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Pre-tax/Roth Deferral Election Form
 
Instructions :
This form may be used to begin making elective deferrals (or to change or revoke previous elections) and to specify what portion of your elective deferrals, if any, are Roth elective deferrals.
I understand that I may designate all or a portion of my elective deferrals, including catch-up contributions, as either pre-tax or Roth elective deferrals.
 
Name:  
 
(1) Pre-tax Elective Deferral :
  $ from each of my paychecks.
     % of my compensation from each of my paychecks (1% to 100%).
  $ from my paycheck dated 
    I elect to terminate pre-tax deferral.
 
(2) Roth Elective Deferral (After-Tax) :
  $ from each of my paychecks.
     % of my compensation from each of my paychecks (1% to 100%).
  $ from my paycheck dated 
    I elect to terminate Roth deferral.
 
Note :
For 2007, the maximum amount of Pre-tax/Roth deferrals is $15,500 or, if you attain age 50 by December 31, 2007, $20,500 ($5,000 “Catch-Up” contribution). The annual limit for additions, in total, to defined contribution plans for 2007 is the lesser of (1) $45,000, or (2) 100% of the participant’s annual compensation. Any choice made above will be subject to the aforementioned limits, except for the $5,000 “Catch-Up” contribution which is not subject to this limit.