Temporary_Employee_Retiriee_Disclosure_Form.pdf

This is a Temporary Employee Retiree Disclosure Form for the City of Tucson, Arizona, required for all individuals placed in temporary positions with the city. All temporary employees must complete the form prior to their first day of assignment, with the contractor agency responsible for collecting and submitting the completed form to the City. The form requires employees to disclose their full name, last four digits of Social Security Number, contractor agency name, and position/department assignment. Employees must indicate their retirement status with respect to the Tucson Supplemental Retirement System (TSRS) or the Public Safety Personnel Retirement System (PSPRS), and acknowledge that placement may not proceed without prior written approval from the City's Human Resources Department if they are a retiree of either system. The form requires signatures from the employee, contractor representative, and City of Tucson Human Resources Department, along with corresponding dates.

The disclosure form serves as a compliance mechanism within the broader Temporary Employment and Staffing Services RFP issued by the City of Tucson in conjunction with Pima County and the Axia Cooperative purchasing program. Failure to provide accurate information on the form may result in immediate removal from the assignment. This requirement applies across all three service categories covered by the solicitation—General Clerical and Administrative Staffing, Information Technology Staffing, and Finance and Business Services Staffing—with proposals due February 27, 2026, at 2:00 p.m. The restriction on TSRS and PSPRS retirees represents a key compliance obligation for staffing vendors, ensuring that the City maintains control over retiree placements that may trigger pension or benefit implications under these retirement systems.