3-Attachment F - URS Post-Retired Verification Form.pdf

This is a URS Post-Retired Verification Form for Independent Contractors issued by Jordan School District in Utah. The form requires individuals who have retired from Utah Retirement Systems (URS) to disclose their retirement status and acknowledge restrictions on re-employment with URS-participating employers. The form must be submitted to the Accounting Department along with a W-9 form prior to commencing work with Jordan School District. Any individual answering affirmatively to URS retirement status is directed to contact the URS Retirement Benefits Department at 801-366-7770 before beginning work to complete and file the required Post-Retirement Employment form (Form RTRT-27A).

URS retirees receiving monthly benefits are subject to strict re-employment restrictions when working for participating URS employers, whether as employees paid through payroll or as independent contractors. Failure to properly report re-employment to URS in violation of Title 49 of the Utah Code subjects the retiree to liability for repayment of any overpayment benefits received as a result of non-disclosure. This verification form ensures compliance with Utah Code Section 49-11-1207(2) and establishes the contractor's acknowledgment of these legal requirements and restrictions prior to contract execution.