Section 6 - IMRF

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3. Authorized Agent Certification Sign and date where indicated. 4. Member Certification Member should sign and date where indicated. Instructions Continued How the member pays for the service EXHIBIT 6I Page 2 of 3 5. Social Security Wage Adjustments If Social Security wages were also omitted, see Section 4 of the IMRF Manual for Authorized Agents. 1. Member Cost IMRF will mail the member a Past Service Payment Schedule which offers two payment plan options for establishing the past service. Option I is the Lump Sum Payment Plan The Lump Sum Payment Plan allows members to pay the total cost with a single payment and purchase all of the eligible service he or she chooses to purchase at once. The member may purchase a portion, all, or none of the past service listed on the payment schedule. 2. Using funds from an IRA or another pension plan to purchase the service The member may pay for this service with a qualified pension plan as defined by Section 401a, 457, 403b, etc. of the Internal Revenue Code, or a traditional individual retirement account (IRA). The member would complete and submit IMRF Form 6.01, “Request for Rollover Approval,” for determination of eligibility. Option 2 is the Unit Payment Plan The Unit Payment Plan allows members to purchase one or more months of service credit at a time. Members may pay as often as they like, buying back credit from the latest month to the earliest month of eligible service. However, they may not buy more months than indicated on the Past Service Payment Schedule. How purchasing the service will affect the member’s pension Members who want to know how the omitted service will affect their pension should wait until they receive the Past Service Payment Schedule. They then can request a formal pension estimate by calling 1-800-ASK-IMRF (1-800-275-4673) or at www.imrf.org through their secure Member Access Account. Members participating in a reciprocal system should contact their current system for an estimate. Members can also refer to the IMRF Past Service Booklet, which can be found online at www.imrf.org, or by calling 1-800-ASK-IMRF. The section titled “Is it worth it to purchase service” provides a detailed description of how to calculate the impact of service on a pension. If the member plans to retire under the Reciprocal Act The Illinois Retirement Systems Reciprocal Act requires a minimum of 12 months of service credit with any single reciprocal pension system. If the member has less than 12 months of service in a reciprocal retirement system, that service will not be counted in the calculation of his or her reciprocal pension. Exception: A former teacher aide who transferred to a position covered by the Teachers’ Retirement System (TRS) and who has less than 12 months of IMRF service credit can apply that service toward a reciprocal pension. A list of the 13 systems covered by the Act are listed in Section 5 of the IMRF Manual for Authorized Agents and on the IMRF website, www.imrf.org. Local police and fire pension funds are not covered by the Act. Employer’s Cost The governmental unit’s contribution for omitted service, plus interest, is made through future contribution rates. Therefore, a separate payment is not required. Interest is calculated on the contributions from the end of the omitted period through December 31st of the year preceding the current year. The actuary will take the retroactive service into account when annually determining the employer contribution rate. IMRF Form 6.05 (Rev. 11/10)
OMITTED SERVICE CREDIT VERIFICATION IMRF Form 6.05 (Rev. 11/10) FOR QUALIFYING PERIODS WHEN THE EMPLOYEE WAS NOT ENROLLED PLEASE PRINT OR TYPE -- USE BLACK INK STOP: IF CONTRIBUTIONS WERE WITHHELD, BUT NOT REPORTED, LOG ON TO EMPLOYER ACCESS TO PERFORM A WAGE ADJUSTMENT. MEMBER’S FIRST NAME MIDDLE INITIAL LAST JR., SR., II, ETC. SOCIAL SECURITY NUMBER __ Janet __ __ __ __ __ __ __ __ J. Doe ____________ 0 0 0 - __________ 0 0 - ____________ 0 0 0 0 STREET (MAILING) ADDRESS CITY STATE ZIP + 4 123 Birch Street Anywhere IL 60000-1234 DATE OF BIRTH TELEPHONE NO OPTIONAL: ANTICIPATED RETIREMENT DATE 09/03/1950 ( 0 0 0 ) 0 0 0 - 0 0 0 0 NAME OF CURRENT RETIREMENT SYSTEM IMRF May 1, 2005 CURRENT EMPLOYER IMRF EMPLOYER I.D. NUMBER CURRENT POSITION EMPLOYER FOR WHOM SERVICE WAS RENDERED PARTICIPATION DATE OF CURRENT SYSTEM City of Anywhere 0 9 9 9 9 Dispatcher City of Anywhere OMITTED POSITION Secretary EXHIBIT 6I Page 3 of 3 CERTIFICATION BY AUTHORIZED AGENT: I certify that the following statements of earnings for the above applicant is in agreement with the governmental unit’s payroll records and represent the entire qualifying employment period determined by the governing body. OMITTED SERVICE PERIOD (DATES) FROM January ______________ 2000 TO _____________ December 2000 For the following Earnings Chart, please refer to the Instructions on Page 1 Page _____ 1 of _____ 1 ENTER YEAR JAN FEB MAR APRIL MAY JUNE JULY AUG SEPT OCT NOV DEC a TOTAL MONTHS CREDIT TOTAL PREVIOUS HOURS WORKED TOTAL OMITTED EARNINGS Year ________ 2000 EXAMPLE IRREGULARLY HOURS EARNINGS PREVIOUSLY PAID “IP” OR SEASONAL EARNINGS “X” WORKED “SE” “X” x x x x x x x x x x 12 600 $31,500 SE SE Year ________ HOURS PREVIOUSLY WORKED IRREGULARLY PAID “IP” OR SEASONAL “SE” Year ________ EARNINGS “X” HOURS PREVIOUSLY WORKED IRREGULARLY PAID “IP” OR SEASONAL “SE” Year ________ EARNINGS “X” HOURS PREVIOUSLY WORKED Do you anticipate that this employee has met or will meet the hourly standard X Yes No IRREGULARLY PAID “IP” OR SEASONAL “SE” Year ________ EARNINGS “X” HOURS PREVIOUSLY WORKED IRREGULARLY PAID “IP” OR SEASONAL “SE” x Signature of Authorized Agent November 1, 2009 Date Choose One: I wish to establish the service on this application as: Regular Service Elected County Official Service—ECO SLEP Service (see instructions; limitations may apply) CERTIFICATION BY MEMBER: I certify that I am currently a member in the Illinois Municipal Retirement Fund or a reciprocal system, and that I received the above earnings from the governmental unit indicated above for the months and years indicated. x Signature of Member November 1, 2009 Illinois Municipal Retirement Fund 2211 York Road, Suite 500, Oak Brook Illinois 60523-2337 IMRF Form 6.05 (Rev. 11/10) Member Services Representatives 1- 800-ASK-IMRF (1-800-275-4673) www.imrf.org Date
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Illinois Municipal Retirement Fund
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Limitation on Frequency • Employe
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Section 6 - IMRF

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