Full Text
DEFERRAL AMOUNT CHANGE FORM ACCG Retirement Services 457(b) Deferred Compensation Plan Section I Section II Participant Signature PLEASE GIVE THIS FORM TO YOUR PAYROLL OFFICE SO THEY CAN CHANGE YOUR DEFERRAL AMOUNT. Do not return this form to ACCG Retirement Services. Participant Phone Number: Social Security Jurisdiction: Please change my deferral amount for each pay period to: I wish to defer the following percentage each payroll period as a 457(b) Plan pre-tax deferral: % (Whole % only) I wish to defer the following percentage each payroll period as a Roth 457(b)* Plan deferral: % *The Roth 457(b) option may not be offered by your plan. Please confirm with (Whole % only) your Employer to find out if this option is available. TOTAL: % (Whole % only) Greene County 0