This Addendum must be adopted by the Lead Employer by the end of the
Plan Year beginning in 2002. For a Plan with an Original Effective Date on or
after January 1, 2002, use this Addendum to supplement the Adoption Agreement
for plan options which are not reflected on the Adoption Agreement. This
Addendum should be adopted with the Adoption Agreement.
PREAMBLE
1. ADOPTION AND EFFECTIVE DATE OF AMENDMENT. Except as otherwise provided,
this Addendum shall be effective as of the first day of the first Plan Year
beginning after December 31, 2001 (or the Plan's Original Effective Date,
if later). This Addendum is intended as good faith compliance with the
requirements of EGTRRA and is to be construed in accordance with EGTRRA and
guidance issued thereunder.
2. INCONSISTENT PROVISIONS. This Addendum shall supersede the provisions of
the Basic Plan Document and the Adoption Agreement to the extent those
provisions are inconsistent with the provisions of this Addendum.
LEAD EMPLOYER OPTIONS
THE FOLLOWING AMENDMENTS REFLECT PROVISIONS OF EGTRRA ON WHICH CHOICES ARE
AVAILABLE TO LEAD EMPLOYERS. LEAD EMPLOYERS MUST COMPLETE THE FOLLOWING
ELECTIONS AND SIGN THIS ADDENDUM ON THE FINAL PAGE. IF YOU DO NOT COMPLETE THIS
ADDENDUM, THE DEFAULT PROVISIONS OF THE BASIC PLAN DOCUMENT WILL CONTINUE TO
APPLY.
PLAN COMPENSATION
EXPLANATION: Tax law limits the amount of a Participant's earnings that can be
considered for purposes of Plan contributions. For the 2001 Plan Year, the limit
was $170,000. Under EGTRRA, this limit was increased to $200,000 in 2002, and
will be adjusted for inflation in future years. This increase is not mandatory
and a Plan on a non-standardized adoption agreement may elect to remain at the
$170,000 limit indefinitely, with no adjustments for inflation. However, a Plan
must use $200,000 (or the applicable yearly limit) for the purposes of
calculating Employer Safe-Harbor Matching or Safe-Harbor Profit Sharing
Contributions for Plan Years beginning on or after January 1, 2002. Please note
that if the Lead Employer has otherwise limited Plan Compensation to a specific
dollar amount under Section E.2. of the Adoption Agreement, it may be
unnecessary to complete this election.
ELECTION: PLAN COMPENSATION. Will the Plan limit Plan Compensation to $170,000
for Plan Years beginning on or after January 1, 2002? ... [check if applicable]:
a. [ ] Yes. [NOTE: NOT A VALID OPTION FOR A PLAN ON A STANDARDIZED ADOPTION
AGREEMENT. THIS LIMIT WILL NOT APPLY FOR THE PURPOSES OF EMPLOYER
SAFE-HARBOR MATCHING OR SAFE-HARBOR PROFIT SHARING CONTRIBUTIONS.]
[NOTE: UNLESS a. IS CHECKED ABOVE, THE PLAN COMPENSATION LIMIT WILL BE $200,000
FOR THE 2002 PLAN YEAR AND WILL CONTINUE TO BE ADJUSTED FOR COST OF LIVING
INCREASES IN FUTURE YEARS. HOWEVER, IF THE LEAD EMPLOYER HAS LIMITED PLAN
COMPENSATION UNDER SECTION E.2.d. OF THE ADOPTION AGREEMENT, THAT LIMITATION
WILL CONTINUE TO APPLY, REGARDLESS OF THE ELECTION MADE ABOVE.]
ROLLOVERS DISREGARDED IN CASH-OUTS
EXPLANATION: Effective January 1, 2002, a Plan may opt to calculate an
involuntary cash-out amount by disregarding the balance of the Participant's
Employee Rollover Account. If this election is made, the balance of the
Participant's Employee Rollover Account will not be considered when determining
if the Participant is subject to the cash-out. For example, a Participant with
an Employee Rollover Account balance of $10,000 may be cashed-out of the Plan,
provided the balance of his/her other Plan Accounts is under the cash-out amount
then in effect for the Plan.
