RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY

CARRIER ALLOCATION FORM

SALARY REDUCTION AGREEMENT

Name: ______Work Phone #______

(Print) Last Name, First Name, MI

Department ______Email Address______Campus:______

Retirement Plan:ACTSABP

(PERS,PFRS)(ALTERNATE BENEFIT PROGRAM)

Type of Activity - Check one:New EnrollmentQuarterly Change

Vesting Status(A) - Check one:I am vestedI am not vested (delayed vesting)

(ABP retirement only)

CARRIER ALLOCATION FORM

I elect to have my required 5% contribution, my employer’s 8% contribution, and my voluntary additional contribution, if any, allocated as indicated below:

 VALIC ______%  AXA EQUITABLE ______%

 THE HARTFORD ______%  ING FINANCIAL ______%

 METLIFE ______%  TIAA-CREF ______%

TOTAL ______must equal 100%

SALARY REDUCTION AGREEMENT

It is hereby agreed by and between (please print)______(employee)

and RUTGERSUNIVERSITY (employer) that the employee’s adjusted biweekly contractual salary will be reduced by the percentage indicated below. At the same time, the employer agrees to remit periodically to the investment company(ies) selected by the employee on the current Carrier Allocation Form the sum of such reduction as a premium on the annuity contracts, which are purchased by the employer on behalf of the employee.

This agreement shall be legally binding and irrevocable as to each of the parties hereto while employment continues; provided, however, that either party may terminate this Agreement as of the end of any pay period, so that it will not apply to salary subsequently earned, and provided, further, that no more than four agreements for such salary reduction may be made within any taxable year. If the University suspends the salary reduction authorized by this agreement because the employee has reached the maximum amount allowed by law, this agreement shall be reinstated as of the beginning of the next taxable year.

THE AMOUNT OF THE VOLUNTARY SALARY REDUCTION SHALL BE:

I elect to tax-defer ______% of my adjusted biweekly contractual salary* in addition to my mandatory 5% retirement contribution. I understand that the amount by which my Rutgers salary may be reduced is subject to the limitations of Section 415 and 402(g) of the Internal Revenue Code and, further, that it is my responsibility not to over tax-defer. I assume full responsibility for authorizing the level of salary reduction set forth above and accept any and all tax consequences that may result.

*NOTE: Adjusted biweekly contractual salary means gross salary minus your mandatory tax-deferred pension contribution (IRC 414 -h).

(A) Refer to reverse side for instructions and carrier information

Employee Signature ______Social Security # ______Date ______

State-authorized Investment Carriers

VALICAXA EQUITABLE

450 HeadquartersPlaza333 Thornall Street, 8th Floor

Morristown, NJ 07960Edison, NJ 08837

1-800-448-25421-866-786-0856

THE HARTFORDING FINANCIAL

303 Lippincott Center, Suite 122581 Main Street, 4th Floor

Marlton, NJ 08053Woodbridge, NJ 07095

1-800-243-7782 ext. 544001-877-873-0321

METLIFE Teachers Insurance and Annuity

Met Life ResourcesAssociation/College Retirement

400 Atrium Drive, Suite 101Equities Fund (TIAA/CREF)

Somerset, NJ 08873730 Third Avenue 732-652-1334 New York, NY 10017-3206

INSTRUCTIONS:

CARRIER ALLOCATION FORM

  1. Select the investment carrier(s) with which you want your contributions invested and the percentage to

be allocated to each carrier (percentages must be in whole numbers, and must total 100%).

2.If you are a “New Enrollment”, obtain and complete investment carrier application(s). For your convenience, a list of State-authorized investment carriers, including contact information, is provided on this form.

  1. Mail original investment carrier application(s) to the carrier. Attach a copy of application(s) to this form.

4.For changes, only one Carrier Allocation Form may be submitted each calendar quarter. Please submit this form to: Payroll Services, 65 Davidson Road, ASB, Room 317, Busch Campus.

A.VESTING :( Note:This only pertains to the Alternate Benefit Program (ABP))

Vesting usually occurs when the employee commences the second year of employment. However, if the employee meets the following criteria upon joining Rutgers, s/he is immediately vested.

a. Employee owns a retirement contract(s) containing employer and employee contributions that is based upon

employment in the field of higher education. Or,

  1. Employee is an active or vested member of a state-administered retirement system in NJ or in the US. The contract

must be in force, meaning that the employee is entitled to receive benefits from the contract at a future date.

Employees not meeting the above criteria are placed in delayed vesting. Employees who are in delayed vesting may direct their ABP contributions to only one carrier and may not transfer funds between carriers. Delayed vesting ends when the employee commences the second year of employment in an eligible position.

Revised 10/2009 Page 2