Mondelez 2012 Annual Report Download - page 522

By signing this Adoption Agreement, the Employer certifies that it has consulted with legal counsel regarding the effects of the Plan, as
applicable, on all parties. The Employer further certifies that it has and will limit participation in the Plan to a select group of management or
highly compensated Employees, Board Members or Other Service Providers, as determined by the Employer in consultation with legal counsel.
The Employer further certifies that it is the Employer’s sole responsibility to ensure that each Participant with the right to direct deemed
investments under the Plan that are based on securities issued by the Employer or a member of its controlled group (as defined in Code
Section 414(b) and (c)) will receive a prospectus for any such deemed investment option based on such Employer securities.
The Employer is solely responsible for its compliance with applicable laws, including Federal and state securities and other applicable laws.
Only those elections that are completed shall be considered as provisions applicable to and forming a part of the Plan.
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16
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32.
Additional Survivor Death Benefit from Life Insurance.
In the event that life insurance is utilized as a funding vehicle for the Plan, the
Employer may wish to provide additional Survivor Benefit from the following options:
[select one]

No additional Survivor Benefit offered, but rather Participant
’
s vested Account balance.
3
Face value of life insurance policy of Participant, if any.
3
Greater of (a) face value of life insurance policy of Participant, if any, or (b) Participant
’
s vested Account balance.
3
Other:
[enter amount or formula]
33.
Payment of Plan Expenses.
Plan expenses may be paid as follows:
[select one]

Directly by the Employer.
3
Deducted from the Participant accounts and Plan
’
s trust or other custodial account (mutual fund plans only, if applicable).
34. “De Minimis” Small Amount Cashouts. If selected by the Employer, Participant account balances that do not exceed a certain threshold
amount will be automatically cashed out upon the Participant
‘
s Termination of Employment or Death, as provided below [
select one]

Yes, amounts that do not exceed the Internal Revenue Code 402(g) limit for a given year will automatically be cashed out .
3
No, no
“
de minimis
”
small amounts will be cashed out.