foothill -de anza community college districthr.fhda.edu/_downloads/final faculty sample packet_09 05...

Supplementary Retirement Plan (SRP)

Foothill-De Anza Community College District Enrollment Packet

First Name Last Name 123 South Main Street Newport Beach, CA 92617

Foothill-De Anza Community College District PARS (Public Agency Retirement Services)

Faculty 1

Take a look inside! ▶

The District is offering a one-time, voluntary retirement incentive program called the Supplementary Retirement Plan (SRP). For more information and to see whether the SRP is a good opportunity for you, please review the enclosed customized Benefit Illustration and enrollment materials.

SAMPLE

Foothill-De Anza Community College District Supplementary Retirement Plan (SRP)

PARS · 4350 Von Karman Avenue, Suite 100, Newport Beach, CA 92660

(800) 731-7884 · Fax (877) 734-6220 · [email protected]

PARS does not provide tax, accounting or legal

advice. Please contact your tax consultant,

accountant or attorney for advice.

P A G E A

Faculty

INTRODUCTION

To: Eligible Employees

Foothill-De Anza Community College District (District) is offering a one-time voluntary retirement incentive plan for

eligible employees for the 2018-2019 academic year, subject to final Board approval at their December meeting.

Based on information provided to Public Agency Retirement Services (PARS) by the District and if you meet the

requirements for participation, you may be eligible to participate in the District’s Supplementary Retirement Plan

(SRP). The District will provide this benefit, which you will receive in addition to and separately from your

CalSTRS/CalPERS retirement allowance. The District is implementing the SRP through PARS. Details of the SRP are

contained in the attached materials.

The attached Benefit Illustration (page B) was prepared specifically for you. Please review the Benefit

Illustration and accompanying enrollment materials carefully to ensure that you understand your rights and

responsibilities should you choose to participate in the SRP.

If you are interested in participating in the SRP, review the “Assumptions Table” on the Benefit Illustration and

enclosed enrollment materials. To change any inaccurate assumptions, submit a Correction Form (page 1) to PARS

in the enclosed return envelope for a revised Benefit Illustration.

To enroll in the SRP and receive benefits as shown on the attached Benefit Illustration, you must meet all of

the Eligibility Requirements outlined in the Plan Summary (page C and D).

The SRP Enrollment Deadline is 5:00PM on Friday, November 2, 2018.

Identical group orientation meetings have been scheduled. Please refer to the enclosed orientation meeting flyer

for the dates, times and locations of the orientation meetings. The orientation meetings are designed to answer

questions about the SRP. If you are interested in participating in the SRP, please attend one or more of the

orientation meetings. Spouses, domestic partners and your financial advisors are also welcome to attend.

If you require accommodation, please contact the PARS Plan Support Department for assistance.

If you have questions about the SRP, please contact the PARS Plan Support Department.

Sincerely,

Plan Support

PARS, Public Agency Retirement Services

(800) 731-7884

[email protected]

BENEFIT ILLUSTRATION Faculty

Prepared for: Sample Employee Supplementary Retirement Plan

SRP Level of Benefit Projected SRP Benefit Payout Amounts

Option 1 (Lifetime): $352.11

Option 2 (Joint & Survivor): $298.40

Option 3 (Lifetime or 10-Years): $346.22

Assumption Table

Resignation Date: 6/28/2019

Participant Birthdate: 5/23/1957 Option 4: N/A

Participant Age @ Resignation: 62.09

Final Pay*: $106,121.31

Options 5-15 (Fixed-Term Payments)*:

Beneficiary Birthdate*: 5/23/1957

Beneficiary Age @ Resignation: 62.09 Option # Years of Payment Monthly Payment

5* 5 $1,330.60

6* 6 $1,126.69

7* 7 $979.76

8* 8 $869.77

SRP Level of Benefit 9* 9 $784.29

10 10 $716.00

11 11 $661.56

12 12 $615.24

13 13 $576.08

14 14 $542.49

15 15 $513.36

1 P A G E B

Neither Foothill-De Anza Community College District nor PARS provides

tax, accounting, or legal advice. See your tax consultant, accountant or

attorney for advice.

* Options 5-9 are eligible for direct rollover into an IRA or to an eligible plan that

accepts the rollover. If you are in the year in which you will attain age 70 ½ or

over the age of 70 ½, you are not eligible to elect a direct rollover of your SRP

benefit payments. SRP benefit payments will be treated as a required minimum

distribution and will be coded as a taxable distribution for the duration of your

benefit period. Please consult with a qualified tax or legal advisor to determine

whether your SRP monthly benefit may be eligible for rollover.

Prepared on: September 4, 2018

75.00% of Final PayA monthly cash payment for your lifetime only.

Option 1 does not pay out to a beneficiary.

Foothill-De Anza Community College District

Option 2 is a modified monthly payment for your

lifetime and the lifetime of your one named beneficiary.

Option 3 is a modified monthly payment for the greater

of your lifetime or 10 years. In the event of death within

10 years of resignation, monthly payments will continue

to your beneficiary or estate until a total of 120 payments

are made.

The Supplementary Retirement Plan (SRP) benefits are

illustrated according to the assumptions listed below. Your

SRP benefit is subject to verification of these assumptions and

will ultimately be determined based on the provisions of the

plan.

To participate in the SRP, you must review and correct any

assumptions that are inaccurate using the enclosed

Correction Form (page 1).

Options 5-15 provide a higher monthly payment

guaranteed for a fixed number of years as shown below.

Payments are made to the participant until the final

payment is made. In the event of death, all remaining

payments will be paid to your beneficiary or estate.

Not applicable. There is no Option 4 available.

The SRP benefit supplements your primary retirement system

allowance. If you participate in the SRP, your choice of

benefit option and beneficiary for Option 2 is final upon the

close of the enrollment window and cannot be changed

thereafter.

*Note: A beneficiary birthdate assumption was created based

on your own date of birth. Beneficiary birthdate only affects the

amount of Option 2.

*The employee’s 2018-2019 Contract Salary. Faculty Contract Salary is

defined as placement on the applicable 2018-2019 salary schedule

multiplied by the participant’s 2018-2019 FTE (full-time equivalent) and

number of regular contract months, and includes applicable earned

Professional Achievement Award/s. Please note that Contract Salary

does not reflect recent negotiated changes to the salary schedule for

2018-2019; the negotiated 5% adjustment to the schedule may result in

an increase to your final benefit.

The projected benefit amounts illustrated for all options are

based on annuity rates at the time this illustration was printed.

The final amount of your benefit will be determined prior to

your first distribution based on the most current annuity rates

at the time of purchasing the annuity.







P A G E C

Faculty

PLAN SUMMARY (SIDE 1 OF 2)

The Supplementary Retirement Plan (SRP) is a retirement incentive plan. The District has agreed to pay all administrative costs

necessary to provide a monthly benefit. The SRP must have plan participation by the enrollment deadline of 5:00PM on

November 2, 2018 sufficient to meet the District’s fiscal and operational objectives in order for the SRP to go into effect.

Participants will have up to 5:00PM on the seventh (7th) calendar day following the date of submission or until 5:00PM on

November 2, 2018, whichever is later, to rescind their enrollment in the SRP. As of the later of 5:00PM on the seventh (7th)

calendar day following the date of submission or 5:00PM on November 2, 2018, resignations of participants are irrevocable and

may not be rescinded unless the District withdraws the SRP. If sufficient participation has not been reached, as determined by

the District and based on the applications filed by the enrollment deadline, the District may withdraw the SRP and will notify

enrolled employees of the withdrawal on or before December 14, 2018. If the District withdraws the SRP, resignations will be

null and void and automatically rescinded.

Benefit Description

The District shall make non-elective employer contributions into the participant’s 403(b) annuity contract held at Pacific Life

Insurance Company. The sum of the contributions shall equal 75% of Final Pay and will be contributed by the District in

accordance with the Plan provisions.

Faculty Final Pay shall be defined as the employee’s 2018-2019 Contract Salary. Faculty Contract Salary is defined as

placement on the applicable 2018-2019 salary schedule multiplied by the employee’s 2018-2019 FTE (full-time equivalent)

and number of regular contract months, and includes applicable earned Professional Achievement Award/s.

Participants shall elect from the following monthly benefit payment options that are calculated based on current annuity

rates obtained at the time of purchasing the annuity.

Option 1: Lifetime

A monthly payment for your lifetime only. Option 1 does not pay out to a beneficiary.

Option 2: Joint-and-Survivor

A modified monthly lifetime payment. Upon your death, the payment continues at the same level for the lifetime of your one

named beneficiary. Upon your beneficiary’s death, the payment ends. If your beneficiary is a non-spouse more than 10 years

younger than you, the monthly benefit payable to your beneficiary may be further reduced based on the age of your

beneficiary.

Option 3: Life or Ten-Year

A modified monthly payment paid for the greater of 10 years or your lifetime. If you live beyond 10 years of your

resignation, the benefit will end at the time of your death. In the event of death within 10 years of your resignation, monthly

payments will continue to be paid to your beneficiary or estate at the same level until a total of 120 payments have been

received.

Option 4: Not Applicable

Options 5-15: Fixed Payments*

A higher monthly payment, but for a fixed period of time, ranging from 5 to 15 years. Upon your death, if you have not

received all of the payments due, payments will continue to your beneficiary or estate until the total number of payments

have been received.

* Options 5-9 may be rolled over into an IRA or to an eligible employer plan that accepts the rollover.







P A G E D

Faculty

PLAN SUMMARY (SIDE 2 OF 2)

Plan Guidelines

All SRP benefits shall be paid to participants exclusively

through annuity payments from Pacific Life Insurance

Company.

All contributions into the participant’s 403(b) account with

Pacific Life Insurance Company shall be made in accordance

with the applicable IRS rules and regulations.

All District contributions made on your behalf are subject to

applicable state annuity premium taxes.

Choice of SRP benefit option and designation of beneficiary

for Option 2 will become final as of 5:00PM on the

November 2, 2018 enrollment deadline and cannot be

changed thereafter.

Enrolled employees may rescind their resignation and

participation in the SRP by submitting written notice to the

PARS office by 5:00PM on the seventh (7th) calendar day

following the date of submission of the SRP enrollment

packet or 5:00PM on November 2, 2018, whichever is later.

Resignation from District employment and participation in

the SRP is irrevocable and cannot be rescinded as of the

later of 5:00PM on the seventh (7th) calendar day following

the date of submission or 5:00PM on November 2, 2018

unless the District withdraws the SRP.

Participants, excluding employees who have met the

conditions for an Early Notice Incentive, shall not be eligible

for any other District sponsored separation or retirement

incentive programs.

Participants shall resign irrevocably and have no right to

return to their positions or any other regular, contract, or

permanent position in the District.

