Temporary Confirmation Statement

Please print out this confirmation page as a temporary record of your elections.

A confirmation statement will be mailed to your home only if you made a change to your benefit elections or dependent information. The statement, verifying your most recent elections, will be mailed in mid-October or early November, depending on when the change was made.

All forms required to complete your enrollment will be mailed with your confirmation statement. The Enrollment Online Web Site will be available for you to use until 11:59 pm, ET on October 31, 2003. You may visit this site and make changes as many times as you like during this period. The last changes you make will be the effective ones.

Marjorie J Flora logged on 10/28/2003 11:24:24 AM

* Spouse = spouse; Child = unmarried child under age 19; FT Student = unmarried child
age 19 to 25 and a full-time student; Dis Child = disabled child age 19 or over;
Dom Part = domestic partner

Click the print icon above if you would like a temporary confirmation of your elections.