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I hereby authorize my employer to reduce my
wages, salary, earnings and/or bonus, as indicated below and that
this reduction will be a contribution under the Plan established by
my employer. This agreement applies to amounts earned until changed
by me through OneAmerica TeleServe®, the Internet, or by paper form.
In the event that AUL has all the information
necessary to establish my participant account, and my employer is
not directing the investment of contributions, and AUL has NOT
received my complete Investment Option Election form, I hereby
direct that AUL apply any contributions received on my behalf to the
plan level default **. This election shall continue
in effect until a properly completed Investment Option Election form
is received by AUL.
My compensation shall be reduced by the
following percentage per pay period.
Please select
percentage. Please refer to your Summary Plan Description for the
deferral percentages permitted by your plan or speak with your
company's Plan Administrator.
** Your request
to change your percentage will be communicated to your
employer. The effective date of this change will be determined by
your employer and is dependent upon plan document provisions.
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Personal Data