Participants shall not return to the District under a regular,

contract, or permanent position without forfeiting their SRP

benefit.

For participants considering re-employment in a part-time

capacity following retirement, please contact

CalSTRS/CalPERS regarding their respective rules

concerning re-employment.

Benefit Payment

SRP benefits shall commence August 1, 2019.

The projected benefit amounts illustrated on the Benefit

Illustration are based on annuity rates at the time the

illustration was printed. The final amount of the benefit

option you select will be determined prior to your first

distribution based on the most current annuity rates at the

time of purchasing the annuity.

If you are in the year in which you will attain age 70 ½ or

over the age of 70 ½, you are not eligible to elect a direct

rollover of your SRP benefit payments. SRP benefit

payments will be treated as a required minimum

distribution and will be coded as a taxable distribution for

the duration of your benefit period.

SRP benefit amounts will ultimately be determined based

on the provisions of the SRP and will be verified by the

District of all relevant assumptions.

Eligibility Requirements

1. Be employed by the District for the 2018-2019 contract year

as a regular employee or contract employee as defined by

Article 1 of the Faculty Agreement (i.e., permanent/tenured

faculty employee, probationary faculty employee, or grant-

funded employee hired on a year-to-year basis in

accordance with Education Code section 87470), or for the

2018-2019 year as a permanent classified employee or

permanent classified hourly employee.

2. Have at least five (5) years of continuous District service as a

regular or contract faculty employee, permanent classified

employee, or permanent classified hourly employee as of

their separation date or June 28, 2019, whichever is earlier.

3. Are eligible to retire under CalSTRS (fifty-five (55) years of

age with five (5) years of CalSTRS service credit or fifty (50)

years of age with thirty (30) years of CalSTRS service credit)

or CalPERS (fifty (50) years of age with five (5) years of

CalPERS service credit) as of as of my separation date or

June 28, 2019, whichever is earlier.

4. Have resigned from District employment effective after the

date of Board approval and not later than June 28, 2019.

5. Have submitted all required SRP enrollment materials,

District Letter of Resignation, and Early Resignation

Incentive Waiver & Release Agreement to be received in the

PARS office no later than 5:00PM on November 2, 2018.

SRP eligibility will ultimately be determined based on the

provisions of the SRP and will be verified by the District of

all relevant assumptions. If it is determined that you do not

meet any one of the eligibility requirements, you will be

notified of your ineligibility.







Faculty

ENROLLMENT PACKET: CONTENTS & INSTRUCTIONS

Enrollment Instructions

1. To enroll in the Supplementary Retirement Plan (“SRP”), submit all required enrollment materials to PARS.

2. Forms must be received in the PARS office by 5:00PM on November 2, 2018. You may send your enrollment

packet directly to PARS via the following methods:

a. Fax to (877) 734-6220

b. Scan and e-mail to [email protected]

c. Mail in the enclosed return envelope to be received by 5:00PM on November 2, 2018 (not-

postmarked). Remember to make a copy for your own records.

d. Attend a PARS walk-in workshop (refer to enclosed yellow flyer for dates, times and locations) to hand

into a PARS representative

3. You will receive a call from PARS confirming the receipt of your enrollment packet.

4. This packet is for the SRP only. If also retiring from CalSTRS/CalPERS, submit a separate application to

CalSTRS/CalPERS before your CalSTRS/CalPERS retirement date. Contact CalSTRS/CalPERS to confirm the

deadline for submission of your CalSTRS/CalPERS retirement application.

Required Materials Checklist

□ Correction Form page 1 – optional

□ Enrollment Form page 2 - required

□ SRP Benefit Option Form page 3 - required

□ Beneficiary Form page 4 - required

□ Tax Withholding Form page 5 - required

□ Direct Deposit/Rollover Form page 6 – optional

□ Proof of Age page 7 – required

□ District Letter of Resignation Page 8 – required

□ Early Resignation Incentive Waiver and Release Agreement required

Please contact the PARS Plan Support Department with any questions at (800) 731-7884 or via email at

[email protected]. Office hours are from 8:30AM – 5:00PM, Monday through Friday.







P A G E 1

Faculty

CORRECTION FORM Optional

Instructions:

Only complete and return this form to PARS if:

Any assumptions listed on your Benefit Illustration (page B) are incorrect.

You are interested in Option 2 (Joint-and-Survivor) and want a more accurate estimate.

For final pay corrections, PARS will ask the District to confirm if any adjustments need to be made.

If corrections are made that change any of the dollar amounts on your Benefit Illustration, PARS will mail

or email you a revised copy.

Personal Information

Name: SSN#:

Address:

City: State: Zip:

Phone: ( ) Email:

Correction of Assumptions

Employee Name Correction:

Employee Date of Birth Correction: / /

Final Pay Correction (as defined on your Benefit Illustration):

Complete ONLY if electing or

interested in Option 2

(Joint-and-Survivor)

Beneficiary Date of Birth: / / Sex: □ Spouse □ Non-Spouse

Acknowledgement

I have reviewed the relevant assumptions on my Benefit Illustration (page B) and have corrected the items that are

inaccurate.

I understand that my SRP eligibility and SRP benefit amounts will ultimately be determined based on the provisions

of the SRP and will be verified by the District of all relevant assumptions. If it is determined that I do not meet any

one of the eligibility requirements, I will be notified of my ineligibility by PARS.

▶ Participant Signature: Date:







P A G E 2

Faculty

ENROLLMENT FORM Required

Participant Information

Name: SSN#:

Date of Birth: Gender:

Address:

City: State: Zip:

Work Phone: ( ) Home/Cell Phone: ( )

Email Address:

Position:

Enrollment Statement

I am employed by the District for the 2018-2019 contract year as a regular employee or contract employee as defined by Article 1 of the Faculty

Agreement (i.e., permanent/tenured faculty employee, probationary faculty employee, or grant-funded employee hired on a year-to-year basis in

accordance with Education Code section 87470), or for the 2018-2019 year as a permanent classified employee or permanent classified hourly employee. I

will have at least five (5) years of continuous District service as a regular or contract faculty employee, permanent classified employee, or permanent

classified hourly employee as of my separation date or June 28, 2019, whichever is earlier. I will be eligible to retire under CalSTRS (fifty-five (55) years of

age with five (5) years of CalSTRS service credit or fifty (50) years of age with thirty (30) years of CalSTRS service credit) or CalPERS (fifty (50) years of age

with five (5) years of CalPERS service credit) as of my separation date or June 28, 2019, whichever is earlier. I will resign from District employment effective

after the date of Board approval and not later than June 28, 2019. I will submit all required SRP enrollment materials, District Letter of Resignation, and

Early Resignation Incentive Waiver & Release Agreement to be received in the PARS office no later than 5:00PM on November 2, 2018. I hereby apply for

the benefits for which I qualify under the Foothill-De Anza Community College District Supplementary Retirement Plan.

To enroll in the SRP, I must submit an Enrollment Form, SRP Benefit Option Form, Beneficiary Form, Tax Withholding Form, Proof(s) of Age,

District Letter of Resignation, and Early Resignation Incentive Waiver & Release Agreement to be received in the PARS office by the 5:00PM November 2,

2018 enrollment deadline. My resignation from District employment and participation in the SRP is irrevocable and cannot be rescinded as of the later of

5:00PM on the seventh (7th) calendar day following the date of submission or 5:00PM on November 2, 2018 unless the District withdraws the SRP.

I understand that the projected monthly benefit amounts illustrated on my Benefit Illustration for all options are based on annuity rates at the

time the illustration was printed. The final amount of the benefit option I select will be determined prior to my first distribution based on the most current

annuity rates at the time of purchasing the annuity.

SRP benefit amounts will ultimately be determined based on the provisions of the SRP and will be verified by the District of all relevant

assumptions. If I elect Option 3 or one of the Options 5-15 and I die before I have received the number of payments due, the payments will continue to the

beneficiary I designate or to my estate until that total number of payments has been received. My choice of benefit option and beneficiary for Option 2 is

final as of 5:00PM on November 2, 2018 and cannot be changed thereafter.

I understand that if I am in the year in which I will attain age 70 ½ or over the age of 70 ½, I am not eligible to elect a direct rollover of my SRP

payments. My SRP benefit payment will be treated as a required minimum distribution and will be coded as a taxable distribution for the duration of my

benefit period.

I understand that I am not required to actually retire, but must be eligible to retire to participate.

Neither Foothill-De Anza Community College District nor PARS offers tax, accounting, or legal advice. I will consult my own tax, accounting or

legal advisors for information on the consequences of my resignation. I will consult CalSTRS/CalPERS for official calculations of my CalSTRS/CalPERS

retirement allowance.

I have reviewed the entire contents of this enrollment packet. I agree to the assumptions used to calculate my SRP benefit.








P A G E 3

Faculty

SRP BENEFIT OPTION FORM Required

▶ Participant Name: SSN#:

SRP Benefit Option Selection

Indicate your SRP Benefit Option from the options listed below (mark only one option). Please see your Benefit

Illustration and Plan Summary for the full descriptions of your SRP Benefit Options.

Lifetime & Survivor Options:

□ Option 1 (Lifetime):

A monthly payment for your

lifetime only. Option 1 does

not pay out to a beneficiary.

□ Option 2 (Joint-and-Survivor):

A modified monthly lifetime payment.

Upon your death, the payment continues

at the same level for the lifetime of your

one named beneficiary.

□ Option 3 (Life or 10 Year):

A modified monthly payment

paid for the greater of your

lifetime or 10 years.

Fixed-Term Payment Options:

□ Option 5* (5-Year Fixed Payment):

A monthly payment for a fixed period of time

– 60 months. □

Option 11 (11-Year Fixed Payment):


– 132 months.



– 72 months. □



– 144 months.



– 84 months. □



– 156 months.



– 96 months. □



– 168 months.



– 108 months. □



– 180 months.

□ Option 10 (10-Year Fixed Payment):


– 120 months.

Acknowledgement

I have reviewed the Benefit Illustration and Plan Summary to ensure understanding of all the SRP Benefit Options along with the

corresponding beneficiary and rollover rules, if applicable. I understand that my choice of SRP Benefit Option cannot be changed

after the enrollment deadline.


*Options 5-9 may be rolled over into an IRA or to an eligible employer plan that

accepts the rollover. If you are in the year in which you will attain age 70 ½ or

over the age of 70 ½, you are not eligible to elect a direct rollover of your SRP

benefit payments. SRP benefit payments will be treated as a required minimum

distribution and will be coded as a taxable distribution for the duration of your

benefit period.







P A G E 4

Faculty

BENEFICIARY FORM Required


Marital Status: □ Single □ Married □ Widowed □ Other:

If Selecting Option 1 (Lifetime)

Complete ONLY if electing

Option 1 (lifetime),

otherwise see below

I have elected Option 1, the unmodified lifetime payment. I understand this option does not pay out

to a beneficiary.


