ࡱ> DGCc 8,bjbjBB A0 f f:::8D4tC\90MOOOOOO$f #s9MMMs4UUUMFMUMMUUURVFU90U##U#Ui"UiiissiiiMMMM#iiiiiiiii: E: SUBSTITUTE TEACHER RETIREMENT OPTION FORM STATE OF MAINE - BUREAU OF HUMAN RESOURCES NAME  FORMTEXT       SOCIAL SECURITY #  FORMTEXT     -  FORMTEXT    -  FORMTEXT     DEPARTMENT  FORMTEXT       CLASS TITLE  FORMTEXT       In accordance with Title 5 MRS, 17652, sub-6, membership in the Maine Public Employees Retirement System (MainePERS) is optional for Substitute Teachers. Maine law requires that these employees must make an election at the time of initial hire whether to be a member of the fb88PERS. Once an election is made, the election is irrevocable with respect to all subsequent employment with the same employer when membership in the program is not mandatory. STEP 1 (Complete only if you have never exercised this option at any time in the past. If you have already made this choice at any time in the past, that choice must remain in effect and you must skip to Step 2): I understand that I must elect whether to join the fb88PERS. I also understand that this election is irrevocable with respect to all subsequent employment with the State when membership in the program is not mandatory. Therefore, I elect the following (check only one):  FORMCHECKBOX  to join the fb88PERS.  FORMCHECKBOX  to not join the fb88PERS (go to STEP 2 below).  STEP 2 (complete only if you elected to not join the fb88PERS now or any time in the past): I understand that I must join a federally approved retirement plan. Therefore, I elect the following (check only one):  FORMCHECKBOX  to join the federal Social Security system.  FORMCHECKBOX  to join one of the States deferred compensation plans and to contribute at least 7.5% of my salary to that plan.  ________________________________________________________________________ ____________________________ (Employees Signature) (Date) _____Employee Copy _____Controllers Office/BHR Copy _____fb88PERS Copy   &<HRTpv    , d f z | ȼ}}}}}ȼ}q^%jh/eh5W5CJU\h/eh)5CJ\jh/eh)5CJU\%jh/ehq<5CJU\jh/ehzF5CJU\h/ehzF5CJ\h/eh,$5CJ\h/ehS*5CJ\hgQ5CJ\aJhS*5CJ\aJhS*5CJ(\aJ(h,$5CJ(\aJ($T  $ & > ekd$$Ifl0* 4 lap $$Ifa$$a$| ~    ͏s`s%jh/ehq<5CJU\jh/ehzF5CJU\h/eh,$5CJ\h/ehS*5CJ\%jh/eh5W5CJU\%jh/eh5W5CJU\h/eh)5CJ\h/ehzF5CJ\*jh/eh)5CJU\mHnHujh/eh)5CJU\"     " $ & < > @ J L ` b d f h j l n p r t v  ¶ΣڶŽ…~~uuh/ehsY_CJ h/ehIOPh/ehIOPCJh/ehIOP5CJ\h/ehS*CJ%jh/ehq<5CJU\h/ehS*5CJ\h/eh,$5CJ\h/ehzF5CJ\jh/ehzF5CJU\*jh/ehzF5CJU\mHnHu*> @ r t v   xoo_$ $Ifa$gd"i$ a$ $ a$gdIOP$a$gdIOP$a$ekdN$$Ifl0* 4 lap $$Ifa$  & - . 2 c w         ( C D O P [ l ثvl__Vh"ih\ZCJh"ih+`56>*CJh"ihIx6CJh"ihgQ56>*CJh"ih+`6CJh"ihgQ6CJh"ihgQ5CJh"ih\Z5CJh/ehS*CJh/eh,$6>*CJh/ehF{=6>*CJh/ehsY_6>*CJh/ehsY_CJh/eh$>*CJh/eh,$>*CJh/ehsY_>*CJ! ]^_`a7ww$ a$nkd$$Ifl*+ t0644 lap yt"i$ $Ifa$gd"i CP*+,-03obh"ih\Z56>*CJjh"ih5WCJUh"ihzFCJjh"ih5WCJUh"ih)CJjh"ih)CJUh"ihsCJh"ih26CJh"ih,$6>*CJh"ihF{=6>*CJh"ih26>*CJh"ih2CJh"ih$CJh"ih\ZCJ&35BCFORT]^_`aghrv%5789:HӏӅ|ofh"ih)CJjh"ih)CJUh"ihzFCJh"ih26CJ hYh CJh"ih+`6CJh"ihz56>*CJh"ihz6CJh"ihz5CJh"ih25CJh/ehzCJh"ih2CJh"ihsCJh"ih$CJh"ihFCJh"ih\ZCJ"78wxgh____$ a$nkd $$Ifl*+ t0644 lap yt"i$ $If^`a$gd"i$ $Ifa$gd"i HIJKS_nuwxyzg{⾮Ш}}}}uqh<%jh<%UhgQ hzhS* hzh-h+`hsCJ hzhshgQh,$CJ h$CJ j h"ih5WCJUh"ih)CJh"ihsCJh"ih2CJh"ihzFCJjh"ih)CJUj<h"ih5WCJU,,,,,, , , , , ,,,',1,2,3,4,5,6,gdz$$dNa$gdz$ a$gdz $ a$,,,,,,,,, , , , , ,,,,,,&,',0,1,2,3,4,5,6,7,8, hzhS*h+` h+`5\ h-5\ h,$5\hzh+`5\h/fh=,\jh<%UUh<%   PER 117-A 03/2020 MD1XELECT 6,7,8,$ a$gdz? 0P&P:pz/ =!"