ELECTION: TREATMENT OF EMPLOYEE ROLLOVER CONTRIBUTIONS IN THE APPLICATION OF THE
CASH-OUT PROVISION. Does the Plan exclude Employee Rollover Contributions (and
earnings allocable thereto) in determining whether the Participant's Benefit is
subject to involuntary cash-out?...[check if applicable]:
a. [ ] Yes. This rule applies to all...[complete if applicable]:
1. [ ] distributions made after ________ [enter a date no earlier
than December 31, 2001]
2. [ ] Participants who separated from service after ________
[enter a date; date may be earlier than December 31, 2001]
[NOTE: EMPLOYEE ROLLOVER ACCOUNT BALANCES WILL BE CONSIDERED IN DETERMINING
CASH-OUTS UNLESS a. IS CHECKED ABOVE. IF a. IS CHECKED, BUT NEITHER 1. NOR 2. IS
COMPLETED, THE NEW RULE WILL APPLY AS OF THE FIRST DAY OF THE PLAN YEAR IN WHICH
THIS ADDENDUM IS SIGNED.]
ROLLOVERS
EXPLANATION: A Plan that accepts rollover contributions will accept rollovers
from qualified plans and conduit IRAs. Starting with the first Plan Year
beginning after December 31, 2001, a Plan may accept rollover contributions and
direct rollovers from additional retirement savings vehicles - 403(b) plans,
certain 457 plans, non-conduit IRAs (but only those amounts attributable to
pre-tax or deductible contributions to the IRA), and rollovers of after-tax
contributions to a retirement plan. If the Plan elects to receive after-tax
contributions, the Plan must separately account for such amounts in order to
track basis. In addition, the basis rules are different for certain after-tax
contributions, depending when made.
ELECTION: ADDITIONAL ROLLOVER SOURCES. Specify the additional sources from which
the Plan will accept rollovers ... [check each of a. through d. that applies]:
a. [ ] Annuity contracts described in Code Section 403(b).
b. [ ] Code Section 457(b) plans maintained by a state, political subdivision
of a state, or any agency or instrumentality of A state or political
subdivision of a state.
c. [ ] IRAs described in Code Section 408(a) or (b) (to the extent the
distribution that is eligible to be rolled over is otherwise
includible in gross income).
d. [ ] After-tax contributions to Code Section 401(a) or 403(a) plan
(excluding after-tax IRA and Roth IRA contributions).
[NOTE: PLANS THAT ELECTED TO ACCEPT ROLLOVER CONTRIBUTIONS IN THE ADOPTION
AGREEMENT WILL AUTOMATICALLY ACCEPT ROLLOVER CONTRIBUTIONS FROM QUALIFIED PLANS
AND CONDUIT IRAs. IF YOU DO NOT COMPLETE THIS ELECTION, ROLLOVER CONTRIBUTIONS
WILL NOT BE ACCEPTED FROM THE NEW SOURCES DESCRIBED IN a. THROUGH d. ABOVE.]
Special Effective Date [complete if any of a. through d. above are checked]:
This provision will be effective as of _____ [month, day, year]. [NOTE: IF THE
EFFECTIVE DATE IS NOT SPECIFIED, THIS PROVISION WILL BE EFFECTIVE ON THE FIRST
DAY OF THE PLAN YEAR IN WHICH THIS ADDENDUM IS SIGNED.]
SUSPENSION PERIOD FOLLOWING HARDSHIP DISTRIBUTION
EXPLANATION: Effective January 1, 2002, Plans may impose a 6 month pre-tax and
after-tax deferral suspension period following a hardship withdrawal made after
December 31, 2001. (Prior to January 1, 2002, the Plan imposed a twelve month
suspension period following a hardship.) This change is mandatory for
safe-harbor plans within the meaning of Code Section 401(k)(12) and 401(m)(11)
(planS that avoid ADP and ACP testing by making 100% vested matching or profit
sharing contributions to the Plan under Article H. of the Adoption Agreement).
ELECTION 1: Will the Plan impose a 6 month suspension period following a
hardship withdrawal made after December 31, 2001? ... [check if applicable]:
a. [X] Yes.