If Selecting Options 2, 3, or 5-15

The Plan requires that if you are married or have a registered

domestic partner (RDP), your surviving spouse/RDP will be your sole

primary beneficiary, unless your spouse/RDP waives this right.

If you wish to designate a Trust or a person other than your

spouse/RDP as your sole primary beneficiary, you must obtain

notarized consent from your spouse/RDP. Failure to obtain your

spouse/RDP’s consent in this instance will render this designation

invalid. Any consent by a spouse/RDP applies only to that spouse

and not to any future spouse/RDP.

You are considered married if you are under decree of separate

maintenance or decree of legal separation.

If the location of your spouse/RDP is unknown, you must contact

PARS for an additional Affidavit to complete.

You may not change your beneficiary designation for Option 2 (Joint-

and-Survivor) after the enrollment deadline.

To designate additional beneficiaries, attach a separate sheet

providing the same information requested below or contact PARS for

an Additional Beneficiaries Form (page 4B)

Beneficiary Percentage: % □ Primary □ Secondary

Name: SSN#: Date of Birth: / /

Phone: ( ) Relationship: Sex:

Address:

City: State: ZIP:

Beneficiary Percentage: % □ Primary □ Secondary

Name: SSN#: Date of Birth: / /

Phone: ( ) Relationship: Sex:

Address:

City: State: ZIP:


Spousal/Registered Domestic Partner Consent*

I hereby consent to the above beneficiary designation of my spouse/registered domestic

partner, a participant of the SRP. I understand that in consenting to the designation of

anyone except myself as beneficiary, I am waiving my rights to a survivor benefit that I

would legally be entitled to at a later date.

▶ Spouse/Registered Domestic Partner Signature: Date:

* Please have the notary attach a

separate acknowledgement to notarize

Spousal/Registered Domestic Partner

Signature.







P A G E 5

Faculty

TAX WITHHOLDING FORM Required


□ I am not a resident of California. I have established residency in:

If Selecting Options 1, 2, 3, or 10-15

If you elect not to have federal or state income tax withheld, you are liable for payment on the taxable

portion of your benefits. You may also be subject to a tax penalty under the “estimated tax” payment

rules if your withholding, plus any estimated tax payments, is not at an adequate level.

Op

tio

ns

1,

2,

3,

or

10

-15

ON

LY Part A:

Federal Income

Tax Withholding

□ Do NOT withhold federal income tax.

□ Withhold federal income tax in the monthly amount of: $

Part B:

State Income

Tax Withholding

□ Do NOT withhold state income tax.

□ Withhold state income tax in the monthly amount of: $

If Selecting Options 5-9

If you select one of the Options 5-9, a mandatory 20% federal income tax withholding and any mandatory

or voluntary state income tax withholding will be deducted from your monthly benefit unless you elect

a direct rollover to an IRA or to an eligible employer plan that accepts the rollover*.

Op

tio

ns

5-9

ON

LY

Part A:

Federal Income

Tax Withholding

□ Withhold ONLY the mandatory 20% federal income tax.

□ IN ADDITION TO the mandatory 20% federal income tax,

withhold federal income tax in the monthly amount of: $

□ I elect a direct rollover to an IRA or other eligible retirement plan; therefore, I do not want

federal taxes withheld from my monthly benefit payments.

Part B:

State Income

Tax Withholding

□ Do NOT withhold state income tax.

□ Withhold state income tax in the monthly amount of: $

□ I elect a direct rollover to an IRA or other eligible retirement plan; therefore, I do not want

state taxes withheld from my monthly benefit payments.

□ I am electing a direct rollover into a Roth IRA,

please withhold taxes in the monthly amounts of: Federal: $ State: $

Authorization

I certify that I have received, read and understand the Special

Tax Notice Regarding Plan Payments on the taxation of

distributions from qualified pension plans.


Enter an amount –

NOT a percentage or

number of exemptions

Enter an amount –

NOT a percentage or

number of exemptions

*If you are in the year in which you will attain age 70 ½ or over the age of 70 ½,

you are not eligible to elect a direct rollover of your SRP benefit payments. SRP

benefit payments will be treated as a required minimum distribution and will

be coded as a taxable distribution for the duration of your benefit period.







P A G E 6

Faculty

DIRECT DEPOSIT/ROLLOVER FORM Optional

If electing to have your benefit payments deposited into a checking or savings account, the payments are made via EFT

(Electronic Funds Transfer) around the first business day of every month.

If electing a direct rollover, your benefit payments will be physically mailed to the financial institution at the address you

provide below. Please allow extra time for mailing and processing of your monthly rollover payments.

This form is NOT required to be submitted by the enrollment window deadline date.

If you are electing a direct deposit or rollover, this form must be received in the PARS office at least 60 days prior to the first

benefit payment. Failure to do so will result in the mailing of your monthly benefit payments to your home address (less any

mandatory federal and/or state tax withholdings, if applicable).

You will NOT receive monthly statements from PARS; contact your financial institution to confirm that deposits are credited

to your account.

Participant Information


To Elect a Direct Deposit into a Checking or Savings Account

Financial Institution Name:

Transit Routing/ABA Number: (9-digit number, not starting with 5)

Account Number: □ Checking □ Savings

To Elect a Direct Rollover (only available for Options 5-9)

Financial Institution Name:

Mailing Address:

City: State: ZIP:

Account Number:

□ IRA □ Roth IRA □ 403(b) □ 457 □ Other:

Authorization

The undersigned participant (Participant) hereby authorizes and directs the Plan Insurer or Trustee to transfer funds for benefit payments to which the Participant may be entitled

under the terms of the Supplementary Retirement Plan (the Plan) as they become due and payable, in accordance with the written direction of the Plan Administrator, and will

directly deposit said funds by electronic transfer or check to the account maintained by the Participant at the “Financial Institution” identified above. Said funds shall be in full

payment, satisfaction and discharge of amounts due the Participant under the Plan. The Participant authorizes and directs the Financial Institution to refund any payments to the

Plan Insurer or Trustee to which the Participant or the Participant’s successors or estate, would not have been entitled under the Plan as a result of the Participant’s death or

otherwise, and the same to the Participant’s Account designated above. Both Participant and any co-tenant on the Participant Account agree on behalf of themselves, their heirs,

executors, successors, and any trustee of his or her trust (if any) to reimburse the Plan Insurer or Trustee for such payments. This authorization is to remain in full force and effect

until the Plan Insurer or Trustee has received written notice from the Participant of its termination. Direct Deposit shall be effective for all payments made by the Plan Insurer or

Trustee on behalf of the Participant as soon as administratively possible upon receipt of this authorization.


Note:

Rollover payments will be mailed to

your financial institution. Please

contact them to verify the best

address to use.

*If you are in the year in which you will attain age 70 ½ or over the age of 70 ½, you are not eligible to elect a

direct rollover of your SRP benefit payments. SRP benefit payments will be treated as a required minimum

distribution and will be coded as a taxable distribution for the duration of your benefit period.







P A G E 7

Faculty

PROOF OF AGE Required

As a plan participant, you are required to submit a copy of your Driver’s License, State ID card, Birth Certificate,

or Passport as proof of age.

You may attach a copy of your Driver’s License or State ID card below (see example) or attach the copy

separately.

Larger forms such as your Birth Certificate or Passport may be attached separately.

If you are selecting Option 2 (Joint-and-Survivor), you are required to submit proof of age for your beneficiary as

well.

Please ensure that the date of birth on all copies is legible.


Proof of Age

Attach Employee Proof of Age Here

Attach Beneficiary Proof of Age Here

(Required for Option 2 ONLY)







P A G E 8

Faculty

** Date must be effective not earlier than December 11, 2018 and not later than June 28, 2019.

** Date must be at least one day before your CalSTRS/CalPERS retirement date (if applicable).

DISTRICT LETTER OF RESIGNATION Required

This District Letter of Resignation will serve as your official notice to the District that you are resigning from District

employment. You do NOT need to submit a separate resignation form to the District. Please submit this District Letter of

Resignation to PARS with your enrollment forms. PARS will forward it to the District on your behalf following the close of

the enrollment window.

▶ I, (print name) , am resigning my full-time faculty

position from the Foothill-De Anza Community College District as follows (mark only one box):

□ I am resigning my full-time position for the purpose of retirement from CalSTRS or CalPERS. I plan to return to district

employment under Article 21 (Post -Retirement Employment) of the FA Agreement for a maximum of three (3) years.

□ I am resigning my full-time position for the purpose of retirement from CalSTRS or CalPERS. I hereby waive any rights

under Article 21 and decline to participate in any post-retirement employment with the District.

□ I am resigning my full-time position but I am not retiring from CalSTRS or CalPERS at this time. I understand that I retain

any existing rights and plan to return to employment under Article 7 (Part-Time Faculty) of the FA Agreement.

□ I am resigning my full-time position but I am not retiring from CalSTRS or CalPERS at this time. I hereby waive any rights

under Article 7 and decline to participate in any post-separation employment with the District.

▶ My resignation will become effective close of business on (list one specific date)**:

I have met the eligibility requirements and will meet the participation requirements established by the District for participation in

the Supplementary Retirement Plan (“SRP”). I will submit this District Letter of Resignation, Early Resignation Incentive Waiver &

Release Agreement, and all other required SRP enrollment materials to be received in the PARS office by the 5:00PM November 2,

2018 enrollment deadline.

Plan participation sufficient to meet the District’s fiscal and operational objectives must be met by 5:00PM on the November 2,

2018 enrollment deadline in order for the SRP to go into effect. Participants will have up to 5:00PM on the seventh (7th) calendar

day following the date of submission or until 5:00PM on November 2, 2018, whichever is later, to rescind their enrollment in the

SRP. As of the later of 5:00PM on the seventh (7th) calendar day following the date of submission or 5:00PM on November 2, 2018,

resignations of participants are irrevocable and may not be rescinded unless the District withdraws the SRP. If sufficient

participation has not been reached, as determined by the District and based on the applications filed by the enrollment deadline,

the District may withdraw the SRP and will notify enrolled employees of the withdrawal on or before December 14, 2018. If the

District withdraws the SRP, resignations will be null and void and automatically rescinded.

I understand that my resignation from District employment and participation in the SRP is irrevocable as of the later of

5:00PM on the seventh (7th) calendar day following the date of submission or 5:00PM on November 2, 2018. I understand

if the District withdraws the SRP, my resignation is automatically rescinded.

I have reviewed, understand, and agree with the provisions of the District’s Supplementary Retirement Plan.


