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Salary Reduction Agreement For The Tacoma Selected Vendors 403(b) Plan

Use this form ONLY for the Tacoma Selected Vendors 403(b) Plan.

You must login on the CPI website to submit an agreement to enroll, cancel, or change contribution amounts in the CPI Common Remitter Plan.

You must contact the Payroll Office to enroll, cancel, or change contribution amounts in the 457(b) Deferred Compensation Plan with either Washington State or T. Rowe Price.

Blank Salary Reduction Form

If you prefer not to complete the fillable SRA Form on this page, don't enter any information on this page, and click the ‘Generate BLANK SRA Form’ button below, complete the form by hand, sign, date, and deliver to Tacoma:

Fillable Salary Reduction Agreement

By entering your information into the fillable form below, and then clicking the 'Generate Printable SRA Form' button, you will generate a printable Salary Reduction Form which should be printed out, signed by you, and then submitted to Tacoma with documentation that you have established an account with each selected Vendor:

Your Information

Your Name, Address, and Contact information is required.

  • Name
  • Street Address
  • Apt, Suite, or Unit (if applicable)
  • City
  • State
  • Zip
  • Telephone (home or mobile)
  • Email
  • Employee ID Number
  • Agent Name and Telephone (If Applicable)

Effective Dates

Implementation: This Salary Reduction Agreement (the 'Agreement') supersedes any previous Salary Reduction Agreement for the person named below (the "Employee") under the Selected Vendors 403(b) Tax Sheltered Annuity Plan (the "Plan") offered by Tacoma Public Schools (the "Employer"), also known as Tacoma Public Schools. The salary reduction specified in this agreement will begin with the first paycheck on or after the "Effective Begin Date" specified below, provided this form is received by the Employer before the Payroll cutoff date for that paycheck. This Agreement will remain effective until a new Agreement is submitted.

  • Begin Date
Employee's Details:

Select the Appropriate Type of Agreement Below:

  • Replace/Override a Previous Selected Vendors 403(b) Plan Salary Reduction Agreement
  • Start/Initiate a Very First (new) Selected Vendors 403(b) Plan Salary Reduction Agreement
  • Cancel/Discontinue an Existing Selected Vendors 403(b) Plan Salary Reduction Agreement

    $ Traditional Dollars per Paycheck

    $ Traditional Dollars per Paycheck

    Clicking the button below will Generate a printable PDF form populated with the information entered above. You must still sign, date, and submit the form to Tacoma :