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� r . <br /> � <br /> Birth or adoption of a Child by the Participant <br /> • Change from part-time to full-time employment <br /> by the Participant <br /> by the Spouse of the Participant <br /> Change from full-time to part-time employment <br /> by the Participant <br /> by the Spouse of the Participant <br /> Significant change in the Participant's or <br /> Spouse's Health Coverage due to the Spouse's <br /> Employment <br /> Commencement of Employment by the <br /> Participant's Spouse <br /> Termination of Employment by the <br /> • Participant's Spouse <br /> Unpaid leave of absence <br /> by the Participant <br /> by the Spouse <br /> i <br /> 3a. Termination of a Participant's employment with the <br /> Employer <br /> continues a Participant's participation in the <br /> Plan automatically until affirmatively revoked by <br /> the Participant. <br /> X revokes participation automatically, effective <br /> as of the last day of employment with the <br /> Employer. <br /> Complete D3b only if Option 1 has been chcsen under <br /> D3a. <br /> 3b. If a Participant fails to make timely contribution to <br /> the <br /> . <br /> Dependent Care FSA <br /> Medical Care FSA <br /> such Participant's participation in that FSA shall <br /> terminate as of the last day of the period for which a <br /> contribution has been accepted by the Employer. <br /> � 4 <br />