EARLY RESIGNATION INCENTIVE WAIVER AND RELEASE AGREEMENT Page 1 of 24

EARLY RESIGNATION INCENTIVE WAIVER AND RELEASE AGREEMENT

This Early Resignation Incentive Waiver and Release Agreement (“Agreement”) is

entered into between [Employee Name] (“Employee”) and the Foothill - De Anza Community College District (“District”). The Effective Date of this Agreement is set forth in Paragraph 9 of this Agreement.

WHEREAS, the Board of Trustees of the District intend to offer an Early Resignation

Incentive (“Incentive”) to eligible employees in the form of a Supplemental Retirement Plan (SRP) contingent on sufficient Plan Participation by November 2, 2018 that meets the District’s budget and operational objectives;

WHEREAS, an eligible employee’s participation in the Incentive is contingent upon,

among other things, resignation from District employment effective no later than June 28, 2019;

WHEREAS, Employee voluntarily desires to resign in order to participate in the Incentive; and

WHEREAS, in consideration for Employee’s participation in the Incentive pursuant to its terms and the terms of the SRP, Employee agrees to waive and release the District from the liabilities and claims set forth herein.

NOW, THEREFORE, in consideration of the mutual covenants set forth below, the parties

agree as follows:

1. Recitals. All of the recitals listed above are material provisions of this Agreement.

2. Employee Consideration. The District agrees to provide Employee with the

Incentive that is outlined in Attachment A to this Agreement (2018-2019 Early Resignation Incentive for Faculty and Classified Employees and SRP Packet) if all of the following occur: (a) Employee is eligible to participate in the Incentive and resigns District employment effective on or before June 28, 2019; (b) Employee executes this Agreement and returns it with his/her completed SRP Enrollment forms and District Letter of Resignation to PARS no later than 5:00 p.m. on November 2, 2018 (see Attachment A for delivery means to PARS); (c) the District does not exercise its right to withdraw the Incentive due to an insufficient level of plan participation; and (d) Employee does not exercise his/her right of revocation set forth in Paragraph 8.h. below.


3. Waiver and Release. In consideration of the Incentive, Employee, on behalf of him/herself, his/her heirs, representatives, successors, and assigns hereby irrevocably and unconditionally releases and discharges the District, its Board of Trustees, officers, executives, directors, managers, administrators, employees, attorneys, agents, executors, affiliates, insurers, successors-in-interest, assigns, and representatives of each of them, past or present (collectively “Releasees”) from any and all claims, actions, causes of action, rights, demands, debts, obligations, damages, or accountings of whatever nature which Employee has or believes he/she has against the District by reason of, or arising out of, Employee’s employment with the District up through the date of execution of this Agreement, but excluding claims for injured worker benefits arising under the Workers’ Compensation and Insurance Law (Labor Code §§ 3200 et. seq.) filed with the Workers’ Compensation Appeals Board. Additionally, Employee expressly waives and relinquishes all known and unknown claims that exist in his/her favor, even if knowledge of such claims would have materially affected his/her decision to enter into this Agreement. This Agreement extends to any claim, filed in any state or federal court, with any administrative body, agency, board, commission, or entity whatsoever, but shall not extend to claims filed with the Workers’ Compensation Appeals Board for injured worker benefits to which he/she may be entitled under the Workers’ Compensation and Insurance Law (Labor Code §§ 3200 et. seq.).

4. No Pending Claims. Employee represents and warrants that he/she has not

filed, will not file, and has not assigned for filing any lawsuits, complaints or charges against the District and Releasees with any state or federal court, or local, state or federal agency, or administrative tribunal or person, based on any events occurring prior to the date of execution of this Agreement, excluding any claims Employee has filed or will file with the Workers’ Compensation Appeals Board for benefits to which he/she may be entitled under the Workers’ Compensation and Insurance Law (Labor Code §§ 3200 et. seq.).

5. Waiver and Release of all Claims Arising under California and Federal law.

Employee’s release includes, without limitation, any and all potential claims he/she may have by virtue of his/her employment with the District, including but not limited to, claims under the California Fair Employment and Housing Act (California Government Code § 12900 et seq.), all provisions of the California Labor Code, other than the Workers’ Compensation and Insurance Law (Labor Code §§ 3200 et. seq.), and any related wage orders or similar directives or authorities issued by any federal or state authority having enforcement powers, the Constitution of the United States, the Constitution of the State of California, Title VII of the Civil Rights Act of 1964 (42 U.S.C. § 2000e et seq.), Title IX of the Education Amendments Act of 1972 (20 U.S.C. §1681 et. seq.), the Equal Pay Act (29 U.S.C. § 206(d)), the Fair Labor Standards Act (29 U.S.C. § 201 et seq.), the Family and Medical Leave Act (29 U.S.C. § 2601 et seq.), Sections 1981-88 of Title 42 of the United States Code (42 U.S.C. § 1981 et seq.), the Americans with Disabilities Act (42 U.S.C. § 12101 et seq.), Age Discrimination in Employment Act (29 U.S.C. § 621 et seq.), claims of retaliation or whistle-blowing (including but not limited to California Labor Code § 1102.5 et seq., Government Code § 12653 and Education Code §87164), claims under the Educational Employment Relations Act (California Government Code § 3540 et seq.), claims under the California Education Code, claims for breach of any type of contract, including written, oral or implied, breach of any covenant, promise or representation pertaining


to Employee’s employment, whether expressed or implied, and all other claims, causes of action, or controversies arising in contract, tort or equity or under any other federal, state, or local statute, up to the date of execution of this Agreement.

6. Civil Code Section 1542 Waiver. Employee acknowledges that he/she enters

into this Agreement voluntarily, and also expressly acknowledges that he/she has been informed of and is familiar with California Civil Code section 1542 which provides as follows:

A general release does not extend to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the releases, which if known by him or her must have materially affected his settlement with the debtor. Employee expressly waives the provisions of California Civil Code section 1542, and

further waives any rights he/she might have to invoke said provisions now or in the future with respect to the releases set out in this Agreement. Employee intends to fully, finally, and forever settle all claims, and hereby agrees to accept and assume the risk that any fact with respect to any matter in this Agreement may hereafter be found to be other than or different from the facts he/she believes at the time of this Agreement to be true, and agrees that this Agreement shall be and will remain effective notwithstanding any such differences in fact.

7. Employee Relations Bound by Agreement. Employee understands and

expressly agrees that this Agreement shall bind and benefit his/her spouse, domestic partner, children, heirs, agents, attorneys, representatives, and assigns, if any.

8. Specific Acknowledgment of Waiver of Claims Under ADEA and OWBPA. The

Age Discrimination in Employment Act of 1967 (“ADEA”; 29 U.S.C. §§ 621-634) makes it illegal for an employer to discharge any individual or otherwise discriminate with respect to the nature and privileges of an individual’s employment on the basis that the individual is age forty or older. The Older Workers Benefit Protection Act (“OWBPA”; 29 U.S.C. §§ 626 et seq.) augments the ADEA and prohibits the waiver of any right or claim under the ADEA unless the waiver is knowing and voluntary. By entering into this Agreement, Employee acknowledges that, in exchange for the consideration stated herein, he/she knowingly and voluntarily waives and releases any rights that he/she may have under the ADEA and/or OWBPA arising out of his/her employment with the District and/or the entering into of this Agreement. Employee further acknowledges that he/she has been advised and understands, pursuant to the provisions of the ADEA and OWBPA that:

a. This waiver/release is written in a manner Employee understands. b. Employee is aware of and has been advised by a representative or legal counsel

of Employee’s own choosing of his/her rights under the ADEA and OWBPA, and of the legal significance of his/her waiver as to any possible claims he/she currently may have under the ADEA, OWBPA, or similar age discrimination laws.

c. Employee knows and understands the Incentive is offered to Faculty and Classified Employees of the District who meet the eligibility requirements set forth in the Incentive and the SRP, the time limits applicable to acceptance of the Incentive, and the effective date of resignation (Attachment A);


d. Employee has received and reviewed Attachment B to this Agreement which provides the ages for all permanent classified employees, according to each classification, and all eligible regular/tenured and contract faculty hired under Education Code section 87470 who are eligible to participate in the Incentive, as well as the ages for each permanent classified employee, according to classification, and regular/tenured and contract faculty hired under Education Code section 87470 who are not eligible to participate in the Incentive;

e. Employee is entitled to a reasonable time of at least forty-five (45) days within which to review and consider this Agreement, and the waiver and release of any rights he/she may have under the ADEA, the OWBPA, or similar age discrimination laws, but Employee may, in the exercise of his/her own discretion, sign and deliver this Agreement to PARS at any time before the expiration of the forty-five (45) day period and thereby waive any remaining number of days within the forty-five (45) day review period.

f. The waivers and releases set forth in this Agreement shall not apply to any rights or claims that may arise after the effective date of this Agreement.

g. Employee has had an opportunity to discuss this waiver and release with, and to be advised with respect thereto, by an attorney of Employee’s choice, and that he/she does not need any additional time within which to review and consider this Agreement.

h. Employee has seven (7) days following his/her execution of this Agreement to revoke it. If Employee desires to revoke this Agreement, and therefore relinquish his/her eligibility for, and participation in, the Incentive, he/she must give express written notice of revocation to the Plan Support Department at PARS, 4350 Von Karman Avenue, Suite 100, Newport Beach, California 92660, no later than 5:00 p.m. on the seventh (7th) calendar day after this Agreement is signed by Employee and delivered to PARS. Such notice of revocation shall be effective only if and when received in writing by PARS before 5:00 p.m. on the seventh (7th) calendar day after Employee submits this signed Agreement.

9. Effective Date of Agreement. The Effective Date of this Agreement shall be the

day after the date on which the seven (7) day revocation period expires as set forth in Paragraph 8.h. above without Employee’s revocation or the enrollment deadline of 5:00p.m., November 2, 2018, whichever is later. Employee’s resignation will become irrevocable on the Effective Date of this Agreement, unless the District exercises its right to withdraw the SRP due to insufficient plan participation necessary to meet the District’s budget and operational objectives in which case the resignation and this Agreement shall be null and void.

10. Indemnity Regarding Assignment of Claims. Employee represents and warrants

that he/she has not heretofore assigned or transferred, or purported to assign or transfer, to any person, entity, or individual whatsoever, any of the claims released as set forth herein. Employee agrees to indemnify and hold harmless the District and the Releasees against any claim, demand, debt, obligation, liability, cost, expense, right of action or cause of action based on, arising out of, or in assignment of any claim waived and released in this Agreement.