[NOTE: THE SUSPENSION PERIOD WILL BE 12 MONTHS UNLESS a. IS CHECKED ABOVE.
HOWEVER, IF THIS PLAN IS A SAFE-HARBOR PLAN UNDER ARTICLE H. OF THE ADOPTION
AGREEMENT, THE SUSPENSION PERIOD WILL BE 6 MONTHS REGARDLESS OF YOUR ELECTION
ABOVE.]
EXPLANATION: Plans may also limit the suspension period for a hardship
withdrawal taken in 2001 to the later of 6 months after receipt of the
distribution or January 1, 2002. A Plan with an Original Effective Date on or
after January 1, 2002, should not complete this election.
ELECTION 2: Will the Plan shorten the suspension period imposed following a
hardship withdrawal made in 2001 to the later of 6 months after the receipt of
the hardship distribution or January 1, 2002? ...[check if applicable]:
a. [ ] Yes.
[NOTE: THE SUSPENSION PERIOD FOLLOWING HARDSHIP WITHDRAWALS MADE IN 2001 WILL BE
12 MONTHS UNLESS a. IS CHECKED ABOVE.]
VESTING SCHEDULE
EXPLANATION: For Plan Years beginning on or after January 1, 2002, Plans are
required to vest Participants in their Matching Contributions at least as
quickly as a six-year graded schedule or a three-year cliff schedule. This
change is required for all Matching Contributions on Elective Deferrals made
after January 1, 2002. For a Plan in existence prior to 2002, the vesting
schedule elected below (if different) replaces the vesting schedule elected in
Section I.11. of the Adoption Agreement for all Matching Contributions made for
Plan Years beginning on or after January 1, 2002. For a Plan with an Original
Effective Date on or after January 1, 2002, the vesting schedule elected below
applies to all Matching Contributions made to the Plan and Section I.11. of the
Adoption Agreement does not apply.
ELECTION 1: VESTING SCHEDULE FOR EMPLOYER MATCHING CONTRIBUTIONS. A
Participant's vested percentage in his/her Employer Regular Matching
Contributions made for Plan Years beginning on or after January 1, 2002 will be
.... [check one]:
a. [ ] 100% at all times.
b. [ ] determined under the following schedule ... [complete as desired]:
Years of Service Vested Percentage
- ---------------- -----------------
0 0%
1 %
2 % [20% or more]
3 % [40% or more]
4 % [60% or more]
5 % [80% or more]
6 or more 100%
c. [ ] determined under the following schedule ... [complete as desired]:
Years of Service Vested Percentage
- ---------------- -----------------
0 0%
1 %
2 %
3 100%
d. [ ] vesting schedule in Section I.11. of the Adoption Agreement complies
with (a), (b) or (c). [NOTE: NOT A VALID OPTION FOR A PLAN WITH AN
ORIGINAL EFFECTIVE DATE ON OR AFTER JANUARY 1, 2002.]
[NOTE: IF THE PLAN MATCHES EMPLOYEE CATCH-UP CONTRIBUTIONS, THOSE MATCHING
CONTRIBUTIONS WILL ALSO VEST ON THE SCHEDULE LISTED ABOVE. IF THE LEAD EMPLOYER
DOES NOT COMPLETE THIS ELECTION AND THE PLAN'S VESTING SCHEDULE DOES NOT SATISFY
THE NEW REQUIREMENTS, A GRADED VESTING SCHEDULE WILL BE DEEMED TO BE A SIX YEAR
GRADED SCHEDULE (20% PER YEAR, STARTING AT TWO YEARS OF SERVICE) AND A CLIFF
VESTING SCHEDULE WILL BE DEEMED TO BE A THREE YEAR CLIFF SCHEDULE (WITH FULL
VESTING AT 3 YEARS OF SERVICE).]
