Exhibit 10.11
Volume Submitter 401(k) Profit Sharing Plan
Adoption Agreement
EMPLOYER INFORMATION
Related Employers - If the Adopting Employer is part of a controlled group of corporations (as defined in Code Section 414(b) as modified by Code Section 415(h)), a group of commonly controlled trades or businesses (as defined in Code Section 414(c) as modified by Code Section 415(h)) or an affiliated service group (as defined in Code Section 414(m)) of which the Adopting Employer is a part, or any other entity required to be aggregated with the Adopting Employer pursuant to Code Section 414(o), then such related employers will participate in this Plan only if listed on Attachment B, Participating Employer Form. Failure to include related employers may cause a violation of the coverage rules in Code Section 410(b). Additions to or deletions from Attachment B, Participating Employer Form do not constitute amendments to this Plan.
SECTION ONE: EFFECTIVE DATES
Complete Part A or B
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Part A. |
þ | New Plan Effective Date | ||||
| This is the initial adoption of a 401(k) profit sharing plan by the Adopting Employer. | ||||||
| The Effective Date of this Plan is January 01, 20 10 . | ||||||
| The Effective Date for Elective Deferrals under this Plan, if different from above, is: | ||||||
| NOTE: The Effective Date is usually the first day of the Plan Year in which this Adoption Agreement is signed and may not be earlier than such date. Elective Deferrals, however, cannot be made available before the later of the date this Adoption Agreement is signed or the Effective Date for Elective Deferrals . | ||||||
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Part B. |
¨ | Existing Plan Amendment or Restatement Date | ||||
| This is an amendment or restatement of an existing qualified plan (a Prior Plan). | ||||||
| The Prior Plan was initially effective on . | ||||||
| The Effective Date of this amendment or restatement is 02 /10 /2010 (except as, otherwise provided on Attachment C, Special Effective Date(s), if applicable, or in the Basic Plan Document). | ||||||
| The Effective Date for Elective Deferrals under this Plan, if added by this amendment and different from above, is: | ||||||
| Pre-Tax Elective Deferrals (select one) | ||||||
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Option 1: |
¨ | The next payroll date coinciding with or following the later of the date this Adoption Agreement is signed or the Effective Date. | ||||
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Option 2: |
¨ | (Must be on or after the later of the date this Adoption Agreement is signed or the Effective Date) | ||||
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NOTE: If no option is selected, Option 1 will apply for Pre-Tax Elective Deferrals. |
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| Roth Elective Deferrals (select one) |
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Option 1: |
¨ | The next payroll date coinciding with or following the later of the date this Adoption Agreement is signed or the Effective Date. | ||||
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Option 2: |
¨ |
(Must be on or after the later of the date this Adoption Agreement is signed or the Effective Date) |
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| NOTE: If no option is selected. Option 1 will apply for Roth Elective Deferrals. |
| NOTE: The restatement Effective Date is generally the first day of the Plan Year in which this Adoption Agreement is signed. An amendment or restatement Effective Date after the first day of the Plan Year in which this Adoption Agreement is signed may result in a reduction or elimination of accrued benefits, violating Code Section 411(d)(6). Notwithstanding the foregoing Effective Dates for certain items (e.g., EGTRRA and other government pronouncements) are governed by the dates specified in the Basic Plan Document. If Elective Deferrals are being made available for the first time as a result of this amendment or restatement, the Elective Deferrals cannot be made available before the later of the date this Adoption Agreement is signed or the Effective Date for Elective Deferrals. If different Effective Dates are selected for Pre-Tax and Roth Elective Deferrals, the Effective Date for Pre-Tax Elective Deferrals must be either the same date or an earlier date than that selected for Roth Elective Deferrals. |
SECTION TWO: ELIGIBILITY
Complete Parts A through G
NOTE: Eligibility requirements selected for Elective Deferrals will also apply to Qualified Nonelective Contributions, if such contributions are made to the Plan Eligibility requirements selected for Matching Contributions will apply to Qualified Matching Contributions, if such contributions are made to the Plan.
| Part A | Age and Years of Eligibility Service |
| 1. | Age Requirement. An Employee will be eligible to become a Participant in the Plan for purposes of becoming a Contributing Participant (and thus eligible to make Elective Deferrals), receiving Matching Contributions, or receiving an allocation of any Employer Profit Sharing Contributions, as applicable, made pursuant to Section Three of the Adoption Agreement, after attaining the following age (select and complete all that apply): |
| þ | Elective Deferrals – Age 21 (no more than 21). |
| þ | Matching Contributions – Age 21 (no more than 21). |
| þ | Employer Profit Sharing Contributions – Age 21 (no more than 21). |
NOTE: If no age is specified for a contribution source there will be no age requirement for such source.
| 2. | Years of Eligibility Service Requirement. An Employee will be eligible to become a Participant in the Plan for purposes of becoming a Contributing Participant (and thus eligible to make Elective Deferrals), receiving Matching Contributions, or receiving an allocation of any Employer Profit Sharing Contributions as applicable, made pursuant to Section Three of the Adoption Agreement (select and complete all that apply): |
| ¨ | No Eligibility Service Required. |
| If this option is selected, there will be no eligibility service requirement for the following contributions (select all that apply): |
| ¨ | Elective Deferrals. |
| ¨ | Matching Contributions. |
| ¨ | Employer Profit Sharing Contributions. |
| þ | After completing 03 consecutive Months of Eligibility Service (no more than 12) . |
| If this option is selected, an Employee will be eligible to become a Participant in the Plan for purposes of the following contributions after completing the Months of Eligibility Service specified above (select all that apply): |
| þ | Elective Deferrals. |
| þ | Matching Contributions. |
| ¨ | Employer Profit Sharing Contributions. |
| ¨ | After completing consecutive Months of Eligibility Service (no more than 12) during which the Employee completes at least 0 Hours of Service (no more than 1000). |
| NOTE: Employees not meeting the hours requirement within the initial number of months indicated in the Adoption Agreement will satisfy the Month of Eligibility Service requirement when they complete 1,000 Hours of Service within the Eligibility Computation Period. |
| If this option is selected, an Employee will be eligible to become a Participant in the Plan for purposes of the following contributions after completing the Months of Eligibility Service and Hours of Service specified above (select all that apply): |
| ¨ | Elective Deferrals. |
| ¨ | Matching Contributions. |
| ¨ | Employer Profit Sharing Contributions. |
After Completing 1 Year of Eligibility Service.
| þ | If this option is selected, an Employee will be eligible to become a Participant in the Plan for purposes of the following contributions after completing one Year of Eligibility Service (select all that apply): |
| ¨ | Elective Deferrals. |
| ¨ | Matching Contributions. |
| þ | Employer Profit Sharing Contributions. |
| ¨ | After completing 2 Years of Eligibility Service. |
If this option is selected, an Employee will be eligible to become a Participant in the Plan for purposes of the following contributions after completing 2 Years of Eligibility Service (select all that apply).
¨ Matching Contributions.
¨ Employer Profit Sharing Contributions.
| ¨ | Other. |
If this option is selected, an Employee will be eligible to become a Participant in the Plan for purposes of the following contributions after completing the following requirements (select and complete all that apply):
¨ Elective Deferrals (Cannot require more than 1 Year of Eligibility Service).
¨ Matching Contributions (Cannot require more than 2 Years of Eligibility Service) months .
¨ Employer Profit Sharing Contributions (Cannot require more than 2 Years of Eligibility Service) months .
NOTE: If no Year of Eligibility Service requirement is selected for a contribution source, an Employee will become eligible to become a Participant upon date of hire with respect to such source. A Participant cannot be required to complete more than one Year of Eligibility Service for Elective Deferrals or two Years of Eligibility Service for Matching Contributions and Employer Profit Sharing Contributions. If more than one Year of Eligibility Service is selected in this Section Two, Part A for either Matching Contributions or Employer Profit Sharing Contributions, the immediate 100 percent vesting schedule in Section Four will automatically apply to such contribution source.
| 3. | Age and Years of Eligibility Service Waivers |
| a. | Employees Employed as of the Effective Date |
Will an Employee (other than an Employee who either is part of an excluded class of Employees or is employed by a related employer that does not participate in the Plan) employed as of the Effective Date(s) listed in Section One, Part A, of the Adoption Agreement who has not otherwise met the age and Years of Eligibility Service requirements listed above be considered to have met those requirements as of the Effective Date and be eligible to become a Participant in the Plan for purposes of becoming a Contributing Participant (and thus eligible to make Elective Deferrals), receiving Matching Contributions, or receiving an allocation of any Employer Profit Sharing Contributions, as applicable, made pursuant to Section Three of the Adoption Agreement (select one) ?
Option 1 : ¨ Yes.
Option 2: þ No.
NOTE: If no option is selected. Option 2 will apply.
| b. | Employees Employed as of a Specified Date |
Will an Employee (other than an Employee who either is part of an excluded class of Employees or is employed by a related employer that does not participate in the Plan) employed on 02 /10 /2010 (specify a month, day, and year) who has not otherwise met the age and Years of Eligibility Service requirements be considered to have met those requirements and be eligible to become a Participant in the Plan for purposes of becoming a Contributing Participant (and thus eligible to make Elective Deferrals), receiving Matching Contributions, or receiving an allocation of any Employer Profit Sharing Contributions, as applicable, made pursuant to Section Three of the Adoption Agreement (select one) ?
Option 1 : ¨ Yes.
Option 2: þ Not applicable.
NOTE: If no option is selected, Option 2 will apply. If Option 1 is selected but no date is specified, no additional age and Years of Eligibility Service waivers will apply. This age and Years of Eligibility Service waiver may be used either when this Plan is adopted or when the Plan is subsequently amended (e.g., to add one or more types of contribution, to add a previously excluded group of Employees, etc.).
| c. | Mergers and Acquisitions |
Will an Employee (other than an Employee who either is part of an excluded class of Employees or is employed by a related employer that does not participate in the Plan) employed on (specify a month, day, and year) who 1) became an Employee as a result of a merger with or acquisition of the prior employer(s) listed below and 2) has not otherwise met the age and Years of Eligibility Service requirements be considered to have met those requirements and be eligible to become a Participant in the Plan for purposes of becoming a Contributing Participant (and thus eligible to make Elective Deferrals), receiving Matching Contributions, or receiving an allocation of any Employer Profit Sharing Contributions, as applicable, made pursuant to Section Three of the Adoption Agreement (select one) ?
