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Page 1: University of Southern California Sec on 457(b) Plan For

University of Southern California Sec on 457(b) Plan For Eligible Faculty and Administra ve Staff

2018 Salary Deferral Agreement

Sec on A – Employee Informa on – Please PRINT Last Name

First Name USC Employee Number (7digit #)

Day me Phone Number Email address

or

The Par cipant is an individual who had income inexcess of $200,000 in each of the two most recentyears, or joint income with his or her Spouse inexcess of $300,000 in each of those years (in eachcase including foreign income, tax exempt incomeand full amount of capital gains and losses butexcluding any income of other family members andany unrealized capital apprecia on) and has areasonable expecta on of reaching the same incomelevel in the current year

t worth, or joint net worth with his or her spouse,

worth, you may include equity in personal property and real estate (however, you cannot include your primary residence), cash, short term investments,

real estate (excluding your primary residence) should be based on the fair market value of such property minus debt secured by such property)

or

The Par cipant is a trustee orexecu ve officer of the University.(The president and any vicepresident and any officer or personwho performs a “policy makingfunc on” for the University will bean “execu ve officer.”)

Con nue prior year’s Elec on

amounts will be adjusted to track with IRS annual limit)

Skip Sec on D

Sec on D – Contribu on Informa on

Start Date: Begin my par cipa on as soon as administra vely possible or Start ____________________ 2018

month Annual Amount: Maximum ($18,500) or $ ___________________ annually

Monthly Deduc on and Vendor Elec on:

Evenly distribute my monthly deduc on based on pay frequencies available and the vendor(s) indicated below:

or Allocate my monthly deferral as indicated below:

Fidelity Fidelity $____________ Per month

TIAA-CREF $____________ Per month TIAA-CREF

Vanguard

Vanguard $____________ Per month

Sec on E – Your Authoriza on

By this agreement made between the above named employee (“the Par cipant”) and the University of Southern California (“the University”), the par es hereto agree asfollows:

Effec ve with respect to amounts paid on or otherwise made available on or a er January 2018, which date is subsequent to the last day of the month in which this Agreement is executed, the Par cipant has elected to defer the amount indicated from his/her salary. At the same me, the University will contribute a corresponding amount to the University of Southern California Sec on 457(b) Plan for Eligible Faculty and Administra ve Staff (the “Plan”) and the Par cipant may direct the investment of such amount among the funds approved by the University. This agreement shall be legally binding and irrevocable with respect to amounts paid or otherwise made available while this Agreement is in effect, except that the University may reduce the amount deferred if it determines that such amount exceeds the applicable limita ons of the Plan and Code Sec on 457. This Agreement may be changed or revoked at any me, effec ve for the calendar month following the month in which such change or revoca on occurs. In no case will the Agreement result in deferral of salary which will cause the contribu on to the Par cipant’s account to exceed the applicable limits of Internal Revenue Code Sec on 457(b). For 2018, this limit is $18,500 .

The Par cipant hereby cer es that his or her responses to the above ques ons are true and correct: ____________________________________________________________ _______________________ Employee Signature Date

Office of Benefits Administra on

Fax: (213) 740-3875

Fax (213) 821-8107 - Phone (213) 821-8106 OFFICE USE ONLY

ANNUAL AMOUNT

PAY FREQ MONTHLY DEDUCTION VENDOR APPROVED BY:

“Par cipant" hereby represents that he or she is an "Accredited Investor" for one or more of the following reasons Sec on B — (Check applicable statements)

First Time Enrollment(Vendor enrollmentform must accompanythis form)

Change MonthlyAmount of Deferral

Change Vendor only (if first me usingvendor a vendorenrollment formmust be included)

Stop Salary Deferral

Sec on C – Type of Transac on

If you choose to par cipate, complete this Salary Reduc on Agreement and fax, mail or deliver to:

3720 S. Flower Street 2nd Floor —Los Angeles, CA 90089-0704