Section 6 - IMRF
Section 6 - IMRF Section 6 - IMRF
Request For Rollover Approval for Past Service IMRF Form 6.01 (Rev. 06/12) PLEASE PRINT OR TYPE — USE BLACK INK Exhibit 6D Page 2 of 2 Avoid delays—read the instructions before completing this form • Do not withdraw any funds or send any rollover distributions to IMRF before we advise you of your eligibility to do so. • Complete this certification to roll over tax-deferred distributions from another qualified plan or qualifying individual retirement account (IRA) for payment of past service credit. • If your rollover is for ERI (Early Retirement Incentive), please use Form 6.01E instead of this form. SECTION 1 — MEMBER INFORMATION MEMBER’S FIRST NAME MIDDLE INITIAL LAST JR., SR., II, ETC. SOCIAL SECURITY NUMBER Mary A. Member 000 00 0000 STREET (MAILING ADDRESS) CITY STATE ZIP +4 123 Elm Street Anywhere, IL 60000 MEMBER’S TELEPHONE NUMBERS WORK ( 000 ) 000 - 0000 HOME ( 000 ) 000 - 0000 SECTION 2 — CERTIFICATION BY FINANCIAL INSTITUTION NAME AND ADDRESS OF PLAN/FINANCIAL INSTITUTION NAME ON ACCOUNT First National Bank of Anywhere Mary A. Member 300 Main Street ACCOUNT NUMBER Anywhere, IL 60000 123-45-0 The qualified plan or individual retirement account named above is (check one) X ________________ - ________ - ________________ TELEPHONE NUMBER (include area code) ( 000 ) 000 - 0000 A retirement plan under Internal Revenue Code Section (circle which one) 401, 457, 403b, other (specify) __________ An individual retirement account (“IRA”) (Not a ROTH IRA) WHAT AMOUNT IS TAX DEFERRED $2,378.22 WHAT AMOUNT, IF ANY, WAS PREVIOUSLY TAXED (CANNOT COME FROM AN IRA) SIGNATURE OF AUTHORIZED OFFICIAL OF FINANCIAL INSTITUTION (NOT EMPLOYER) WRITE - DO NOT PRINT OR TYPE DATE (MM/DD/YY) August 18, 2007 PRINTED NAME OF AUTHORIZED OFFICIAL OF FINANCIAL INSTITUTION SECTION 3 — MEMBER CERTIFICATION I request that IMRF accept a rollover distribution in the amount of $______________ from the institution named above. (IMRF CANNOT ACCEPT AN AMOUNT LARGER THAN THE COST TO PURCHASE THE PAST SERVICE) With this distribution I am purchasing _____________ months of IMRF Past Service Credit. (Check type of Past Service below.) Military Service Omitted Service Prior Service SLEP Conversion Reinstated Service Retroactive Service Out-of-State Service I understand that I may be required to provide proof, if requested, in support of the above statements. I also understand that my rollover must be made to IMRF within 60 days of receipt of the distribution. I agree with the information provided by my financial institution. Member Signature (write - do not print or type) X Sandra Smith X 19 2,378.22 ALL QUESTIONS MUST BE ANSWERED BEFORE SUBMITTING FORM TO IMRF Completed form may be mailed to: Illinois Municipal Retirement Fund Suite 500 2211 York Road Oak Brook IL 60523-2337 Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) — Fax (630) 706-4289 IMRF Form 6.01 (Rev. 06/12) www.imrf.org TITLE Date Bank Administrator August 18, 2007
Application for Military Service Credit IMRF Form 6.02J (Rev. 9/2007) Exhibit 6E Page 1 of 2 If you have any questions, call 1-800-ASK-IMRF (1-800-275-4673) • The purchase of military service for public employees is a benefit designed to partially compensate veterans for their service in the armed forces. • Any converted military service credit is applied toward the calculation of a member’s IMRF benefits. • Member cost and other requirements differ under each law. Please read the following information carefully to determine if you are eligible to establish military service credit under one of the following laws. • If member contributions and interest are required, IMRF will mail you a payment schedule after your application is received and your cost is calculated. • Establishing service as Elected County Official (ECO) Service: To establish ECO service, the member must have previously participated, or be currently participating, in IMRF under the ECO plan. The member must also have IMRF Form 6.21B, “Election to Contribute under the ECO Plan” on file with IMRF, and the county under which the member opted to participate in ECO must have a standing resolution on file allowing such participation. (NOTE: Only members under the Original ECO plan may establish military service credit as ECO service. Members of the Revised ECO plan may convert their military service credit only to Regular service credit.) • When submitting this form, you should also request formal pension estimates with and without the additional service credit by submitting IMRF Form BF-20, “Pension Estimate Request.” Request Form BF-20 by calling 1-800-ASK-IMRF (1-800-275-4673) or by downloading the form from www.imrf.org. You can also request a Formal Pension Estimate through your IMRF Member Access account. UNDER ILLINOIS LAW UNDER FEDERAL LAW MILITARY SERVICE EARNED BEFORE IMRF PARTICIPATION OR DID NOT RETURN TO IMRF WITHIN 90 DAYS