11. Waiver and Indemnity for Joinder in Claims. Employee represents and warrants that he/she has not been joined, and Employee shall not cause to be joined, in any claim, action or lawsuit, including any certified or putative class action, against the District. Should Employee be joined in any claim, action or lawsuit by order of any court of competent jurisdiction or administrative tribunal, Employee agrees to waive his/her entitlement to any remedy, compensation or award and to indemnify and hold harmless the District and the Releasees against any claim, demand, debt, obligation, liability, cost, expense, right of action or cause of action based on, or arising out of, claims waived and released in this Agreement

12. Employee’s Right to Advice of Counsel. Employee acknowledges that he/she is

entitled to have this Agreement reviewed by an attorney chosen and paid for by the Employee and have the advice of such attorney before entering into this Agreement. Employee understands that the waiver and releases he/she has made and the terms he/she has agreed to herein are knowing, conscious, and with the full appreciation that he/she is forever foreclosed from pursuing any of the rights so waived. No promise, inducement, or agreement not expressed herein has been made to Employee in connection with this Agreement.

13. Forum. This Agreement is executed and delivered in the State of California and

the rights and obligations of the parties hereunder shall be construed and enforced in accordance with the laws of the State of California. Any litigation concerning this Agreement shall be venued in Santa Clara County.

14. Waiver of Breach. No waiver by any party of any breach of any term or

provision of this Agreement shall be construed to be, nor shall be, a waiver of any preceding, concurrent or succeeding breach of the same or any other term or provision of this Agreement.

15. Fully Integrated Agreement. This Agreement, including Attachments A and B, is

fully integrated and contains and constitutes the entire understanding and agreement between the parties hereto with respect to Employee’s Incentive and the waiver and release of any and all claims against the District. This Agreement cancels all previous oral and written negotiations, agreements, commitments and writings in connection therewith.

16. Joint Drafting. This Agreement is deemed to have been drafted jointly by the

parties. Any uncertainty or ambiguity shall not be construed for or against any party passed upon attribution of drafting to any party.

17. This Agreement shall be admissible in counterparts. All executed copies are

duplicate originals and are equally admissible in evidence.


By: Employee Signature

Date:

Print Employee Name

By: Judy C. Miner

Date:

Chancellor, Foothill-De Anza Community College District


ATTACHMENT A

Forms must be received in the PARS office by 5:00PM on November 2, 2018. Participants may

send their enrollment packet directly to PARS via the following methods:

a) Fax to (877) 734-6220.

b) Scan and e-mail to [email protected].

c) Mail in the enclosed return envelope to be received by 5:00PM on November 2,

2018 (not-postmarked).

d) Attend a PARS walk-in workshop to hand into a PARS representative.

mailto:[email protected]


ATTACHMENT B

The following describes the group of individuals eligible and ineligible for the

Incentive described in the EARLY RESIGNATION INCENTIVE WAIVER AND RELEASE

AGREEMENT:

Employees Eligible for the Incentive:

Faculty and Classified Staff who:

a) Are employed by the District for the 2018-2019 contract year as a regular

employee or contract employee as defined by Article 1 of the Faculty Agreement (i.e., permanent/tenured faculty employee, probationary faculty employee, or grant-funded employee hired on a year-to-year basis in accordance with Education Code section 87470), or for the 2018-2019 year as a permanent classified employee or permanent classified hourly employee;

b) Has or will have at least five (5) years of continuous District service as a

regular or contract faculty employee, permanent classified employee, or permanent classified hourly employee as of their separation date or June 28, 2019, whichever is earlier;

c) Are or will be eligible to retire under CalSTRS (fifty-five (55) years of age with

five (5) years of CalSTRS service credit or fifty (50) years of age with thirty (30) years of CalSTRS service credit) or CalPERS (fifty (50) years of age with five (5) years of CalPERS service credit) as of as of my separation date or June 28, 2019, whichever is earlier. Actual retirement with CalSTRS or CalPERS is not required in order to participate;

d) Will resign from District employment effective after the date of Board

approval and not later than June 28, 2019; and

e) Has submitted all required SRP enrollment materials, Early Resignation Incentive Wavier and Release Agreement, and District Letter of Resignation to PARS no later than 5:00 p.m. on November 2, 2018.


LIST OF ELIGIBLE EMPLOYEES FACULTY

Position # of Eligibles Age

Articulation/Curriculum Officr

1 61.30

Assistant Director, EOPS 1 64.61 Athletic Director - DA 1 59.39 Child Development Teacher

4 61.86

58.63 56.39 67.27 Counselor 7 61.43 55.98 65.13 57.91 64.92 68.95 64.31 Counselor, Trnsfr/Articulation

1 63.25

Director, Health Ed & Wellness

1 63.04

Director, Inst Comm & Civ Eng

1 59.34

Faculty Dir Stdnt Ldrshp/Svc

1 55.11

Instr/Pgm Dir,Medical Lab Tech

1 66.42

Instructor 149 56.70 58.29 65.35 59.58 59.85 60.49 56.63 64.16 55.00 57.53 65.58

68.69 60.67 62.04 59.34 57.77 65.29 55.49 56.86 65.66 55.50 61.57 66.50 57.09 61.64 59.38 65.70 59.24 56.14 59.41 59.25 63.56 65.93 66.25 64.34 57.42 64.41 80.16 61.10 61.76 60.46 65.88 55.18 58.98 61.66 59.18 55.08 63.59


78.22 60.74 66.37 56.24 84.56 57.74 72.75 60.93 57.09 56.16 62.60 73.30 65.24 57.37 63.11 61.72 60.96 59.26 63.95 64.02 70.26 56.58 57.09 57.93 65.62 57.80 55.81 65.78 65.98 58.47 60.56 56.76 67.17 59.18 55.56 59.43 69.43 63.29 71.16 61.44 59.65 59.18

64.23 61.55 55.60 62.40 62.04 66.99 56.60 61.39 62.11 55.29 60.14 66.63 63.70 56.13 60.24 57.57 57.65 60.68 65.68 64.43 55.14 56.50 76.11 59.24 59.99 60.24 71.97 57.88 60.71 63.28 67.46 65.53 61.90 56.53 57.21 70.29 58.54 56.26 65.25 61.68 60.10 59.01


72.03 62.51 63.48 65.63 68.54 64.42 72.19 58.85 55.51 55.89 59.07 61.13 64.96

71.43 65.99 72.25 59.39 Instructor/Clinical Coord, DH

1 56.75

Instructor/Pgm Direc, Vet Tech

1 62.99

Librarian 3 64.84 57.51 55.50 Transfer Ctr Cnslr/Coordinator

1 57.55


LIST OF ELIGIBLE EMPLOYEES CLASSIFIED STAFF


Academic Advisor 2 65.20

52.53 Academic Scheduling Coord

1 52.41

Accountant 3 54.37 52.96 52.45 Accountant, Senior 2 53.25 57.38 Accounting Assistant 3 55.48 61.69 59.92 Accounting Supervisor 1 50.05 Accounts Payable Supervisor

1 50.47

Adaptive PE Class Assistant II

3 56.79

60.78 54.68 Administrative Assistant I 2 64.24 59.81 Administrative Assistant II 6 56.65 75.08 68.37 59.79 52.12 55.46 Administrative Assistant, Sr

2 63.51

55.90 Admissions & Records Assistant

4 63.29

61.34 55.89 66.05

Alternative Media Specialist

1 62.22

Assistant To The Chancellor

1 52.12

Asst Director, Child Devel 1 61.68 Athletic Trainer 1 61.16 Automotive Technician 1 68.91 BAS/BMS/EMS Technician 1 63.15 Bookstore Courseware Coord

1 63.83

Budget Analyst 1 54.58 Business Continuity Grp Supv

1 65.06

Buyer, Sr - Special Projects 2 56.78 56.66 Call Center Supervisor 1 51.95 Call Center Support Technician

1 61.28

Campus Budget/Enroll Analyst

1 62.93

Campus Personnel Assistant

1 56.55

Cashier, Senior 1 52.44 Cashiering Services Supervisor

1 55.20

Child Devel Center Teacher

4 70.38

63.83 54.31 56.88 Community Services Officer

1 65.17

Computer Lab Instr Coordinator

4 51.86

51.54 76.22 63.58


Computer Lab Operations Coord

2 61.61

59.83 Computer Network Supervisor

1 62.37

Computer Project Coordinator

1 52.80

Coord, District Communications

1 67.32

Custodian I 1 65.59 Custodian II 16 53.56 59.08 61.13 58.91 58.10 58.09 56.93 62.18 64.51 64.04 64.41 68.86 63.76 56.93 55.02 63.73 Custodian III 4 53.17 59.61 56.28 66.27 Custodian Lead 2 51.73 60.44 Deaf & Hard of Hearing Svc Sup

1 65.91

Dist Financial Analyst, Lead

1 63.52

District Tech Services Supv 1 51.89 Division Administrative Asst

10 59.73

63.98 56.71 57.91

59.36 61.91 70.51 64.48 55.55 51.17 DSP & S Supervisor 1 58.49 Enrollment Services Specialist

1 53.82

Enrollment Services Supervisor

1 56.40

Environmental Studies Tech

1 59.73

EOPS Services Coordinator 2 69.23 54.15 EOPS Supervisor 2 57.22 63.00 Evaluation Specialist 3 65.92 52.11 61.89 Exec Director, Calif Hist Ctr 1 61.25 Executive Assistant 2 67.21 55.28 Executive Assistant II 2 53.98 53.78 Facilities & Equipment Asst

1 59.12

Financial Aid Assistant 2 67.43 55.84 Food Service Assistant III 1 62.32 Food Service Dishroom Asst

1 54.32

Food Service Operations Coord

1 57.00

Food Service Worker II 1 67.40 Graduation & Evaluation Coord

2 51.43

55.97 Grounds Gardener II 2 54.41 59.94 Grounds Gardener III 2 50.71 60.99


Grounds Supervisor 1 57.76 HR Spec, Class/Management

1 52.04

HR Spec, Faculty 1 63.34 Human Resources Technician I

1 67.32

Human Resources Technician II

1 61.45

Human Resources Technician III

1 53.66

HVAC, Journey 1 56.67 Instr Support Tech, Discipline

1 71.49

Instr Tech Solutions Syst Engr

1 54.86

Instructional Associate 6 66.78 62.30 72.88 53.82 54.29 55.39 Instructional Designer 1 52.82 Intl Operations Analyst 1 59.04 Journey - Carpenter 1 61.42 Journey - Electrician 3 55.97 57.51 55.31 Journey - Heat,Vent, Air Cond

1 63.78

Journey - Painter 1 54.14 Journey - Plumber 1 59.01 Laboratory Technician 1 60.96 Laboratory Technician, Photo

1 50.64

Library Technician, Senior 5 55.99 63.60 68.83 53.25 62.88 Maintenance Worker 1 57.83 Mobility Assistant/Driver 1 65.10 Museum Programs Coordinator

