SIMPLE IRA Employee Salary Reduction Agreement

I, the undersigned employee, wish to set aside, as Elective Deferrals, into my Employer's SIMPLE IRA Plan by way of payroll deduction.
Financial Institution: Ameriprise Financial Services, Inc., 70100 Ameriprise Financial Center Minneapolis, MN 55475
Note: If you are eligible to defer and you attain age 50 before the close of the Plan Year, you may be able to make Catch-Up Contributions under the SIMPLE IRA plan. Certain limits, as required by law, must be met prior to being eligible to make Catch-Up Contributions. Your election above will pertain to Elective Deferrals which may include Catch-Up Contributions. See your Employer for additional information, including the Catch-Up Contribution limit for the Year.
I agree that my pay will be reduced in the manner I have indicated above, and I affirmatively elect to have this amount contributed to the investments listed below. This Salary Reduction Agreement will continue to be effective while I am employed, unless I change or terminate it as explained in Part 2. I acknowledge that I have read this entire Salary Reduction Agreement, I understand it and I agree to its terms. Furthermore, I acknowledge that I have received a copy of the Participation Notice and Summary Description.

Selection

Please list EITHER the % OR $ amount you would like withdrawn through payroll deduction:
HLM matches up to 3% contribution.
HLM matches $ amount contributions up to 3% of salary.

Signature

MM slash DD slash YYYY
Consent to Electronic Signature