401(k) Plan Open Enrollment Communication Acknowledgment Form
Please complete this form to acknowledge receipt and understanding of the 401(k) open enrollment communications. All fields are required for recordkeeping.
Employee Full Name
*
First Name
Last Name
Employee ID
*
Department
*
Please Select
Human Resources
Finance
Engineering
Sales
Marketing
Operations
Other
Job Title
*
Work Email Address
*
example@example.com
Office Location
*
Please Select
Headquarters
Remote
Regional Office
Other
Manager/Supervisor Name
*
Date of Acknowledgment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
I acknowledge that I have received and reviewed the 401(k) open enrollment communications and understand the information provided.
*
I acknowledge
Comments or Questions (optional)
Submit Acknowledgment
Should be Empty: