Adoption Agreement (569K)
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ADOPTION AGREEMENT FOR
MFS RETIREMENT SERVICES, INC.
NON-STANDARDIZED 401(K) PROFIT SHARING
PLAN AND TRUST
The undersigned Employer adopts the MFS Retirement Services, Inc. Prototype
Non-Standardized 401(k) Profit Sharing Plan and Trust and elects the following
provisions:
CAUTION: Failure to properly fill out this Adoption Agreement may result in
disqualification of the Plan.
EMPLOYER INFORMATION (An amendment to the Adoption Agreement is not needed
solely to reflect a change in the information in this Section.)
1. EMPLOYER'S NAME, ADDRESS AND TELEPHONE NUMBER
Name: Baldwin Americas Corporation
___________________________________________________________________
Address: 12 Commerce Drive
___________________________________________________________________
Street
Shelton Connecticut 06484
_____________________ ________________ ____________
City State Zip
Telephone: 203-402-1000
___________________
2. EMPLOYER'S TAXPAYER IDENTIFICATION NUMBER 11-1737201
__________________________________
3. TYPE OF ENTITY
a.[X] Corporation (including Tax-exempt or Non-profit Corporation)
b.[ ] Professional Service Corporation
c.[ ] S Corporation
d.[ ] Limited Liability Company that is taxed as:
1. [ ] a partnership or sole proprietorship
2. [ ] a Corporation
3. [ ] an S Corporation
e.[ ] Sole Proprietorship
f.[ ] Partnership (including Limited Liability)
g.[ ] Other
_______________________________________________________________
AND, the Employer is a member of...
h.[ ] a controlled group?
i.[ ] an affiliated service group?
4. EMPLOYER FISCAL YEAR means the 12 consecutive month period:
Beginning on July 1st (e.g., January 1st)
_______________________________
month day
and ending on June 30th
_______________________________
month day
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PLAN INFORMATION
(An amendment to the Adoption Agreement is not needed solely to reflect a change
in the information in items 9 through 11 of this Section.)
5. PLAN NAME:
Baldwin Technology Profit Sharing and Savings Plan
____________________________________________________________________________
____________________________________________________________________________
6. EFFECTIVE DATE
a.[ ] This is a new Plan effective as of ____________ (hereinafter called
the "Effective Date").
b.[ ] This is an amendment and restatement of a previously established
qualified Plan and Trust of the Employer which was originally
effective ____________ (hereinafter called the "Effective Date").
The effective date of this amendment and restatement is
___________________________________________________________________.
c.[X] FOR GUST RESTATEMENTS: This is an amendment and restatement of a
previously established qualified Plan and Trust of the Employer to
bring the Plan into compliance with GUST (GATT, USERRA, SBJPA and
TRA '97). The original Plan effective date was June 29,1955
(hereinafter called the "Effective Date"). Except as specifically
provided in the Plan, the effective date of this amendment and
restatement is January 1st 2002. (Enter a date during the current
Plan Year. The Plan contains appropriate retroactive effective dates
with respect to provisions for the appropriate laws.)
7. PLAN YEAR means the 12 consecutive month period:
Beginning on January 1st (e.g., January 1st)
_______________________________
month day
and ending on December 31st
______________________________
month day
except that there will be a short Plan Year:
a.[X] N/A
b.[ ] beginning on (e.g., July 1, 2000)
_____________________________
month day, year
and ending on
_____________________________
month day, year
8. VALUATION DATE means:
a.[X] Every day that the Trustee, any transfer agent appointed by the
Trustee or the Employer, and any stock exchange used by such agent
are open for business (daily valuation).
b.[ ] Other (specify day or dates):_______________________________________
9. PLAN NUMBER assigned by the Employer (select one)
a.[X] 001
b.[ ] 002
c.[ ] 003
d.[ ] Other____________________________________
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10. TRUSTEE(S): (Please complete either a., b., or c. and d. and e. if
applicable)
a.[ ] NAME(S) AND TITLE(S) OF INDIVIDUAL TRUSTEE(S):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
NOTE: An Individual Trustee may not act as a Directed (Nondiscretionary)
Trustee.
b.[ ] NAME(S) OF BANK OR TRUST COMPANY TRUSTEE(S):________________________
c.[X] MFS HERITAGE TRUST COMPANY (MHTC)
NOTE: MHTC serves only as Directed (Nondiscretionary) Trustee and only
when all Plan investments are maintained on a participant
recordkeeping system used by MFS Retirement Services, Inc. pursuant
to a contract for recordkeeping and administrative support services
and all other requirements imposed by MHTC are satisfied. The Plan
Administrator is responsible for directing MHTC in the performance
of the rights, powers, duties, and obligations of the Trustee,
including, without limitation, those rights, powers, duties and
obligations with respect to the investment and distribution of Plan
assets.
d. AND, if b. above is completed, is the Trustee a Directed
(Nondiscretionary) Trustee? (If so, Plan assets are invested in
accordance with directions provided by the Plan Administrator).
1. [ ] Yes 2. [ ] No 3. [ ] N/A
e. AND, shall a separate trust agreement be used with this Plan?
1. [ ] Yes 2. [ ] No
NOTE: If Yes, an executed copy of the trust agreement between the Trustee
and the Employer must be attached to this Plan. The Plan and trust
agreement will be read and construed together. The responsibilities,
rights and powers of the Trustee shall be those specified in the
trust agreement.
