Retiree Notice Of Postretirement Employment Form - Alabama
Download a blank fillable Retiree Notice Of Postretirement Employment Form - Alabama in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Retiree Notice Of Postretirement Employment Form - Alabama with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Retiree Notice of Postretirement Employment
Retirement Systems of Alabama
PO Box 302150, Montgomery, Alabama 36130-2150
877.517.0020 • 334.517.7000 •
*RSA PRE RN//1/*
Your SSN
Check One: q ERS q TRS
Your
Name __________________________________________________________________________________________
Information
First
Middle/Maiden
Last
Please type or print
Address _________________________________________________________________________________________
Street or P.O. Box
City
State
ZIP Code
Daytime Telephone ___________________________ Email Address _________________________________________
(
)
Date of Birth ________________________________ Sex
q Male q Female
Status
q Married q Single q Widowed q Divorced
Postretirement
Employing Agency* ______________________________________ Telephone _______________________________________
Information
Expected annual compensation or amount Not to Exceed (NTE) from an ERS or TRS agency for the current calendar year.
$_________________
The retiree must compute annual calendar salary based on rate of pay and hours/days/weeks/months expected to work in a calendar
year. An amount not to exceed for the calendar year is sufficient, but should also be detailed in any contract between the retiree and
the employing agency.
Will you be employed: (Check ONE for a. and ONE for b.)
a. q Part time or q Full time
b. q Permanent or q Temporary
Date employment begins_______________________
Do you have a Contract? q Yes q No
If yes, please attach.
Brief description of duties: __________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Retiree
I certify that the above information is accurate and true.
Certification
Sign Here
Signature ________________________________________________ Date __________________________________
è
*If multiple campuses, please identify specific campus such as George Wallace – Selma.
continued on next page
RSA PRE RN
REV 4-16
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal