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{\fhimajor\f31536\fbidi \froman\fcharset163\fprq2 Cambria (Vietnamese);}{\fbimajor\f31538\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}{\fbimajor\f31539\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}
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{\fdbminor\f31559\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}{\fdbminor\f31561\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\fdbminor\f31562\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}
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{\fhiminor\f31576\fbidi \fswiss\fcharset163\fprq2 Calibri (Vietnamese);}{\fbiminor\f31578\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}{\fbiminor\f31579\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}
{\fbiminor\f31581\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\fbiminor\f31582\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}{\fbiminor\f31583\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}
{\fbiminor\f31584\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}{\fbiminor\f31585\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}{\fbiminor\f31586\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}}
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{\author Nelda Davila}{\operator Pino, Ann M}{\creatim\yr2011\mo5\dy22\hr11\min6}{\revtim\yr2011\mo5\dy22\hr11\min6}{\printim\yr2007\mo7\dy10\hr9\min10}{\version2}{\edmins0}{\nofpages1}{\nofwords28}{\nofchars164}{\*\company É«»¨ÌÃ}
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{\*\wgrffmtfilter 013f}\ilfomacatclnup0\ltrpar \sectd \ltrsect\linex0\endnhere\sectdefaultcl\sftnbj {\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl3
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\s17\qc \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs32\alang1025 \ltrch\fcs0 \b\fs32\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13111206  }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid13263697 {\*\xmlopen\xmlns2{\factoidname PlaceType}}{\*\xmlopen\xmlns2{\factoidname place}}University{\*\xmlclose} of {\*\xmlopen\xmlns2{\factoidname PlaceName}}Houston{\*\xmlclose}{\*\xmlclose} System
\par }\pard\plain \ltrpar\s19\qc \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 
\fs20\insrsid13263697 Retirement Program Participation Form / Salary Reduction Agreement
\par }\pard\plain \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13263697 
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\par Name: ________________________________________________    }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4793063\charrsid3825454 Empl ID:___________________________}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 
\par              }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \insrsid13263697\charrsid3825454 (Last, First, MI)
\par 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 Department: ___________________________________________    Campus: ___________________________
\par 
\par Telephone #: ___________________________________________   Campus Mail ID _____________________
\par }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \insrsid13263697\charrsid3825454 
\par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\wrapdefault\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs20\alang1025 \ltrch\fcs0 \b\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 
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\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 Effective the _______ day of _____________________, 20_____, the {\*\xmlopen\xmlns2{\factoidname place}}
{\*\xmlopen\xmlns2{\factoidname PlaceType}}University{\*\xmlclose} of {\*\xmlopen\xmlns2{\factoidname PlaceName}}Houston{\*\xmlclose}{\*\xmlclose}
 is hereby authorized and directed to reduce my compensation to purchase for me a non-transferable and non-forfeitable retirement account or tax deferred an}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454\charrsid3825454 nuity as hereinafter described.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 
\par 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f293\insrsid13263697\charrsid3825454 \loch\af293\dbch\af0\hich\f293 \'71\tab}}\pard \ltrpar\qj \fi-360\li360\ri0\widctlpar\jclisttab\tx360\wrapdefault{\*\pn \pnlvlblt\ilvl0\ls1\pnrnot0
\pnf293\pnfs24\pnindent360\pnsp120\pnhang {\pntxtb q}}\faauto\ls1\adjustright\rin0\lin360\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid13263697\charrsid3825454 Optional Retirement Program}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454  
\endash  Which will reduce my gross compensation by the amount specified by the State of {\*\xmlopen\xmlns2{\factoidname State}}Texas{\*\xmlclose}
 to provide retirement benefits; and apply said funds as payment for a retirement annuity contract selected by me }{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid13263697\charrsid3825454 and }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 
approved by the {\*\xmlopen\xmlns2{\factoidname place}}{\*\xmlopen\xmlns2{\factoidname PlaceType}}University{\*\xmlclose} of {\*\xmlopen\xmlns2{\factoidname PlaceName}}Houston System{\*\xmlclose}{\*\xmlclose}
, in accordance with the terms of the Optional Retirement Program.  The {\*\xmlopen\xmlns2{\factoidname place}}{\*\xmlopen\xmlns2{\factoidname PlaceType}}University{\*\xmlclose} of {\*\xmlopen\xmlns2{\factoidname PlaceName}}Houston System{\*\xmlclose}
{\*\xmlclose} reserves the right to amend these amounts should future legislation make it necessary to do so.   }{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid13263697\charrsid3825454 I acknowledge that the State\rquote 
s contribution for the first full year (or fractional part thereof) of participation will be refunded to the state by the ORP carrier in the event I do not begin a second year of employment with the State of {\*\xmlopen\xmlns2{\factoidname place}}
{\*\xmlopen\xmlns2{\factoidname State}}Texas{\*\xmlclose}{\*\xmlclose} in an ORP eligible position in accordance with the provisions of the Optional Retirement Statute.
