4.1415 Application for enrollment.

(a) An application for enrollment shall be made on the participation agreement form prescribed by the board and shall be filed with the administrator;

(b) An applicant for enrollment shall enter on the participation agreement form the following:

(1) identifying information, including name, social security number, date of birth, home address, and home telephone number;

(2) employment information, including employer, department, division, business telephone number, and annual salary;

(3) designations allowed under the plan, including investment preference, amount of compensation to be deferred per pay period per investment product, normal retirement age, and beneficiary; and

(4) signature to indicate that the applicant:

(A) agrees to the provisions of the plan, which are incorporated by reference;

(B) authorizes disclosure of any information necessary for administration of the plan; and

(C) certifies that the information furnished on the form is true and correct to the best of the applicant's knowledge and belief.