HomeMy WebLinkAboutResolutions - R-87-10 - 07/01/1987 - IMRF for Library EmployeeR-97-/0
Illinois Municipal Retirement Fund
100 South Wacker Drive Chicago, IL 60606 312/346-6722
OMITTED SERVICE CREDIT VERIFICATION
(See instructions on reverse side)
Member Name Social Security N m
Janice J. IRegener 329-3C-�qM
Member Address Street or Route City State, Zip Code Current Position
4220 W. Sioux McHenry, IL 60050
Special Services Clerk
Employer Name C;; y o F �N en ry Employer Number (State SSA No.) Omitted Service Position
69-033 -L— -,5-- Special Services Clerk
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
EarningsMonths
of Creditable Service
With Earnings
Without Earnings`
With Earnings
Without Earnings'
ss83
0� 9�8.OD
--
-
-
/9P3'
y �• z
2
9�
D 09 IPA
/2
9F*7
6
TOTAL
" SE — (seasonal leave explained on reverse side)
Date Signature of Authorize�Ag.nt
RESOLUTION BY GOVERNING BODY
WHEREAS, the member named herein for the period indicated above totaling _
but was not reported to the Illinois Municipal Retirement Fund for membership.
RESOLVED, that it is the finding of this City of McHenry
51 months should have been
that:
Name of Governing Body
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. Gilpin 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 1st _ day of July 19 87 ` .
_-1-31-8i -
Date 4lerk or Secretary
IMRF Form 6.05
(Rev.) 7184