11. TRUSTEES' MAILING ADDRESS:
a. [ ] Use Employer Address and Telephone Number.
b. [ ] Use other Address:
____________________________________________________________________
Street
__________________________________ __________________ ____________
City State Zip
__________________________________
Telephone
c. [X] If MFS HERITAGE TRUST COMPANY is selected as trustee.
c/o RSI
P.O. Box 2281, Boston, MA 02107-9906
12. PLAN ADMINISTRATOR'S NAME, ADDRESS AND TELEPHONE NUMBER: (If none is named,
the Employer will become the Administrator.)
a.[X] Employer (Use Employer address and telephone number).
b.[ ] Use name, address and telephone number below:
Name:
____________________________________________________________
Address:
____________________________________________________________
Street
______________________________ ________________ __________
City State Zip
______________________________ ________________ __________
Telephone:
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13. CONSTRUCTION OF PLAN
This Plan shall be governed by the laws of the state or commonwealth where
the Employer's (or, in the case of a corporate Trustee, such Trustee's)
principal place of business is located unless another state or commonwealth
is specified:________
If MFS Heritage Trust Company is selected as directed (nondiscretionary)
Trustee in Section 10. above, the Plan shall be governed by the laws of the
state of New Hampshire.
ELIGIBILITY REQUIREMENTS
14. ELIGIBLE EMPLOYEES (Plan Section 1.18)
For all purposes of the Plan (except as elected below) Eligible Employees
are all Employees (including Leased Employees) except:
a.[ ] N/A. No exclusions.
b.[X] The following are excluded (select all that apply):
1. [ ] Union Employees (as defined in Plan Section 1.18)
2. [ ] Non-resident aliens (as defined in Plan Section 1.18)
3. [ ] Salaried Employees
4. [ ] Highly Compensated Employees
5. [X] Leased Employees
6. [ ] Other:_______________________________________________________
However, for purposes of Employer Matching Contributions, Eligible Employees are
all Employees (including Leased Employees) except:
c.[X] N/A. The option elected in a. above applies for Employer Matching
Contributions.
d.[ ] The following are excluded (select all that apply):
1. [ ] Union Employees (as defined in Plan Section 1.18)
2. [ ] Non-resident aliens (as defined in Plan Section 1.18)
3. [ ] Salaried Employees
4. [ ] Highly Compensated Employees
5. [ ] Leased Employees
6. [ ] Other:_______________________________________________________
And, for purposes of Employer Profit Sharing Contributions, Eligible Employees
are all Employees (including Leased Employees) except:
e. [X] N/A. The option elected in a. above applies for Employer Profit
Sharing Contributions.
f. [ ] No exclusions
g. [ ] The following are excluded (select all that apply):
1. [ ] Union Employees (as defined in Plan Section 1.18)
2. [ ] Non-resident aliens (as defined in Plan Section 1.18)
3. [ ] Salaried Employees
4. [ ] Highly Compensated Employees
5. [ ] Leased Employees
6. [ ] Other:_______________________________________________________
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15. THE FOLLOWING AFFILIATED EMPLOYERS (Plan Section 1.6) will adopt this Plan
as Participating Employers (if there is more than one, or if Affiliated
Employers adopt this Plan after the date the Adoption Agreement is executed,
attach additional executed "Affiliated Employer Participation Agreement(s)"
to this Adoption Agreement):
a.[X] N/A
b.[ ] Name of Employer:___________________________________________________
Address:__________________________________________________________________
City:_______________________________ State:__________________ Zip:________
Telephone:_________________ Federal Tax Identification Number:____________
Type of Entity (select one):
c.[ ] Corporation (including Tax-exempt or Non-profit Corporation)
d.[ ] Professional Service Corporation
e.[ ] S Corporation
f.[ ] Limited Liability Company
g.[ ] Sole Proprietorship
h.[ ] Partnership (including Limited Liability Partnership)
i.[ ] Other_________________________________________________________________
NOTE: Employees of an Affiliated Employer that does not adopt this
Adoption Agreement as a Participating Employer shall not be Eligible
Employees. This Plan could violate the Code Section 410(b) coverage
rules if all Affiliated Employers do not adopt the Plan.
16. CONDITIONS OF ELIGIBILITY (Plan Section 3.1) Any Eligible Employee will be
eligible to participate in the Plan upon satisfaction of the following:
NOTE: If the Year(s) of Service selected is or includes a fractional year,
an Employee will not be required to complete any specified number of
Hours of Service to receive credit for such fractional year. If
expressed in months of service, an Employee will not be required to
complete any specified number of Hours of Service in a particular
month, unless elected below.
Eligibility for all purposes of the Plan (except as elected below):
a.[X] No age or service required. (skip b. and c. below)
b.[ ] Completion of the following service requirement which is based on
Years of Service (or Periods of Service if the Elapsed Time Method
is elected):
1. [ ] No service requirement
2. [ ] 1/2 Year of Service or Period of Service
3. [ ] 1 Year of Service or Period of Service
4. [ ] _____ Hours of Service within _____ months from the Eligible
Employee's employment commencement date, but in no event more
than 1 Year of Service.
5. [ ] Other: _____ (may not exceed one (1) Year of Service or
Period of Service)
c.[X] Attainment of age:
1. [X] No Age Requirement
2. [ ] 20 -1/2
3. [ ] 21
4. [ ] Other: _____ (may not exceed 21)
d.[ ] The service and/or age requirements specified above shall be waived
with respect to any Eligible Employee who was employed on _____ and
such Eligible Employee shall enter the Plan as of such date. The
requirements to be waived are (select one or both):
1. [ ] service requirement
2. [ ] age requirement
NOTE: If d. is elected, the Plan may violate the nondiscrimination rules.
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However, the following eligibility requirements will apply for purposes of
Employer Matching Contributions:
e.[X] N/A. The options elected in a. - d. above apply for Employer
Matching Contributions.
f.[ ] No age or service requirements. (skip g. and h. below)
g.[ ] Completion of the following service requirement which is based on
Years of Service (or Periods of Service if the Elapsed Time Method
is elected):
1. [ ] No service requirement
2. [ ] -1/2 Year of Service or Period of Service
3. [ ] 1 Year of Service or Period of Service
4. [ ] _____ Hours of Service within _____months from the Eligible
Employee's employment commencement date, but in no event more
than 1 Year of Service.
5. [ ] 2 Years of Service or Periods of Service
6. [ ] Other _____ (may not exceed two (2) Years of Service or
Periods of Service)
h.[ ] Attainment of age:
1. [ ] No Age Requirement
2. [ ] 20 -1/2
3. [ ] 21
4. [ ] Other _____ (may not exceed 21)
i.[ ] The service and/or age requirements specified above shall be waived
with respect to any Eligible Employee who was employed on _____ and
such Eligible Employee shall enter the Plan as of such date. The
requirements to be waived are (select one or both):
1. [ ] service requirement
2. [ ] age requirement
NOTE: If more than 1 Year of Service is elected 100% immediate vesting is
required. Also, if (i) is elected, the Plan may violate the
nondiscrimination rules.
And, the following eligibility requirements will apply for purposes of
Employer Profit Sharing Contributions:
j.[X] N/A. The options elected in a. - d. above apply for Employer Profit
Sharing Contributions.
k.[ ] No age or service requirements (skip l. and m. below).
l.[ ] Completion of the following service requirement which is based on
Years of Service (or Periods of Service if the Elapsed Time Method
is elected):
1. [ ] No service requirement
2. [ ] 1/2 Year of Service or Period of Service
3. [ ] 1 Year of Service or Period of Service
4. [ ] _____ Hours of Service within _____ months from the Eligible
Employee's employment commencement date, but in no event more
than 1 Year of Service.
5. [ ] 2 Years of Service or Periods of Service
6. [ ] Other _____ (may not exceed two (2) Years of Service or
Periods of Service)
m.[ ] Attainment of age:
1. [ ] No Age Requirement
2. [ ] 20 -1/2
3. [ ] 21
4. [ ] Other _____ (may not exceed 21)
n.[ ] The service and/or age requirements specified above shall be waived
with respect to any Eligible Employee who was employed on _____ and
such Eligible Employee shall enter the Plan as of such date. The
requirements to be waived are (select one or both):
1. [ ] service requirement
2. [ ] age requirement
NOTE: If more than 1 Year of Service is elected 100% immediate vesting is
required. Also, if n. is elected, the Plan may violate the nondiscrimination
rules.
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17. EFFECTIVE DATE OF PARTICIPATION (Plan Section 3.2)
An Eligible Employee who has satisfied the applicable eligibility
requirements will become a Participant for all purposes of the Plan
(except as elected below) on (select one):
a. [X] the day on which such requirements are satisfied.
b. [ ] the first day of the month coinciding with or next
following the date on which such requirements are satisfied.
c. [ ] the first day of the Plan Year quarter coinciding with or
next following the date on which such requirements are satisfied.
d. [ ] the earlier of the first day of the seventh month or the
first day of the Plan Year coinciding with or next following the
date on which such requirements are satisfied.
e. [ ] the first day of the Plan Year next following the date on
which such requirements are satisfied. (Eligibility must be -1/2
Year of Service (or Period of Service) or less and age must be 20
-1/2 or less.)
f. [ ] Other: ________, provided that an Eligible Employee who
has satisfied the maximum age 21 and service requirements (one
(1) Year or Period of Service) and who is otherwise entitled to
participate, shall commence participation no later than the
earlier of (a) 6 months after such requirements are satisfied, or
(b) the first day of the first Plan Year after such requirements
are satisfied, unless the Employee separates from service before
such participation date.
However, an Eligible Employee who has satisfied the applicable
eligibility requirements will become a Participant for purposes of
Employer Matching Contributions on (select one):
g. [X] N/A. The options elected in a. - f. above apply for Employer
Matching Contributions.
h. [ ] the day on which such requirements are satisfied.
i. [ ] the first day of the month coinciding with or next
following the date on which such requirements are satisfied.
j. [ ] the first day of the Plan Year quarter coinciding with or
following the date on which such requirements are satisfied.
k. [ ] the first day of the Plan Year in which such requirements
are satisfied.
l. [ ] the first day of the Plan Year in which such requirements
are satisfied, if such requirements are satisfied in the first 6
months of the Plan Year, or as of the first day of the next
succeeding Plan Year if such requirements are satisfied in the
last 6 months of the Plan Year.
m. [ ] the earlier of the first day of the seventh month or the
first day of the Plan Year coinciding with or next following the
date on which such requirements are satisfied.
n. [ ] the first day of the Plan Year next following the date on
which such requirements are satisfied, (Eligibility must be -1/2
Year of Service (or Period of Service) or less and age 20 -1/2 or
less.)
o. [ ] Other: _________, provided that an Eligible Employee who
has satisfied the maximum age 21 and service requirements (one
(1) Year or Period of Service (or more than one (1) year if full
and immediate vesting)) and who is otherwise entitled to
participate, shall commence participation no later than the
earlier of (a) 6 months after such requirements are satisfied, or
(b) the first day of the first Plan Year after such requirements
are satisfied, unless the Employee separates from service before
such participation date.
