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6.4.A. - Page 19 <br /> Actuarial Office <br /> P.O. Box 1494 <br /> �� Sacramento, CA 95812-1494 <br /> Telecommunications Device for the Deaf -(916) 795-3240 <br /> Ca1PERS �$$$) CaIPERS (225-7377) FAX (916) 795-2744 <br /> CONTRACT AMENDMENT REOUEST <br /> To initiate an amendment to contract, complete and return this form to the address above. The <br /> necessary documents will be prepared and mailed to you within 30 davs of the date this reauest is <br /> received in our o�ce. <br /> Employer Name: CIN OF REDWOOD CIN <br /> Employer Number: Member Group or Plan: SAFEf1' PLAN <br /> Coverage Group(s) affected by the Amendment: 74001 AND 75001 <br /> Description of Benefit Provisions and Section(s): Section 20475 Different Level of Benefits. Section 21362.2 (3% @ <br /> 50 Full Formula) and Section 20042 (One-Year Final Compensation) are applicable to only those local safety <br /> members entering membership on or prior to the effective date of this amendment to contract. Section 21363.1 (3% <br /> @ 55 Full Formula) and Section 20037 (Three-Year Final Compensation) are applicable to local safety members <br /> entering membership for the first time in the safety classification after the effective date of this amendment to <br /> contract. (Coverage groups 74101 and 75101 will be established for this benefit). <br /> Please indicate your choice: <br /> ❑ Standard Method <br /> ❑ Temporary Pooling Option <br /> Please initiate the amendment to this employer's contract with CaIPERS: <br /> Name and Title: (Please Print): <br /> Signature: Date: <br /> Mailing Address: <br /> Street Address: <br /> City/State/Zip: <br /> Telephone Number: Fax Number: <br /> E-mail Address: <br /> \ <br />