Pension Plan Enrollment Form
Name: Peter Sumner | Date of Birth: 7//23/2053 |
Employee ID: 908-890 | Social Security Number: 9088764 |
Job Title: Senior Accountant | Date of Hire: 4/14/2074 |
Pension Plan Options
Please select the pension plan option you wish to enroll in:
Beneficiary Designation
In the event of your passing, please provide the following information regarding your chosen beneficiary:
Full Name: [Beneficiary Name]
Relationship: [Beneficiary Relationship]
Date of Birth: [MM/DD/YYYY]
Social Security Number: [00-000000]
Contribution Election
Please indicate your contribution preferences for the Defined Contribution Plan (if applicable):
Employee Contribution (Minimum 3%, Maximum 10%):
Employer Contribution:
Consent and Acknowledgment
I [Employee Name], hereby acknowledge that I have received and reviewed the summary plan description for the selected pension plan. I understand that I have the right to obtain additional information about the plan, including a copy of the full plan document, and I may contact the HR department for such information.
I agree to the terms and conditions of the pension plan and authorize the appropriate deductions from my salary for my chosen contribution rate, if applicable. I understand that I have the option to change my contribution rate during the annual open enrollment period or due to qualifying life events.
[Employee Signature]
Date: [MM/DD/YYYY]
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