And, an Eligible Employee who has satisfied the applicable eligibility
requirements will become a Participant for purposes of Employer Profit
Sharing Contributions on (select one):
p. [X] N/A. The options elected in a. - f. above apply for Employer
Profit Sharing Contributions.
q. [ ] the day on which such requirements are satisfied.
r. [ ] the first day of the month coinciding with or next
following the date on which such requirements are satisfied.
s. [ ] the first day of the Plan Year quarter coinciding with or
following the date on which such requirements are satisfied.
t. [ ] the first day of the Plan Year in which such requirements
are satisfied.
u. [ ] the first day of the Plan Year in which such requirements
are satisfied, if such requirements are satisfied in the first 6
months of the Plan Year, or as of the first day of the next
succeeding Plan Year if such requirements are satisfied in the
last 6 months of the Plan Year.
v. [ ] the earlier of the first day of the seventh month or the
first day of the Plan Year coinciding with or next following the
date on which such requirements are satisfied.
w. [ ] the first day of the Plan Year next following the date on
which such requirements are satisfied, (Eligibility must be -1/2
Year of Service (or Period of Service) or less and age 20 -1/2 or
less.)
x. [ ] Other:_________, provided that an Eligible Employee who
has satisfied the maximum age 21 and service requirements (one
(1) Year or Period of Service (or more than one (1) year if full
and immediate vesting)) and who is otherwise entitled to
participate, shall commence participation no later than the
earlier of (a) 6 months after such requirements are satisfied, or
(b) the first day of the first Plan Year after such requirements
are satisfied, unless the Employee separates from service before
such participation date.
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SERVICE
18. RECOGNITION OF SERVICE WITH PREDECESSOR EMPLOYER
a. [ ] No service with a predecessor employer shall be recognized.
b. [X] Service with:
1. [X] Kansa will be recognized except as follows
(select a. or all that apply of b. through d.):
a. [X] N/A, no limitations.
b. [ ] service will only be recognized for vesting
purposes.
c. [ ] service will only be recognized for eligibility
purposes.
d. [ ] service prior to _________ will not be
recognized.
2. [ ] ______ will be recognized except as follows (select a.
or all that apply of b. through d.):
a. [ ] N/A, no limitations.
b. [ ] service will only be recognized for vesting
purposes.
c. [ ] service will only be recognized for eligibility
purposes.
d. [ ] service prior to _________ will not be
recognized.
NOTE: If the predecessor Employer maintained this qualified Plan or
maintained a qualified plan that has been merged with this
qualified Plan, then Years of Service (and/or Periods of Service)
with such predecessor Employer shall be recognized pursuant to
Plan Sections 1.57 and 1.85 and b.(1) above must be marked.
Attach additional sections for other predecessor Employers.
19. SERVICE CREDITING METHOD
Elapsed Time Method (If the Plan only uses the Hours of Service Method,
skip to d. - h. below)
a. Shall be used for all money types under the Plan (except as selected
below) for purposes of:
1.[X] eligibility to participate.
2.[ ] vesting.
3.[ ] sharing in allocations or contributions.
b. However, for Employer Matching Contributions, the Elapsed Time
Method shall be used for purposes of:
1.[ ] N/A. The options elected in a. above apply for Employer
Matching Contributions.
2.[X] N/A. The Hours of Service Method will be used for Employer
Matching Contributions as selected in 19(d) - (h) below.
3.[ ] eligibility to participate.
4.[ ] vesting.
5.[ ] sharing in allocations or contributions.
c. And, for Employer Profit Sharing Contributions, the Elapsed Time
Method shall be used for purposes of:
1.[ ] N/A. The options elected in a. above apply for Employer
Profit Sharing Contributions.
2.[X] N/A. The Hours of Service Method will be used for Employer
Profit Sharing Contributions as selected in 19(d) - (h) below.
3.[ ] eligibility to participate.
4.[ ] vesting.
5.[ ] sharing in allocations or contributions.
Hours of Service Method. (If the Plan only uses the Elapsed Time
Method, skip to 20., Vesting)
d. Shall be used for all money types under the Plan (except as selected
below) for purposes of:
1.[ ] Eligibility Computation. The eligibility computation period
after the initial eligibility computation period shall...
a. [ ] be based on the date an Employee first performs an
Hour of Service (initial computation period) and
subsequent computation periods shall be based on each
anniversary date thereof.
b. [ ] shift to the Plan Year after the initial computation
period.
2.[X] Vesting. The vesting computation period shall be...
a. [ ] the date an Employee first performs an Hour of
Service and each anniversary thereof.
b. [X] the Plan Year.
3.[ ] Sharing in Allocations or Contributions (the computation
period shall be the Plan Year).
e. However, for Employer Matching Contributions, the Hours of Service
Method shall be used for purposes of:
1.[X] N/A. The options elected in d. above apply for Employer
Matching Contributions.
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2.[ ] N/A. The Elapsed Time Method will be used for Employer
Matching Contributions as selected in 19(a) - (c) above.
3.[ ] Eligibility Computation. The eligibility computation period
after the initial eligibility computation period shall...
a. [ ] be based on the date an Employee first performs an
Hour of Service (initial computation period) and
subsequent computation periods shall be based on each
anniversary date thereof.
b. [ ] shift to the Plan Year after the initial computation
period.
4.[ ] Vesting. The vesting computation period shall be ...
a. [ ] the date an Employee first performs an Hour of
Service and each anniversary thereof.
b. [ ] the Plan Year.
5.[ ] Sharing in Allocations or Contributions (the computation
period shall be the Plan Year).
f. And, for Employer Profit Sharing Contributions, the Hours of Service
Method shall be used for purposes of:
1.[X] N/A. The options elected in d. above apply for Employer Profit
Sharing Contributions.
2.[ ] N/A. The Elapsed Time Method will be used for Employer
Profit Sharing Contributions as selected in 19(a) - (c) above.
3.[ ] Eligibility Computation. The eligibility computation period
after the initial eligibility computation period shall...
a. [ ] be based on the date an Employee first performs an
Hour of Service (initial computation period) and
subsequent computation periods shall be based on each
anniversary date thereof.
b. [ ] shift to the Plan Year after the initial computation
period.
4.[ ] Vesting. The vesting computation period shall be ...
a. [ ] the date an Employee first performs an Hour of
Service and each anniversary thereof.
b. [ ] the Plan Year.
