Salary Deferral Agreement

Name*:

Address*:

City*:

State*:

Zip Code*:

Date of Birth*:

Phone*:

Email*:

Employer Name*:

Beneficiary Name*:

Role:

Relationship:

Secondary Beneficiary Name:

Role:

Relationship

I authorize my Employer to defer the total above per pay period crediting to the investment(s) indicated as follows: this dollar amount will replace previous deferral amount)*:

Amount per pay period*:

Select from the following options (see link below form for Investment Performance Information):

N. Conservative Long-Term:

O. Moderate Long-Term:

P. Aggressive Long-Term:

A. NSB Variable Rate:

B. NSB Blended Rate:

C. BlackRock Equity Dividend:

D. TAP Stock Index:

E. Nicholas Fund:

F. TAP Large Core:

G. TAP Large Growth:

H. TAP Mid Value:

I. Nicholas II Fund:

J. Nicholas Limited Edition Fund:

K. Royce Pennsylvania Small Core:

L. Federated Total Return Bond:

M. EuroPacific Growth R3:

S. Morgan Stanley Mid Cap Growth:

T. Nicholas Equity Income Fund:

U. American Fundamental Investors R-4:

V. Heartland Value Plus:

Y. BlackRock LifePath 20XX:

If investing in BlackRock LifePath:

Total Per Pay Period*:

*All mutual fund investment options provided within this plan are; not insured by the FDIC or any other agency of the United States or the bank; are not deposits or other obligations of the institution and are not guaranteed by North Shore Bank; and are subject to investment risks, including loss of principal. Neither the EMPLOYER nor North Shore Bank can provide any level of assurance that these funds will perform in a specific manner.

Investment Performance Information

Account Management Resources

FAQs

Distributions are not required at the time of retirement, but are required beginning in the year you attain the age of 72 years. However, you may elect to take your distribution at termination of employment as a lump sum, monthly, quarterly or annual payment. You may also choose to roll over your funds as permitted in your plan document. North Shore Bank will assist you in structuring your repayments to meet your individual needs and goals.

Yes, participation in a 457 plan does not preclude you from participating in other retirement plans.

The minimum deferral is $10.00 per pay period. The maximum deferral may change annually. As of tax year 2025, the contribution limit is $23,500. Employees age 50 and older are eligible for catch up contributions of an additional $7,500 with total allowable to $31,000.

Since the inception of the North Shore Bank Deferred compensation program, the bank has assessed no service charges or administrative fees for funds allocated to a North Shore Bank Certificate of Deposit. A small annual asset fee is incurred when funds are allocated to the mutual fund options.

Note:

Our representatives may not give legal or tax advice. Please consult your attorney or tax advisor for answers to your specific tax questions.
Your North Shore Bank 457(b) Plan can be funded by both FDIC insured North Shore Bank Certificates of Deposit (CDs) and/or non-Bank investments provided through TransAmerica Funds.
Investments held in North Shore Bank CDs are FDIC insured.
However, investments other than North Shore Bank CDs are NOT a deposit or other obligation of the Bank or its affiliates; NOT insured by the FDIC or any other agency of the United States; are subject to investment risk, including possible loss of value.

Yes, participation in a 457 plan does not preclude you from participating in other retirement plans.

Note:

Our representatives may not give legal or tax advice. Please consult your attorney or tax advisor for answers to your specific tax questions.
Your North Shore Bank 457(b) Plan can be funded by both FDIC insured North Shore Bank Certificates of Deposit (CDs) and/or non-Bank investments provided through TransAmerica Funds.
Investments held in North Shore Bank CDs are FDIC insured.
However, investments other than North Shore Bank CDs are NOT a deposit or other obligation of the Bank or its affiliates; NOT insured by the FDIC or any other agency of the United States; are subject to investment risk, including possible loss of value.

Salary Deferral Agreement

Account Management Resources

FAQs

How are my Section 457 distributions paid to me when I retire?

May I participate in a Section 457 plan in addition to other retirement plans?

What are the minimum and maximum amounts I can contribute to a 457 plan?

What costs are involved in a deferred compensation plan?

How are my Section 457 distributions paid to me when I retire?

May I participate in a Section 457 plan in addition to other retirement plans?

What are the minimum and maximum amounts I can contribute to a 457 plan?

What costs are involved in a deferred compensation plan?