AEA Deferred Salary Agreement

Equity-League 401(k) Benefit Fund

165 West 46 St., 14th Fl. New York, NY 10036

(212)869-9380 or toll free (800) 344-5220

First*

Middle*

Last*

Email (for receipt)

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Social Security No.*

Name of Show in Which Employed*

Employer's Name

Employer EIN

Effective Date: This Deferred Salary Agreement is effective for the first payroll period starting on and after,*

Date

DEFERRED SALARY CONTRIBUTIONI DO NOT ELECT TO HAVE CONTRIBUTIONS DEDUCTED FROM MY SALARY

DEFERRED SALARY CONTRIBUTION: You may elect to defer a minimum of 1% of salary on each pay period to the Equity-League 401(k) Benefit Fund, to be deposited in my Deferred Salary Account. I understand that I may revoke my election at any time or I may change this election at any time. Such revocation or change shall take effect as soon as practicable. I elect to contribute ___ %.

You can change the rate of your future Salary Deferral Contributions or suspend them by completing and submitting a new form to your employer. Such a change or suspension will take effect as soon as administratively possible.

The maximum weekly compensation that counts towards salary deferrals is $7,500.00. Under the terms of the Plan, if your weekly salary is above $7,500. the salary above $7,500 may not be deferred. regardless of how much higher your weekly salary may be. For example, if you elect to defer 1%. and your weekly salary is $9,000. your weekly deferral will be $75 (1% of $7,500 If you are employed under a contract where the weekly compensation limit is less than $7,500.00. then salary deferrals are only permitted up to that amount. Please note that you may defer only taxable income. For example, you cannot defer non-taxable overscale per diem.

In addition, your TOTAL YEARLY Deferred Salary Contribution cannot exceed the amount established by law $19,500 for 2021 to this Plan and any other employer's plan combined. Salary deferrals for ALL EMPLOYERS (not just work under Actors' Equity Association employment contracts) are limited to the maximum amounts for each tax year.

Note that if you are 50 or older by December 31 of a given calendar year, you may defer an additional $6,500 (total of $26,000) for 2021. The $7,500.00 maximum weekly compensation limit does not apply for such additional deferrals.

Any amount deferred shall be returned to the Participant if the plan does not meet IRS guidelines. To notify the Plan of salary deferrals to another Plan that may cause the limit to be exceeded. contact the Fund Office at the above address. If you are deferring salary to this and another plan. you should contact your tax advisor about the applicable limits.

Participant Signature

Date

*NOTE This deferral form will be in effect for all shows performed under the same LORT Theatre, or under the same COST employment contract, unless a new form is submitted to the Fund Office.

DEFERRED SALARY AGREEMENT