PERSONNEL
490.2E1 - EMPLOYEE EARLY RETIREMENT APPLICATION
EMPLOYEE EARLY RETIREMENT APPLICATION
The undersigned employee is applying for early retirement pursuant to Board Policy 490.2. Please complete the following information:
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Full Legal Name Social Security Number
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Current Job Title Date of Birth Years of Service
Please designate which option you choose:
_________Option 1: (CASH) The district will pay the retiree a monthly payment beginning the first month of retirement and continuing to a maximum of 120 months. Such payment shall be in an amount equal to 0.010 times the annual salary received by the retiree during the fiscal year immediately preceding retirement. “Annual salary” refers to compensation that the retiree received under the Master Contract between the WACO Community Schools, the WACO Education Association and the WACO Education Support Association, the annual salary for administrators, and the annual salary for nonunion non-certified staff. It excludes all supplemental pay, extra-duty pay and extended contract pay.
__________ Option 2 (Board Benefit) The retiree may receive the Board Benefits for a maximum of 120 months and continue in the district’s group health insurance (including dental and vision) covering the employee at the time of their retirement through the month in which the retiree attains 65 years of age. The benefits under such plan and the types of coverage to be provided to retiree shall be identical to the benefits and type of coverage in effect from year to year for employees. The employee may elect to continue family coverage at his or her expense if enrolled. Employment elsewhere resulting in the retiree being eligible to receive health, dental and vision benefits will void this option.
The undersigned employee acknowledges that application and participation in the early retirement plan is entirely voluntary.
The undersigned employee acknowledges that the school district suggests that the employee contact legal counsel and the employee’s own personal accountant regarding participation in the early retirement program and taxation of benefits.
Please attach a letter of resignation effective June thirtieth of the year in which the undersigned employee intends to retire.
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Employees Signature Date
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Witness Signature Date