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�� � � <br /> �� B. No Sotvidng Spooee or Surfiiag Depeadena . � <br /> If rhere are no living apouse m depmdenu u rhe cime of death of �he Partidpant, the accounc will revert m du Plan o0 <br /> be applied as apecified in Section VIII. <br /> RII. T6e Plan will operare aaording to the following ptmaione: <br /> A. Employer Respo°�ibllltke <br /> 1. T6e Empbyer will submit all VmngeCue Reeiwen[ Hnlrh Savinp Phn conuibimon dam via elannn'x aubmiemm. <br /> � 2. The Employa will submi� ell VanngeCam Rerinmmc Health Savings Plan Pu[icipaut a�azus upda�a or pawnal <br /> informauon updacea via dettmnic submiuion. This includea buc is no[ limiad to armination aotificacion and <br /> benefit digibility noti6catioa <br /> & Paccicipant ucount adminianaon and aaseabaaed fw will be paid through the iedrmpdon of Putiuqn� a«ount <br /> sham, unlese agt«d upon otLerwite in the AdminLaative Services Agieemmt <br /> C. A¢cigommt of benefits is mt permitted. Bene6u will be paid only to the Pattiupant, hia/her Surviwn, �he <br /> - Employc or an inaumntt provider (aa allowed bq che claims admiais¢amr). Paymenrs ro en third P°9a <br /> � (a&. �dical setvia pmvider) are not permitted with rLe aceptioa of mimbwsemmt m che Empbyer or insuran« <br /> ptovider (aa allowed by t6e claims administramr). <br /> D. An eligible dependmt it the Puticipanti lawful spouse and any other individual wLo ia a pamn detuibed in IRC <br /> Saxioa 152(a), u darified by Inmmal Revenue Service Notice 2004-79. <br /> E. The Fmploya will be cesponmbk for wi[hholding, nporting and remit[ing any appGrrble tues for paymenu which <br /> am deemed w be discrimimtory under IRC Seainn 105(I�, aa oudiaed in the VantageCate Retiremeat Hahh <br /> Savings Plan Employer MeauaL <br /> �� XIII.BmP�lv��8��+ <br /> A. Thc Employa hereby acknowledgn it underannda t6az fiilure ro proPeciy 611 oue rhia Emploqer Vaar�geCue <br /> Retirement Health Saviagp Plan Adopdon Ageemeot mry reault in the loss of taa eamption of the Trurt and/or loss <br /> of rax-deferred mnu for Employu contributions. - <br /> B. Q Chxk thie boz ifyou are indudYnB s�PP��B dnwmenn that indude plaa provisions. <br /> EMPLOYERSIGNATURH <br /> A, r�,�iS� .� � �: /l- 03 I <br /> . <br /> r�� e�_��,� �� <br /> �� �: <br /> r,��� <br /> Ac�zpted: VANTAGEPOINT TRANSFER AGENTS, LLC <br /> � ���� <br /> n��� s� �cMn Rc <br /> \ x - � �euw'y # :. ,+ � � n � r �, a,w ... .; : � � .. . <br /> �c " v #" a�k `� tfl '�k� c�'Sa " r 'L��. r � �w 1 ��i � r�}+ �'v��"Yr � 4�5�°^ n �„ +r � <br /> t�?.�f"�� ��� aa i r' $ 3 3 .,� � ?" , ''t,`fi€9m �'� £!` v�,C�jafi�y� v � $�, " <br /> s � �^r,-�. q„ y, t!2a�"'r -�1. s ! r < s3 x o 5 k a'E <br /> �' C+ t '�e .f ` 3� d n t 4 ,�" � 21 ,� ��n $� e <br /> I .! d+. �Pf � 3f � 6. 3� µ t 4 � �4 { p �.. �'` +i, � � � `l-bn. D$ <br /> �r 2, __�.rdC.a.. ,... � b.s.C.. ,�...�a�...� �x...K.i ... ...._.'�.$.'n..�.{� �.�u� � .��:=1_ .'N„�M�....s�.. -.1._. <br />