5.[ ] Sharing in Allocations or Contributions (the computation
period shall be the Plan Year).
g. And, if the Hours of Service Method is being used, the Hours of
Service will be determined on the basis of the method selected
below. Only one method may be selected. The method selected below
will be applied to:
1.[ ] all Employees.
2.[ ] salaried Employees only (for hourly Employees, actual Hours
of Service will be used).
On the basis of:
3.[X] actual hours for which an Employee is paid or entitled to
payment.
4.[ ] days worked. An Employee will be credited with ten Hours of
Service if under the Plan such Employee would be credited with
at least one Hour of Service during the day.
5.[ ] weeks worked. An Employee will be credited with forty-five
Hours of Service if under the Plan such Employee would be
credited with at least one Hour of Service during the week.
6.[ ] semi-monthly payroll periods. An Employee will be credited
with ninety-five Hours of Service if under the Plan such
Employee would be credited with at least one Hour of Service
during the semi-monthly payroll period.
7.[ ] months worked. An Employee will be credited with one
hundred ninety Hours of Service if under the Plan such
Employee would be credited with at least one Hour of Service
during the month.
h. And, a Year of Service means the applicable computation period
during which an Employee has completed at least 1,000 (may not be more
than 1,000) Hours of Service (if left blank, the Plan will use 1,000
Hours of Service).
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VESTING
20. VESTING OF PARTICIPANT'S INTEREST (Plan Section 6.4(b))
Vesting for Employer Contributions (except as otherwise elected in
20(i) - (q). below for Employer Matching Contributions). The vesting
schedule, based on a Participant's Years of Service (or Periods of
Service if the Elapsed Time Method is elected), shall be as follows:
a. [ ] N/A. No Employer Contributions.
b. [ ] 100% upon entering Plan. (Required if eligibility requirement is
greater than one (1) Year of Service or Period of Service.)
c. [ ] 3 Year Cliff: d. [ ] 5 Year Cliff:
0-2 years 0 % 0-4 years 0 %
3 years 100 % 5 years 100 %
e. [X] 6 Year Graded f. [ ] 4 Year Graded:
0-1 year 0 % 1 year 25 %
2 years 20 % 2 years 50 %
3 years 40 % 3 years 75 %
4 years 60 % 4 years 100 %
5 years 80 %
6 years 100 %
g. [ ] 5 Year Graded: h. [ ] 7 Year Graded:
1 year 20 % 0-2 years 0 %
2 years 40 % 3 years 20 %
3 years 60 % 4 years 40 %
4 years 80 % 5 years 60 %
5 years 100 % 6 years 80 %
7 years 100 %
i. [ ] Other - Must be at least as liberal as either c. or g. above.
Service Percentage
1. _____________ ________________
2._____________ ________________
3._____________ ________________
4._____________ ________________
5._____________ ________________
6._____________ ________________
7._____________ ________________
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VESTING FOR EMPLOYER MATCHING CONTRIBUTIONS
The vesting schedule for Employer matching contributions, based on a
Participant's Years of Service (or Periods of Service if the Elapsed
Time Method is elected) shall be as follows:
j. [ ] N/A. No Employer Contributions.
k. [ ] N/A. The schedule in 20(a) - (h) above shall also apply to
Employer Matching Contributions.
l. [X] 100% upon entering Plan. (Required if eligibility requirement is
greater than one (1) Year of Service or Period of Service.)
m. [ ] 3 Year Cliff
n. [ ] 5 Year Cliff
o. [ ] 6 Year Graded
p. [ ] 4 Year Graded
q. [ ] 5 Year Graded
r. [ ] 7 Year Graded
s. [ ] Other - Must be at least as liberal as either l. or p. above.
Service Percentage
1. _____________ ________________
2._____________ ________________
3._____________ ________________
4._____________ ________________
5._____________ ________________
6._____________ ________________
7._____________ ________________
21. FOR AMENDED PLANS (Plan Section 6.4(f)) If the vesting schedule has
been amended to a less favorable schedule, enter the pre-amended
schedule below:
a. [X] Vesting schedule has not been amended, amended schedule is more
favorable in all years or prior schedule was immediate 100%
vesting.
b. [ ] Pre-amended schedule for all Employer Contributions except
for [ ] Employer Profit Sharing Contributions, [ ] Employer
Matching Contributions, [ ] Other:___________
Service Percentage
1. _____________ ________________
2._____________ ________________
3._____________ ________________
4._____________ ________________
5._____________ ________________
6._____________ ________________
7._____________ ________________
22. TOP HEAVY VESTING (Plan Section 6.4(c)) If this Plan becomes a Top
Heavy Plan, the following vesting schedule, based on number of Years of
Service (or Periods of Service if the Elapsed Time Method is elected),
shall apply and shall be treated as a Plan amendment pursuant to this
Plan. Once effective, this schedule shall also apply to any
contributions made before the Plan became a Top Heavy Plan and shall
continue to apply if the Plan ceases to be a Top Heavy Plan unless an
amendment is made to change the vesting schedule.
a. [ ] N/A (the regular vesting schedule(s) already satisfies one
of the minimum top heavy schedules.)
b. [X] 6 Year Graded
c. [ ] 3 Year Cliff
d. [ ] Other - Must be at least as liberal as either b. or c. above.
Service Percentage
1. _____________ ________________
2._____________ ________________
3._____________ ________________
4._____________ ________________
5._____________ ________________
6._____________ ________________
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7._____________ ________________
NOTE: This Section does not apply to the account balances of any
Participant who does not have an Hour of Service after the Plan
has initially become top heavy. Such Participant's Account
balance attributable to Employer contributions and Forfeitures
will be determined without regard to this Section.