#$% DpDNAMEEnter your name.D  SSN_first_3<Enter the first three digits of your social security number.D  SNN_second_2AEnter the fourth and fifth digits of your social security number.D  SSN_final_4:Enter the last four digits of your social security number.$$If!vh#v:V l 5/ 4pD DepartmentEnter Department name.DText1Enter Job Class Title$$If!vh#v:V l 5/ 4pDeCheck1>I choose to join the Maine Public Employees Retirement System.DeCheck2BI choose not to join the Maine Public Employees Retirement System.$$If!vh#v+:V l t065+p yt"iDeCheck54I choose to join the federal Social Security system.hDeCheck6zI choose to join one of the State's deferred compensation plans and to contribute at least 7.5% of my salary to that plan.$$If!vh#v+:V l t065+p yt"iw2&6FVfv2(&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@6666_HmH nH sH tH 8`8 Normal_HmH sH tH DA D Default Paragraph FontRi@R  Table Normal4 l4a (k (No List 4@4 Header  !4 @4 Footer  !<< Default TextCJaJj#j \Z Table Grid7:V0PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VGRU1a$N% ʣꂣKЛjVkUDRKQj/dR*SxMPsʧJ5$4vq^WCʽ D{>̳`3REB=꽻Ut Qy@֐\.X7<:+& 0h @>nƭBVqu ѡ{5kP?O&Cנ Aw0kPo۵(h[5($=CVs]mY2zw`nKDC]j%KXK 'P@$I=Y%C%gx'$!V(ekڤք'Qt!x7xbJ7 o߼W_y|nʒ;Fido/_1z/L?>o_;9:33`=—S,FĔ觑@)R8elmEv|!ո/,Ә%qh|'1:`ij.̳u'k CZ^WcK0'E8S߱sˮdΙ`K}A"NșM1I/AeހQתGF@A~eh-QR9C 5 ~d"9 0exp<^!͸~J7䒜t L䈝c\)Ic8E&]Sf~@Aw?'r3Ȱ&2@7k}̬naWJ}N1XGVh`L%Z`=`VKb*X=z%"sI<&n| .qc:?7/N<Z*`]u-]e|aѸ¾|mH{m3CԚ .ÕnAr)[;-ݑ$$`:Ʊ>NVl%kv:Ns _OuCX=mO4m's߸d|0n;pt2e}:zOrgI( 'B='8\L`"Ǚ 4F+8JI$rՑVLvVxNN";fVYx-,JfV<+k>hP!aLfh:HHX WQXt,:JU{,Z BpB)sֻڙӇiE4(=U\.O. +x"aMB[F7x"ytѫиK-zz>F>75eo5C9Z%c7ܼ%6M2ˊ 9B" N "1(IzZ~>Yr]H+9pd\4n(Kg\V$=]B,lוDA=eX)Ly5ot e㈮bW3gp : j$/g*QjZTa!e9#i5*j5ö fE`514g{7vnO(^ ,j~V9;kvv"adV݊oTAn7jah+y^@ARhW.GMuO "/e5[s󿬅`Z'WfPt~f}kA'0z|>ܙ|Uw{@՘tAm'`4T֠2j ۣhvWwA9 ZNU+Awvhv36V`^PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!g theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] 8:0 579<|   3H8, > 76,8, ams %17+9Iy8FFFFFFG$G$G$G$@ @H 0(  0(  B S  ? BM______NAME SSN_first_3 SNN_second_2 SSN_final_4 DepartmentText1Check1Check2Check5Check6a%9y9  t8,J9BB3398899*urn:schemas-microsoft-com:office:smarttagsplace9*urn:schemas-microsoft-com:office:smarttagsState  69 69YY,9Jy 0269YY,9Jy 693.+ Yh 4'%-$,$<%^:)q<F{=@|NIOPgQ5W=,\sY_+``2b/e/fsasIxR$S*hQ>d\IF%-qO>z)/)~;q\v"i2zF\Z@ nsnn48 @X@UnknownG*Ax Times New Roman5Symbol3. *Cx ArialC.,*{ @Calibri Light7.*@ CalibriA$BCambria Math"+33)311qr43?S**!xx PER 117 9/97 Gerald RogersCotnoir, Thaddeus Oh+'0  (4 T ` l xPER 117 9/97Gerald Rogers Normal.dotmCotnoir, Thaddeus3Microsoft Office Word@^в@/f@j@{M1 ՜.+,0 hp  State Of fb88 PER 117 9/97 Title  "#$%&'()*+,-./012456789:<=>?@ABEFIRoot Entry F[VH@Data 1Table!#WordDocument A0SummaryInformation(3DocumentSummaryInformation8;MsoDataStoreQVRVFJVKUF2VABXA==2QVRVItem  2PropertiesUCompObj r   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q