1 59.88

Network & Communications Admin

2 55.44

54.34 Network Engineer 2 57.14 54.68 Network Security Engineer 1 53.81 Office Coord, Printing Service

1 68.04

Office Services Supervisor 1 50.96 OTI Program Supervisor 1 58.61 Payroll Supervisor 1 60.69 Payroll Technician II 1 59.21 Payroll Technician, Senior 1 61.64 PE/Wellness Assistant 1 54.68 Plumber, Journey 1 61.03 Police Officer II 4 52.82 51.05 50.53 53.74 Press Operator, Senior 1 57.68 Printing Services Coordinator

1 60.38

Program Coordinator I 2 50.09 66.11 Program Coordinator II 4 53.76 55.50 51.27 52.35 Program Coordinator, Senior

1 63.09

Programmer Analyst I 1 67.23 Programmer Analyst II 1 68.30 Project Mgmt Office Supv 1 53.13 Psme Lab Instructional Coord

1 62.62

Real Time Captioner 1 53.34 Res Analyst Sr/Data Whse Cor

1 53.72

Secretary, Senior 2 58.61 55.39 Security Technician 1 56.25


Student Activities Specialist

1 66.75

Student Affairs Specialist 1 62.04 System & Network Programmer II

2 52.33

61.88 Systems & Network Programmer I

1 51.26

Systems & Network Progrm, Sr

1 55.67

Technology Resource Coord

1 63.50

Technology Services Tech II

1 64.74

Television Systems Engineer

1 60.67

Testing Technician 2 62.19 57.91 Utility Maintenance Worker II

1 63.88

Veterans Resource Specialist

1 62.68

Warehouse Worker II 1 62.87 Web & Print Comm Design Coord

1 53.89

Web Support Technician 1 64.48 Wkst & Systems Support Tech I

1 60.68

Wkst & Systems Support Tech II

3 55.01

60.04 51.94 Wkst & Systems Support Tech Sr

4 55.84

60.86 Wkst & Systems Support Tech Sr (Continued)

58.53

51.78 Writer/Editor/Web Content Dev

1 60.32


LIST OF INELIGIBLE EMPLOYEES

FACULTY Position # of Eligibles Age

Articulation Ofr/Tran Svcs Crd 1 54.87 Athletics Counselor 1 48.98 Coordinator, Faculty Prof Deve

1 48.63

Coordinator,Student Activities 1 47.23 Counselor 26 41.29

47.64 33.33 47.72 47.50 52.90 34.95 52.81 38.62 51.35 49.83 50.09 54.01 48.15 43.30 52.66 45.71 54.79 46.48 27.89 37.81 33.45 42.05 42.62 54.93 44.74

Counselor for the Disabled 3 50.49 53.46 41.87

Counselor, Adt Ed Tr,ESL,BscSk

1 34.03

Counselor, Basic Skls/LangArts

1 44.16

Counselor, Career Services 1 37.94 Counselor, Disb Stdnts Pgm/Svc

2 50.40

52.36 Counselor, ISP 1 31.78 Counselor, Math Success Pgm 2 32.88

30.85 Counselor, Otrch & Rel w/Schls

2 39.99

38.04 Counselor, Phys Ed & Athletics

1 32.14

Counselor, Psych Svcs Dir 1 53.99 Counselor, Psychological Svc 3 36.81

46.90 51.87

Counselor, SSR FYE/UMOJA 1 33.89 Counselor, SSRS – FYE 1 38.36 Counselor, Stdnts w/Dis & Vets

1 62.23

Counselor/Instructor 3 38.09 46.31 37.44

Director, Professional Devel 1 43.73 Fac Prof Dev Coord: Instr Dev 1 56.82 Fac Prof Dev Coord: Tech Trng 1 48.11 Instructor 21

0 53.21

54.92 44.29 53.12 34.68 34.05 48.40


34.01 54.96 42.75 39.64 45.47 41.86 44.83 49.58 38.11 41.17 47.50 45.98 31.42 44.32 37.50 38.89 37.26 36.96 50.04 39.52 35.09 50.03 50.86 53.84 51.80 43.38 48.24 47.82 51.91 42.84 48.53 39.25 32.21 44.42 38.49 64.72 44.45 48.55 44.71 52.86 48.84 54.79

44.99 44.46 42.49 48.63 50.94 38.69 49.57 52.22 37.91 32.61 41.76 49.71 51.84 38.84 54.24 52.31 43.71 36.94 53.83 47.28 48.15 44.31 46.91 48.64 38.68 51.36 43.41 51.15 50.82 40.81 49.85 36.54 40.04 36.93 42.71 51.16 38.49 43.10 50.27 49.25 47.56 40.13


41.29 48.23 39.85 42.96 45.61 39.38 55.44 45.04 48.80 48.98 35.89 52.71 49.33 40.46 42.11 50.90 28.94 49.62 48.59 39.53 30.69 50.28 53.16 51.10 48.00 48.81 47.85 45.05 46.48 36.33 47.99 52.87 44.65 51.90 40.40 45.64 51.76 38.78 43.42 43.70 44.80 44.80

52.86 41.85 57.74 38.78 53.29 54.33 41.00 44.69 34.20 37.83 48.64 48.27 54.22 45.96 43.82 30.39 42.97 37.83 50.12 35.75 35.54 50.59 39.46 54.91 50.67 48.78 43.74 44.71 40.16 41.28 33.39 46.75 49.62 32.14 47.28 47.73 54.06 63.11 53.25 47.20 54.78 49.39


40.78 48.65 50.12 30.64 50.11 54.74 51.16 54.29 38.64 38.06 54.97 37.13 44.32 52.77 47.60 39.88 57.50 39.18 34.81 50.79 41.82 46.91 53.42 57.73 47.94 47.41 47.36

41.39 43.20 43.22 50.56 40.14 51.53 54.26 42.38

Instructor/Dir Clin Ed-Rsp Thr 1 57.54 Instructor/HeadCoachMensSoccer

1 40.51

Instructor/Men's Bsktbll Coach

1 39.30

Instructor/Spv Dent-Dntl Hygn

1 44.07

Learning Disability Specialist 3 40.31 33.78 36.76

Librarian 4 52.75 45.61 53.41 29.16

Librarian, Equity 1 27.97 Teacher in Residence 1 48.71 Transfer Ctr Dir, Counslr/Inst 1 42.71


LIST OF INELIGIBLE EMPLOYEES CLASSIFIED STAFF


Academic Advisor 5 33.61 27.74 41.97 43.77 32.99 Academic Scheduling Coord

1 46.72

Academic Services Tech, Senior

2 41.43

44.83 Academic Services Technician

1 49.36

Accommodations Instr Tech Coor

1 29.08

Accountant 2 48.62 42.63 Accountant, Senior 1 37.51 Accountant, Sr/Grants Monitor

2 41.05

41.09 Accounting Technician, Sr 1 37.74 Accounts Payable Assistant 3 45.44 31.31 36.16 Adapted Physical Educ Spec

1 39.94

Adaptive PE Class Assistant II

1 45.41

Administrative Assistant I 11 51.04 53.56 39.08 40.40 30.18 59.41 26.76 31.41 54.18

26.89 31.74 Administrative Assistant II 14 30.94 33.55 35.31 43.52 48.22 50.46 59.18 26.93 39.58 53.24 48.57 51.17 62.38 38.87 Administrative Assistant, Sr

5 39.33

37.85 36.51 49.32 42.01 Admissions & Records Assistant

2 48.17

53.01 Admissions & Records Coord, Sr

1 45.74

Admissions & Records Supv

1 33.66

Allied Health & Nursing Spec

1 24.81

Articulation Specialist 2 48.67 30.94 Assessment Center Supervisor

2 34.37

33.15 Assessment Specialist 3 36.86


27.61 47.77 Athletic Trainer 1 38.78 BAS/BMS/EMS Technician 1 45.49 Benefits Specialist 1 27.45 Benefits Syst Analyst, Lead 1 40.35 Benefits Technician 1 40.03 Bookstore Courseware Coord

2 34.20

26.90 Buyer 2 42.19 38.55 Campus Facilities Rental Coord

2 48.55

32.35 Campus Personnel Assistant

1 40.71

Campus Supervisor 1 37.64 Cashiering Services Supervisor

1 43.79

CDC Teaching Assistant 5 47.97 62.27 54.10 48.88 34.11 Ceramics Technician 2 40.62 27.27 Child Devel Center Teacher 5 36.04 48.81 47.08 47.36 32.44 Clinic Nurse 1 46.10 Cmps Ctr/Food Service Asst

1 47.05

College Researcher 2 46.86 35.79 College Web Coordinator, Sr

2 49.22

40.13 Comm Educ & Planetarium Asst

1 28.62

Comm Education Programs, Lead

1 45.62

Communications & Devel Coord

1 31.59

Community Education Asst 1 28.94 Computer & Ntwk Data Ctr Supv

1 49.70

Computer Project Coordinator

4 45.98

43.66 32.84 45.78 Constr & Maintenance Worker II

1 43.51

Construction Laborer II 1 34.80 Curriculum Coordinator 2 46.49 38.80 Custodian I 10 34.29 54.05 43.57 56.91 49.48 32.28 28.04 51.31 53.89 41.89 Custodian II 5 44.87 51.83 42.80 48.06 47.24 Customer Service Assistant 1 38.34 Database Programmer Analyst

1 31.49

Dental Clinic Admin Asst 1 33.15 Disability Resource Ctr Supv

1 44.93

Division Administrative Asst

9 53.09

33.45 45.98 62.42


20.81 49.84 48.29 34.09 39.61 Electrician, Apprentice I 1 33.09 Enrollment Services Specialist

5 45.99

45.06 37.45 35.97 39.31 EOPS Specialist 1 49.87 EOPS Specialist, Senior 1 49.44 Evaluation Specialist 4 26.76 30.92 48.54 31.93 Evaluation Specialist, Senior

2 40.86

41.66 Evening Clinic Nurse 1 61.03 Exec Asst - Presidents Office

2 27.33

32.45 Executive Assistant 1 34.90 Executive Assistant II 3 44.48 29.88 49.00 Executive Asst - Business Serv

1 39.35

Executive Asst - HR & EO 1 46.98 Facilities & Equipment Asst 2 35.51 28.31 Facilities & Equipment Coord

1 34.51

FEI Supervisor 1 28.83 Financial Aid Assistant 5 31.00 57.58 37.79 26.98 48.69

Financial Aid Coordinator 1 38.72 Financial Aid Outreach Asst 3 24.17 29.77 25.50 Financial Aid Outreach Coord