MILITARY LEAVE INTERRUPTED MILITARY LEAVE INTERRUPTED IMRF PARTICIPATION AND RETURNED TO IMRF WITHIN 90 DAYS IMRF PARTICIPATION AND RETURNED TO SAME EMPLOYER Member participation as related to military leave Military leave can have occurred at any time, even prior to first date of participation in IMRF. Must have participated in IMRF before and after military leave; can participate with different IMRF employers. Must return to IMRF participating employment within 90 days of discharge. Must participate in IMRF before and after military leave with the same IMRF employer. Return to work requirement varies. Member’s current participation Must be currently participating in IMRF. Must be participating in IMRF or in another retirement system covered by the Reciprocal Act. Must be participating in IMRF or in another retirement system covered by the Reciprocal Act. Member cost If member has cost, IMRF will calculate your cost and send you a payment schedule. You may purchase the service credit in a lump sum or on a payment plan. Member and “normal” employer contributions plus interest calculated from first date of participation in IMRF. Salary used to calculate cost is first salary earned as IMRF member. Free Member contributions plus interest calculated from the end of the military leave period. Salary used to calculate cost is the salary in effect when the military leave began. Maximum number of years member can purchase Two or four years, determined by employer resolution No maximum, but employer may limit by resolution. Five years. Military documentation A copy of release order or military discharge must accompany this form. A copy of release order or military discharge must accompany this form. A copy of release order or military discharge must accompany this form. Military pension May still use the service in the computation of a pension or retirement pay from the U.S. government. May not use the service in the computation of a pension or retirement pay from the U.S. government. May still use the service in the computation of a pension or retirement pay from the U.S. government. Employer resolution required Yes, covers all IMRF members under that employer. Yes, covers all IMRF members under that employer. No. Employer cost Through future employer rates. Through future employer rates. Through future employer rates. IMRF Form 6.02J (Rev 9/2007)
- Page 1 and 2: Illinois Municipal Retirement Fund
- Page 3 and 4: Illinois Municipal Retirement Fund
- Page 5 and 6: Illinois Municipal Retirement Fund
- Page 7 and 8: Illinois Municipal Retirement Fund
- Page 9 and 10: Illinois Municipal Retirement Fund
- Page 11 and 12: Illinois Municipal Retirement Fund
- Page 13 and 14: Illinois Municipal Retirement Fund
- Page 15 and 16: Illinois Municipal Retirement Fund
- Page 17 and 18: Illinois Municipal Retirement Fund
- Page 19 and 20: Illinois Municipal Retirement Fund
- Page 21 and 22: Illinois Municipal Retirement Fund
- Page 23 and 24: Illinois Municipal Retirement Fund
- Page 25 and 26: Illinois Municipal Retirement Fund
- Page 27 and 28: Illinois Municipal Retirement Fund
- Page 29 and 30: Illinois Municipal Retirement Fund
- Page 31 and 32: Illinois Municipal Retirement Fund
- Page 33 and 34: Illinois Municipal Retirement Fund
- Page 35 and 36: Illinois Municipal Retirement Fund
- Page 37 and 38: Illinois Municipal Retirement Fund
- Page 39 and 40: Illinois Municipal Retirement Fund
- Page 41 and 42: Illinois Municipal Retirement Fund
- Page 44 and 45: This page intentionally left blank.
- Page 46 and 47: This page intentionally left blank.
- Page 48 and 49: This page intentionally left blank.
- Page 52 and 53: Application for Military Service Cr
- Page 54 and 55: IMRF will mail you a Past Service P
- Page 56 and 57: This page intentionally left blank.
- Page 58 and 59: Exhibit 6G - Page 2 of 3 “Instruc
- Page 60 and 61: This page intentionally left blank.
- Page 62 and 63: This page intentionally left blank.
- Page 64 and 65: 3. Authorized Agent Certification S
- Page 66 and 67: This page intentionally left blank.
- Page 68 and 69: “How to pay...” continued from
- Page 70 and 71: This page intentionally left blank.
- Page 72 and 73: 1. Member Cost Mem bers whose emplo
- Page 74 and 75: This page intentionally left blank.
- Page 76 and 77: This page intentionally left blank.
- Page 78 and 79: X NOTICE OF ENROLLMENT IN IMRF IMRF
- Page 80 and 81: Exhibit 6O Page 2 of 4 If you are n
- Page 82 and 83: Exhibit 6O Conditions of IMRF Desig
- Page 84 and 85: • “PLAN” refers to either Reg
- Page 86 and 87: This page intentionally left blank.
- Page 88 and 89: This page intentionally left blank.
- Page 90 and 91: Instructions EXHIBIT 6S Page 1 of 2
- Page 92 and 93: This page intentionally left blank.
- Page 94 and 95: This page intentionally left blank.
- Page 96 and 97: This page intentionally left blank.
- Page 98 and 99: This page intentionally left blank.