EXPLANATION: Plans may also apply the vesting schedule elected above to past
Employer Regular Matching Contributions and to Employer Regular Profit Sharing
Contributions for all Active Participants. Plans with an Original Effective Date
on or after January 1, 2002, should not complete Election 2. For a Plan with an
Original Effective Date prior to January 1, 2002, the Elections below will
replace the applicable elections in the Adoption Agreement, if different,
including Sections I.11. and J.9. of the Adoption Agreement. If the revised
schedule is not applied to past matching contributions, a separate source will
be required to track the vested percentage of the pre-2002 and post-2001
Matching Contributions.
ELECTION 2: OTHER CONTRIBUTIONS. Specify the other contributions (which are
currently subject to a vesting schedule), if any, to which the revised vesting
schedule will apply...[check a., or each of b. and c. that applies]:
a. [ ] N/A - the revised vesting schedule only applies to Employer Regular
Matching Contributions made for Plan Years beginning on or after
January 1, 2002.
b. [ ] all Employer Regular Matching Contributions, whenever made.
c. [ ] also to Employer Regular Profit Sharing Contributions ... [check one]:
1. [ ] whenever made.
2. [ ] made for Plan Years beginning on or after January 1, 2002.
[NOTE: UNLESS b. OR c. IS CHECKED ABOVE, THE REVISED VESTING SCHEDULE WILL ONLY
APPLY TO MATCHING CONTRIBUTIONS MADE FOR PLAN YEARS BEGINNING ON OR AFTER
JANUARY 1, 2002. IF b. OR c. IS CHECKED ABOVE, THE REVISED VESTING SCHEDULE WILL
ONLY APPLY TO THE SPECIFIED ACCOUNTS OF PARTICIPANTS WHO ARE ACTIVE PARTICIPANTS
AT SOME TIME DURING THE 2002 PLAN YEAR. IF VESTING OCCURS AT A SLOWER RATE UNDER
THE REVISED SCHEDULE, THE ELECTION PROVISIONS OF PLAN SECTION 10.2(k) WILL
APPLY.]
EMPLOYEE CATCH-UP CONTRIBUTIONS
EXPLANATION: Effective January 1, 2002, a Plan may now allow Participants age 50
or over (plus those projected to attain age 50) in the applicable year to make
additional pre-tax contributions ("Employee Catch-up Contributions") to the Plan
when the Participant's pre-tax contributions are otherwise limited under the
Plan or by law. However, if a Plan allows for Employee Catch-up Contributions,
all plans in the Controlled Group that allow for pre-tax contributions must
generally provide Participants with the same "effective opportunity" to make
Employee Catch-up Contributions.
ELECTION 1: EMPLOYEE CATCH-UP CONTRIBUTIONS. Will Employee Catch-up
Contributions be allowed under this Plan? ... [check one]:
a. [ ] No.
b. [X] Yes. This provision will be effective as of ... [check one]:
1. [X] January 1, 2002.
2. [ ] The first day of the Plan Year beginning __ [specify date no
earlier than January 1, 2002].
3. [ ] Other __ [specify date no earlier than January 1, 2002].
[NOTE: THE PLAN WILL NOT ACCEPT EMPLOYEE CATCH-UP CONTRIBUTIONS UNLESS b. IS
CHECKED ABOVE. EMPLOYEE CATCH-UP CONTRIBUTIONS WILL GENERALLY BE SUBJECT TO THE
SAME ADMINISTRATIVE OPTIONS AND REQUIREMENTS THAT APPLY TO EMPLOYEE PRE-TAX
CONTRIBUTIONS UNDER THE PLAN (E.G., THE DATES AS OF WHICH A PAY REDUCTION
AGREEMENT MAY BE MODIFIED, ETC.).]
ELECTION 2: MAXIMUM CONTRIBUTIONS. Employee Catch-up Contributions will be
limited to ...[complete if applicable]:
a. [ ] A maximum of ______ % of Plan Compensation each payroll period.
[NOTE: IN ADDITION TO ANY PERCENTAGE LIMIT ON CONTRIBUTIONS ELECTED ABOVE,
EMPLOYEE CATCH-UP CONTRIBUTIONS WILL BE LIMITED TO THE DOLLAR AMOUNT FOR THE
APPLICABLE YEAR UNDER THE TAX LAWS.]
