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Agmt04 Separation incentive SIP
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Agmt04 Separation incentive SIP
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Last modified
7/5/2005 2:48:58 PM
Creation date
7/19/2004 12:03:36 PM
Metadata
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Template:
Agreement
Contractor Name
separation incentive plan SIP
PROJECT NAME
defined benefit
RMP File Number
904
Date
4/12/2004
Reso Ref
14577
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<br /> EXHIBIT 1 C <br /> DATA REQUIREMENTS <br /> Phase II Systems will provide the Services under this Agreement contingent upon receiving <br /> the following information: <br /> 1. Participant Data (provided by Agency): <br /> (A) Participant's legal name <br /> (B) Participant's position <br /> (C) Participant's address <br /> (D) Participant's birth date <br /> (E) Participant's hire date <br /> (F) Participant's Contract Salary <br /> (G) Years of Agency Service <br /> (H) Retirement Date <br /> 2. Executed Legal Documents (provided by Agency): <br /> (A) Certified Board Resolution <br /> (B) Adoption Agreement <br /> (C) Plan Document <br /> (D) Trustee Investment Forms <br /> (E) IRS Information Form <br /> 3. Completed Funding Documents (provided by Agency): <br /> (A) Authorization to Pay Benefits Form <br /> (B) Funding of PARS Supplementary Retirement Plan Form <br /> 4. Completed Enrollment Forms (timely submitted by Participant): <br /> (A) Correction Form <br /> (B) Enrollment Form <br /> (C) Beneficiary Designation Form <br /> (D) Tax Withholding Request Form <br /> (E) Letter of Resignation <br /> 5. Other information requested by Phase II Systems <br /> Page 8 <br /> ,.. -.,., <br />
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