If you would like a 401k/Roth deduction from your 2021 year-end bonus please fill out THIS form.  If you do not wish to have a 401k/Roth amount deducted from your bonus, you do not need to fill out a form.  When completed, return the form to your supervisor no later than close of business (5pm EST) November 24th.

Here are some instructions:

  • Print personal information (Click here for the form)
  • Indicate 401k or Roth Amount
    • If you decline to have any 401(k) or Roth amounts taken from your bonus check, no action is required.  You do not need to turn in a form.
    • If you prefer to have a 401(k) or Roth amount taken from your bonus check, indicate the dollar or percentage amount
  • Sign, date, and return to supervisor
    • Supervisors are responsible to return forms back to payroll

Anyone that we do not receive a form back from will not have any 401k or Roth deducted from their bonus check.   If you have any questions, please reach out to Tracy Marks or Patti Taylor at [email protected].