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55B - RESO AND AGMT WITH POA
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04/18/2011
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55B - RESO AND AGMT WITH POA
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Last modified
1/3/2012 3:47:02 PM
Creation date
4/14/2011 4:37:37 PM
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Template:
City Clerk
Doc Type
Agenda Packet
Item #
55B
Date
4/18/2011
Destruction Year
2016
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DRAFT <br />VvuTUr'r 1 r` <br />DATA REQUIREMENTS <br />PARS will provide the Services under this Agreement contingent upon receiving the <br />following information: <br />1. Participant Data (provided by Agency): <br />(A) Participant's Legal Name <br />(B) Participant's Position <br />(C) Participant's Address <br />(D) Participant's Birth Date <br />(E) Participant's Hire Date <br />(F) Participant's Contract Salary <br />(G) Years of Agency Service <br />(H) Retirement Date <br />2. Executed Legal Documents (provided by Agency): <br />(A) Certified Resolution <br />(B) Adoption Agreement <br />(C) Plan Document <br />(D) Trustee Investment Forms <br />3. Completed Funding Documents (provided by Agency): <br />(A) Authorization to Pay Benefits Form <br />(B) Funding of PARS Supplementary Retirement Plan Form <br />4. Completed Enrollment Forms (timely submitted by Participant): <br />(A) Correction Form <br />(B) Enrollment Form <br />(C) Beneficiary Designation Form <br />(D) Tax Withholding Request Form <br />(E) Letter of Resignation <br />5. Other information pertinent to the Services as reasonably requested by PARS. <br />Page 8 <br />55B-14
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