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Download Agreement for Opting Out of the Ithaca College 403(b) Retirement Plan
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Agreement for Opting Out of the Ithaca College 403(b) Retirement Plan This form serves as notice to Ithaca College that you wish to opt-out or decline enrollment in the Ithaca College 403(b) Retirement Plan at this time. Please complete, sign, and return the form to the Office of Human Resources. If you decide to enroll on your own later, simply complete a Salary Deferral Agreement and return it to the Office of Human Resources and complete the TIAA-CREF online application for the Ithaca College 403(b) Plan. By initialing these boxes and signing this form, you acknowledge the following: I wish to OPT-OUT or defer from participating in the Ithaca College 403(b) Retirement Plan (the “Plan). I understand that by signing this document, I am forfeiting my rights to any current and/or future matching contributions by the College until such time as I enroll in the Plan. I understand that I may restart my contributions at any time as long as I continue in an eligible class. I may restart my contribution by completing a Salary Deferral Agreement and submitting it to the Office of Human Resources. In addition, I also will need to complete an on-line application for the IC 403(b) Plan. (The online application can be found at: http://www1.tiaa-cref.org/tcm/ithaca/.) I understand that if I have not completed and submitted this form in time to stop the automatic contributions, I can receive a refund of the contributions (plus or minus investment earnings or losses) for a short time, despite general limits on Plan withdrawals. During the 45 days after automatic contributions are fist taken from my salary, I may contact TIAA-CREF directly at (Participant Services 1-800-842-2252) to request that all funds contributed by payroll deduction from my payroll check be refunded to me. I understand if I request funds to be refunded, I will forfeit the College’s contribution(s) during this period. I also understand that the payroll deduction will be appropriately taxed and reflected on a 1099. The 1099 will be issued at the end of the calendar year that the transaction occurred. I understand that contributions to the Plan will cease as soon as administratively possible upon receipt of this form by the Office of Human Resources. Employee Name ________________________________________ Employee Signature ________________________ Date Ithaca College Employing Institution ________________________________ Authorization Benefits/Benforms/TIAA CREF/Auto Enrollment/Agreement for Opting Out of the IC 403(b) Retirement Plan Final 022015 953 Danby Road • Ithaca, NY 14850 • (607) 274-8000 • [email protected]
