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

134 KB Posted

Attached to
IFB -Palo Alto Firewall, 3-Year License and Support
Solicitation number
IFB# 27TH07
Issued by
Utah

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This is a URS Post-Retired Verification Form for Independent Contractors (1099 Employees) required by Jordan School District in Utah. The form is designed to identify whether contractors, owners, partners, or principals have retired from the Utah Retirement Systems (URS) and therefore may be subject to re-employment restrictions. Contractors must complete the form by providing their name, business name, birthdate if applicable, type of business, and signature with date, then submit it along with a W-9 to the Accounting Department. The form establishes that re-employment includes work performed as either a paid employee through payroll or as an independent contractor paid through Accounting for a participating URS employer.

URS retirees receiving monthly benefits face specific restrictions when returning to work and are required to report re-employment to URS on Form RTRT-27A in compliance with Utah Code Section 49-11-1207(2). Failure to report re-employment may result in the retiree being held liable to repay URS any overpayment resulting from non-compliance. Retirees must contact URS's Retirement Benefits Department at 801-366-7770 before beginning work with Jordan School District to complete and file the Post-Retirement Employment form.

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Name

Business Name

Have you (or the contractor, owner, partner, or principal) retired from

Utah Retirement Systems (URS)?

No *Yes

*If you answered yes:

*Provide your birthdate _________________ (required)

*Type of business you provide _______________________________ (required)

Signature Date

Please submit this form along with the W-9 to the Accounting Department.

Retirees receiving a monthly benefit from URS have restrictions when returning to work. Re-employment includes work or service performed as an employee (paid through Payroll) OR on a contract (as a business or independent contractor paid through Accounting) for a participating URS employer if the retiree is listed as the contractor, owner, partner, or principal of the contractor (business).

If it is discovered that a URS retiree failed to report reemployment to URS on its Post-

Retirement Employment form (Form RTRT-27A) in violation of Title 49, the retiree will be liable to repay URS the amount of any overpayment resulting from the violation to report. See Utah code section 49-11-1207(2).

*The retiree is directed to contact URS's Retirement Benefits Department at 801-

366-7770 before beginning work with Jordan District. You will be asked to complete and file a Post-Retirement Employment form (Form RTRT-27A).

URS Post-Retired Verification

Independent Contractors (1099 Employees)

File details come from the government source that posted it. Updated .