Gannett
Company, Inc.
Key Executive Life Insurance Plan
Participation Agreement
I, the
undersigned Participant, hereby agree to be bound by the terms and
conditions of the Key Employee Life Insurance Plan
(“KELIP”), as effective October 29,
2010.
By signing
this Participation Agreement, I agree to be bound by the terms of
the KELIP as set forth in the plan document. If there is a conflict
between the plan document, including this Participation Agreement,
and any other communication, written or oral, including any plan
summary materials, then the terms of the plan document will
control.
I also
understand that my benefit under the KELIP will be calculated as
follows:
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Pre-Termination
(but not beyond age 65)
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<Flat Dollar
Amount>
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<Flat Dollar
Amount>
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Duration of
Employer Contributions
Annual
Employer Contributions may be made, in the Employer’s sole
discretion, each calendar year during my employment. No Employer
Contributions will be payable after termination of employment or
after your sixty-second (62 nd)
birthday
(assuming you have received a