1990-31357-Resolution No. 90-096 Recorded 10/5/199090 -31357
BEFORE THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON
REVI,V,'LD
A Resolution Approving the
Fifth Amendment to the
Deferred Compensation Plan
for Deschutes County
Employees.
RESOLUTION NO. 90 -096
MIC OFILMED
OCT1 81990
WHEREAS, Deschutes County adopted a deferred compensation
plan by Resolution No. 84 -001; and
WHEREAS, the Board of County Commissioners having considered
and approved participation by plan participants in IDS Financial
Services, Inc.; now, therefore,
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
DESCHUTES COUNTY, OREGON, as follows:
Section 1. That the Fifth Amendment to the Deferred Compen-
sation Plan for Deschutes County employees, marked Exhibit "A,"
attached hereto and by this reference incorporated herein, is
hereby approved.
Section 2. That the Administrator is hereby authorized to
execute for the County individual participation agreements and to
execute such agreements and contracts as are necessary under the
program.
DATED this „t day of ) , 1990.
BOARD OF COUNTY COMMISSIONERS
OF DESC TES COUJ TY, OREGON
LOIS B
TOW PRANTE, Commissioner
A EST: Chair
Recording` Secretary i CK MAUDLIN, Commissioner
1 - RESOLUTION NO. 90 -096
105 0143
EXHIBIT "A"
FIFTH AMENDMENT TO
DEFERRED COMPENSATION PLAN
FOR
DESCHUTES COUNTY EMPLOYEES
1. This Fifth Amendment amends the Deferred Compensation Plan
for Deschutes County employees adopted January 11, 1984,
(the "Plan "), and the terms used in the plan shall have the
same meaning in this Fifth Amendment.
2. The Participation Agreement or Consent to Compensation
Change Form is amended as set forth in Exhibit "1," attached
hereto and by this reference incorporated herein.
1 - FIFTH AMENDMENT TO DEFERRED COMPENSATION PLAN
105 0144
EXHIBIT "1"
PARTICIPATION AGREEMENT OR
CONSENT TO COMPENSATION CHANGE
Social Security No.
Name of Public Employee Sex DOB
Address City State Zip
Employer Division or Department
I have read the attached Deschutes County Deferred Compensation Plan
(Plan).
Deferral of Compensation or Chanae of Amount
I wish to have a portion of my compensation deferred under the Plan
until I terminate service with Deschutes County.
I wish to begin deferring compensation as of the day
of , 19
Subject to the limits stated in the plan, I want to defer:
$ each pay period as follows:
Total
$ To John Hancock Mutual Life
$ To Great West Life
$ To Benjamin Franklin Savings and Loan
$ To Lincoln National Life
(American Funds Group)
$ To Nationwide Life Insurance Co.
$ To North American Security Life
Venture Annuity Contract
$ IDS Financial Services, Inc.
(Non -Stock Plans)
I request that the amount of compensation I elected to defer with said
agreement be paid to me pursuant to the terms of the Plan.
1 - PARTICIPATION AGREEMENT OR CONSENT TO COMPENSATION CHANGE
•
Selection of Option
105
I wish to elect the following form of payment pursuant to
Single Lump Sum Payment
Payment for a Specified Period
Life Annuity
Life Annuity with Period Certain Guaranteed
Joint and Survivor Annuity
Desianation or Chanae of Beneficiary.
- -0145
the Plan:
In the event of my death, when and if a beneficiary is entitled to
receive my benefits under this Plan, I designate the following person as my
beneficiary.
Name of Beneficiary:
Relationship to me, if any:
Street Address:
I realize that this Agreement will continue to be effective until I
elect in writing to stop deferring compensation or the County amends or
terminates the Plan.
If I elect to stop deferring compensation, I must file a written
election to discontinue deferral with the Administrator before the begin-
ning of the first pay period for which I wish no compensation to be
deferred.
Election to Discontinue Deferral of Compensation
I elect to stop deferral of my compensation effective on the day
of , 19
Agreed this
day of , 19 , at
State
Signed:
Participant
Acknowledgment of Receipt by Employer:
Signature
Title
Date
City
2 - PARTICIPATION AGREEMENT OR CONSENT TO COMPENSATION CHANGE