23. FOR VESTING PURPOSES, Years of Service (or Periods of Service)
attributable to the following shall be excluded (select all that apply):
a. [X] No exclusions.
b. [ ] Service prior to the Effective Date of the Plan or a predecessor
plan.
c. [ ] Service prior to the time an Employee has attained age 18.
24. VESTING FOR DEATH AND TOTAL AND PERMANENT DISABILITY
Regardless of the vesting schedule(s), Participants shall become fully
Vested upon (select a. or all that apply of b. and c.)
a. [ ] N/A. Apply vesting schedule(s).
b. [X] Death.
c. [X] Total and Permanent Disability.
25. NORMAL RETIREMENT AGE ("NRA") (Plan Section 1.45) means the:
a. [X] date of a Participant's 65th birthday (not to exceed 65th).
b. [ ] later of a Participant's ________ birthday (not to exceed 65th)
or the __________ (not to exceed 5th) anniversary of the:
1. [ ] first day of the Plan Year in which participation in
the Plan commenced.
2. [ ] Participant's date of hire.
26. NORMAL RETIREMENT DATE (Plan Section 1.46) means the:
a. [ ] Participant's "NRA."
b. [X] first day of the month...
1. [X] coinciding with or next following the Participant's "NRA."
2. [ ] nearest the Participant's "NRA."
c. [ ] Anniversary Date (Plan Section 1.7)...
1. [ ] coinciding with or next following the Participant's "NRA."
2. [ ] nearest the Participant's "NRA."
27. EARLY RETIREMENT DATE (Plan Section 1.15).
a. Early retirement date means the:
1.[ ] No Early Retirement provision provided.
2.[ ] date on which a Participant...
a. [ ] attains age _________
b. [ ] attains age _________ and completes at least _________
Years of Service (or Periods of Service) for vesting
purposes.
3.[ ] first day of the month coinciding with or next following
the date on which a Participant...
a. [ ] attains age _________
b. [ ] attains age _________ and completes at least _________
Years of Service (or Periods of Service) for
vesting purposes.
4.[X] Anniversary Date (Plan Section 1.7) coinciding with or next
following the date on which a Participant...
a. [X] attains age 55
b. [ ] attains age _________ and completes at least Years of
Service (or Periods of Service) for vesting purposes.
b. And, if 2., 3. or 4. is selected, shall a Participant become fully
Vested upon attainment of the Early Retirement Date?
1.[X] Yes
2.[ ] No
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28. TOTAL AND PERMANENT DISABILITY (Plan Section 1.79) For purposes of
this Plan, Total and Permanent Disability shall mean:
a. [X] 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 twelve (12) months.
b. [ ] 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.
c. [ ] _________________________________________________________________
COMPENSATION (PLAN SECTION 1.11)
29. FOR ALL PURPOSES OF THE PLAN, other than Employer Matching
Contributions, Employer Profit Sharing Contributions, and 414(s)
Compensation, compensation:
a. With respect to any Participant means:
1.[X] Wages, tips and other compensation on Form W-2.
2.[ ] Section 3401(a) wages (wages for withholding purposes).
3.[ ] 415 safe-harbor compensation.
b. And, compensation shall be adjusted by (for salary deferral purposes
the Plan automatically includes amounts in 2 below): (select all
that apply)
1.[ ] N/A. No adjustments.
2.[X] including compensation which is not currently includible in
the Participant's gross income by reason of the application of
Code Sections 125 (cafeteria plan), 402(e)(3) (401(k) plan),
402(h)(1)(B) (simplified employee pension plan), 414(h)
(employer pickup contributions under a governmental plan),
403(b) (tax sheltered annuity) or 457(b) (eligible deferred
compensation plan).
3.[X] excluding reimbursements or other expense allowances, fringe
benefits (cash or non-cash), moving expenses, deferred
compensation (other than deferrals specified in b. above) to a
qualified plan and welfare benefits.
4.[X] excluding Compensation paid during the determination period
prior to the period of participation in the component of the
Plan for which the definition is being used.
5.[ ] excluding overtime.
6.[ ] excluding bonuses.
7.[ ] excluding commissions.
8.[X] other severance payments _____________________________________.
NOTE: If 5, 6, 7 or 8 is elected the definition of Compensation could
violate the nondiscrimination rules.
30. FOR PURPOSES OF EMPLOYER MATCHING CONTRIBUTIONS, compensation:
a. With respect to any Participant means:
1.[X] Wages, tips and other compensation on Form W-2.
2.[ ] Section 3401(a) wages (wages for withholding purposes).
3.[ ] 415 safe-harbor compensation.
b. And, compensation shall be adjusted by: (select all that apply)
1.[ ] N/A. No adjustments.
2.[X] including compensation which is not currently includible in
the Participant's gross income by reason of the application of
Code Sections 125 (cafeteria plan), 402(e)(3) (401(k) plan),
402(h)(1)(B) (simplified employee pension plan), 414(h)
(employer pickup contributions under a governmental plan),
403(b) (tax sheltered annuity) or 457(b) (eligible deferred
compensation plan).
3.[X] excluding reimbursements or other expense allowances, fringe
benefits (cash or non-cash), moving expenses, deferred
compensation (other than deferrals specified in b. above) to a
qualified plan and welfare benefits.
4.[X] excluding Compensation paid during the determination period
prior to the period of participation in the component of the
Plan for which the definition is being used.
5.[ ] excluding overtime.
6.[ ] excluding bonuses.
7.[ ] excluding commissions.
8.[X] other severance payments _____________________________________.
NOTE: If 5, 6, 7 or 8 is elected the definition of Compensation could
violate the nondiscrimination rules.
