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Exhibit 4.2

Action Required: Must be returned by December 23, 2004

 

 

 

CHS Inc.

 

New Plan Participants

 

 

2005 Plan Agreement and Election Form

 

 

Deferred Compensation Plan

 

 

 

 


 

 


 

Name (Last, First, Middle Initial)

 

Social Security Number

You may use this form to:

 

 

Indicate the amount of your Base Salary, Bonus and Director Fees that you wish to defer during the 2005 Plan Year.

 

 

 

Elect to receive a Scheduled Distribution (optional)

 

 

 

 

Select the form of your Retirement Benefit (required)

 

 

 

 

Select form of your Disability Benefit payment (required)

 

 

 

 

Allocate new deferrals and new company contributions among the available investment options.

 

 

 

 

 

Deferral Election -

 

Please select all that apply; fill in the appropriate blanks with whole

Employee


 

 

percentages or whole dollar amounts.


 

o Base Salary

 

I elect to defer                                        % or $                                        of my Base Salary earned in 2005.

 

 

 

o Bonus

 

I elect to defer                                        % or $                                        of my Bonus earned during the 2005 fiscal year.

 

 

 

o Non-Participation

 

I elect not to participate in the 2005 Plan Year.

 

 

 

 

Deferral Election -

 

Please select one box; fill in the appropriate blanks with whole percentages or

Board of Directors


 

 

whole dollar amounts.


 

o Director Fees

 

I elect to defer                                        % or $                                        of my Director Fees earned in 2005.

 

 

 

o Non-Participation

 

I elect not to participate in the 2005 Plan Year.

 

 

*

 

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.

1


 

 

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