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<br />Plan Sponsor <br />or Employer: <br /> <br />Plan Name: <br /> <br />By: <br /> <br />Its: <br /> <br />E-mail Address: <br /> <br />Date: <br /> <br />* These tees, rates, and minimums are subject to change by NRS upon reasonable notice to the Plan Sponsor. Loan tees will <br />appear as administrative charges on Participant Statements. <br />