EMPLOYER CATCH-UP MATCHING CONTRIBUTIONS
EXPLANATION: Plans that allow Employee Catch-up Contributions may decide to
match those contributions. While Employee Catch-up Contributions are generally
exempt from the Plan's testing requirements, including the Actual Deferral
Percentage Test, any matching contributions made on these Employee Catch-up
Contributions will be considered in the Plan's testing. Employer Catch-up
Matching Contributions will be allocated in the same manner and under the same
formula as other Employer Regular Matching Contributions (or Employer
Safe-Harbor Matching Contributions) made under the Plan.
ELECTION: EMPLOYER CATCH-UP MATCHING CONTRIBUTIONS. Will the Plan match Employee
Catch-up Contributions?...[check one]:
a. [X] No.
b. [ ] Yes. This provision will be effective as of ... [check one]:
1. [ ] January 1, 2002.
2. [ ] The first day of the Plan Year beginning ________ [specify
date no earlier than January 1, 2002].
3. [ ] Other ________ [specify date no earlier than January 1,
2002].
[NOTE: EMPLOYER CATCH-UP MATCHING CONTRIBUTIONS WILL NOT BE MADE UNLESS b. IS
CHECKED ABOVE. EMPLOYER CATCH-UP MATCHING CONTRIBUTIONS WILL BE DETERMINED UNDER
THE SAME FORMULA USED FOR EMPLOYER REGULAR MATCHING CONTRIBUTIONS (OR EMPLOYER
SAFE-HARBOR MATCHING CONTRIBUTIONS).]
MANDATORY PLAN AMENDMENTS
THE FOLLOWING AMENDMENTS ARE MANDATORY CHANGES TO YOUR BASIC PLAN DOCUMENT AS A
RESULT OF EGTRRA. ALTHOUGH YOU DO NOT HAVE TO MAKE ANY CHOICES ON THESE
PROVISIONS, YOU SHOULD READ THROUGH THE CHANGES TO SEE HOW THEY AFFECT YOUR
PLAN.
SECTION 2.56(f) - PLAN COMPENSATION
Effective January 1, 2002, Plan Section 2.56(f) is amended to add the following
sentence at the end of the subsection:
If so specified in the Adoption Agreement (or addendum thereto), for Plan
Years beginning on or after January 1, 2002, Plan Compensation will be
limited to $170,000, the Code Section 401(a)(17) limit in effect for 2001.
SECTION 2.70 - TERMINATION OF SERVICE
Effective for distributions made after December 31, 2001, Plan Section 2.70 is
amended to replace the words "separation from service" with the words "severance
from employment". In addition, the following sentence is added to the end of the
section:
The "severance from employment" standard applies to all distributions made
after December 31, 2001, regardless of when the severance from employment
occurred.
SECTION 4.1 - PRE-TAX CONTRIBUTIONS
Effective January 1, 2002, Plan Section 4.1(e) is amended to add the following
to the end of the subsection:
However, the limit in this subsection does not apply to any contributions
permitted by the Plan and specified in the Adoption Agreement (or addendum
thereto) which are subject to Code Section 414(v).
Effective January 1, 2002, Plan Section 4.1 is amended to add a new subsection
(i) to read as follows:
(i) Employee Catch-up Contributions. If so specified in the Adoption
Agreement (or addendum thereto), an eligible Active Participant may
elect to have his/her Plan Compensation further reduced to make
additional pre-tax contributions to the Plan, as provided in Code
Section 414(v) and regulations thereunder. Such additional
contributions are Employee Catch-up Contributions. To be eligible to
make Employee Catch-up Contributions, the Active Participant must be
otherwise eligible to make Employee Pre-Tax Contributions and must be
age 50 or older. For purposes of this rule, a Participant who is
projected to attain age 50 before the end of a calendar year is deemed
to be age 50 as of January 1 of that year.
Except to the extent required by applicable regulations, such Employee
Catch-up Contributions shall not be taken into account for purposes of
the provisions of the Plan implementing the required limitations of
Code Section 401(a)(30) and 415(c). The Plan shall not be treated as
failing to satisfy the provisions of the Plan implementing Code
Section 401(k)(3), 401(a)(4), 401(k)(3), 401(k)(11), 410(b) or 416, as
applicable, by reason of allowing such Employee Catch-up
Contributions.
