Employee Meal Plan Participation Opt In/Out

The employee food plan (three meals per week) is a benefit taxable for payroll tax purposes. By “opting in”, you acknowledge that you are aware that this benefit will be reported on your W-2 tax form.

Your First and Last Name*

Choice*

Opt in to the employee meal plan benefit of 3 meals/week, knowing that this is a taxable benefit.
Opt out of participating in the employee meal plan benefit.

Electronic Signature*

I am the above named employee.