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Option 1: ¨ |
Yes. | |||||
| Prior Employer(s): |
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Option 2: þ |
Not applicable. | |||||
| NOTE: If no option is selected, Option 2 will apply. If Option 1 is selected but no date is specified, no additional age and Years of Eligibility Service waivers will apply. This age and Years of Eligibility Service waiver may be used either when this Plan is adopted or when a merger or acquisition occurs. Waivers that include only Employees from certain prior employers may create testing implications under Code Sections 401(a)(4) or 410(b). | ||||
| Part B. | Exclusion of Certain Classes of Employees | |||
| An Employee will be eligible to become a Participant in the Plan unless such Employee is (select all that apply): | ||||
| þ a. | Included in a unit of Employees covered by a collective bargaining agreement between the Employer and Employee representatives, if retirement benefits were the subject of good faith bargaining and if two percent or less of the Employees who are covered pursuant to that agreement are professionals as defined in Treasury Regulation Section 1.410(b)-9. For this purpose, the term “Employee representatives” does not include any organization in which more than half of the members are Employees who are owners, officers, or executives of the Employer. | |||
| ¨ b. | Not included in a unit of Employees covered by a collective bargaining agreement between the Employer and Employee representatives, if retirement benefits were the subject of good faith bargaining and if two percent or less of the Employees who are covered pursuant to that agreement are professionals as defined in Treasury Regulation Section 1.410(b)-9. For this purpose, the term “employee representatives” does not include any organization more than half of whose members are Employees who are owners, officers, or executives of the Employer. | |||
| þ c. | A nonresident alien (within the meaning of Code Section 7701(b)(1)(B)) who received no earned income (within the meaning of Code Section 911(d)(2)) from the Employer which constitutes income from sources within the United States (within the meaning of Code Section 861(a)(3)). | |||
| þ d. | An Employee as the result of a transaction described in Code Section 410(b)(6)(C). Such Employee will be excluded during the period beginning on the date of the change in the member(s) of the group and ending on the last day of the first Plan Year beginning after the date of the change. A transaction described in Code Section 410(b)(6)(C) is an asset or stock acquisition, merger, or similar transaction involving a change in the employer of the employees of a trade or business. | |||
| ¨ e. | A Leased Employee. | |||
| ¨ f. | A Highly Compensated Employee. | |||
| ¨ g. | An Employee incorrectly determined not to be an Employee (e.g., erroneously classified as an independent contractor). | |||
| ¨ h. | Other (Describe the classification(s) of Employees that will be excluded from the Plan. Classifications cannot be based on time, service or Compensation) | |||
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| NOTE: A related employer will be excluded from the Plan unless such employer signs a Participating Employer Form . | ||||
NOTE: Exclusions of Employees (other than statutorily excluded Employees under Code Section 410(b)(3) and (4) may result in the Plan needing to be amended to include enough Employees to pass the minimum coverage requirements under Code Section 410(b).
NOTE: If item a, is selected, then item b may not be selected. If Item b is selected item a may not be selected. If both item a and b are selected, the Plan will operate as if item b had not been selected .
| 1. | 1,000 Hours of Service (no more than 1,000) shall be required to constitute a Year of Eligibility Service. | |||
| 2. | 500 Hours of Service (no more than 500 and less than the number specified in Part D, item 1, above) must be exceeded to avoid a Break in Eligibility Service. | |||
| NOTE: If no hours are specified, 1,000 and 500 will apply for items 1 and 2, respectively unless the Elapsed Time method of determining service applies. | ||||
| Part E. | Eligibility Computation Period | |||
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An Employee’s Eligibility Computation Periods after their initial Eligibility Computation Period shall be (select one) :
Option 1: þ Each Plan Year commencing with the Plan Year beginning during their initial Eligibility Computation Period.
Option 2: ¨ The 12-consecutive month periods commencing on the anniversaries of their Employment Commencement Date.
NOTE: If no option is selected, Option 1 will apply. |
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| Part F. | Participation Following Breaks in Service | |||
| Will the rehire hold-out rule described in Plan Section 2.04(C) apply for purposes of determining eligibility (select one) ? | ||||
| Option 1: ¨ Yes. | ||||
| Option 2: þ No. | ||||
| NOTE: If no option is selected, Option 2 will apply. | ||||
| Part G. | Election Not To Participate | |||
| May an Employee or a Participant elect not to participate in this Plan pursuant to Section 2.07 of the Plan? | ||||
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Option 1: ¨ Yes.
Option 2: þ No. |
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| NOTE: If no option is selected, Option 2 will apply. | ||||
| SECTION THREE: CONTRIBUTIONS |
| Complete Parts A through I |
| 5. | Claiming Excess Elective Deferrals | |||||||
| A Participant who claims Excess Elective Deferrals for the preceding calendar year must submit their claim in writing to the Plan Administrator by (select one) : | ||||||||
| Option 1: ¨ March 1. | ||||||||
| Option 2: þ Other (specify a date not later than April 15) April 15 . | ||||||||
| NOTE: If no option is selected, Option 1 will apply. If Excess Elective Deferrals are not removed by April 15, they will be includible in income when distributed and may be subject to a 10% early distribution penalty under Code Section 72(t). | ||||||||
| 6. | Automatic Enrollment for Elective Deferrals | |||||||
| a. Authorization of Automatic Elective Deferrals | ||||||||
| Will the Automatic Elective Deferral enrollment Provisions in Plan Section 3.01(E) apply (select one) ? | ||||||||
| Option 1: ¨ Yes. | ||||||||
| Option 2: þ No. | ||||||||
| NOTE: If no option is selected, Option 2 will apply. Complete the remainder of this item 6 only if Option 1 is selected. | ||||||||
| i. | New Employees | |||||||
| If an Employee who has met the eligibility requirements set forth in Section Two of the Adoption Agreement fails to provide the Employer a salary reduction agreement, will a portion of such eligible Employee’s Compensation be automatically withheld and contributed to the Plan as an Elective Deferral (select one) ? | ||||||||
| Option 1: ¨ | Percent. | |||||||||
| Option 2: ¨ | $ . | |||||||||
| NOTE: If no option is selected, Option 1 will apply and three percent of Compensation will be withheld. | ||||||||||
| c. | Tax Character of Elective Deferrals – Automatic Enrollment | |||||||||
| How will amounts automatically withheld from Compensation and contributed to the Plan under Part A, item 6 above as Elective Deferrals be designated for tax purposes (select one) ? | ||||||||||
| Option 1: ¨ | Pre-tax Elective Deferrals. | |||||||||
| Option 2: ¨ | Roth Elective Deferrals. | |||||||||
| NOTE: If no option is selected, Option 1 will apply. Option 2 may only be selected if Section Three, Part A of the Adoption Agreement allows Roth Elective Deferrals. | ||||||||||
| 7. | Automatic Increase in Elective Deferrals | |||||||||
| a. | Authorization of Automatic Elective Deferral Increase | |||||||||
| Will Elective Deferrals be increased automatically each year for Employees who are automatically enrolled under item 6 above (select one) ? | ||||||||||
| Option 1: ¨ | Yes. | |||||||||
| Option 2: þ | No. | |||||||||
| NOTE: If no option is selected, Option 2 will apply. Complete the remainder of this item 7 only if Option 1 is selected. | ||||||||||
| b. | Will Elective Deferrals be increased automatically each year for Employees whose deferral elections are below percent (specify a percentage) , whether or not automatically enrolled under item 6 above? | |||||||||
| Option 1: ¨ | Yes. | |||||||||
| Option 3: ¨ | Two-Tiered Percentage of Contribution Match. | |||||||||
| That percentage of each Qualifying Contributing Participant’s Elective Deferral (and/or Nondeductible Employee Contribution, if applicable) determined by the Contributing Participant’s rate of Elective Deferrals (and/or Nondeductible Employee Contribution, if applicable) as specified in the matching schedule below. | ||||||||||
| Elective Deferral Percentage | Matching Percentage | |||||||||||
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Base Rate |
Less than or equal to % | % | ||||||||||
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Tier 2 |
Greater than , but less than or equal to % | % | ||||||||||
| Notwithstanding the Matching Contribution formula specified above, no Matching Contributions in excess of $ or percent of a Contributing Participant’s Compensation will be made with respect to any Contributing Participant for any Plan Year. (Complete the applicable blank(s), if any) | ||||||||||||
| Option 4: ¨ | Multi-Tiered Percentage of Contribution Match. | |||||||||||
| An amount equal to a percentage of each Qualifying Contributing Participant’s Elective Deferral (and/or Nondeductible Employee Contribution, if applicable) determined by the Contributing Participant’s rate of Elective Deferrals (and/or Nondeductible Employee Contribution, if applicable) as specified in the matching schedule below. | ||||||||||||
| Elective Deferral Percentage | Matching Percentage | |||||||||||
| Base Rate |
Less than or equal to % |
% | ||||||||||
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Tier 2 |
Greater than , but less than or equal to % |
% | ||||||||||
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Tier 3 |
Greater than , but less than or equal to % |
% | ||||||||||
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Tier 4 |
Greater than % |
% | ||||||||||
| Notwithstanding the Matching Contribution formula specified above, no Matching Contributions in excess of $ or percent of a Contributing Participant’s Compensation will be made with respect to any Contributing Participant for any Plan Year. (Complete the applicable blank(s), if any) | ||||||||||||
| Option 5: ¨ | Years of Service Match. | |||||||||||
| An amount equal to a percentage of each Qualifying Contributing Participant’s Elective Deferral (and/or Nondeductible Employee Contribution, if applicable) determined by the number of such Contributing Participant’s Years of ¨ Eligibility ¨ Vesting Service with the Employer as specified in the matching schedule below. | ||||||||||||
| Years of Service | Matching Percentage | |||||||||||
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Base Rate |
Less than or equal to years |
% | ||||||||||
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Tier 2 |
Greater than , but less than or equal to years |
% | ||||||||||
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Tier 3 |
Greater than , but less than or equal to years |
% | ||||||||||
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Tier 4 |
Greater than years |
% | ||||||||||
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Notwithstanding the Matching Contribution formula specified above, no Matching Contributions in excess of $ or percent of a Contributing Participant’s Compensation will be made with respect to any Contributing Participant for any Plan Year. (Complete the applicable blank(s), if any) |
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| Option 6: ¨ | Discretionary Match By Location or Business Classification. | |||||||||||
| Any Matching Contribution will be allocated in a nondiscriminatory manner based upon each Qualifying Contributing Participant’s Elective Deferral (and/or Nondeductible Employee Contribution, if applicable) which the Employer, in its sole discretion, determines from year to year for each separate location or business classification. The amount, the allocation formula, and the percentage or dollar amount limit applicable to such match, if any, is at the complete discretion of the Employer and may vary for each location or business classification on a separate and individual basis. | ||||||||||||
