Long Valley Charter School

To enroll, make changes, or request a plan transaction, please complete the online form below. Please include appropriate documents where applicable.

CLICK HERE for more information on plan transactions.

Approved Vendors Contact Information

403b Plan Enrollment and Transaction Request (required if marked with *)

Please upload your relevant forms. Images/Photos or Documents are acceptable.

Documents or Files (no Images)

Images/Photos

By signing the Agreement, Employee agrees to modify his/her salary as indicated above and Employer agrees to contribute this amount on Employee’s behalf into the 403(b)/457 annuity or custodial account(s) selected by Employee and authorized by the Employer properly identifying pre-tax contributions and post-tax Roth 403(b) contributions for proper allocation to segregated accounts by the Service Provider(s): By signing the Agreement, I authorize any Service Provider, or their delegate to provide information on my Account to Employer or another Service Provider if such information is necessary for compliance purposes or to effectuate such transactions as I may request.

I agree that I have an active account with the vendor selected. I understand that should I elect a salary reduction and have not established the appropriate account, that my contribution will not be processed.

E-Sign with your mouse,finger or stylus (click and move)

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