Attachment to:
Public Act No. 03-138 Memo
Municipal Employees Retirement System (MERS)
Retirement Credit Purchase Request Pursuant to Public Act No. 03-138
Purchase Description: All or part of the member's prior (non-MERS) municipal service may be purchased for credit in the MERS if the former municipal employer declines to voluntarily transfer the entire amount paid into such municipal fund by the employer and the employee, the funds still reside with the former employer, and the member will not receive credit for the same period of service from the former retirement system or any other source.
Purchase Cost: Either 2 ? % or 5%, as applicable, on the salary for the period of the former service and the actuarial cost necessary to fund the increased benefits payable by reason of such purchase plus interest at the rate of 6 ?%, compounded annually on such payment. The purchase cost will be based on an assumed retirement date. If the member's actual retirement effective date differs from the date used to compute the initial purchase cost, an adjustment will be made at the time of the member's retirement. If there is an increase in the cost, no credit will be given in the MERS pension calculation until full payment is made; if there is a cost decrease, the member will be refunded the difference in cost.
***********************************************************************************
Member's Information (Please print)
| Member's Name: _________________________________________ | Social Security Number:_________________ |
| Member's Mailing Address:______________________________________________________________________ | |
| Current Municipal Employer:_____________________________________________________________________ | |
| Employer's Address: ___________________________________________ | Telephone Number:_________________ |
**********************************************************************************
Member's Statement
| I wish to purchase my former service from _________________ through ________________ while I was employed by | |
| _______________________________________________ | for credit in the MERS. I hereby certify that I have not |
| (Name of Former Municipality) | |
| received a refund of the retirement contributions I made during that time and I will not receive a pension based on this employment period from such former employer or any other source. | |
| __________________________________________ | _______________________________________ |
| Member's Signature | Date |
**********************************************************************************
Former Employer's Vertification
| Name of Pension Plan: __________________________________________________________________________ | |||
| Date of Hire: ____________ | Date of Termination: _____________ | Plan: Contributory ____or | Non-Contributory____ |
| (Please check one) | |||
| Did this former employee receive a refund of his/her retirement contributions to your plan? | Yes _______ | No ______ | |
| (Please check one) | |||
| Is this former employee entitled to any benefits from your municipal retirement plan? | Yes________ | No_______ | |
| (Please check one) | |||
| Total wages earned during employment period the member wishes to purchase: | $_____________________________ | ||
| I hereby certify that to the best of my knowledge the information contained herein is correct. | |||
| _________________________________ | _____________________ | __________________ | _________________ |
| Authorized Municipal Signature | Title | Telephone Number | Date |
**********************************************************************************
Please return the completed form to: Retirement & Benefit Services Division, Municipal Employees Retirement System Unit, 55 Elm Street, Hartford, CT 06106, Attention: Rudy Nelson. Questions regarding the completion of this form may be directed to the MERS Unit at (860) 702-3500.
New - 10/2003
Return to Public Act No. 03-138 Memo
Return to Index of 2003 Retirement Division
Memoranda
Return to Index of Comptroller's Memoranda
Return to Comptroller's Home Page