| Option 7: ¨ | Other formula (Specify an amount equal to a percentage of the Elective Deferrals (and/or Nondeductible Employee Contribution, if applicable) of each Qualifying Contributing Participant entitled thereto) | |||||||||||
| . | ||||||||||||
| NOTE: If no option is selected, Option 1 will apply. If Matching Contribution percentages in Options 3 through 7 above increase as the percentage of a Contributing Participant’s Elective Deferral percentage increases (i.e., the Matching Contribution Percentage in Tier 3 may not exceed the number in Tier 2, the Matching Contribution Percentage in Tier 4 may not exceed the number in Tier3, etc.), special nondiscrimination testing under Code Section 401(a)(4) may be necessary. If Option 7 is selected, the formula specified can only allow Matching Contributions to be made with respect to a Contributing Participant’s Elective Deferrals (and/or Nondeductible Employee Contribution, if applicable). Matching Contributions in excess of 100% of a Contributing Participant’s Elective Deferrals (and/or Nondeductible Employee Contribution, if applicable) will be subject to the additional ACP testing limits under Plan Section 3.02 and Treasury Regulation Section 1.401(m)-2(a)(5). | ||||||||||||
| 4. | Supplemental Match | |||||||||||
| Will the Employer be permitted to make supplemental Matching Contributions, in an amount to be determined from year to year at the Employer’s discretion, in addition to the Matching Contributions described in Part B, items 2 and 3 above (select one)? | ||||||||||||
| NOTE: If no suboption is selected. Suboption (a) will apply. | ||||||||||
| The integration level will be (select one) : | ||||||||||
| Suboption (a): | ¨ The Taxable Wage Base. | |||||||||
| Suboption (b): | ¨ $ | (a dollar amount less than the Taxable Wage Base). | ||||||||
| Suboption (c): | ¨ | percent (not more than 100%) of the Taxable Wage Base. | ||||||||
| NOTE: If no suboption is selected, Suboption (a) will apply | ||||||||||
| Allocation = | Points of Qualifying Participant | x | Employer Profit | |||
| Total Points of all Qualifying Participants | Sharing Contribution |
| Step 3: | Make any reallocations as necessary to satisfy either the safe harbor formula for plans with a uniform points allocation or the general test described in Code Section 401(a)(4) and the corresponding Treasury Regulations concerning nondiscrimination in the amount of Employer Profit Sharing Contributions. Identify whether the safe harbor or general test will be satisfied for the selected formula (select one) : | |||||||||
| Allocation Group 6: | ||||||
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| NOTE: If more than six allocation groups are needed, complete Attachment D, New Comparability Allocation Group(s). The Employer must notify the Trustee or Custodian and the Plan Administrator either in writing (or in any other form permitted by rules promulgated by the IRS or DOL) of the amount of the contribution for each group. | ||||||
| ¨ | Flat Dollar (i.e., the same dollar amount for each Qualifying Participant in the applicable allocation group). | |||||
| þ | Pro-rata (i.e., in the ratio that the Compensation of each Qualifying Participant in the applicable allocation group for the Plan Year bears to the total Compensation of all Qualifying Participants in such allocation group for the Plan Year) to the Individual Accounts of all Qualifying Participants in such allocation group. The amounts so allocated shall satisfy the cross-testing gateway requirements set forth in the Plan and shall not exceed the limits imposed by Section 415 of the Internal Revenue Code. (If elected, complete the Interest Rate and Mortality Assumptions and Cross-Testing Gateway sections below) | |||||
| Suboption (c): | ¨ | Employer Contributions shall be allocated based upon the following age and/or service weighted formula (select one) : | ||||
| Option 1: ¨ | Contributions will be allocated based on the following Years of Vesting Service: | |||||
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Years of Vesting Service (Identify categories) |
Allocation Rate | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| Option 2: ¨ | Contributions will be based on the following age of the Participant: | |||||
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Age (Identify categories) |
Allocation Rate | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| Option 3: ¨ | Contributions will be based on the following sum of the age of the Participant and Years of Vesting Service: | |||||
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Sum of Age and Years of Vesting Service (Identify categories) |
Allocation Rate | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
| ____________________ | % | |||||
Interest Rate Assumption and Mortality Table:
For purposes of demonstrating that the Employer Contribution amounts allocated to the Individual Accounts of Participants are nondiscriminatory as required by Section 401(a)(4) of the Code and the regulations thereunder, the following shall apply:
| 1. | Interest Rate. The pre-retirement and post-retirement interest rate assumption shall be (select one) |
Option 1: ¨ 7.5%
Option 2: ¨ 8.0%
Option 3: þ 8.5%
NOTE: If no option is selected, Option 3 will be deemed to be selected.
| 2. | Mortality Table. The mortality table shall be (select one) |
Option 1: þ UP-1984 Mortality Table
Option 2: ¨ 1983 Group Annuity Mortality Table (1983 GAM)
Option 3: ¨ 1983 Individual Annuity Mortality Table (1983 1AM)
Option 4: ¨ 1971 Group Annuity Mortality Table (1971 GAM)
Option 5: ¨ 1971 Individual Annuity Mortality Table (1971 IAM)
NOTE: If no option is selected, Option 1 will be deemed to be selected.
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New Comparability Gateway |
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For purpose of satisfying the new comparability gateway the Plan shall use the following method (select one): |
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| Option 1: ¨ | The Plan will provide benefits that satisfy the broadly available basis requirements described in Plan Section 3.04(B)(9)(a). | |||
| Option 2: ¨ | Not Applicable . Suboption C of this Option 4 has been selected and the formula provides age/service based allocation rates as described in Section 3.04(B)(9)(b) of the Plan. | |||
| Option 3: þ | The Plan will satisfy the minimum allocation method identified below (select one): | |||
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Suboption A: ¨ |
Provide each non-Highly Compensated Employee with a minimum allocation of at least 5% of the non-Highly Compensated Employee’s Compensation (if the definition of Compensation is not within the meaning of Code Section 415(c)(3), a definition which satisfies Code Section 415(c)(3) will apply). | |||
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Suboption B: ¨ |
Provide each non-Highly Compensated Employee with a minimum allocation so that each non-Highly Compensated Employee has an allocation rate of at least one-third of the allocation rate of the Highly Compensated Employee with the highest allocation rate. | |||
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Suboption C: ¨ |
Provide each non-Highly Compensated Employee with a minimum allocation equal to the lesser of the amount described in Suboption A or Suboption B above. | |||
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Suboption D: ¨ |
Reallocate contributions allocated to Highly Compensated Employees to non-Highly Compensated Employees so that the allocation to each non-Highly Compensated Employee equals at least one-third of the allocation rate of the Highest Compensated Employee with the highest allocation rate in the manner as described in Plan Section 3.04(B)(10). | |||
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Suboption E: ¨ |
Reallocate contributions allocated to Highly Compensated Employees to non-Highly Compensated Employees so that the allocation to each non-Highly Compensated Employee equals at least 5% of the non-Highly Compensated Employee’s Compensation (if the definition of Compensation is not within the meaning of Code Section 415(c)(3), a definition which satisfies Code Section 415(c)(3) will apply) in the manner as described in Plan Section 3.04(B)(11). | |||
|
Suboption F: þ |
Reallocate preliminary contributions or hypothetical contributions paid to Highly Compensated Employees to non-Highly Compensated Employees so that the allocation to each non-Highly Compensated Employee equals the lesser of the amount described in Suboption D or Suboption E above. | |||
| NOTE: If Option 3 is selected and no suboption is selected, Suboption F will apply, if necessary. | ||||
NOTE: If no option is selected, Option 1 will apply unless the government contract contribution formula is selected in item 2 above, in which case Option 4 will apply. Option 4 cannot be selected unless the government contract contribution formula in item 2 above applies. In the case of Self-Employed Individuals, the requirements of Treasury Regulation Section 1.401(k)-1(A)(6) continue to apply, and a new comparability or age-weighted allocation method should not be such that a cash or deferred election is created for a Self-Employed Individual as a result of the allocation method.
| 4. | Employer Profit Sharing Contribution Computation Period |
For purposes of applying the Employer Profit Sharing contribution, Compensation will be based on the period selected below (select one) :
| Option 1: ¨ Payroll period |
| Option 2: þ Plan Year |
| Option 3: ¨ Calendar Month |
| Option 4: ¨ Plan Year Quarter |
| Option 5: ¨ Semi-annual |
NOTE: The calculation of a Employer Profit Sharing Contribution based on the computation period selected shall not require the Employer to remit the Employer Profit Sharing Contribution to the Trust earlier than the time required by Plan Section 3.04(D). However, if the Integrated or Cross-Tested Formula is selected, then Option 2. Plan Year must be selected.
| 5. | Qualifying Participants |
A Participant will be a Qualifying Participant, and thus entitled to share in the Employer Profit Sharing Contribution for any Plan Year, only if the Participant has satisfied all of the eligibility requirements described in Section Two of this Adoption Agreement on at least one day of such Plan Year and satisfies the following additional condition(s) (select one) :
Option 1: ¨ Hours of Service Requirement. The Participant completes at least 500 (not more than 1,000) Hours of Service during the Plan Year. However, this condition will be waived for the following reason(s) (select all that apply) :
| ¨ | The Participant’s Death |
| ¨ | The Participant’s Termination of Employment after having incurred a Disability. |
| ¨ | The Participant’s Termination of Employment after having reached Normal Retirement Age. |
| ¨ | The Participant’s Termination of Employment after having reached Early Retirement Age. |
| þ | The Participant is employed on the last day of the Plan Year. |
| þ | Last Day Requirement. The Participant is an Employee of the Employer on the last day of the Plan Year. However, this condition will be waived for the following reason(s) (select all that apply) : |
| ¨ | The Participant’s Death. |
| ¨ | The Participant’s Termination of Employment after having incurred a Disability. |
| ¨ | The Participant’s Termination of Employment after having reached Normal Retirement Age. |
| ¨ | The Participant’s Termination of Employment after having reached Early Retirement Age. |
| ¨ | The Participant’s Termination of Employment after having completed at least Hours of Service during the Plan Year. |
Option 2: ¨ No additional conditions apply.
NOTE: If no option is selected, Option 2 will apply.
| 6. | Contributions To Non-Highly Compensated Disabled Participants |
Will a non-Highly Compensated Employee Participant who has incurred a Disability be entitled to an Employer Profit Sharing Contribution pursuant to Plan Section 3.04(B)(1) (select one) ?