Employee Catch-up Contributions may not exceed the limit in effect
under Code Section 414(v) for such taxable year. All Catch-up
Contributions made by the Participant to any qualified plan or Code
Section 403(b), 408(k) or 408(p) plan sponsored by a Controlled Group
Member will be aggregated for purposes of this limit.
Employee Catch-up Contributions under the Plan will be administered in
accordance with Code Section 414(v) and any applicable regulations or
other IRS guidance thereunder.
Employee Catch-up Contributions will be subject to the same
administrative options and requirements that apply to Employee Pre-Tax
Contributions, as specified in the Adoption Agreement or other Plan
procedures.
SECTION 4.5 - ROLLOVER CONTRIBUTIONS
Effective January 1, 2002, Plan Section 4.5 is amended to replace the second
paragraph with the following:
An "Employee Rollover Contribution" means a rollover contribution or
rollover amount from another qualified plan or "conduit" individual
retirement account described in Code Section 401(a)(31), 402(c), 403(a)(4)
or 408(d)(3), or an elective transfer described in Treas. Reg. Section
1.411(d)-4(Q&A-3), as allowed under the Code as in effect on December 31,
2001. As of the first day of the Plan Year beginning in 2002, or any later
date that may be indicated in the Adoption Agreement (or addendum hereto),
"Employee Rollover Contribution" also includes rollover contributions from
the sources, if any, specified in the Adoption Agreement (or addendum
thereto).
SECTION 5.2 - REGULAR MATCHING CONTRIBUTIONS
Effective January 1, 2002, Plan Section 5.2 is amended to add a new subsection
(h) to read as follows:
(h) Matching Employee Catch-up Contributions. If so specified in the
Adoption Agreement (or addendum thereto), the Employer will make
Employer Catch-up Matching Contributions on the Employee Catch-up
Contributions made under the Plan. Employer Catch-up Matching
Contributions will be allocated in the same manner as Employer Regular
Matching Contributions (or Employer Safe-Harbor Matching
Contributions). Any such Employer Catch-up Matching Contributions
under the Plan will be administered in accordance with Code Section
414(v) and any applicable regulations or other IRS guidance
thereunder.
SECTION 10.2 - VESTING SCHEDULE FOR EMPLOYER REGULAR MATCHING CONTRIBUTIONS
Effective January 1, 2002, Plan Section 10.2 is amended to add a new subsection
(n) to read as follows:
(n) Vesting of Employer Matching Contributions. Notwithstanding any
provision of the Plan to the contrary, all Employer Regular and
Catch-up Matching Contributions made for Plan Years beginning on or
after January 1, 2002, shall vest as specified in the Adoption
Agreement (or addendum thereto), provided such vesting schedule
satisfies the requirements of Code Section 411(a). If the specified
vesting schedule does not satisfy the requirements of Code Section
411(a), a graded vesting schedule will be deemed to be a six year
graded schedule (20% per year, starting at 2 years of Service) and a
cliff vesting schedule will be deemed to be a three year cliff
schedule (with full vesting at 3 years of Service).
If and to the extent so specified in the Adoption Agreement (or
addendum thereto), the vesting schedule required by Code Section
411(a) will be applied to other Contribution Accounts, including
Employer Regular Matching Contributions made for Plan Years beginning
prior to January 1, 2002, and Employer Regular Profit Sharing
Contributions.
SECTION 11.2(b) - SUSPENSION PERIOD FOLLOWING HARDSHIP DISTRIBUTION
Effective January 1, 2002, Plan Section 11.2(b)(3)(B)(iii) is amended to add the
following paragraph:
If so specified in the Adoption Agreement (or addendum thereto), for
withdrawals made on or after January 1, 2002, the Participant's Pre-Tax and
After-Tax Contributions, Elective Deferrals and other voluntary
contributions will be suspended for a period of six months after such
withdrawal. For Plans that are safe-harbor plans within the meaning of Code
Section 401(k)(12) or 401(m)(11), the suspension period is six months after
such withdrawal. For withdrawals made in 2001, the suspension period will
be the later of 6 months after the receipt of the distribution or January
1, 2002, if so specified in the Adoption Agreement (or addendum thereto).