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31. FOR PURPOSES OF EMPLOYER PROFIT SHARING CONTRIBUTIONS, compensation:
a. With respect to any Participant means:
1.[X] Wages, tips and other compensation on Form W-2.
2.[ ] Section 3401(a) wages (wages for withholding purposes).
3.[ ] 415 safe-harbor compensation.
b. And, compensation shall be adjusted by: (select all that apply)
1.[ ] N/A. No adjustments.
2.[X] including compensation which is not currently includible in
the Participant's gross income by reason of the application of
Code Sections 125 (cafeteria plan), 402(e)(3) (401(k) plan),
402(h)(1)(B) (simplified employee pension plan), 414(h)
(employer pickup contributions under a governmental plan),
403(b) (tax sheltered annuity) or 457(b) (eligible deferred
compensation plan).
3.[X] excluding reimbursements or other expense allowances, fringe
benefits (cash or non-cash), moving expenses, deferred
compensation (other than deferrals specified in b. above) to a
qualified plan and welfare benefits.
4.[X] excluding Compensation paid during the determination period
prior to the period of participation in the component of the
Plan for which the definition is being used.
5.[ ] excluding overtime.
6.[ ] excluding bonuses.
7.[ ] excluding commissions.
8.[X] other severance payments _____________________________________.
NOTE: If 5., 6., 7. or 8. is elected the definition of Compensation
could violate the nondiscrimination rules.
32. FOR PURPOSES OF 414(s) COMPENSATION (Plan Section 1.29), compensation:
a. With respect to any Participant means:
1.[X] Wages, tips and other compensation on Form W-2.
2.[ ] Section 3401(a) wages (wages for withholding purposes).
3.[ ] 415 safe-harbor compensation.
b. And, compensation shall be adjusted by: (select all that apply)
1.[ ] N/A. No adjustments.
2.[X] including compensation which is not currently includible in
the Participant's gross income by reason of the application of
Code Sections 125 (cafeteria plan), 402(e)(3) (401(k) plan),
402(h)(1)(B) (simplified employee pension plan), 414(h)
(employer pickup contributions under a governmental plan),
403(b) (tax sheltered annuity) or 457(b) (eligible deferred
compensation plan).
3.[X] excluding reimbursements or other expense allowances, fringe
benefits (cash or non-cash), moving expenses, deferred
compensation (other than deferrals specified in b. above) to a
qualified plan and welfare benefits.
4.[X] excluding Compensation paid during the determination period
prior to the period of participation in the component of the
Plan for which the definition is being used.
5.[X] other severance payments _____________________________________.
NOTE: If 5. is elected the definition of Compensation could violate
the nondiscrimination rules.
33. COMPENSATION, for all purposes of the plan, shall be based on the
following determination period:
1.[X] the Plan Year.
2.[ ] the Fiscal Year coinciding with or ending within the Plan
Year.
3.[ ] the calendar year coinciding with or ending within the Plan
Year.
NOTE: The Limitation Year for Code Section 415 purposes shall be the
same as the determination period for Compensation unless an
alternative period is specified:
14
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CONTRIBUTIONS AND ALLOCATIONS
34. SALARY REDUCTION ARRANGEMENT - ELECTIVE DEFERRALS (Plan Section 12.2)
a. Each Participant may elect to have Compensation reduced by:
1.[ ] ________%.
2.[ ] up to_________%.
3.[X] from 1% to 20%.
4.[ ] up to the maximum percentage allowable not to exceed the
limits of Code Sections 401(k), 402(g), 404 and 415.
b. Highly Compensated Employees may only elect to reduce Compensation by:
1.[X] N/A. Same limits as specified above.
2.[ ] up to ________% (should not be greater than the limits
specified above).
3.[ ] the percentage equal to the deferral limit in effect under
Code Section 402(g)(3) for the calendar year that begins with
or within the Plan Year divided by the annual compensation
limit in effect for the Plan Year under Code Section
401(a)(17).
c. May a special salary reduction election with respect to bonuses be
made?
1.[ ] Yes, any Participant may elect to defer up to the entire
amount of any bonus.
2.[ ] Yes, any Participant may elect to defer up to _________% of any
bonus.
3.[ ] Yes, any Non-Highly Compensated Employee may elect to
defer up to the entire amount of any bonus.
4.[ ] Yes, any Non-Highly Compensated Employee may elect to
defer up to _______ % of a bonus.
5.[X] No.
d. Participants may commence salary deferrals on the effective date of
participation and on any payroll period thereafter. Participants may
modify salary deferral elections:
1.[X] as of each payroll period.
2.[ ] On the first day of the month.
3.[ ] On the first day of each Plan Year quarter.
4.[ ] On the first day of the Plan Year or the first day of the
7th month of the Plan Year.
5.[ ] Other ________ (specify a date or dates).
e. Automatic Election: Shall Participants who do not affirmatively
elect to receive cash or have at least the amount specified in 1.
below contributed to the Plan automatically have Compensation
reduced?
1.[ ] Yes, by _______% of Compensation.
2.[X] No.
NOTE: If 1. is selected, certain notices must be provided to employees.
f. Shall there be a special effective date for the salary deferral
component of the Plan?
1.[X] No.
2.[ ] Yes, the effective date of the salary deferral component of
the Plan is ________ (enter month, day and year).
35. 401(K) SAFE HARBOR PROVISIONS (Plan Section 12.8)
Will the ADP and/or ACP test safe harbor provisions be used? (select
a., b. or c.)
a. [ ] No. (If selected, skip to Question 36.)
b. [ ] Yes, but only the ADP (and NOT the ACP) Test Safe Harbor
provisions will be used.
c. [X] Yes, both the ADP and ACP Test Safe Harbor provisions will be
used.
IF c. is selected, does the Plan permit matching contributions in
addition to any safe harbor contributions elected in d. or e. below?