Option 1: ¨ Yes.
Option 2: þ No.
NOTE: If no option is selected, Option 2 will apply.
| 7. | One-Time Irrevocable Participation Elections |
May an Employee make a one-time irrevocable election, as described in Plan Section 3.05. upon first becoming eligible to participate in the Plan, to have the Employer make annual contributions equal to a specified amount or percentage of their Compensation (including an election to contribute no amount or percentage of Compensation) contributed to the Plan (select one) ?
Option 1: ¨ Yes.
Option 2: þ No.
NOTE: If no option is selected, Option 2 will apply. Contributions made pursuant to Plan Section 3.05 will be considered Employer Profit Sharing Contributions for purposes of nondiscrimination testing.
| Part E. | Qualified Nonelective Contributions |
| 1. | Qualified Nonelective Contribution Formula |
For each Plan Year, the Employer may contribute an amount to be determined from year to year.
| 2. | Allocation of Qualified Nonelective Contributions |
Allocation of Qualified Nonelective Contributions to Participants entitled thereto shall be made (select one):
| Option 1 : ¨ | Targeted QNEC. In an amount, determined pursuant to Plan Section 3.06, required to satisfy either the Actual Deferral Percentage test described in Plan Section 3.14, the Actual Contribution Percentage test described in Plan Section 3.15, or both. |
| Option 2 : þ | Pro Rata Non-Highly Compensated Employee Participants. In the ratio that each non-Highly Compensated Employee Participant’s Compensation for the applicable Plan Year bears to the total Compensation of all non-Highly Compensated Employee Participants for such Plan Year. |
| Option 3 : ¨ | Pro Rata All Participants. In the ratio that each Participant’s Compensation for the applicable Plan Year bears to the total Compensation of all Participants for such Plan Year. |
| Option 4 : ¨ | Limited Pro Rata Non-Highly Compensated Employee Participants. In the ratio that each non-Highly Compensated Employee Participant’s Compensation not in excess of $ for the applicable Plan Year bears to the total Compensation of all non-Highly Compensated Employee Participants entitled to an allocation not in excess of $ for such Plan Year. |
| Option 5: ¨ | Government Contract Formula. In an amount based on each Hour of Service of covered employment under a government contract, as described in Plan Section 3.06(B). |
NOTE: If no option is selected. Option 1 will apply.
| 3. | Additional Conditions for Receiving Qualified Nonelective Contributions |
A Participant will be a Qualifying Participant, and thus entitled to share in Qualified Nonelective Contribution for any Plan Year, only if the Participant has satisfied all of the eligibility requirements of Section Two of this Adoption Agreement on at least one day of such Plan Year and satisfies the following additional condition(s) (select one):
| Option 1 : ¨ | Hours of Service Requirement. The Participant completes more than (not more than 1000) Hours of Service during the Plan Year. However, this condition will be waived for the following reason(s) (select all that apply): |
| ¨ | The Participant’s Death. |
| Elective Deferral Percentage | Matching Percentage | |||||||||||
| Base Rate |
Less than or equal to % |
% | ||||||||||
|
Tier 2 |
Greater than , but less than or equal to % |
% | ||||||||||
| Notwithstanding the Qualified Matching Contribution formula specified above, no Qualified Matching Contributions in excess of $ or percent of a Contributing Participant’s Compensation will be made with respect to any Contributing Participant for any Plan Year. (Complete the applicable blank(s), if any) | ||||||||||||
| Option 3: þ | Such amount, if any, as determined by the Employer in its sole discretion, equal to that percentage of the Elective Deferrals (and/or Nondeductible Employee Contribution, if applicable) of each Contributing Participant entitled thereto that would be sufficient to cause the Plan to satisfy either the Actual Deferral Percentage test (described in Plan Section 3.14) or the Actual Contribution Percentage test (described in Plan Section 3.15) for the Plan Year, or both. | |||||||||||
| Notwithstanding the Qualified Matching Contribution formula specified above, no Qualified Matching Contribution in excess of $ or percent of a Contributing Participant’s Compensation will be made with respect to any Contributing Participant for any Plan Year (Complete the applicable blank(s), if any). | ||||||||||||
| i. | Sources of Eligible Rollover Distributions | |||||||||||
| The Plan will accept Direct Rollovers of Eligible Rollover Distributions from (select “Yes” or “No” to each of the following items by selecting the appropriate box): | ||||||||||||
| Option 1: ¨ Yes. | If “Yes,” check here if such contributions will be mandatory. þ | |||||||||||
| Option 2: þ No. | ||||||||||||
| NOTE: If no option is selected, Option 2 will apply. | ||||||||||||
| Nondeductible Employee Contributions may commence on (must be on or after the Effective Date). | ||||||||||||
| 4. | Top-Heavy Contributions | |||||||||||
| a. | Minimum Allocation or Benefit | |||||||||||
| For any Plan Year with respect to which this Plan is a Top-Heavy Plan, any minimum allocation required pursuant to Plan Section 3.04(E) shall be made (select one) : | ||||||||||||
| Option 1 : þ To this Plan. (If the allocation formula selected in Part D above does not satisfy the top-heavy minimum allocation by design, select either Suboption 1 or Suboption 2 below.) | ||||||||||||
| Suboption 1: þ | Step 1: | The annual Employer Profit Sharing Contribution shall be initially allocated to the accounts of all Employees based upon the formula set forth in Part D above. If any non-Key Employee does not receive a top-heavy minimum allocation under the formula, the Employer Profit Sharing Contribution shall instead be allocated first to the non-Key Employees having less than the minimum top-heavy allocation in an amount equal to the initial allocation plus any additional amount necessary to provide the top-heavy minimum allocation. |
| Step 2: |
The remaining Employer Profit Sharing Contributions shall then be allocated based upon the formula set forth in Part D, provided, however, those non-Key Employees receiving a top-heavy minimum allocation under Step 1 of this suboption (a) shall not be entitled to receive any additional allocation. Should any remaining non-Key Employee fail to receive a top-heavy minimum allocation under this Step 2, the calculation set forth in Step 1 shall be repeated until all non-Key Employees have received a top-heavy minimum allocation and the remaining Employer Profit Sharing Contribution has been allocated.
In the event the annual Employer Profit Sharing Contribution does not equal or exceed three percent (3%) of the total Compensation of all eligible non-Key Employees, eligible Key Employees shall not share in the allocation and such three percent (3%) allocation on behalf of non-Key Employees shall be reduced pro rata based upon the ratio each eligible non-Key Employee’s Compensation bears to the total of all such non-Key Employee’s Compensation. |
|||||||||||
| Suboption 2: ¨ | An allocation of three percent (3%) of Compensation will first be made to all Employees eligible to participate in the Plan; thereafter the remaining Employer Profit Sharing Contribution will be allocated to the accounts of all Employees as set forth in Part D above. In the event the annual Employer Profit Sharing Contribution does not equal or exceed three percent (3%) of the total Compensation of all eligible non-Key Employees, such three percent (3%) allocation shall be reduced pro rata based upon the ratio each eligible non-Key Employee’s Compensation bears to the total of all such non-Key Employees’ Compensation, | |||||||||||
| NOTE: If no option is selected, Option 1 will apply. | ||||||||||||
| Option 1: ¨ | Prior Year Testing Method. | |||||||||||
| Initial Plan Year ADP | ||||||||||||
| If this is not a successor Plan, then for the first Plan Year that this Plan permits any Participant to make Elective Deferrals, the ADP for Participants who are non-Highly Compensated Employees shall be (select one) : | ||||||||||||
| Suboption (a): ¨ 3%. | ||||||||||||
| Suboption (b): ¨ Such first Plan Year’s ADP. | ||||||||||||
| NOTE: If no suboption is selected, Suboption (a) will apply. | ||||||||||||
| Option 2: þ | Current Year Testing Method. | |||||||||||
| NOTE: If no option is selected, Option 1 will apply unless the Adopting Employer elects to apply the Safe Harbor CODA provisions of Section Three, Part C above, in which case Option 2 will apply. If the Adopting Employer elects to apply the Safe Harbor CODA provisions of Section Three, Part C above, Option 2 must be selected. If Option 2 is selected, the current year testing method must continue to be used unless 1) the Plan has been using the current year testing method for the preceding five Plan Years, or, if fewer, the number of Plan Years the Plan has been in existence, or 2) the Plan otherwise meets one of the conditions specified in the Treasury Regulations (or additional guidance issued by the Internal Revenue Service (IRS)) for changing from the current year testing method. The current year testing method may be elected for the ADP test even if prior year testing is elected for the ACP test. However, if different testing methods for the ADP and ACP tests are selected, the Plan cannot use recharacterization to correct Excess Contributions, take Elective Deferrals into consideration to satisfy the ACP test, or use Qualified Matching Contributions to satisfy the ADP test. | ||||||||||||
| Part I. | ACP Testing Method |
The testing method used for purposes of the ACP test under this Plan shall be (select one) :
| Option 1: ¨ | Prior Year Testing Method. | |||||||||
| Initial Plan Year ACP | ||||||||||
| If this is not a successor Plan, then for the first Plan Year that this Plan permits any Participant to make Nondeductible Employee Contributions, provides for Matching Contributions or both, the ACP for Participants who are non-Highly Compensated Employees shall be (select one) : | ||||||||||
| Suboption (a): ¨ 3%. | ||||||||||
| Suboption (b): ¨ Such first Plan Year’s ADP. | ||||||||||
| NOTE: If no suboption is selected, Suboption (a) will apply. | ||||||||||
| Option 2: þ | Current Year Testing Method. | |||||||||
| NOTE: If no option is selected. Option 1 will apply unless the Adopting Employer elects to apply the Safe Harbor CODA provisions of Section Three, Part C above, in which case Option 2 will apply. If the Adopting Employer elects to apply the Safe Harbor CODA provisions of Section Three, Part C above. Option 2 must be selected. If Option 2 is selected, the current year testing method must continue to be used unless 1) the Plan has been using the current year testing method for the preceding five Plan Years, or, if fewer, the number of Plan Years the Plan has been in existence, or 2) the Plan otherwise meets one of the conditions specified in the Treasury Regulations (or additional guidance issued by the Internal Revenue Service (IRS)) for changing from the current year testing method. The current year testing method may be elected for the ACP test even if prior year testing is elected for the ADP test. However, if different testing methods for the ADP and ACP tests are selected, the Plan cannot use recharacterization to correct Excess Contributions, take Elective Deferrals into consideration to satisfy the ACP test, or use Qualified Matching Contributions to satisfy the ADP test. | ||||||||||
|
SECTION FOUR: VESTING AND FORFEITURES Complete Parts A through K |
| Part A. | Vesting Schedule For Matching Contributions |
A Participant will become Vested in the portion of their Individual Account derived from Matching Contributions (including ACP Test Safe Harbor Matching Contributions), if applicable, made pursuant to Section Three of the Adoption Agreement as follows.
