Member Forms

RETIREMENT ENROLLMENT FORM

• Enrollment Form
  With this document, you apply for membership and participation in the Board of Retirement’s Plan. It is vital that you:
  1. Complete the application in its entirety.
  2. Sign the application and return the original in an enclosed self-addressed envelope. Make a copy for your records.
  3. An initial contribution must accompany the application in order to be accepted into the Plan.
• Retirement Life Insurance Enrollment Form
  Group term life insurance is available for enrollees who are under 65 years of age. Participants enrolling in Plan 1 (full employer participation) are required to apply for the insurance. The monthly premium is deducted from the employer contribution for those in Plan 1. The same insurance is available, but not mandatory for those enrolling in Plan 2. The monthly premium for those in Plan 2 is deducted from the participant’s personal contribution (either “after-tax” or “Salary Reduction”).
• Maximum Contributions Worksheet (PDF)

LIFE INSURANCE ENROLLMENT AND RECORD FORM

• Life Insurance Enrollment Form
• Enrollment Kit

INVESTMENT SELECTION FORM

• Investment Selection Form
  In recent years participants have requested additional investment options for the funds they have invested with the Board of Retirement. In 2009, we added a second investment option, the ProBlend Fund. This is a conservatively invested fund. In the Spring of 2012 we added two more funds, the Moderate and the Maximum Funds.Our four investment options and their description are:
  1. Conservative Fund. This is what we now have that we call the Pro-Blend Fund. It is designed for people who are within 0-5 years of retirement. Investment in the stock market can range from 5%-35% with a target point of 20%.
  2. Moderate Fund. This is one of the new options and is designed for participants who are within 3-10 years of retirement. Investment in the stock market can range from 20%-60% in the market with a target of point 40%.
  3. Default Fund. This is the option we’ve had since 1986 when we entered the market. It is designed for participants who are between 7-20 years of retirement. Investment in the stock market can range from 40%-70% with a target point of 55%.
  4. Maximum Fund. This is the other new option. It is more aggressive in its investments. It is designed for participants who have 15 or more years before retirement. Investment in the stock market can range from 70%-95% with a target point of 85%.

  As a participant, you have the option of allocating your funds to any or all of the above funds. You may only transfer up to 50% of your balance in any one month, however. The Default Fund will automatically be the option for those who do not direct all or part of their funds to the new options.

SALARY REDUCTION AGREEMENT

• Salary Reduction Agreement (PDF)
  A Salary Reduction Agreement is an agreement between the employer and employee under which the employee takes a reduction in salary for the purpose of participating in the Plan. The participant must sign a new agreement each time he/she seeks a change in the amount withheld through the Salary Reduction Agreement or he/she changes employers. A copy of this form must be on file with the Board of Retirement before we can accept any Salary Reduction contributions on behalf of the employee.
• Retirement Plan Life Insurance Certificate Book (PDF)

OTHER FORM DOWNLOADS

• Summary Plan Document (PDF)
• Deposit Coupons (Editable PDF)
  1. You will need Adobe Acrobat Reader software to open the file. You can download it for free here.
  2. Click on the link below to open the PDF.
  3. To change the words, highlight the portion of the text and retype your specific information.
  4. Once you’ve finished, you can save the PDF to your computer and print it.
• Bank Draft
• Beneficiary Update
• Investment Selection Form
• Note Payment Vouchers (Editable PDF)
  1. You will need Adobe Acrobat Reader software to open the file. You can download it for free here.
  2. Click on the link below to open the PDF.
  3. To change the words, highlight the portion of the text and retype your specific information.
  4. Once you’ve finished, you can save the PDF to your computer and print it.