Instructions For The New Hire Tier Determination (Form 1002) (Page 2 of 2) in pdf

State Employees' Retirement System of Illinois

STATE

General Assembly Retirement System

RETIREMENT

Judges' Retirement System of Illinois

SYSTEMS

Internet:

E-Mail: sers@srs.illinois.gov

2101 South Veterans Parkway, P.O. Box 19255, Springfield, IL 62794-9255

NEW HIRE TIER DETERMINATION

On April 14, 2010, Governor Quinn signed Senate Bill 1946 into law (P.A. 96-0889) creating a second tier of benefits and retirement rules

aimed at new employees covered by SERS, effective January 1, 2011. SERS has designated these two groups of employees as: a) Tier 1- those

employees who have been a member of SERS, or any other reciprocal retirement system, prior to January 1, 2011; and b) Tier 2 - those employees

hired on or after January 1, 2011, and who have never been a member of SERS or any other reciprocal retirement system. Current members of

SERS (Tier 1) are not affected by this Legislation.

Please check this box if you have never been a member of any of the retirement systems listed below.

Reset Form

If you have ever been a member of the following retirement systems within the State of Illinois prior to January 1, 2011, please check the

appropriate box(es) and provide the dates of membership on the lines below:

Earliest Membership Date

Chicago Teachers’ Pension Fund – (312) 641-4464

County Employees’ Annuity and Benefit Fund of Cook County – (312) 603-1200

Forest Preserve District Employees’ Annuity and Benefit Fund of Cook County – (312) 603-1200

General Assembly Retirement System (GARS) – (217) 782-8500

Illinois Municipal Retirement Fund (IMRF) – (800) 275-4673

Judges Retirement System (JRS) – (217) 782-8500

Laborers’ Annuity and Benefit Fund of Chicago - (312) 236-2065

Metropolitan Water Reclamation District Retirement Fund – (312) 751-3222

Municipal Employees’Annuity and Benefit Fund of Chicago – (312) 236-4700

Park Employees’ Annuity and Benefit Fund of Chicago – (312) 553-9265

State Employees’ Retirement System of Illinois (SERS) – (217) 785-7190

State Universities Retirement System (SURS) – (800) 275-7877

Teachers’ Retirement System of the State of Illinois (TRS) – (800) 877-7896

Name________________________________________________________________________ Social Security Number _______________________

(Please print)

Signature________________________________________________________ Telephone # ______________________ Date_________________

To be completed by Employing Agency:

This form must be returned to SERS within 5 business days from the employees’ initial start date. Questions regarding this form should be

directed to the Accounting Division at (217)785-7191. This form can be faxed to (217)785-7019.

Agency Name ____________________________________________________________________ Telephone # ___________________________

Agency Address _________________________________________________________________________ Fax # ___________________________

Retirement Contributions will begin on Payperiod _____________________________________________ Paycode _________________________

Authorized Agency Representative:_________________________________________________________________ Date ____________________

(Please print)

Signature

1002 (N 2-11)

Instructions For The New Hire Tier Determination (Form 1002) Page 2

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