|
YEARS OF VESTING SERVICE |
VESTED PERCENTAGE | |||||||||||||||||||
|
Matching |
Option 1 þ | Option 2 ¨ | Option 3 ¨ |
Option 4
¨
(complete if chosen) |
Option 5
¨
(complete if chosen) |
|||||||||||||||
|
Less than One |
100 | % | 0 | % | 0 | % | % | % | ||||||||||||
|
1 |
100 | % | 0 | % | 0 | % | % | % | ||||||||||||
|
2 |
100 | % | 0 | % | 20 | % | % | % | ||||||||||||
|
3 |
100 | % | 100 | % | 40 | % | % | 100 | % | |||||||||||
|
4 |
100 | % | 100 | % | 60 | % | % | 100 | % | |||||||||||
|
5 |
100 | % | 100 | % | 80 | % | % | 100 | % | |||||||||||
|
6 |
100 | % | 100 | % | 100 | % | 100 | % | 100 | % | ||||||||||
| NOTE: If no option is selected as of the first date on which such contributions may be made to the Plan, Option 1 will apply. A Participant with accrued benefits derived from Matching Contributions who has not completed at least one Hour of Service under the Plan in a Plan Year beginning after December 31, 2001, will be subject to the vesting schedule in effect after January 1, 2002, unless otherwise elected by the Employer in an amendment adopting provisions of the Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA). Please list the pre-EGTRRA vesting schedules, if applicable, on the Attachment A, Protected Benefits and Prior Plan Provisions. | ||||||||||
| Part B. | Vesting Schedule For Employer Profit Sharing Contributions |
A Participant will become Vested in the portion of their Individual Account derived from Employer Profit Sharing Contributions, if applicable, made pursuant to Section Three of the Adoption Agreement as follows.
|
YEARS OF VESTING SERVICE |
VESTED PERCENTAGE | |||||||||||||||||||
|
Profit Sharing |
Option 1 ¨ | Option 2 þ | Option 3 ¨ |
Option 4
¨
(complete if chosen) |
Option 5
¨
(complete if chosen) |
|||||||||||||||
|
Less than One |
100 | % | 0 | % | 0 | % | % | % | ||||||||||||
|
1 |
100 | % | 0 | % | 0 | % | % | % | ||||||||||||
|
2 |
100 | % | 0 | % | 20 | % | % | % | ||||||||||||
|
3 |
100 | % | 100 | % | 40 | % | % | 100 | % | |||||||||||
|
4 |
100 | % | 100 | % | 60 | % | % | 100 | % | |||||||||||
|
5 |
100 | % | 100 | % | 80 | % | % | 100 | % | |||||||||||
|
6 |
100 | % | 100 | % | 100 | % | 100 | % | 100 | % | ||||||||||
|
NOTE: If no option is selected as of the first date on which such contributions may be made to the Plan, Option 1 will apply. |
||||
| Part C. | Measuring Period For Vesting |
Years of Vesting Service shall be measured over the following 12-consecutive month period:
|
Option 1: |
þ | The Plan Year. | ||||
|
Option 2: |
¨ | The 12-consecutive month period commencing with the Employee’s Employment Commencement Date and each successive 12-month period commencing on the anniversaries of the Employee’s Employment Commencement Date. | ||||
| Option 3: | ¨ | Other (specify) . | ||||
| NOTE: If no option is selected, Option 1 will apply. | ||||||
| Part D. | Year of Vesting Service |
|
1. |
1,000 | Hours of Service (no more than 1,000) shall be required to constitute a Year of Vesting Service. | ||
|
2. |
500 | Hours of Service (no more than 500 but less than the number specified in Part D, item 1, above) must be exceeded to avoid a Break in Vesting Service. | ||
| NOTE: If no hours are specified, 1,000 and 500 will apply for items 1 and 2, respectively. | ||||
| Part E. | Exclusion of Certain Years of Vesting Service |
All of an Employee’s Years of Vesting Service with the Employer are counted to determine the Vested percentage in the Participant’s Individual Account except (select all that apply) :
| ¨ | Years of Vesting Service before the Employee reaches age 18. | |||
| ¨ | Years of Vesting Service before the Employer maintained this Plan or a predecessor plan. | |||
| ¨ | Years of Vesting Service during a period for which the Employee made no mandatory Nondeductible Employee Contributions. | |||
| Part F. | Vesting Following Breaks in Service |
Will the rehire hold-out rule specified in Plan Section 2.04(C) apply for purposes of determining the Vested portion of a Participant’s Individual Account?
|
Option 1: ¨ Yes. |
||||
|
Option 2: þ No. |
||||
| NOTE: If no option is selected, Option 2 will apply. | ||||
| Part G. | Fully Vested Under Certain Circumstances |
Will an Employee be fully Vested under the following circumstances (select “Yes” or “No” to each of the following items by selecting the appropriate box)?
| 1. | The Employee dies. | þ Yes ¨ No | ||
| 2. | The Employee incurs a Disability. | þ Yes ¨ No | ||
| 3. | The Employee satisfies the conditions for Early Retirement Age (if applicable). | ¨ Yes þ No | ||
| NOTE: If a box is not selected for an item, “Yes” will apply for that item. | ||||
| Part H. | Timing of Forfeiture Allocations |
Timing of forfeiture allocations of all Employer Contributions will be (select one) :
|
Option 1: |
þ | In the same Plan Year in which the forfeitures occur: | ||||
|
Option 2: |
¨ | In the Plan Year following the Plan Year in which the forfeitures occur. | ||||
| NOTE: If no option is selected. Option 1 will apply. Pursuant to Plan Section 3.04(C) and notwithstanding the election made above, the Employer may first apply Forfeitures to the payment of the Plan’s administrative expenses in accordance with Plan Section 7.04 and/or the restoration of Participant’s Individual Accounts pursuant to Plan Section 4.01(C)(3). | ||||
| Part I. | Allocation of Forfeitures of Matching Contributions |
Forfeitures of Matching Contributions will be (select one) :
|
Option 1: |
¨ | Allocated to the Individual Accounts of the Participants specified below in the ratio that each Participant’s Compensation for the Plan Year bears to the total Compensation of all Participants for such Plan Year. The Participants entitled to receive allocations of such Forfeitures will be (select one) : | ||||
|
Suboption (a): ¨ Qualifying Contributing Participants.
Suboption (b): ¨ Qualifying Participants.
Suboption (c): ¨ All Participants. |
||||||
| NOTE: If no suboption is selected, Suboption (a) will apply. | ||||||
|
Option 2: |
þ | Applied to reduce Employer Contributions. |
| NOTE: If no option is selected, Option 2 will apply. Pursuant to Plan Section 3.04(C) and notwithstanding the election made above, the Employer may first apply Forfeitures to the payment of the Plan’s administrative expenses in accordance with Plan Section 7.04 and/or the restoration of Participant’s Individual Accounts pursuant to Plan Section 4.01(C)(3). | ||||
| Part J. | Allocation of Forfeitures of Excess Aggregate Contributions |
Forfeitures of Excess Aggregate Contributions will be (select one) :
| Option 1: ¨ | Allocated to the Individual Accounts of each Qualifying Contributing Participant’s Matching Contribution account in the ratio that each Qualifying Contributing Participant’s Compensation for the Plan Year bears to the total Compensation of all Qualifying Contributing Participants who are non-Highly Compensated Employees for such Plan Year. | |||||||||
| Option 2: þ | Applied to reduce Employer Contributions. | |||||||||
| NOTE: If no option is selected, Option 2 will apply. Pursuant to Plan Section 3.04(C) and notwithstanding the election made above, the Employer may first apply Forfeitures to the payment of the Plan’s administrative expenses in accordance with Plan Section 7.04 and/or the restoration of Participant’s Individual Accounts pursuant to Plan Section 4.01(C)(3). | ||||||||||
| Part K. | Allocation of Forfeitures of Employer Profit Sharing Contributions |
Forfeitures of Employer Profit Sharing Contributions will be (select one) :
| Option 1: ¨ | Allocated to the Individual Accounts of the Participants specified below in the manner described in Plan Section 3.04(C) (for Employer Profit Sharing Contributions). | |||||||||
| The Participants entitled to receive allocations of such Forfeitures will be (select one) : | ||||||||||
| Suboption (a): ¨ Qualifying Participants. | ||||||||||
| Suboption (b): ¨ All Participants. | ||||||||||
| NOTE: If no suboption is selected, Suboption (a) will apply. | ||||||||||
| Option 2: þ | Applied to reduce Employer Contributions. | |||||||||
| NOTE: If no option is selected, Option 2 will apply. Pursuant to Plan Section 3.04(C) and notwithstanding the election made above, the Employer may first apply Forfeitures to the payment of the Plan’s administrative expenses in accordance with Plan Section 7.04 and/or the restoration of Participant’s Individual Accounts pursuant to Plan Section 4.01(C)(3). | ||||||||||
|
SECTION FIVE: DISTRIBUTIONS AND LOANS Complete Parts A through D |
| Part A. | Eligibility for Distributions (Answer each of the following items.) |
| 1. | Distributions Upon Termination of Employment | |||||||||||
| a. | Individual Account Balances Less Than or Equal to the Cashout Level | |||||||||||
| i. | Cashout Level for Terminated Participants | |||||||||||
| For purposes of applying the cashout rules in Plan Section 4.01(C), the cashout level shall be (select one) : | ||||||||||||
| Option 1: þ $5,000. | ||||||||||||
| Option 2: ¨ $1,000. | ||||||||||||
| Option 3: ¨ $200. | ||||||||||||
| Option 4: ¨ $ (specify an amount less than $1,000). | ||||||||||||
| Option 5: ¨ Not Applicable. The cashout distribution provisions in Plan Section 4.01(C)(1) will not apply. | ||||||||||||
| NOTE: If no option is selected, Option 2 will apply. A cashout level exceeding $1,000 will subject the Plan to the automatic rollover requirements of Code Section 401(a)(31)(B) as described in Plan Section 5.01(B). If Option 5 is selected, you may skip item (ii) below because the value of the Vested portion of the Participant’s Individual Account must remain in the Plan until the Participant is entitled to, and requests (if required), a distribution. | ||||||||||||
| ii. | Rollovers Disregarded in Involuntary Cashouts | |||||||||||
| Will rollover contributions be included in determining the value of a Participant’s Vested Individual Account for purposes of Plan Sections 5.01 and 5.04 (select one) ? | ||||||||||||
| Option 1: þ Yes. | ||||||||||||
| Option 2: ¨ No. | ||||||||||||
| NOTE: If no option is selected, Option 1 will apply. If Option 2 is selected, the Plan may be subject to the automatic rollover rules pertaining to cashout amounts described in Plan Section 5.01 even if the cashout amount is $ 1,000 or less. | ||||||||||||
| b. | Individual Account Balances Exceeding Cashout Level | |||||||||||
| i. | Employee Has Not Reached Normal Retirement Age | |||||||||||
