Additional Information Required With Retirement Application

Information to be submitted with the retirement application

* Please note omission of any of the above items, if applicable, will result in a staff member from the division contacting your office.

Tips to ensure forms are executed properly:

* Only approved and current OSC forms from the Retirement Division will be accepted. Please ensure you are utilizing the most current SERS retirement forms. If other versions are submitted, you will be notified by the division to complete an approved form. This will jeopardize the applicants’ placement on the payroll.

(1) If the type of option checked off on the application does not match the option form submitted and/or if the type of retirement is not checked off on the application, you will be notified and a written memo from the agency explaining the discrepancies will be required.

(2) The application must be completed by the agency both front and back for inclusion on the retirement payroll. Incomplete applications will not be processed.

Procedure for Faxed Applications
Faxing of applications to secure the date of retirement is for emergency purposes only
, i.e., in case of an illness or an employee contacting agency personnel at the last minute. You must contact the supervisor of the Audit Unit for approval to explain the circumstances prior to faxing of the application.

Option Form
The witness has to actually witness the retiree’s signature on the same day. Anyone (except an annuitant) can be a witness. Agency personnel may but are not required to be a witness.

Certification of Martial Status Form
The Notary or Commissioner of the Superior Court and the spouse signatures have to be signed on the same day. The retiree can sign the form, with the option election filled out at an earlier date. The Notary must provide their commission expiration date.

Service Credit Section of the Application
The purpose of the service credit portion of the application is to establish eligibility. Do not represent part-time equivalent in the date to date section. In the service credit section agencies should indicate whether the service is full time or part-time. If part-time service, represent percentage of part-time service or total number of hours worked (ex. 50% time or 6543.50 hrs.).

Average Salary
Average salary consists of the average of any three high year periods of 12 consecutive months each year.
A. Average salary for part-time lecturers equal the three highest academic years. Two consecutive semesters equal one academic year. Each semester equals 12 credits for full time inflation. Multiply the 12 credits by the value of a credit for that semester. Summer session equal additional earnings.
B. Do not inflate summer months for a 10 month employee.
C. Part-time earnings have to be inflated to the full time (bi-weekly) base salary.
D. Leave of absence less than 90 days in duration may be inflated to the full time (bi-weekly) base salary.

Additional Information
(1) The retirement application, option form, spouse waiver form and health insurance form all have to reflect the correct date of retirement.
(2) If the employee is out on Workers Compensation at the end of service, please submit accident report related to the injury.
(3) Hazardous duty retirements; include hazardous duty chronology listing with position title, compensation class code, date started and ended in the position.
(4) Exclude purchases or free credits not acknowledged by the Retirement Division Purchasing Unit.
(5) It is the obligation of the current employing agency to obtain or request information from all previous employing agencies.
(6) The proof of Birth Affidavit is only utilized when an employee has exhausted all options in obtaining an original copy.
(7) All non-English language documents must be certified.

Return to Retirement Services Division Memorandum 2016-03

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