Effective January 1, 2002, Plan Section 11.2(b)(3)(B)(iv) is amended to add the
following paragraph:
Effective January 1, 2002, this paragraph (iv) shall cease to apply to this
Plan.
SECTION 11.3(g) - PLAN LOANS FOR OWNER-EMPLOYEES AND SHAREHOLDER EMPLOYEES
Plan Section 11.3(g), prohibiting Plan loans to any owner-employee or
shareholder-employee, shall cease to apply effective for Plan loans made after
December 31, 2001.
SECTION 12.4 - CASH-OUT OF SMALL BENEFITS
Effective January 1, 2002, Plan Section 12.4 is amended to add the following
paragraph:
If so specified in the Adoption Agreement (or addendum thereto), Benefits
attributable to Employee Rollover Contributions, and earnings thereon,
shall be disregarded in determining the cash-out amount.
SECTION 12.8 - DIRECT ROLLOVERS
Effective for distributions made after December 31, 2001, Plan Section
12.8(c)(1) is amended to replace subsections (C) and (D) as follows:
(C) Any distribution to the extent such a distribution is attributable to
a Hardship.
(D) Any portion of a distribution shall not fail to be an Eligible
Rollover Distribution merely because the portion consists of after-tax
employee contributions which are not includible in gross income.
However, such portion may be transferred only to an individual
retirement account or annuity described in Code Section 408(a) or (b),
or to a qualified defined contribution plan described in Code Section
401(a) or 403(a) that agrees to separately account for amounts so
transferred, including separately accounting for the portion of such
distribution which is includible in gross income and the portion of
such distribution which is not so includible.
Effective for distributions made after December 31, 2001, Plan Section
12.8(c)(3) is amended to read as follows:
(3) "Eligible Retirement Plan" - means an individual retirement account
described in Code Section 408(a), an individual retirement annuity
described in Code Section 408(b), an annuity plan described in Code
Section 403(a), a qualified trust described in Code Section 401(a), an
annuity contract described in Code Section 403(b), an eligible plan
under Code Section 457(b) which is maintained by a state, political
subdivision of a state, or any agency or instrumentality of a state or
political subdivision of a state and which agrees to separately
account for amounts transferred into such plan from this Plan, or any
other plan
or account allowed under future legislation or regulation that accepts
the Eligible Rollover Distribution. The definition of Eligible
Retirement Plan also applies in the case of a distribution to a
surviving spouse, or to a spouse or former spouse who is the alternate
payee under a qualified domestic relations order, as defined in Code
Section 414(p).
SECTION 12.17 - SPECIAL DISTRIBUTION PROVISIONS
Effective January 1, 2002, Plan Section 12.17 is amended to add the following
sentence to the end of the section:
Effective January 1, 2002, subsections (b) and (c) shall cease to apply to
this Plan.
ARTICLE XVII - TOP-HEAVY RULES
For Plan Years beginning after December 31, 2001, Plan Section 17.1(a) is
amended to add the following paragraph:
As of the first day of the Plan Year beginning on or after January 1, 2002,
Employer Regular and Catch-up Matching Contributions under this Plan (and
employer matching contributions under any other plan whose contributions
are to be used to satisfy the requirements of this section) may be used to
satisfy the minimum amount of employer contributions which must be
allocated under this section. Matching Contributions that are used to
satisfy the requirements of this section shall be treated as Employer
Regular and Catch-up Matching Contributions for purposes of the Actual
Contribution Percentage Test and other requirements of Code Section 401(m).
For Plan Years beginning after December 31, 2001, Plan Section 17.1(b) is
amended to add a new paragraph (7) to read as follows:
(7) As of the first day of the Plan Year beginning on or after January 1,
2002, this Article XVII shall not apply in any year in which the Plan
consists solely of a cash or deferred arrangement which meets the
requirements of Code Section 401(k)(12) and Safe-Harbor Matching
Contributions with respect to which the requirements of Code Section
401(m)(11) are met.