| May an Employee who has not reached Normal Retirement Age request a distribution from the Plan of that portion of the Participant’s Individual Account attributable to Employer Contributions upon incurring a Termination of Employment (select one) ? | ||||||||||||
| Option 1: þ Yes. | ||||||||||||
| Option 2: ¨ No. | ||||||||||||
| NOTE: If no option is selected, Option 1 will apply. | ||||||||||||
| ii. | Severance from Employment | |||||||||||
| May a Participant request a distribution of their Elective Deferrals, Qualified Nonelective Contributions, Qualified Matching Contributions, and earnings on account of Severance from Employment pursuant to Plan Section 5.01(A)(2)? | ||||||||||||
| Option 1: þ Yes. | ||||||||||||
| Option 2: ¨ No. | ||||||||||||
| NOTE: If no option is selected, Option 1 will apply. | ||||||||||||
| 2. | Distributions During Employment | |||||||||||
| a. | In-Service Withdrawals | |||||||||||
| i. | In-Service Availability for Elective Deferrals | |||||||||||
| Will a Participant who has not incurred a Severance from Employment be entitled to request an in-service withdrawal from the Plan of that portion of the Participant’s Individual Account attributable to Elective Deferrals. Qualified Nonelective Contributions, and Qualified Matching Contributions (select one) ? | ||||||||||||
| þ Yes, if he or she has attained age 59 1 / 2 (must be at least age 59 1 / 2 . If no age is specified, age 59 1 / 2 will apply) | ||||||||||||
| ¨ Yes, if he or she has attained Normal Retirement Age. | ||||||||||||
| NOTE: If either box is selected above, select whether in-service distributions will be available from Pre-Tax and/or Roth Elective Deferrals. | ||||||||||||
| þ Pre-Tax Elective Deferrals. | ||||||||||||
| þ Roth Elective Deferrals. | ||||||||||||
| NOTE: If a Participant is permitted to request an in-service distribution upon attainment of Normal Retirement Age, he or she must also be at least age 59 1 / 2 to be eligible for the distribution. If in-service distributions are permitted and neither Pre-Tax nor Roth Elective Deferrals is selected, in-service distributions will be permitted from both Pre-Tax Elective Deferrals and Roth Elective Deferrals. | ||||||||||||
| ii. | In-Service Availability for Employer Contributions | |||||||||||
| Will a Participant be entitled to request an in-service withdrawal from the Plan of that portion of the Participant’s Individual Account attributable to Matching Contributions, and Employer Profit Sharing Contributions (select one) ? | ||||||||||||
|
Matching
Contributions |
Employer
Profit Sharing Contributions |
|||
|
Upon attainment of age 59 1 / 2 |
||||
|
Upon attainment of Normal Retirement Age |
||||
|
Upon attainment of age (specify an age other than age 59 1 / 2 ) : |
||||
|
Upon reaching a Vested percentage equal to: 100% |
||||
|
The maximum Vested percent of the Individual Account that may be withdrawn is (specify Vested percent) : |
||||
|
After contributions have been allocated to the Plan for a period of years equal to (must be at least two) : |
||||
|
After participating in the Plan for a period of years equal to (must be at least five unless the applicable contributions have been allocated to the Plan for at least two years as specified in the box above) : |
||||
|
The maximum number of in-service withdrawals that may be taken while a Participant is employed by the Employer is (specify either “unlimited” or the actual number that applies (e.g., one, one per year, etc.)) : Unlimited |
||||
|
After participating in the Plan for a period of years equal to (a) and attaining age (b). |
(a)
(b) |
(a)
(b) |
||
|
After becoming 100% Vested, participating in the Plan for a period of years equal to (a) and attaining age (b). |
(a)
0
(b) 59.5 |
(a)
0
(b) 59.5 |
| NOTE: Place an “x” or enter the specific criteria (e.g., age, vested percentage, etc.) in each box, as applicable. A Participant need only satisfy the criteria in one of the rows to be eligible for an in-service distribution. If Option 1 applies and no selections or entries are made in the table above. Plan Section 5.01(C)(1) will apply in determining whether a Participant is entitled to an in-service distribution and there will be no limit on the number of in-service distributions. | ||||||||||||
| b. | Hardship Withdrawals | |||||||||||
| i. | Hardship Availability for Elective Deferrals | |||||||||||
| ii. | Hardship Availability for Matching Contributions, and Employer Profit Sharing Contributions | |||||||||||
| Will a Participant be entitled to request a hardship distribution from the Plan (select one) ? | ||||||||||||
| 3. | Miscellaneous Distribution Issues | |||||||||||
| a. | Withdrawals of Rollover Contributions | |||||||||||
| Will an Employee be entitled to request a distribution of their rollover contributions at any time (select one) ? | ||||||||||||
| Option 1: ¨ Yes. | ||||||||||||
| Option 2: þ No. | ||||||||||||
| NOTE: If no option is selected, Option 1 will apply. If Option 2 applies, the Plan’s provisions governing distributions will apply according to Plan Section 5.01 (A)(1). | ||||||||||||
| Part D. | Loans |
| May a Participant request a loan pursuant to Plan Section 5.16 (select one) ? | ||||||||||
| Option 1: | þ | Yes. | ||||||||
| Option 1: | ¨ | No. | ||||||||
| NOTE: If no option is selected. Option 2 will apply. | ||||||||||
NOTE: Generally, Code Section 411(d)(6) prohibits the elimination of protected benefits. Protected benefits include the timing of payout options. If the Plan is restating a Prior Plan that permitted a distribution option described above that involves the timing of a distribution, the selections must generally be at least as favorable as under the Prior Plan. Certain forms of distributions (e.g., redundant forms of distribution) may, however, be eliminated. Refer to Code Section 411(d)(6) and the corresponding Treasury regulation for details pertaining to the elimination of otherwise protected benefits. Note that ADP Test Safe Harbor Contributions may not be distributed earlier than Severance from Employment, death, Disability, an event described in Section 401(k)(10) of the Code, or, in the case of a profit sharing plan, the attainment of age 59 1 / 2 .
|
SECTION SIX: DEFINITIONS Complete Parts A through 1 |
| Part A. | Compensation |
| In addition to any adjustment to Compensation elected above, will leave payments be excluded from Compensation (select one) ? | ||||||||||
| Option 1: þ Yes. | ||||||||||
| Option 2: ¨ No. | ||||||||||
| NOTE: If no option is selected, Option 1 will apply. | ||||||||||
| 6. | Pre-Entry Date Compensation | |||||||||
| Unless a different definition of Compensation is required by either the Code or ERISA, for the Plan Year in which an Employee enters the Plan, the Employee’s Compensation that will be taken into account for purposes of the Plan will be (select one) : | ||||||||||
| Option 1: þ Compensation from the Entry Date. | ||||||||||
| Option 2: ¨ Compensation for the full Plan Year. | ||||||||||
| NOTE: If no option is selected, Option 1 will apply. | ||||||||||
| Part B. | Disability |
| For purposes of this Plan, Disability shall mean (select one) : | ||||||||||
| Option 1: þ | The inability to engage in any substantial, gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. | |||||||||
| Option 2: ¨ | The inability to engage in any substantial, gainful activity in the Employee’s trade or profession for which the Employee is best qualified through training or experience. | |||||||||
| NOTE: If no option is selected, Option 1 will apply. | ||||||||||
| Part C. | Highly Compensated Employee |
| 1. | Top Paid Group Election | |||||||
| For purposes of determining who is a Highly Compensated Employee under the Plan, will the top paid group election apply (select one) ? | ||||||||
| Option 1: ¨ Yes. | ||||||||
| Option 2: þ No. | ||||||||
| NOTE: If no option is selected, Option 2 will apply. | ||||||||
| 2. | Calendar Year Data Election | |||||||
| If the Plan Year is a fiscal year other than a calendar year, for purposes of determining who is a Highly Compensated Employee (other than a five-percent owner) under the Plan, will the calendar year data election apply (select one) ? | ||||||||
| Option 1: ¨ Yes. | ||||||||
| Option 2: þ No. | ||||||||
| NOTE: If no option is selected, Option 2 will apply. If the Plan Year is a calendar year, the Highly Compensated Employee determination will be based on the calendar year. | ||||||||
| Part D. | Hour of Service - Method of Determining Service |
| Service will be determined on the basis of (select one) : | ||||||||||
| Option 1: ¨ | Elapsed Time. | |||||||||
| Option 2: þ | Actual hours for which an Employee is paid or entitled to payment. | |||||||||
| Option 3: ¨ | Days worked. An Employee will be credited with 10 Hours of Service if under the definition of Hours of Service such Employee would be credited with at least one Hour of Service during the day. | |||||||||
| Option 4: ¨ | Weeks worked. An Employee will be credited with 45 Hours of Service if under the definition of Hours of Service such Employee would be credited with at least one Hour of Service during the week. | |||||||||
| Option 5: ¨ | Semi-Monthly payroll periods worked. An Employee will be credited with 95 Hours of Service if under the definition of Hours of Service such Employee would be credited with at least one Hour of Service during the semi-monthly payroll period. | |||||||||
| Option 6: ¨ | Months worked. An Employee will be credited with 190 Hours of Service if under the definition of Hours of Service such Employee would be credited with at least one Hour of Service during the month. | |||||||||
| NOTE: If no option is selected, Option 2 will apply. | ||||||||||
| Part E. | Limitation Year Means |
| Option 1: þ | The Plan Year. | |||||||||
| Option 2: ¨ | The calendar year. | |||||||||
| Option 3: ¨ | Other 12-consecutive month period (Specify a 12-consecutive month period selected in a uniform and nondiscriminatory manner.) . | |||||||||
| NOTE: If no option is selected, Option 1 will apply. | ||||||||||
| Part F. | Plan Year Means | |||||||||
| Option 1: | ¨ | The 12-consecutive month period which coincides with the Adopting Employer’s tax year. | ||
| Option 2: | þ | The calendar year. | ||
| Option 3: | ¨ | The 52/53 week period ending on the (specify day of the week) nearest (specify month and day) of each year. | ||
| Option 4: | ¨ | Other 12-consecutive month period (Specify a 12-consecutive month period selected in a uniform and nondiscriminatory manner.) | ||
NOTE: If no option is selected, Option 1 will apply.
