Maple Crest Manor Simple IRA PLAN
Model Notification to Eligible Employees
I. Opportunity to Participate in the SIMPLE IRA Plan
You are eligible to make salary reduction contributions to the Maple Crest Manor Simple IRA plan. This notice and the attached summary description provide you with information that you should consider before you decide whether to start, continue, or change your salary reduction agreement.
II. Employer Contribution Election
For the 2022 calendar year, the Employer elects to contribute to your SIMPLE IRA (employer must select either (1), (2), or (3)):
(1) A matching contribution equal to your salary reduction contributions up to a limit of 3% of your compensation for the year;
A matching contribution equal to your salary reduction contributions up to a limit of %number from 1 to 3 and is subject to certain restrictions) of your compensation for the year; or
(3) A nonelective contribution equal to 2% of your compensation for the year (limited to compensation of $250,000*) if you are an employee who makes at least $ (employer must insert an amount that is $5,000 or less) in compensation for the year.
III. Administrative Procedures
To start or change your salary reduction contributions, you must complete the salary reduction agreement and return it to Betty Davis by 10/01/2022.
Model Salary Reduction Agreement
Subject to the requirements of the SIMPLE IRA plan of Maple Crest Manor
Choose to contribute as percentage (%) or dollar amount ($) of your compensation:
*
As percent (%) of my compensation
As dollar amount ($) of my compensation
I authorize:
*
Enter % Amount of my eligible compensation to be withheld from my pay for each pay period and contributed to my SIMPLE IRA as a salary reduction contribution.
I authorize:
*
Enter $ Amount of my eligible compensation to be withheld from my pay for each pay period and contributed to my SIMPLE IRA as a salary reduction contribution.
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
II. Maximum Salary Reduction
I understand that the total amount of my salary reduction contributions in any calendar year cannot exceed the applicable amount for that year. See instructions.
III. Date Salary Reduction Begins
I understand that my salary reduction contributions will start as soon as permitted under the SIMPLE IRA plan and as soon as administratively feasible or, if later,
Effective Date Of Salary Reduction
*
-
Month
-
Day
Year
(Fill in the date you want the salary reduction contributions to begin. The date must be after you sign this agreement.)
IV. Duration of Election
This salary reduction agreement replaces any earlier agreement and will remain in effect as long as I remain an eligible employee under the SIMPLE IRA plan or until I provide my Employer with a request to end my salary reduction contributions or provide a new salary reduction agreement as permitted under this SIMPLE IRA plan.
Signature
*
Clear
Date
-
Month
-
Day
Year
Date
* This is the amount for 2012. For later years, the limit may be increased for cost-of-living adjustments. The IRS announces the increase, if any, in a news release, in the Internal Revenue Bulletin, and on the IRS website at IRS.gov.
Submit
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