Manor Concrete Construction 401(k) Plan

CAPITAL GROUP AMERICAN FUNDS

Manor Concrete Constructoin 401(k) Plan
For questions regarding this form, visit the Web site at myretirement. americanfunds.co or contact Service Center at 1-800-204-3731.

Account extension, if applicable, identifies funds transferred to a beneficiary due to participant's death, alternate payee due to divorce or a participant with multiple accounts
Account Extension
Account extension, if applicable, identifies funds transferred to a beneficiary due to participant's death, alternate payee due to divorce or a participant with multiple accounts.
SSN
Name (The name provided MUST match the name on file with Service Center

First NameLast Name
Middle Initial
Daytime Phone Number
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Payroll Election(s)

Paycheck Contribution Election (Payroll Deductions)
Select One:

StartRestartChangeStop
I elect to contribute to the Plan the following of my eligible compensation indicated below (per pay period):

Before Tax ContributionsRoth Contributions
Before Tax $ (do not complete both) (up to $19,500.00)
Before Tax % (do not complete both) (1% - 100%)
Roth $ (do not complete both) (up to $19,500.00)
Roth % (do not complete both) (1% - 100%)
Date of Hire

MonthDayYear
Date
The total annual before-tax and Roth contributions cannot exceed $19,500.00 of my eligible compensation in the 2021 tax year.
Age 50 Catch-Up Election
I elect to contribute to the Plan additional Age 50 Catch-Up amounts of my eligible compensation as indicated below (per pay period):

The total before-tax and Roth Age 50 Catch-Up amount cannot exceed $6,500.00 of my eligible compensation in the 2021 tax year. I must be
age 50 or older during this calendar year and I must be currently deferring the maximum amount allowable under the Internal Revenue Code
and applicable regulations and/or my Plan. If I stop my deferrals and/or do not defer the maximum amount during this calendar year, the Age 50
Catch-Up amount I have elected to contribute will not be considered a Catch-Up deferral. The Catch-Up contributions will be allocated in the same
manner as my regular contributions.
I elect to cancel my Catch-Up contribution election.

Yes
Signatures and Consent

Participant Consent
My signature acknowledges that I have read, understand and agree to all pages of this form and affirms that all information that I have provided
is true and correct. I also understand that:
- Until cancelled, superseded or I cease to be an eligible employee, all election(s) shall apply to all eligible compensation allowed by the Plan
  paid from the effective date specified unless a different effective date is required under the terms of the Plan and cancels all previous elections.
- I may change the amount of compensation contributed as allowed under the terms of the Plan.
- It is my responsibility to comply with any Internal Revenue Code deferral limits and that I may be responsible for any costs, including taxes
  and penalties that I may incur as a result of excess contributions.
- My Plan Administrator may take any action that may be necessary to ensure that my participation is in compliance with any applicable
  requirement of the Plan Document and the Internal Revenue Code.
- I authorize the payroll deduction as indicated on this form.
Participant Signature

Clear
Date (Required)

MonthDayYear
Date
Name

First NameLast Name
Middle Initial
Social Security Number
Should be Empty:

CAPITAL GROUP AMERICAN FUNDS

Payroll Election(s)

Age 50 Catch-Up Election

Signatures and Consent