If the initial Plan Year or any subsequent Plan Year is less than 12 months (a short Plan Year) specify such Plan Year’s beginning and ending
dates. .
| Option 1: | þ | An Early Retirement Age is not applicable under the Plan. | ||||
| Option 2: | ¨ | A Participant satisfies the Plan’s Early Retirement Age conditions by attaining age and completing Years of Vesting Service. | ||||
| NOTE: If no option is selected, Option 1 will apply . | ||||||
|
2. Normal Retirement Age |
||||||
|
The Normal Retirement Age under the Plan will be (select and complete one) : |
||||||
| Option 1: | þ | Daily. | ||||
| Option 2: | ¨ | The last day of the Plan Year and each other date designated by the Plan Administrator which is selected in a uniform an nondiscriminatory manner. | ||||
| Option 3: | ¨ | The last day of each Plan quarter. | ||||
| Option 4: | ¨ | The last day of each month. | ||||
| Option 5: | ¨ | Other (Specify one or more dates that are selected in a uniform and nondiscriminatory manner, including the last day of the Plan Year.) | ||||
| NOTE: If no option is selected, Option 2 will apply . | ||||||
SECTION SEVEN: MISCELLANEOUS
Complete Parts A and B
| Part A. | Life Insurance | |||||
| Will life insurance investments be permitted under the Plan (select one) ? | ||||||
| Option 1: | ¨ | Yes. | ||||
| Option 2: | þ | No. | ||||
| NOTE: If no option is selected, Option 2 will apply . | ||||||
| Part B. | Participant Direction | |||||
|
1. Authorization |
||||||
|
SECTION EIGHT: TRUSTEE AND CUSTODIAN Complete Parts A and B (as applicable) |
| Part A. | Trustee (This Part A must be completed unless the Plan only covers one or more Self-Employed Individuals or satisfies another exception under ERISA. Select one.) | |||||||||||
| 1. | Trustee Appointment | |||||||||||
| Option 1: | ¨ | Financial Organization as Trustee | ||||||||||
| Option 2: | þ | Individual Trustee(s) | ||||||||||
| The Trustee of this Plan shall be a: þ Directed Trustee ¨ Discretionary Trustee | ||||||||||||
| Name of Trustee | ||||||||||||
| Corrine Allen | ||||||||||||
| Address | ||||||||||||
| 1511 3rd St. | ||||||||
| City Santa Fe | ||||||||
|
Telephone 505-988-5520 |
State NM | Zip 87505 | ||||||
| Signature | ||||||||
| SECTION NINE: EMPLOYER SIGNATURE |
| Practitioner | ||
| Name of Practitioner | Paychex, Inc. | |
| Address | 1175 John Street, West Henrietta, NY 14586 | |
| Telephone | 1-800-472-0072 | |
Plan Administrator
| ¨ | Check here and provide the applicable information below if someone other than the Adopting Employer will be the Plan Administrator. | |||||
| Name of Plan Administrator |
|
| Address |
|
|||||||||
| City |
|
State Zip | ||||||
| Telephone |
|
|||||||
| Signature of Plan Administrator |
|
Date Signed | ||||||
| Type Name |
|
|||||||||
| Check the applicable box if there is an attachment(s) that applies to this Plan other than a separate trust or custodial agreement. | ||||||||
| ¨ | Attachment A, Protected Benefits and Prior Plan Provisions. | |||||||
| ¨ | Attachment B, Participating Employer Form. | |||||||
| ¨ | Attachment C, Special Effective Date(s). | |||||||
| ¨ | Attachment D, New Comparability Allocation Group(s) | |||||||
| Other: (If this box is checked, please describe the attachment(s)) | ||||||||
| ¨ | ||
| Authorized Employer Signature | ||
| I am an authorized representative of the Adopting Employer named above and I state the following: | ||
| 1. | I acknowledge that I have relied upon my own advisors regarding the completion of this Adoption Agreement and the legal tax implications of adopting this Plan; | |
| 2. | I understand that my failure to properly complete this Adoption Agreement may result in disqualification of the Plan; | |
| 3. | I understand that the Prototype Sponsor will inform me of any amendments made to the Plan and will notify me should it discontinue or abandon the Plan; and | |
| 4. | I have received a copy of this Adoption Agreement, the corresponding Basic Plan Document and, if applicable, any separate trust or custodial agreement used in lieu of the trust or custodial agreement contained in the Basic Plan Document. | |
| Signature of Adopting Employer |
Date Signed 01/12/2010 |
| Type Name | Title | |
| Corinne Allen | CFO | |
NOTE: The Adopting Employer may rely on an opinion letter issued by the Internal Revenue Service as evidence that the Plan is qualified under Code Section 401 of the Internal Revenue Code except to the extent provided in Revenue Procedure 2005-16. An Employer who has ever maintained or who later adopts any plan (including a welfare benefit fund, as defined in Code Section 419(e), which provides post-retirement medical benefits allocated to separate accounts for key employees, as defined in Code Section 419A(d)(3), or an individual medical account, as defined in Code Section 415(1)(2) in addition to this Plan may not rely on the opinion letter issued by the Internal Revenue Service with respect to the requirements of Code Sections 415 and 416.
If the Employer who adopts or maintains multiple plans wishes to obtain reliance with respect to the requirements of Code Sections 415 and 416, application for a determination letter must be made to Employee Plans Determinations of the Internal Revenue Service. The Employer may not rely on the opinion letter in certain other circumstances, which are specified in the opinion letter issued with respect to the Plan or in Revenue Procedure 2005-16. This Adoption Agreement may be used only in conjunction with Basic Plan Document #01.
| SECTION TEN: ALLOCATION FACTOR TABLES |
Employers selecting the Age-Weighted Formula in the Adoption Agreement for purposes of allocation Employer Profit Sharing Contributions shall use the following tables in determining the Allocating Factor.
Age Related Allocation Factors*
|
Participant’s
|
7.5% |
Interest Rate
8.0% |
8.5% | |||
|
1 |
0.991 | 0.714 | 0.515 | |||
|
2 |
1.066 | 0.771 | 0.559 | |||
|
3 |
1.146 | 0.833 | 0.606 | |||
|
4 |
1.232 | 0.899 | 0.658 | |||
|
5 |
1.324 | 0.971 | 0.714 | |||
|
6 |
1.423 | 1.049 | 0.775 | |||
|
7 |
1.530 | 1.133 | 0.840 | |||
|
8 |
1.645 | 1.223 | 0.912 | |||
|
9 |
1.768 | 1.321 | 0.989 | |||
|
10 |
1.901 | 1.427 | 1.074 | |||
|
11 |
2.043 | 1.541 | 1.165 | |||
|
12 |
2.197 | 1.665 | 1.264 | |||
|
13 |
2.361 | 1.798 | 1.371 | |||
|
14 |
2.539 | 1.942 | 1.488 | |||
|
15 |
2.729 | 2.097 | 1.614 | |||
|
16 |
2.934 | 2.265 | 1.751 | |||
|
17 |
3.154 | 2.446 | 1.900 | |||
|
18 |
3.390 | 2.641 | 2.062 | |||
|
19 |
3.644 | 2.853 | 2.237 | |||
|
20 |
3.918 | 3.081 | 2.427 | |||
|
21 |
4.212 | 3.327 | 2.634 | |||
|
22 |
4.527 | 3.594 | 2.857 | |||
|
23 |
4.867 | 3.881 | 3.100 | |||
|
24 |
5.232 | 4.192 | 3.364 | |||
|
25 |
5.624 | 4.527 | 3.650 | |||
|
26 |
6.046 | 4.889 | 3.960 | |||
|
27 |
6.500 | 5.280 | 4.297 | |||
|
28 |
6.987 | 5.703 | 4.662 | |||
|
29 |
7.511 | 6.159 | 5.058 | |||
|
30 |
8.075 | 6.652 | 5.488 | |||
|
31 |
8.680 | 7.184 | 5 954 | |||
|
32 |
9.331 | 7.758 | 6.461 | |||
|
33 |
10.031 | 8.379 | 7.010 |
|
34 |
10.783 | 9.049 | 7.606 | |||
|
35 |
11.592 | 9.773 | 8.252 | |||
|
36 |
12.462 | 10.555 | 8.953 | |||
|
37 |
13.396 | 11.400 | 9.714 | |||
|
38 |
14.401 | 12.311 | 10.540 | |||
|
39 |
15.481 | 13.296 | 11.436 | |||
|
40 |
16.642 | 14.360 | 12.408 | |||
|
41 |
17.890 | 15.509 | 13.463 | |||
|
42 |
19.232 | 16.750 | 14.607 | |||
|
43 |
20.674 | 18.090 | 15.849 | |||
|
44 |
22.225 | 19.537 | 17.196 | |||
|
45 |
23.892 | 21.100 | 18.658 | |||
|
46 |
25.684 | 22.788 | 20.244 | |||
|
47 |
27.610 | 24.611 | 21.964 | |||
|
48 |
29.681 | 26.580 | 23.831 | |||
|
49 |
31.907 | 28.706 | 25.857 | |||
|
50 |
34.300 | 31.002 | 28.055 | |||
|
51 |
36.872 | 33.483 | 30.439 | |||
|
52 |
39.638 | 36.161 | 33.027 | |||
|
53 |
42.611 | 39.054 | 35.834 | |||
|
54 |
45.806 | 42.178 | 38.880 | |||
|
55 |
49.242 | 45.553 | 42.185 | |||
|
56 |
52.935 | 49.197 | 45.770 | |||
|
57 |
56.905 | 53.133 | 49.661 | |||
|
58 |
61.173 | 57.383 | 53.882 | |||
|
59 |
65.761 | 61.974 | 58.462 | |||
|
60 |
70.693 | 66.932 | 63.431 | |||
|
61 |
75.995 | 72.286 | 68.823 | |||
|
62 |
81.695 | 78.069 | 74.673 | |||
|
63 |
87.822 | 84.315 | 81.020 | |||
|
64 |
94.408 | 91.060 | 87.907 | |||
|
65 |
101.489 | 98.345 | 95.379 |
*Based on the UP 1984 Mortality Table Testing Age 65
ATTACHMENT A
PROTECTED BENEFITS AND PRIOR PLAN PROVISIONS
This Attachment may be used by an Adopting Employer to document protected benefits and other prior plan provisions that apply to some or all of the assets of the Adopting Employer’s Plan.
| ADOPTING EMPLOYER PLAN INFORMATION |
Name of Adopting Employer
Plan Name
| Plan Sequence Number | Trust Identification Number ( if applicable ) | Account Number |
| PROTECTED BENEFITS AND PRIOR PLAN PROVISIONS |
Provision 1:
Source of Provision (e.g., plan name and sequence number, good faith amendment, etc.):
Provision 2:
Source of Provision (e.g., plan name and sequence number, good faith amendment, etc.):
Provision 3:
Source of Provision (e.g., plan name and sequence number, good faith amendment, etc.):
ATTACHMENT B
PARTICIPATING EMPLOYER FORM
This Attachment is used only when a restated plan document is prepared and special effective dates apply for certain plan provisions.
| ADOPTING EMPLOYER PLAN INFORMATION |
Name of Adopting Employer
Name of Plan
| Plan Sequence Number | Trust Identification Number (if applicable) | Account Number |
| SPECIAL EFFECTIVE DATES |
The following participating employer will participate in the Plan of the Adopting Employer as described in the Effective Date section.
