Get Salary Redirection Agreement - Foundation Csupomona

Filling out the Salary Redirection Agreement is an important step in managing your benefits and contributions through your employer. This guide will provide you with clear, step-by-step instructions to successfully complete this form online, ensuring you understand each section and field.

Follow the steps to accurately complete the Salary Redirection Agreement online.

1. Use the 'Get Form' button to obtain the Salary Redirection Agreement and open it in your preferred online editor.
2. Begin by entering the employer's name and Tax ID number in the designated fields at the top of the form.
3. Provide the affiliate name and location, followed by the affiliate Tax ID number.
4. Indicate your choice regarding participation in the Flex One® FSA by selecting 'Yes' or 'No'.
5. Fill in the cafeteria plan year or, if newly eligible, enter your eligibility date.
6. Complete your personal details, including your social security number, date of birth, name, street address, city, state, ZIP code, and phone number.
7. State the number of payroll cycles in the plan year and the date of the first deduction.
8. Select your payroll mode from the available options: Weekly, Bi-Weekly, Semi-Monthly, or Monthly.
9. Review the section concerning your benefit elections and requested contributions, ensuring to check 'Pre-Tax' or 'After-Tax' as applicable for each coverage option.
10. If participating in a Medical or Dependent Care Reimbursement Plan, specify the per pay period deduction amounts and calculate the annual election totals.
11. Initial where required to acknowledge your understanding of the Flexible Benefits Plan and any waivers of pre-tax benefits if applicable.
12. Finally, ensure you sign and date the form before submitting it as outlined in the instructions.
13. Once all information is complete and reviewed, you may save any changes, download, print, or share the completed form as necessary.

Complete your Salary Redirection Agreement online today to manage your benefits effectively.