Application for Military Service Credit<br />
<strong>IMRF</strong> Form 6.02J (Rev. 9/2007)<br />
Exhibit 6E<br />
Page 1 of 2<br />
If you have any questions, call 1-800-ASK-<strong>IMRF</strong> (1-800-275-4673)<br />
• The purchase of military service for public employees is a benefit designed to partially compensate veterans for their service in the armed forces.<br />
• Any converted military service credit is applied toward the calculation of a member’s <strong>IMRF</strong> benefits.<br />
• Member cost and other requirements differ under each law. Please read the following information carefully to determine if you are<br />
eligible to establish military service credit under one of the following laws.<br />
• If member contributions and interest are required, <strong>IMRF</strong> will mail you a payment schedule after your application is received and your<br />
cost is calculated.<br />
• Establishing service as Elected County Official (ECO) Service: To establish ECO service, the member must have previously participated, or<br />
be currently participating, in <strong>IMRF</strong> under the ECO plan. The member must also have <strong>IMRF</strong> Form 6.21B, “Election to Contribute under the<br />
ECO Plan” on file with <strong>IMRF</strong>, and the county under which the member opted to participate in ECO must have a standing resolution on file<br />
allowing such participation. (NOTE: Only members under the Original ECO plan may establish military service credit as ECO service.<br />
Members of the Revised ECO plan may convert their military service credit only to Regular service credit.)<br />
• When submitting this form, you should also request formal pension estimates with and without the additional service credit by submitting<br />
<strong>IMRF</strong> Form BF-20, “Pension Estimate Request.” Request Form BF-20 by calling 1-800-ASK-<strong>IMRF</strong> (1-800-275-4673) or by downloading the<br />
form from www.imrf.org. You can also request a Formal Pension Estimate through your <strong>IMRF</strong> Member Access account.<br />
UNDER ILLINOIS LAW<br />
UNDER FEDERAL LAW<br />
MILITARY SERVICE EARNED BEFORE<br />
<strong>IMRF</strong> PARTICIPATION OR DID NOT<br />
RETURN TO <strong>IMRF</strong> WITHIN 90 DAYS<br />
MILITARY LEAVE INTERRUPTED<br />
MILITARY LEAVE INTERRUPTED<br />
<strong>IMRF</strong> PARTICIPATION AND RETURNED<br />
TO <strong>IMRF</strong> WITHIN 90 DAYS<br />
<strong>IMRF</strong> PARTICIPATION AND<br />
RETURNED TO SAME EMPLOYER<br />
Member participation<br />
as related to military leave<br />
Military leave can have occurred<br />
at any time, even prior to first<br />
date of participation in <strong>IMRF</strong>.<br />
Must have participated in <strong>IMRF</strong><br />
before and after military leave;<br />
can participate with different<br />
<strong>IMRF</strong> employers. Must return to<br />
<strong>IMRF</strong> participating employment<br />
within 90 days of discharge.<br />
Must participate in <strong>IMRF</strong> before<br />
and after military leave with the<br />
same <strong>IMRF</strong> employer. Return to<br />
work requirement varies.<br />
Member’s current<br />
participation<br />
Must be currently participating<br />
in <strong>IMRF</strong>.<br />
Must be participating in <strong>IMRF</strong> or<br />
in another retirement system<br />
covered by the Reciprocal Act.<br />
Must be participating in <strong>IMRF</strong> or<br />
in another retirement system<br />
covered by the Reciprocal Act.<br />
Member cost<br />
If member has cost, <strong>IMRF</strong> will<br />
calculate your cost and send you<br />
a payment schedule. You may<br />
purchase the service credit in a<br />
lump sum or on a payment plan.<br />
Member and “normal” employer<br />
contributions plus interest<br />
calculated from first date of<br />
participation in <strong>IMRF</strong>. Salary<br />
used to calculate cost is first<br />
salary earned as <strong>IMRF</strong> member.<br />
Free<br />
Member contributions plus interest<br />
calculated from the end of the<br />
military leave period. Salary<br />
used to calculate cost is the<br />
salary in effect when the military<br />
leave began.<br />
Maximum number of years<br />
member can purchase<br />
Two or four years, determined<br />
by employer resolution<br />
No maximum, but employer may<br />
limit by resolution.<br />
Five years.<br />
Military documentation<br />
A copy of release order<br />
or military discharge must<br />
accompany this form.<br />
A copy of release order<br />
or military discharge must<br />
accompany this form.<br />
A copy of release order<br />
or military discharge must<br />
accompany this form.<br />
Military pension<br />
May still use the service in the<br />
computation of a pension or<br />
retirement pay from the U.S.<br />
government.<br />
May not use the service in the<br />
computation of a pension or<br />
retirement pay from the U.S.<br />
government.<br />
May still use the service in the<br />
computation of a pension or<br />
retirement pay from the U.S.<br />
government.<br />
Employer resolution<br />
required<br />
Yes, covers all <strong>IMRF</strong> members<br />
under that employer.<br />
Yes, covers all <strong>IMRF</strong> members<br />
under that employer.<br />
No.<br />
Employer cost<br />
Through future employer rates.<br />
Through future employer rates.<br />
Through future employer rates.<br />
<strong>IMRF</strong> Form 6.02J (Rev 9/2007)