Attachment "C-II"
(Tier II)
"Reservation List"

To: Retirement & Benefit Services Division
55 Elm Street, Hartford, CT 06106
From: ______________________________;
Designated Agency Contact
_______________________________;
Agency
_____________________;
Telephone Number
________________________
Fax Number

The following Tier II employees are eligible for early or normal retirement under the 1997 incentive program and wish to attend one of the workshops being conducted between June 24, 1997 and July 24, 1997.

Tier II
Employee Name Employee Number
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

_____________________________________
Designated Agency Contact Signature
___________________
Date

To be completed by the Retirement & Benefit Services Division:

The above named individuals have been scheduled to attend the 1997 Early Retirement Incentive Workshop on _________________________. Please advise these employees of their reserved date and of the information and materials they should bring with them to make the workshop meaningful (refer to Retirement & Benefit Services Division Memorandum dated June 9, 1997 for specifics).

_____________________________________
Authorized Division Signature
____________________
Date

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