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault{\*\pn \pnlvlcont\ilvl0\ls0\pnrnot0\pndec }\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid13263697\charrsid3825454 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f293\insrsid13263697\charrsid3825454 \loch\af293\dbch\af0\hich\f293 \'71\tab}}\pard \ltrpar\qj \fi-360\li360\ri0\widctlpar\jclisttab\tx360\wrapdefault{\*\pn \pnlvlblt\ilvl0\ls1\pnrnot0
\pnf293\pnfs24\pnindent360\pnsp120\pnhang {\pntxtb q}}\faauto\ls1\adjustright\rin0\lin360\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid13263697\charrsid3825454 Tax Deferred Annuity }{\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid10164761 (403b)}{\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454  \endash }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10164761  W}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 ill reduce my gross compensation by the amount shown below and apply said sum }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 (Pre-Tax) }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 toward the purchase }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454 of a 403 b agreement in my name.}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid13263697\charrsid3825454  
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault{\*\pn \pnlvlcont\ilvl0\ls0\pnrnot0\pndec }\faauto\adjustright\rin0\lin0\itap0\pararsid9399980 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f293\insrsid9399980\charrsid3825454 \loch\af293\dbch\af0\hich\f293 \'71\tab}}\pard \ltrpar\qj \fi-360\li360\ri0\widctlpar\jclisttab\tx360\wrapdefault{\*\pn \pnlvlblt\ilvl0\ls1\pnrnot0
\pnf293\pnfs24\pnindent360\pnsp120\pnhang {\pntxtb q}}\faauto\ls1\adjustright\rin0\lin360\itap0\pararsid9399980 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid9399980\charrsid3825454 Roth 403 b }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 
\endash  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10164761 W}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 ill reduce my gross compensation by the amount shown below and apply said sum (Post Tax) toward the purchase }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid3825454 of a 403b agreement in my name}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 . }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault{\*\pn \pnlvlcont\ilvl0\ls0\pnrnot0\pndec }\faauto\adjustright\rin0\lin0\itap0\pararsid3825454 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f293\insrsid3825454 \loch\af293\dbch\af0\hich\f293 \'71\tab}}\pard \ltrpar\qj \fi-360\li360\ri0\widctlpar\jclisttab\tx360\wrapdefault{\*\pn \pnlvlblt\ilvl0\ls1\pnrnot0
\pnf293\pnfs24\pnindent360\pnsp120\pnhang {\pntxtb q}}\faauto\ls1\adjustright\rin0\lin360\itap0\pararsid9399980 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid3825454 457 DC (Texa$aver) }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454 \endash  }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid10164761 W}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454 ill reduce my gross compensation by the amount shown below and apply said sum (pre-tax) toward the purchase defer compensation agreement in my name.}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid3825454\charrsid3825454 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid13263697 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 
\par }}}{\shprslt{\*\do\dobxmargin\dobymargin\dodhgt8192\dptxbx\dptxlrtb{\dptxbxtext\ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13263697\charrsid3825454 Employee Information}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 :
\par 
\par Name: ________________________________________________    }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4793063\charrsid3825454 Empl ID:___________________________}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 
\par              }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \insrsid13263697\charrsid3825454 (Last, First, MI)
\par 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 Department: ___________________________________________    Campus: ___________________________
\par 
\par Telephone #: ___________________________________________   Campus Mail ID _____________________
\par }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \insrsid13263697\charrsid3825454 
\par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\wrapdefault\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs20\alang1025 \ltrch\fcs0 \b\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid13263697\charrsid3825454 Participation Acknowledgement
\par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 

\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 Effective the _______ day of _____________________, 20_____, the {\*\xmlopen\xmlns2{\factoidname place}}
{\*\xmlopen\xmlns2{\factoidname PlaceType}}University{\*\xmlclose} of {\*\xmlopen\xmlns2{\factoidname PlaceName}}Houston{\*\xmlclose}{\*\xmlclose}
 is hereby authorized and directed to reduce my compensation to purchase for me a non-transferable and non-forfeitable retirement account or tax deferred an}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454\charrsid3825454 nuity as hereinafter described.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 
\par 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f293\insrsid13263697\charrsid3825454 \loch\af293\dbch\af0\hich\f293 \'71\tab}}\pard \ltrpar\qj \fi-360\li360\ri0\widctlpar\jclisttab\tx360\wrapdefault{\*\pn \pnlvlblt\ilvl0\ls1\pnrnot0
\pnf293\pnfs24\pnindent360\pnsp120\pnhang {\pntxtb q}}\faauto\ls1\adjustright\rin0\lin360\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid13263697\charrsid3825454 Optional Retirement Program}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454  