2 29.69

41.69 Financial Aid Supervisor 1 37.21 Fire/LifeSftySysTech, App III

1 37.50

Flea Market Coordinator 1 39.98 Food Service Exec Chef, Lead

1 36.40

Food Svc Prod Asst/Sous Chef

1 36.15

Furniture, Fixt & Equip Coord

2 44.21

40.65 Grounds Gardener I 3 24.17 51.85 28.46 Grounds Gardener III 1 27.63 HR Spec, Recruitment & Empl

1 35.96

Human Resources Technician I

1 29.84

Human Resources Technician II

1 37.83

Human Resources Technician III

1 46.55

HVAC, Apprentice II 2 57.83 37.01 HVAC, Apprentice III 1 41.04 Instr Comp Lab Admin, Sr 1 41.24 Instr Computer Lab Admin 3 47.24 61.08 49.82 Instr Support Tech, Discipline

6 30.08

26.23 43.02 61.32 27.68


42.01 Instructional Associate 5 50.53 46.58 33.47 35.67 28.01 Instructional Designer 4 34.61 61.41 46.46 31.48 Instructional Services Coord

3 56.74

26.53 38.39 Instructional Support Coord

1 38.80

Intl Student Programs Supv 2 42.82 49.26 Journey - Carpenter 1 47.93 Journey - Electrician 1 37.30 Laboratory Tech, Art 1 24.73 Laboratory Technician 7 36.71 69.76 36.27 30.87 34.77 49.29 60.24 Laboratory Technician II 1 47.78 Library Technician, Senior 7 49.77 36.93 47.21 40.85 33.95 39.97 42.04 Machine Tool Technician 1 38.80 Maintenance Worker 4 43.52 32.41 34.79 55.41 Massage Therapy Assistant 1 57.34

Mobility Assistant/Driver 1 64.20 Multimedia Coordinator 1 50.25 Multimedia Producer 1 37.33 Network & Communications Admin

2 49.03

47.63 Office Assistant 3 58.19 52.52 50.28 Office Coordinator 3 29.76 61.58 42.77 P M Storeroom Clerk 1 25.30 Payroll Technician II 2 35.64 31.42 Payroll Technician, Senior 1 46.24 Performance Class Accompanist

1 52.36

Planetarium Coordinator 1 41.61 Planetrm Presenter & Tech Asst

1 63.15

Plumber, Apprentice I 1 22.31 Police Dispatcher 1 25.54 Police Officer I 3 30.94 31.68 52.97 Police Officer II 1 45.07 Police Records Specialist 1 44.38 Police Sergeant 2 59.51 64.56 Pool Maintenance Worker 1 39.55 Postal Services Assistant 1 44.81 Program Coordinator I 4 40.34 28.92 49.54 46.84 Program Coordinator II 13 44.66 40.29 32.87 51.02 27.75 37.52


46.65 39.70 35.08 37.38 42.81 30.20 48.18 Program Coordinator, Senior

4 49.29

41.26 30.02 40.40 Program Supervisor 3 42.66 30.68 31.83 Programmer Analyst II 1 39.08 Programmer Analyst, Senior

2 45.10

42.53 Project Analyst 1 43.61 Radio Station Coordinator 1 50.78 Real Time Captioner 1 53.43 Research Analyst 1 36.30 School Relations Specialist 1 39.88 Secretary, Senior 2 39.14 38.19 Senior Enrollment Serv Supv

1 49.06

Senior Mechanic 1 49.43 Senior Mechanic - Da 1 60.56 Sign Language Interpreter II

3 46.16

38.62 40.73 Student Activities Specialist

1 44.28

Student Success Specialist 4 31.19 33.87 31.59 27.44 Systems & Network Progrm, Sr

1 46.91

Technology Training Specialist

1 62.25

Testing Technician 2 41.89 32.24 Theatre & Fine Arts Assistant

2 57.76

40.77 Tutorial Assistant 4 66.53 48.61 32.33 37.46 Utility Maintenance Worker I

1 41.72

Veterans Resource Specialist

2 26.76

45.51 Warehouse Worker I 1 37.66 Web & Print Comm Design Coord

1 47.35

Wkst & Systems Support Tech I

2 37.10

27.93 Wkst & Systems Support Tech II

1 36.81

Wkst & Systems Support Tech Sr

1 45.69

Writer/Editor/Web Content Dev

1 58.54


SRP Enrollment STEPS

1. Receive SRP Packet:

Read over the Plan Introduction and Plan Summary to gain a better understanding of the

Supplementary Retirement Plan (SRP). Review your customized Benefit Illustration to see what

benefit amounts you may receive if you enroll in the SRP.

2. Attend Orientation:

Attend one or more of the identical group orientation meetings for information about the SRP. PARS

will explain the structure of the plan, the different options available to you, how to complete the

forms and when/how your benefit payments will be sent to you. Please bring any questions you may

have.

3. If Retiring, Contact CalSTRS or CalPERS Regarding Your Pension:

Since the SRP benefit may be in addition to your CalSTRS or CalPERS benefit, it is very important for

you to contact CalSTRS or CalPERS to obtain an estimate of your benefits and find out what

paperwork you need to complete in order to retire.

4. Contact Social Security Regarding Applicable Benefits:

If you are eligible for Social Security benefits, you need to contact Social Security to find out what

steps you need to take in order to start collecting benefits.

5. If Enrolling, Hand-In Packet At PARS Walk-In Workshop:

Walk-in workshops have been scheduled to allow you to submit your SRP enrollment forms and

District Letter of Resignation directly to PARS. At these meetings, PARS representatives will sit with

you one-on-one to review your SRP enrollment materials and hand you a receipt confirming your

enrollment into the SRP (contingent on meeting all of the eligibility requirements).

If you are unable to attend a walk-in workshop, you may send your enrollment packet directly to PARS

via the following methods:

Fax to (877) 734-6220 by 5:00PM on November 2, 2018

Scan and email to [email protected] by 5:00PM on November 2, 2018

Mail in the enclosed return envelope to be received by 5:00PM on November 2, 2018 (not-

postmarked)

Contact us:

Please contact the Plan Support Department with any questions at

(800) 731-7884 or via email at [email protected].

Faculty

mailto:[email protected]



FACULTY Group Orientation Meetings

Tuesday, September 18, 2018 · 11:00AM

De Anza College

MLC 270

Tuesday, September 18, 2018 · 3:30PM

Foothill College

ETS D120

Friday, September 21, 2018 · 10:30AM *

De Anza College

MLC 270

Friday, September 21, 2018 · 3:00PM *

Foothill College

ETS D120

Friday, October 12, 2018 · 9:00AM *

Foothill College

ETS D120

Friday, October 12, 2018 · 1:30PM *

De Anza College

MLC 112

* A Spanish speaker will be available for questions at the end of the select orientation meetings.

If you are interested in the SRP, please attend one or more of the identical meetings.

The meetings will answer questions about the plan, the enrollment materials

and the enrollment procedures.

If you require accommodation, please contact the PARS Plan Support Department for

assistance.

Spouses, domestic partners, and your financial advisors are also welcome to attend.

Please bring your enrollment packet to the orientation you attend.

Contact us:



Faculty



Individual assistance Walk-In Workshops

First-come, first-served – no appointments.

Monday, October 29, 2018

9:00AM – 12:00PM

De Anza College

ADM 109

Monday, October 29, 2018

1:30PM – 4:30PM

Foothill College

ADM 1901

Tuesday, October 30, 2018

9:00AM – 12:00PM

Foothill College

ADM 1901

Tuesday, October 30, 2018

1:30PM – 4:30PM

De Anza College

ADM 106

If you have NOT submitted your enrollment packet to PARS, attend a workshop to:

Sit with a PARS representative one-on-one to review your completed enrollment packet for

accuracy (complete your packet prior to coming to the workshop).

Turn in your completed enrollment packet to a PARS representative and receive a receipt.

This confirms your enrollment in the SRP contingent on meeting all of the eligibility

requirements.

Remember to bring a copy of your proof of age (driver’s license, passport, or birth

certificate) and if selecting Option 2, your beneficiary’s proof of age.

Ask questions about the incentive being offered.

If you require accommodation, please contact the PARS Plan Support Department for

assistance.

Contact us:



Remember to:

Contact STRS/PERS for an official estimate of your STRS/PERS pension

benefits.

Complete and submit a separate application to STRS/PERS before your

STRS/PERS retirement date.

Contact STRS/PERS to confirm the deadline for submission of your

STRS/PERS retirement application.

STRS

(800) 228-5453

www.calstrs.com

PERS

(888) 225-7377

www.calpers.ca.gov

Social Security Administration

can be reached at (800) 772-1213 or visit their website at www.ssa.gov

Remember to:

Contact STRS/PERS for an official estimate of your STRS/PERS pension

benefits.

Complete and submit a separate application to STRS/PERS before your

STRS/PERS retirement date.

Contact STRS/PERS to confirm the deadline for submission of your

STRS/PERS retirement application.

STRS

(800) 228-5453

www.calstrs.com

PERS

(888) 225-7377

www.calpers.ca.gov

Social Security Administration

can be reached at (800) 772-1213 or visit their website at www.ssa.gov

SAMPLE

Direct Rollover of PARS Benefit

(Options 5-9 ONLY)

If you select one of the fixed payment Options 5 – 9, you may elect a direct rollover of your SRP

monthly payments into an Individual Retirement Account (IRA) or to an eligible employer plan that

accepts the rollover (i.e. 403(b), 401(a), 457, etc.).‡

Important Information Regarding Direct Rollover:

A direct rollover allows you to defer taxation of your SRP retirement benefit.

When choosing a direct rollover, you must roll over the full amount of your SRP monthly payment into the rollover.

You may start and stop the rollover at any time while receiving your SRP benefit.

PARS does not offer tax, accounting or legal advice. You should consult with your rollover provider, financial advisor and/or tax accountant for information regarding the provisions of direct rollovers and your retirement.

To Elect a Direct Rollover:

Complete the Direct Deposit/Rollover Form in your SRP enrollment packet, providing PARS with the financial institution name, physical mailing address and rollover account number.

Submit the completed Direct Deposit/Rollover Form to PARS. Your request will be processed as soon as administratively possible.

Benefit payments will be mailed directly to your financial institution.

You will not receive statements from PARS regarding deposits into your rollover account. Contact your financial institution to confirm that deposits were credited to your direct rollover account.

Contact us:



‡ If you are in the year in which you will attain age 70 ½ or over the age of 70 ½, you are not eligible to

elect a direct rollover of your SRP monthly payments. Payments will be treated as a required minimum

distribution and will be coded as a taxable distribution for the duration of your benefit period.

