Temporary_Employee_Retiriee_Disclosure_Form.pdf

This is a Temporary Employee Retiree Disclosure Form required by the City of Tucson for the Temporary Employment and Staffing Services contract opportunity. The form must be completed by all individuals prior to beginning any temporary placement with the City and establishes disclosure requirements regarding retirement status from the Tucson Supplemental Retirement System (TSRS) or the Public Safety Personnel Retirement System (PSPRS). The form collects employee information including full name, last four digits of Social Security Number, contractor agency, and position/department of assignment. Individuals who are retirees of either TSRS or PSPRS require prior written approval from the City of Tucson Human Resources Department before placement can proceed. The contractor agency is responsible for collecting the completed and signed form from the temporary employee and submitting it to the City prior to the employee's first day of placement.

The form requires acknowledgment and certification by the temporary employee that all provided information is true and accurate, with signatures required from the employee, contractor representative, and City of Tucson Human Resources Department. Failure to disclose accurate information may result in immediate removal from assignment. This disclosure requirement reflects the City's compliance and oversight procedures for temporary staffing services across its various departments, including General Staffing, Information Technology Staffing, and Finance and Business Services Staffing categories available through the contract opportunity.