\endash  Which will reduce my gross compensation by the amount specified by the State of {\*\xmlopen\xmlns2{\factoidname State}}Texas{\*\xmlclose}
 to provide retirement benefits; and apply said funds as payment for a retirement annuity contract selected by me }{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid13263697\charrsid3825454 and }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 
approved by the {\*\xmlopen\xmlns2{\factoidname place}}{\*\xmlopen\xmlns2{\factoidname PlaceType}}University{\*\xmlclose} of {\*\xmlopen\xmlns2{\factoidname PlaceName}}Houston System{\*\xmlclose}{\*\xmlclose}
, in accordance with the terms of the Optional Retirement Program.  The {\*\xmlopen\xmlns2{\factoidname place}}{\*\xmlopen\xmlns2{\factoidname PlaceType}}University{\*\xmlclose} of {\*\xmlopen\xmlns2{\factoidname PlaceName}}Houston System{\*\xmlclose}
{\*\xmlclose} reserves the right to amend these amounts should future legislation make it necessary to do so.   }{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid13263697\charrsid3825454 I acknowledge that the State\rquote 
s contribution for the first full year (or fractional part thereof) of participation will be refunded to the state by the ORP carrier in the event I do not begin a second year of employment with the State of {\*\xmlopen\xmlns2{\factoidname place}}
{\*\xmlopen\xmlns2{\factoidname State}}Texas{\*\xmlclose}{\*\xmlclose} in an ORP eligible position in accordance with the provisions of the Optional Retirement Statute.
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault{\*\pn \pnlvlcont\ilvl0\ls0\pnrnot0\pndec }\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid13263697\charrsid3825454 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f293\insrsid13263697\charrsid3825454 \loch\af293\dbch\af0\hich\f293 \'71\tab}}\pard \ltrpar\qj \fi-360\li360\ri0\widctlpar\jclisttab\tx360\wrapdefault{\*\pn \pnlvlblt\ilvl0\ls1\pnrnot0
\pnf293\pnfs24\pnindent360\pnsp120\pnhang {\pntxtb q}}\faauto\ls1\adjustright\rin0\lin360\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid13263697\charrsid3825454 Tax Deferred Annuity }{\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid10164761 (403b)}{\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454  \endash }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10164761  W}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 ill reduce my gross compensation by the amount shown below and apply said sum }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 (Pre-Tax) }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697\charrsid3825454 toward the purchase }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454 of a 403 b agreement in my name.}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid13263697\charrsid3825454  
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault{\*\pn \pnlvlcont\ilvl0\ls0\pnrnot0\pndec }\faauto\adjustright\rin0\lin0\itap0\pararsid9399980 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f293\insrsid9399980\charrsid3825454 \loch\af293\dbch\af0\hich\f293 \'71\tab}}\pard \ltrpar\qj \fi-360\li360\ri0\widctlpar\jclisttab\tx360\wrapdefault{\*\pn \pnlvlblt\ilvl0\ls1\pnrnot0
\pnf293\pnfs24\pnindent360\pnsp120\pnhang {\pntxtb q}}\faauto\ls1\adjustright\rin0\lin360\itap0\pararsid9399980 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid9399980\charrsid3825454 Roth 403 b }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 
\endash  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10164761 W}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 ill reduce my gross compensation by the amount shown below and apply said sum (Post Tax) toward the purchase }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid3825454 of a 403b agreement in my name}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980\charrsid3825454 . }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9399980 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault{\*\pn \pnlvlcont\ilvl0\ls0\pnrnot0\pndec }\faauto\adjustright\rin0\lin0\itap0\pararsid3825454 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f293\insrsid3825454 \loch\af293\dbch\af0\hich\f293 \'71\tab}}\pard \ltrpar\qj \fi-360\li360\ri0\widctlpar\jclisttab\tx360\wrapdefault{\*\pn \pnlvlblt\ilvl0\ls1\pnrnot0
\pnf293\pnfs24\pnindent360\pnsp120\pnhang {\pntxtb q}}\faauto\ls1\adjustright\rin0\lin360\itap0\pararsid9399980 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid3825454 457 DC (Texa$aver) }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454 \endash  }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid10164761 W}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3825454 ill reduce my gross compensation by the amount shown below and apply said sum (pre-tax) toward the purchase defer compensation agreement in my name.}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid3825454\charrsid3825454 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid13263697 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 
\par }}\dpx-699\dpy952\dpxsize10080\dpysize7560\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13263697 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang1024\langfe1024\noproof\insrsid16669842 
{\shp{\*\shpinst\shpleft5541\shptop9254\shpright6981\shpbottom9686\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz2\shplid1027{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn dhgt}{\sv 251657728}}{\sp{\sn fLayoutInCell}{\sv 1}}{\sp{\sn fPseudoInline}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 1}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8194\dprect\dpx5541\dpy9254\dpxsize1440\dpysize432