1.[X] No or N/A. Any matching contributions, other than any Safe
Harbor Matching Contributions elected in d. below, will be
suspended in any Plan Year in which the safe harbor provisions
are used.
2.[ ] Yes, the Employer may make matching contributions in
addition to any Safe Harbor Matching contributions elected in
d. below. (If elected, complete the provisions of the Adoption
Agreement relating to matching contributions that will apply
in addition to any elections made in d. below.) NOTE:
Regardless of any election made, the Plan automatically
provides that only Elective Deferrals up to 6% of Compensation
are taken into account in applying the match set forth in that
Question and that the maximum discretionary matching
contribution that may be made on behalf of any Participant is
4% of Compensation.
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{PAGE}
THE EMPLOYER WILL MAKE THE FOLLOWING ADP TEST SAFE HARBOR CONTRIBUTION
FOR THE PLAN YEAR:
NOTE: The ACP Test Safe Harbor is automatically satisfied if the only
matching contribution made to the Plan is either (1) a Basic
Matching Contribution or (2) an Enhanced Matching Contribution
that does not provide a match on Elective Deferrals in excess of
6% of Compensation.
d. [X] Safe Harbor Matching Contribution (select 1. or 2. AND 3.)
1.[X] BASIC MATCHING CONTRIBUTION. The Employer will make Matching
Contributions to the account of each "Eligible Participant" in
an amount equal to the sum of 100% of the amount of the
Participant's Elective Deferrals that do not exceed 3% of the
Participant's Compensation, plus 50% of the amount of the
Participant's Elective Deferrals that exceed 3% of the
Participant's Compensation but do not exceed 5% of the
Participant's Compensation.
2.[ ] ENHANCED MATCHING CONTRIBUTION. The Employer will make
Matching Contributions to the account of each "Eligible
Participant" in an amount equal to the sum of:
a.[ ] ________ % (may not be less than 100%) of the
Participant's Elective Deferrals that do not exceed
_______ % (if over 6% or if left blank, the ACP test
will still apply) of the Participant's Compensation, plus
b.[ ] ________ % of the Participant's Elective Deferrals
that exceed _________ % of the Participant's
Compensation but do not exceed ________ % (if over 6%
or if left blank the ACP test will still apply) of the
Participant's Compensation.
NOTE: a. and b. must be completed so that, at any rate of
Elective Deferrals, the matching contribution is at
least equal to the matching contribution receivable if
the Employer were making Basic Matching Contributions,
but the rate of match cannot increase as deferrals
increase. For example, if a. is completed to provide a
match equal to 100% of deferrals up to 4% of
Compensation, then b. need not be completed.
3.[X] The safe harbor matching contribution will be made on the
following basis (and Compensation for such purpose will be
based on the applicable period):
a.[X] the entire Plan Year.
b.[ ] each payroll period.
c.[ ] all payroll periods ending with or within each month.
d.[ ] all payroll periods ending with or within the Plan
Year quarter.
e. [ ] Nonelective Safe Harbor Contributions (select one)
1. [ ] The Employer will make a Safe Harbor Nonelective
Contribution to the account of each "Eligible Participant"
in an amount equal to _________ % (may not be less than
3%) of the Employee's Compensation for the Plan Year.
2. [ ] The Employer will make a Safe Harbor Nonelective
Contribution to another defined contribution plan
maintained by the Employer (specify the name of the other
plan): .
FOR PURPOSES OF THE ADP Test Safe Harbor contribution, the term
"Eligible Participant" means any Participant who is eligible to make
Elective Deferrals with the following exclusions:
f. [ ] Highly Compensated Employees.
g. [X] Employees who have not satisfied the greatest minimum age and
service conditions permitted under Code Section 410(a).
h. [ ] Other ____________________________________________________________
(must be a category that could be excluded under the permissive
or mandatory disaggregation rules of Regulations 1.401(k)-1(b)(3)
and 1.401(m)-1(b)(31)).
SPECIAL EFFECTIVE DATE OF ADP AND ACP TEST SAFE HARBOR PROVISIONS
i. [X] N/A. The safe harbor provisions are effective as of the later of
the Effective Date of this Plan or, if this is an amendment or
restatement, the effective date of the amendment or restatement.
j. [ ] The ADP and ACP Test Safe Harbor provisions are effective
for the Plan Year beginning:
_________________________________________(enter the first day
of the Plan Year for which the provisions are (or, for GUST
updates, were) effective and, if necessary, enter any other
special effective dates that apply with respect to the
provisions).
16
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36. FORMULA FOR DETERMINING EMPLOYER MATCHING CONTRIBUTIONS (Plan Section
12.1(a)(2))
NOTE: Regardless of any election below, if the ACP test safe harbor is
being used then the Plan automatically provides that only
Elective Deferrals up to 6% of Compensation are taken into
account in applying the match set forth below and that the
maximum discretionary matching contribution that may be made on
behalf of any Participant is 4% of Compensation.
a. [X] N/A. There will not be any matching contributions (Skip to
Question 37).
b. [ ] The Employer will make matching contributions equal to
_______ % of the Participant's Elective Deferrals, plus:
1. [ ] N/A.
2. [ ] additional discretionary percentage, to be determined by
the Employer.
c. [ ] The Employer may make matching contributions equal to a
discretionary percentage of the Participant's Elective Deferrals,
to be determined by the Employer.
AND, in determining the matching contributions in b. and c.
above, only Elective Deferrals up to the percentage or dollar
amount specified below will be matched:
(select 3. and/or 4. OR 5.)
3. [ ] ________ % of a Participant's Compensation.
4. [ ] $_______ .
5. [ ] a discretionary percentage of a Participant's
Compensation or a discretionary dollar amount, the
percentage or dollar
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