Office of Human Resources TIAA/CREF RETIREMENT CONTRIBUTION AND SALARY REDUCTION AGREEMENT

NAME: ______DEPARTMENT: ______

SSN: ______DATE OF HIRE: ______

MONTHLY PAYROLL: ______BI-WEEKLY PAYROLL: ______

I elect to contribute my monthly/bi-weekly pay as follows:

Level of Employee Trinity’s Trinity’s Total Contribution Contribution Contribution Match Select One: % % RA  0 2.00 2.00  1 0.66 2.66  2 1.33 3.33  3 2.00 4.00  4 2.66 4.66  5 3.33 5.33  6 4.00 6.00 SRA  $ ______Total Election: (RA) % ______(RA) %______(SRA) $ ______

I agree to hold harmless and indemnify Trinity Washington University, its officers and employees, from any demand or claim asserted by the Internal Revenue Service of payment by the University of income taxes, and any interest of penalties related thereto, which taxes and other sums are due on wages paid by the University and not deducted or withheld by the University in the full amount by reason of said employee or employee’s agents to correctly compute the maximum exclusion allowance, for tax sheltering purpose.

______Employee Signature Date TIAA/TIAA CREF FORM