PEDAKCN_Mosbacher.pdf

This document is a Non-Member Acknowledgment form from the Ohio Public Employees Retirement System (OPERS), located in Columbus, Ohio. The form is specifically for an individual named Linda Mosbacher who is classified as an independent contractor providing personal services to a public employer, effective January 7, 2013. The form is designed to document that the individual will not be considered a public employee and will not have contributions made to OPERS.

The service details indicate that Mosbacher will be serving as a Hearing Officer for an employer identified as "GOD" (possibly an abbreviation), with a service period starting July 1, 2025, and ending June 31, 2027. The form requires acknowledgment that the individual understands their classification as an independent contractor and has been informed that no retirement system contributions will be made on their behalf. The document provides instructions for potential challenges to the classification and requires the individual's signature to confirm understanding of their employment status.