Name of Participating Employer
Address
| City | State | Zip |
| Telephone | Participating Employer’s Federal Tax Identification Number |
Participating Employer’s Tax Year End (specify month and day)
Type of Business (select one):
¨ Sole Proprietorship ¨ Partnership ¨ C Corporation ¨ S Corporation ¨ LLC
¨ Other (specify a legal entity recognized under federal or exempt from federal income tax laws)
The participating Employer þ is ¨ is not a member of a controlled group of corporations (as defined in Code Section 414(b) as modified by Code Section 415(h)), a commonly controlled trade or business (as defined in Code Section 414(c) as modified by Code Section 415(h)) or an affiliated service group (as defined in Code Section 414(m)).
| EFFECTIVE DATES |
| ¨ | New Plan – This is the initial adoption of a plan by the participating employer. The effective date of the Plan is . The Effective Date is usually the first day of the Plan Year in which this Attachment. Participating Employer Form is signed and may not be earlier than such date. Elective Deferrals, however, cannot be made available before the later of the date this Attachment, Participating Employer Form is signed or the Effective Date for Elective Deferrals specified in the Adoption Agreement. | |
| ¨ | Existing Plan Restatement – This is a restatement of an existing qualified plan of the participating employer. The effective date of this restatement is . The EGTRRA restatement Effective Date generally is the first day of the Plan Year in which this Attachment B, Participating Employer Form is signed. An amendment or restatement Effective Date after the first day of the Plan Year in which this Adoption Agreement is signed may result in a reduction or elimination of accrued benefits, violating Code Section 411 (d)(6). If Elective Deferrals are being made available for the first time as a result of an amendment or restatement. Elective Deferrals cannot be made available before the later of the date this Attachment, Participating Employer Form is signed or the Effective Date for Elective Deferrals specified in the Adoption Agreement. | |
| ¨ | Cessation – This is the cessation of participation in the Plan by the participating employer. The effective date of the cessation is . | |
| SIGNATURES |
Adopting Employer
I am an authorized representative of the Adopting Employer named above and I acknowledge that the related employer listed on this Participating Employer Form will participate in the Plan as described above. I agree to provide the participating employer identified above with any amendments that have been made to the Plan and, if applicable, I agree to notify the participating employer of a decision to discontinue or abandon the Plan. I acknowledge that I have relied upon my own advisors regarding such employer participating or ceasing to participate in the Plan.
| Signature of Adopting Employer | Date Signed | |
| Type Name | Title | |
Participating Employer
I am an authorized representative of the related employer name above. I acknowledge that I have received a copy of the Basic Plan Document, the Adoption Agreement, IRS opinion letter and, if applicable, any separate trust agreement used in lieu of the trust agreement contained in the Basic Plan Document. In addition, I authorize the Adopting Employer to make amendments to the Plan on my behalf. I understand that the Adopting Employer, not the Prototype Sponsor, will provide me with any amendments made to the Plan, including a notification if the Adopting Employer has discontinued or abandoned the Plan. I acknowledge that I have relied upon my own advisors regarding the legal and tax implications of participating or ceasing to participate in the Plan.
| Signature of Adopting Employer | Date Signed | |
| Type Name | Title | |
Trustee (The Trustee, if any, named on the Adoption Agreement, must sign below)
| Signature of Trustee | Date Signed | |
| Type Name | Title | |
| Signature of Trustee | Date Signed | |
| Type Name | Title | |
| Signature of Trustee | Date Signed | |
| Type Name | Title | |
ATTACHMENT C
SPECIAL EFFECTIVE DATE(S)
This Attachment is used only when a restated plan document is prepared and special effective dates apply for certain plan provisions.
| EMPLOYER INFORMATION |
| Name of Adopting Employer | ||||
| Name of Plan | ||||
| Plan Sequence Number | Trust Identification Number (if applicable) | Account Number | ||
| SPECIAL EFFECTIVE DATES |
The following special effective dates shall apply to the plan: (Select one or more as applicable) Note : All parameters or limitations stated in the Adoption Agreement apply.
| A. | SECTION TWO: ELIGIBILITY | |||||||||
| ¨ Part A | Age and Years of Eligibility Service. |
|
||||||||
| Effective Date: | ||||||||||
| ¨ Part B | Exclusion of Certain Classes of Employees. | |||||||||
| Effective Date: | ||||||||||
| ¨ Part C | Entry Dates. |
|
||||||||
| Effective Date: | ||||||||||
| ¨ Part D | Hours Required for Eligibility Purposes. |
|
||||||||
| Effective Date: | ||||||||||
| B. | SECTION THREE: CONTRIBUTIONS | |||||||||
| ¨ Part A | Elective Deferrals - Automatic Enrollment for Elective Deferrals | Effective Date: | ||||||||
| Elective Deferrals - Automatic Increases for Elective Deferrals | Effective Date: | |||||||||
| Elective Deferrals -Frequency or Limits |
|
|||||||||
| Effective Date: | ||||||||||
| ¨ Part B | Matching Contributions |
|
||||||||
| Effective Date: | ||||||||||
| ¨ Part C | Safe Harbor CODA Contributions |
|
||||||||
| Effective Date: | ||||||||||
| ¨ Part D | Employer Profit Sharing Contributions |
|
||||||||
| Effective Date: | ||||||||||
| ¨ Part G | ADP Testing Method |
|
||||||||
| Effective Date: | ||||||||||
| ¨ Part H | ACP Testing Method |
|
||||||||
| Effective Date: | ||||||||||
| C. SECTION FOUR: VESTING AND ALLOCATION OF FORFEITURES | ||||||||||
| ¨ Part A | Vesting Schedule for Matching Contributions |
|
||||||||
| Effective Date: | ||||||||||
| ¨ Part B | Vesting Schedule for Employer Profit Sharing Contributions |
|
||||||||
| Effective Date: | ||||||||||
| D. SECTION FIVE: DISTRIBUTIONS AND LOANS | ||||||||||
| ¨ Part A | Eligibility for Distributions (e.g., hardship, in-service) |
|
||||||||
| Effective Date: | ||||||||||
| Part B | Form of Distribution (e.g., lump sum, installment, annuity) |
|
||||||||
| Effective Date: | ||||||||||
| ¨ Part D | Loans |
|
||||||||
| Effective Date: | ||||||||||
| E. | SECTION SIX: DEFINITIONS | |||||||||
| ¨ Part A | Compensation |
|
||||||||
| Effective Date: | ||||||||||
| ¨ Part C | Highly Compensated Employee (e.g., top-paid group, calendar year election) |
|
||||||||
| Effective Date: | ||||||||||
| F. | OTHER (Specify) |
|
||||||||
| Effective Date: | ||||||||||
ATTACHMENT D
NEW COMPARABILITY ALLOCATION GROUP(S)
This attachment is used only when the Adopting Employer selects a new comparability allocation formula to allocate Employer Profit Sharing Contributions, chooses to identify the allocation groups in the Adoption Agreement and uses more than six allocation groups.
EMPLOYER INFORMATION
Name of Adopting Employer
CytoDyn Inc.
Name of Plan
| CytoDyn Inc. | 401(k) Profit Sharing Plan and Trust |
| Plan Sequence Number | Trust Identification Number (if applicable) | Account Number | ||
| 001 | 75-3056237 | |||
ALLOCATION GROUPS
The following allocation groups shall apply in addition to those identified in the Adoption Agreement. (Specify the groups by category of Qualifying Participant, including both Highly Compensated Employees and non-Highly Compensated Employees.)
| Allocation Group 7: |
|
|
| Allocation Group 8: |
|
|
| Allocation Group 9: |
|
|
| Allocation Group 10: |
|
|
| Allocation Group 11: |
|
|
| Allocation Group 12: |
|
|
| Allocation Group 13: |
|
|
| Allocation Group 14: |
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|
| Allocation Group 15: |
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|
| Allocation Group 16: |
|
|
| Allocation Group 17: |
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|
| Allocation Group 18: |
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|
| Allocation Group 19: |
|
|
| Allocation Group 20: |
|
|
| Allocation Group 21: |
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|
| Allocation Group 22: |
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|
| Allocation Group 23: |
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|
| Allocation Group 24: |
|
|
| Allocation Group 25: |
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| Allocation Group 26: |
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| Allocation Group 27: |
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| Allocation Group 28: |
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| Allocation Group 29: |
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| Allocation Group 30: |
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| Allocation Group 31: |
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| Allocation Group 32: |
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| Allocation Group 33: |
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| Allocation Group 34: |
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| Allocation Group 35: |
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| Allocation Group 36: |
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| Allocation Group 37: |
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| Allocation Group 38: |
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| Allocation Group 39: |
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| Allocation Group 40: |
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| Allocation Group 41: |
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| Allocation Group 42: |
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| Allocation Group 43: |
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| Allocation Group 44: |
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| Allocation Group 45: |
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| Allocation Group 46: |
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| Allocation Group 47: |
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| Allocation Group 48: |
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| Allocation Group 49: |
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| Allocation Group 50: |
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