Exhibit 4.2
Action Required: Must be returned by
December 23, 2004
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New Plan
Participants
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2005 Plan Agreement and Election
Form
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Deferred Compensation
Plan
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Name (Last,
First, Middle Initial)
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Social Security
Number
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You may use this form
to:
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Indicate the amount of your Base
Salary, Bonus and Director Fees that you wish to defer during the
2005 Plan Year.
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Elect to receive a Scheduled
Distribution (optional)
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Select the form of your Retirement
Benefit (required)
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Select form of your Disability
Benefit payment (required)
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Allocate new deferrals and new
company contributions among the available investment
options.
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Deferral
Election -
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Please select all that apply; fill
in the appropriate blanks with whole
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Employee
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percentages or whole dollar
amounts.
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I elect to
defer
% or $
of my
Base Salary earned in 2005.
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I elect to
defer
% or $
of my
Bonus earned during the 2005 fiscal year.
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I elect not to
participate in the 2005 Plan Year.
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Deferral
Election -
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Please select one box; fill in the
appropriate blanks with whole percentages or
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Board of
Directors
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whole dollar
amounts.
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I elect to
defer
% or $
of my
Director Fees earned in 2005.
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I elect not to
participate in the 2005 Plan Year.
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*
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You may elect to defer up to a
maximum of 30% of Base Salary, 100% of Bonus, and 100% of Director
Fees . The
minimum aggregate deferral amount for Base Salary and/or Bonus is
$2,000. There is no minimum deferral amount for Director Fees. The
minimum deferral amounts will be pro-rated in accordance with the
terms of the Plan for any Participant who commences participation
in the Plan after the first day of a Plan Year.
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