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft2301\shptop9254\shpright3741\shpbottom9686\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz3\shplid1028{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn dhgt}{\sv 251658752}}{\sp{\sn fLayoutInCell}{\sv 1}}{\sp{\sn fPseudoInline}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 1}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8195\dprect\dpx2301\dpy9254\dpxsize1440\dpysize432
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft-699\shptop7574\shpright9381\shpbottom11174\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz1\shplid1029{\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn lTxid}{\sv 131072}}{\sp{\sn dhgt}{\sv 251656704}}{\sp{\sn fLayoutInCell}{\sv 1}}{\sp{\sn fPseudoInline}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 1}}{\shptxt \ltrpar \pard\plain \ltrpar
\ql \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13263697 Contract Criteria:
\par }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13263697 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 Name of Carrier: _____________________________________________________________________
\par 
\par Agent Name ___________________________________  Telephone # __________________________
\par 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  Initial Authorization      }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 
{\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697   Amended Authorization     }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts"
 \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  Termination of Salary Agreement     }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid13263697  Carrier Change
\par 
\par 
\par Reduction Amount:  Monthly:                                              or Bi-Weekly: 
\par 
\par Is Age Related or Retirement Date Catch-up provision being used?     \tab }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 
 Yes      }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  No
\par 
\par Is 402(g) Service Date Catch-up provision being used?\tab \tab }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  Yes      }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  No\tab 
\par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8193\dptxbx\dptxlrtb{\dptxbxtext\ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13263697 Contract Criteria:
\par }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13263697 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 Name of Carrier: _____________________________________________________________________
\par 
\par Agent Name ___________________________________  Telephone # __________________________
\par 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  Initial Authorization      }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 
{\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697   Amended Authorization     }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts"
 \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  Termination of Salary Agreement     }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid13263697  Carrier Change
\par 
\par 
\par Reduction Amount:  Monthly:                                              or Bi-Weekly: 
\par 
\par Is Age Related or Retirement Date Catch-up provision being used?     \tab }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 
 Yes      }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  No
\par 
\par Is 402(g) Service Date Catch-up provision being used?\tab \tab }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  Yes      }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697 {\field{\*\fldinst SYMBOL 113 \\f "Monotype Sorts" \\s 10}{\fldrslt\f293\fs20}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13263697  No\tab 
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This agreement shall continue for the duration of my employment; provided that a change, modification, or termination of the agreement may be made only as prescribed by law and the {\*\xmlopen\xmlns2{\factoidname PlaceType}}
{\*\xmlopen\xmlns2{\factoidname place}}{\*\xmlopen\xmlns2{\factoidname PlaceName}}University{\*\xmlclose}{\*\xmlclose} of {\*\xmlopen\xmlns2{\factoidname PlaceName}}Houston System{\*\xmlclose}{\*\xmlclose}
 rules governing the Optional Retirement Program and the Tax Deferred Annuity Program.  It is agreed and understood that the {\*\xmlopen\xmlns2{\factoidname PlaceType}}{\*\xmlopen\xmlns2{\factoidname place}}{\*\xmlopen\xmlns2{\factoidname PlaceName}}
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\par 
\par I hereby acknowledge that I have read and understand the above information.  I further understand that the {\*\xmlopen\xmlns2{\factoidname PlaceType}}{\*\xmlopen\xmlns2{\factoidname place}}{\*\xmlopen\xmlns2{\factoidname place}}
{\*\xmlopen\xmlns2{\factoidname PlaceName}}University{\*\xmlclose}{\*\xmlclose} of {\*\xmlopen\xmlns2{\factoidname place}}Houston System{\*\xmlclose}{\*\xmlclose}{\*\xmlclose}
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\par 
\par Employee Signature _____________________________________________________  \tab \tab Date __________________________________
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\par Human Resources Approval _______________________________________________\tab \tab Date __________________________________
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This agreement shall continue for the duration of my employment; provided that a change, modification, or termination of the agreement may be made only as prescribed by law and the {\*\xmlopen\xmlns2{\factoidname PlaceType}}
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