For Plan Years beginning after December 31, 2001, Plan Section 17.4(b) is
amended to read as follows:
(b) Key Employee - means any individual defined as such in Code Section
416(i); generally, any Employee or former Employee (including the
Beneficiary of a deceased Employee or former Employee) who at any time
during the Plan Year that includes the Determination Date was:
(1) An officer having Top-Heavy Compensation greater than $130,000
(as adjusted under Code Section 416(i)(1) for Plan Years
beginning after December 31, 2002).
(2) A five-percent owner.
(3) A one-percent owner who has Top-Heavy Compensation of more than
$150,000.
The determination of who is a Key Employee will be made in accordance
with Code Section 416(i)(1) and the applicable regulations and other
guidance of general applicability issued thereunder.
For Plan Years beginning after December 31, 2001, Plan Section 17.4(l) is
amended to add a new paragraph (5) to read as follows:
(5) As of the first day of the Plan Year beginning on or after January 1,
2002, any distribution due to severancen from employment, death or
disability which was made prior to the one-year period ending on the
Determination Date shall be disregarded for purposes of applying the
top-heavy rules. Paragraphs (1) and (2) of this subsection shall also
apply to distributions under a terminated plan which, had it not been
terminated, would have been aggregated with this Plan under Code
Section 416(a)(2)(A)(i). If an individual has not performed services
for the employer at any time during the one-year period ending on the
Determination Date, any account balance or accrued benefit for such
individual shall not be taken into account.
SECTION 18.4(a) - ANNUAL ADDITIONS
Effective January 1, 2002, Plan Section 18.4(a) is amended to add the following
paragraph:
Annual Additions do not include any Employee Rollover Contribution made to
this Plan. For Plan Years commencing in 2002 or later, any contributions to
the Plan determined to be Employee Catch-up Contributions under Code
Section 414(v) are not Annual Additions.
SECTION 18.4(j) - MAXIMUM PERMISSIBLE AMOUNT
For Limitation Years beginning after December 31, 2001, Plan Section 18.4(j) is
amended to read as follows:
(j) Maximum Permissible Amount - means the maximum Annual Addition that
may be contributed or allocated to a Participant's Contribution
Accounts under the Plan for any Limitation Year, which (except to the
extent permitted under Code Section 414(v), if applicable) will not
exceed the lesser of:
(1) $40,000, (as adjusted for increases in the cost-of-living under
Code Section 415(d)).
If a short Limitation Year is created because of an amendment
changing the Limitation Year to a different
twelve-consecutive-month period, the dollar limit above will be
multiplied by the number of months (full months) in the short
Limitation Year and divided by 12.
(2) 100% of the Participant's 415 Compensation for the Limitation
Year.
The limitation referred to in paragraph (2) will not apply to any
contribution for medical benefits (within the meaning of Code
Section 401(h) or 419A(f)(2)) which is otherwise treated as an
Annual Addition under Code Section 415(l)(1) or 419A(d)(2).
SECTION 19.4 - MULTIPLE USE TEST
Effective January 1, 2002, Plan Section 19.4 is amended to add a new subsection
(c) to read as follows:
(c) This section will not apply to any Plan Years beginning on or after
January 1, 2002.
SECTION 19.6(h) - EXCESS DEFERRALS
Effective January 1, 2002, Plan Section 19.6(h) is amended to add the following
sentence to the end of the subsection:
However, in determining Excess Deferrals, any contributions to the Plan
subject to Code Section 414(v) shall be disregarded.
LEAD EMPLOYER SIGNATURE
IN WITNESS WHEREOF, the Lead Employer has caused this EGTRRA Addendum to be
adopted effective as of the date specified below.
YOU SHOULD CONSULT WITH AN ATTORNEY OR OTHER INDEPENDENT QUALIFIED ADVISOR AS TO
THE LEGAL AND TAX EFFECT OF ADOPTING THIS ADDENDUM.
Date signed: _______________________________ Lead Employer: Range Resources
Corporation.
By: ______________________________
Name [print]: _______________
Its [title]: ________________