HomeMy WebLinkAboutResolutions - R-87-11 - 07/01/1987 - IMRF for 2nd Library EmployeeJF
Member Name
Member Address
Employer Name
R-87-11
Illinois Municipal Retirement Fund
100 South Wacker Drive Chicago, IL 60606 312/346-6722
OMITTED SERVICE CREDIT VERIFICATION
(See instructions on reverse side)
Street or Route I City, State, Zip Code
C, Ty o F /hc genrx
fnc
Social Security Number
Current Position
Number (State SSA No.) I Omitted Service Position
69-033 0 / z7L 3
F-4
CERTIFICATION BY AUTHORIZED AGENT
I certify that earnings for the above named member shown in the following statement are in agreement with the governmental
unit's payroll records.
Year
Earnings
Months of Creditable Service
Year
Earnings
Months of Creditable Service
With Earnings
Without Earnings'
With Earnings
Without Earnings'
o,z
G
9
1.366,77
043,62
;all_
U
78'
4308,36
/�
O
2 7. sa
v
91?
Cl
C,
17 ma o,7
�oZ
O
TOTAL
13
SE — (seasonal leave explained on reverse side)
7-3 r—drj
Date Signature of Auth+.dent
RESOLUTION BY GOVERNING BODY
WHEREAS, the member named herein for the period indicated above totaling 132 months should have been
but was not reported to the Illinois Municipal Retirement Fund for membership.
RESOLVED, that it is the finding of this Ci ty—af_MtHenr
Name of Governing Body that:
1. The member worked in a position which qualified him or her for membership in IMRF during the years and months
shown above.
2. None of the service of the member during these years and months was in a probationary position of four months or less;
3. The member is currently employed in a qualifying position with an IMRF employer.
FURTHER RESOLVED, that the governing body agrees to accept the obligation due IMRF for the omitted service employer
contributions payable through future employer contribution rates and to accept the charges for employer and employee social security
taxes if such taxes have not been paid on the omitted service earnings.
FURTHER RESOLVED, that the authorized agent is hereby authorized and directed to file a certified copy of this resolution
and all other pertinent forms and documents with the Illinois Municipal Retirement Fund.
CERTIFICATION BY CLERK OR SECRETARY OF GOVERNING BODY
I, Barbara E. G-710._n the City Clerk of
Name Clerk or Secretary
City of McHenry Name of Governmental Unit do hereby certify that I am the
keeper of its records and that the foregoing is a true and correct copy of a resolution duly adopted by its governing body at a
meeting held on the 1 S t day of July 19 87
';�, ,
Daa te Jerk or Secretary Signature
IMRF Form 6.05
(Rev.) 7,184