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

Create Online Account to Submit & Manage Salary Reduction Agreements

Current and New Participants

  • To create an online account to submit and manage your Salary Reduction Agreements, click here.

  • If you have already established a login account on this website click here or click the "Login" link at the top right of this page to access your account.

  • If you do not wish to create an Online Account but wish to enroll, you may submit an SRA in paper format (for more information please see below).

Options Below this Line Are For Paper SRA Submission Only

Blank Salary Reduction Form

If you do not wish to have online access and prefer not to complete the fillable SRA Form on this page, you may click the ‘Generate BLANK SRA Form’ button below, complete the form by hand, sign, date, and deliver to CCC:

Fillable Salary Reduction Agreement

If you do not wish to have online access, but would like to complete the fillable form below, you may fill in the requested information below, click on the ‘Generate Printable SRA Form Populated With Above Information’ button at the bottom of this page, print it off, sign, date and deliver to CCC 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
  • Social Security 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 School District 1C, Clatsop County, Oregon (the "Employer"), also known as Astoria School District. 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 403(b) Plan Salary Reduction Agreement
  • Start/Initiate a Very First (new) 403(b) Plan Salary Reduction Agreement
  • Cancel/Discontinue an Existing 403(b) Plan Salary Reduction Agreement (Cancels Deductions to All Vendors)

Distribution Among Vendors

If selecting a new Vendor, you MUST include documentation that an account has been established with the new Vendor that is linked to Astoria. Vendor accounts linked to former employers may not be used for contributions at Astoria. Astoria allows you to contribute to a maximum of 3 different vendors. If Replacing/Overriding a Previous Salary Reduction Agreement or Starting/Initiating a New Salary Reduction Agreement, you must select at least one Vendor.

$ Traditional Dollars per Paycheck
$ Roth Dollars per Paycheck
Or % Traditional Percent
Or % Roth Percent

$ Traditional Dollars per Paycheck
$ Roth Dollars per Paycheck
Or % Traditional Percent
Or % Roth Percent

$ Traditional Dollars per Paycheck
$ Roth Dollars per Paycheck
Or % Traditional Percent
Or % Roth Percent

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 CCC :


Page Last Modified: 7/9/2018 12:48:55 PM