401K Employee Sign Up Page

Please complete the online form below to make your salary deferral. Your salary deferral is the percentage of your paycheck you'd like deposited into your 401K. Please contact your HR department for information about employer matching contributions (if any). If you complete the online form below, YOU WILL BE AUTOMATICALLY ENROLLED into the appropriate Vanguard Target Date Fund coinciding with an estimated retirement age of 65. You can also check the ESG box and you will be enrolled into the appropriate Lifepath Target Date Fund if you'd like to invest in an index-like fund that considers the environmental, social, and governance factors.

IF YOU WANT TO SELECT YOUR OWN INVESTMENTS, please click "Retirement Portal Login" below and navigate through the prompts. Refer to the Online Enrollment Guide button below for more instructions.
401K Participant Application
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Field is required!
Voluntary Salary Deferral Agreement
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Field is required!
Disclaimer:
Field is required!
Field is required!
Company Name:
Company Name
Required Field
Required Field
First Name:
First Name
Required Field
Required Field
Last Name:
Last Name
Field is required!
Field is required!
Taxpayer ID:
Your Taxpayer ID:
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Field is required!
Street Address:
Street Address
Required Field
Required Field
City:
City
Required Field
Required Field
State:
  • - select a state -
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
- select a state -
Required Field
Required Field
Zip Code
Zipcode
Required Field
Required Field
Phone Number:
Your phone number
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Field is required!
Email Address:
Your email address
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Field is required!
Date of Birth:
Date of birth
Field is required!
Field is required!
Date of Hire:
Date of hire
Field is required!
Field is required!
401K Start Date (1st of the month)
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Field is required!
401(k) Contribution %:
A percentage up to 2 decimals.
Field is required!
Field is required!
Are you a Corporate Officer / Owner?
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Field is required!
Ownership % of Company:
% of Company you Own
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Field is required!
Comments & Instructions for us:
Ask us any questions...
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Signature:
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