FBC Salary Reduction Agreement
    San Diego County
    Riverside County
        Corona Norco Unified
    Imperial County

Use this form to begin, stop, or change amounts that will be withheld by payroll as 403(b) or 457(b) contributions regardless of which approved vendor is receiving the funds.

Submit ORIGINAL to your District Payroll Office

Fax a copy to (800) 597-8206.

If you have questions on this form, please contact your  FBC / Nationwide Retirement Specialist.