SAMPLE

Special Tax Notice Regarding Plan Payments 401(a) and 403(b)

This notice explains how you can continue to defer federal income tax on your retirement savings and contains important information you will need before you decide how to receive your benefits from the Plan. SUMMARY There are two ways you may be able to receive a Plan payment that is eligible for a rollover: (1) Certain payments can be made directly to a traditional or Roth IRA that you establish or to an eligible employer plan that will accept it and hold it for your benefit (“DIRECT ROLLOVER”) or (2) The payment can be PAID TO YOU. If you are in the year in which you will attain age 70 ½ or over the age of 70 ½, you are not eligible to elect a direct rollover of your SRP monthly payments. Payments will be treated as a required minimum distribution and will be coded as a taxable distribution for the duration of your benefit period. I. PAYMENTS THAT CAN AND CANNOT BE ROLLED OVER Payments from the Plan may be "eligible rollover distributions." This means that they can be rolled over to a traditional or Roth IRA or to an eligible employer plan that accepts rollovers. Payments from a plan cannot be rolled over to a SIMPLE IRA, or a Coverdell Savings Account. Your Plan administrator should be able to tell you what portion of your payment is an eligible rollover. After-tax Contributions: If you made after-tax contributions to the Plan, these contributions may be rolled into either a traditional or Roth IRA or to certain employer plans that accept rollovers of the after-tax contributions. The following rules apply: • Rollover into a Traditional or Roth IRA. You can roll over your after-tax

contributions to a traditional or Roth IRA either directly or indirectly. Your plan administrator should be able to tell you how much of your payment is the taxable portion and how much is the after-tax portion.

If you roll over after-tax contributions to a traditional or Roth IRA, it is your responsibility to keep track of, and report to the Service on the applicable forms, the amount of these after-tax contributions. This will enable the nontaxable amount of any future distributions from the traditional or Roth IRA to be determined. Once you roll over your after-tax contributions to a traditional or Roth IRA, those amounts CANNOT later be rolled over to an employer plan.

• Rollover into an Employer Plan. You can rollover after-tax contributions

from an employer plan that is qualified under Code section 401(a) or a section 403(a) annuity plan to another such plan using a direct rollover if the other plan provides separate accounting for amounts rolled over, including separate accounting for after-tax employee contributions and earnings on those contributions. You CANNOT roll over after-tax contributions to a governmental 457 plan. If you want to roll over your after-tax contributions to an employer plan that accepts these rollovers, you cannot have the after-tax contributions paid to you first. You must instruct the Plan Administrator of this Plan to make a direct rollover on your behalf. Also, you cannot first roll over after-tax contributions to a traditional or Roth IRA and then roll over that amount into an employer plan.

II. DIRECT ROLLOVER A DIRECT ROLLOVER is a direct payment of the amount of your Plan benefits to a traditional or Roth IRA or an eligible employer plan that will accept it. You can choose a DIRECT ROLLOVER of all or any portion of your payment that is an eligible rollover distribution, as described in Part I above. You are

not taxed on any taxable portion of your Plan payment for which your choose a DIRECT ROLLOVER until you later take it out of the traditional or Roth IRA or the eligible employer plan. In addition, no income tax withholding is required for any taxable portion of your Plan benefits for which you choose a DIRECT ROLLOVER. This Plan might not let you choose a DIRECT ROLLOVER if your distributions for the year are less than $200. DIRECT ROLLOVER to a Traditional or Roth IRA: You can open a traditional or Roth IRA to receive the direct rollover. If you choose to have your payment made directly to a traditional or Roth IRA, contact an IRA sponsor (usually a financial institution) to find out how to have your payment made in a direct rollover to a traditional or Roth IRA at that institution. If you are unsure of how to invest your money, you can temporarily establish a traditional or Roth IRA to receive the payment. However, in choosing a traditional or Roth IRA, you may wish to make sure that the traditional or Roth IRA you choose will allow you to move all or a part of your payment to another traditional or Roth IRA at a later date, without penalties or other limitations. See IRS Publication 590, Individual Retirement Arrangements, for more information on traditional IRAs (including limits on how often you can roll over between IRAs). DIRECT ROLLOVER to a Plan: If you are employed by a new employer that has an eligible employer plan, and you want a direct rollover to that plan, ask the plan administrator of that plan whether it will accept your rollover. An eligible employer plan is not legally required to accept a rollover. Even if your new employer's plan does not accept a rollover, you can choose a DIRECT ROLLOVER to a traditional or Roth IRA. If the employer plan accepts your rollover, the plan may provide restrictions on the circumstances under which you may later receive a distribution of the rollover amount or may require spousal consent to any subsequent distribution. Check with the plan administrator of that plan before making your decision. Change in Tax Treatment Resulting from a DIRECT ROLLOVER: The tax treatment of any payment from the eligible employer plan or traditional or Roth IRA receiving your DIRECT ROLLOVER might be different than if you received your benefit in a taxable distribution directly from the Plan. For example, if you were born before January 1, 1936, you might be entitled to ten-year averaging or capital gain treatment, as explained below. However, if you have your benefit rolled over to a section 403(b) tax-sheltered annuity, a governmental 457 plan, or a traditional or Roth IRA in a DIRECT ROLLOVER, your benefit will no longer be eligible for that special treatment. See the sections below entitled “Additional 10% Tax if You Are under Age 59 ½ “ and “Special Tax Treatment if You Were Born before January 1, 1936. III. PAYMENT PAID TO YOU If your payment can be rolled over (see Part I above) and the payment is made to you in cash, it is subject to 20% federal income tax withholding on the taxable portion (state tax withholding may also apply). The payment is taxed in the year you receive it unless, within 60 days, you roll it over to a traditional or Roth IRA or an eligible employer plan that accepts rollovers. If you do not roll it over, special tax rules may apply. Income Tax Withholding: • Mandatory Withholding. If any portion of your payment can be rolled

over under Part I above and you do not elect to make a DIRECT ROLLOVER, the Plan is required by law to withhold 20% of the taxable amount. This amount is sent to the IRS as federal income tax withholding. For example, if you can roll over a taxable payment of $10,000, only $8,000 will be paid to you because the Plan must withhold $2,000 as income tax. However, when you prepare your income tax return for the year, unless you rollover within 60 days (see

SAMPLE

“Sixty-Day Rollover Option” below), you must report the full $10,000 as a payment from the Plan. You must report the $2,000 as tax withheld, and it will be credited against any income tax you owe for the year. There will be no income tax withholding if your payments for the year are less than $200.

• Voluntary Withholding. If any portion of your payment is taxable but

cannot be rolled over under Part I above, the mandatory withholding rules described above do not apply. In this case, you may elect not to have withholding apply to that portion. If you do nothing, an amount will be taken out of this portion of your payment for federal income tax withholding. To elect out of withholding, ask the Plan administrator for the election form and related information.

• Sixty-Day Rollover Option. If you receive a payment that can be rolled

over under Part I above, you can still decide to roll over all or part of it to a traditional or Roth IRA or to an eligible employer plan that accepts rollovers. If you decide to roll over, you must contribute the amount of the payment you received to a traditional or Roth IRA or eligible employer plan within 60 days after you receive the payment. The portion of your payment that is rolled over will not be taxed until you take it out of the traditional or Roth IRA or the eligible employer plan.

• You can roll over up to 100% of your payment that can be rolled over

under Part I above, including an amount equal to the 20% of the taxable portion that was withheld. If you choose to roll over 100%, you must find other money within the 60-day period to contribute to the traditional or Roth IRA or the eligible employer plan to replace the 20% that was withheld. On the other hand, if you roll over only the 80% of the taxable portion that you received, you will be taxed on the 20% that was withheld.

Example: The taxable portion of your payment that can be rolled over under Part I above is $10,000, and you choose to have it paid to you. You will receive $8,000, and $2,000 will be sent to the IRS as income tax withholding. Within 60 days after receiving the $8,000, you may roll over the entire $10,000 to a traditional or Roth IRA or an eligible employer plan. To do this, you roll over the $8,000 you received from the Plan, and you will have to find $2,000 from other sources (your savings, a loan, etc.). In this case, the entire $10,000 is not taxed until you take it out of the traditional or Roth IRA or an eligible employer plan. If you roll over the entire $10,000, when you file your income tax return you may get a refund of part or all of the $2,000 withheld. If, on the other hand, you roll over only $8,000, the $2,000 you did not roll over is taxed in the year it was withheld. When you file your income tax return you may get a refund of part of the $2,000 withheld. (However, any refund is likely to be larger if you roll over the entire $10,000.)

Additional 10% Tax If You Are Under Age 59½. If you receive a payment before you reach age 59½ and you do not roll it over, then, in addition to the regular income tax, you may have to pay an extra tax equal to 10% of the taxable portion of the payment. The additional 10% tax generally does not apply to (1) payments that are paid to you after you separate from service with your employer during or after the year you reach age 55, (2) payments that are paid because you retire due to disability, (3) payments that are paid to an alternate payee under a qualified domestic relations order or (4) payments that do not exceed the amount of your deductible medical expenses. See IRS Form 5329 for more information on the additional 10% tax. The additional 10% tax will not apply to distributions from a governmental 457 plan, except to the extent the distribution is attributable to an amount you rolled over to that plan (adjusted for investment returns) from another type of eligible employer plan or IRA. Any amount rolled over from a governmental 457 plan to another type of eligible employer plan or to a traditional or Roth IRA will become subject to the additional 10% tax if it is distributed to you before you reach age 59½, unless one of the exceptions applies. Special Tax Treatment If You Were Born before January 1, 1936. If you receive a payment from a plan qualified under section 401(a) or a section 403(a) annuity plan that can be rolled over under Part I and you do not roll it

over to a traditional or Roth IRA or an eligible employer plan, the payment will be taxed in the year you receive it. However, if the payment qualifies as a "lump sum distribution," it may be eligible for special tax treatment. A lump sum distribution is a payment, within one year, of your entire balance under the Plan (and certain other similar plans of the employer) that is payable to you after you have reached age 59½ or have separated from service with your employer (or, in the case of a self-employed individual, after you have reached age 59½ or have become disabled). For a payment to be treated as a lump sum distribution, you must have been a participant in the Plan for at least five years before the year in which you received the distribution. The special tax treatment for lump sum distributions that may be available to you is described below. Ten-Year Averaging. If you receive a lump sum distribution and you were born before January 1, 1936, you can make a one-time election to figure the tax on the payment by using "10-year averaging" (using 1986 tax rates). 10-year averaging often reduces the tax you owe. There are other limits on the special tax treatment for lump sum distributions. For example, you can generally elect this special tax treatment only once in your lifetime, and the election applies to all lump sum distributions that you receive in that same year. If you have previously rolled over a distribution from this Plan (or certain other similar plans of the employer), you cannot use this special averaging treatment for later payments from the Plan. If you roll over your payment to a traditional or Roth IRA, governmental 457 plan, or 403(b) tax-sheltered annuity, you will not be able to use special tax treatment for later payments from that IRA, plan or annuity. Also, if you roll over only a portion of your payment to a traditional or Roth IRA, governmental 457 plan, or 403(b) tax-sheltered annuity, this special tax treatment is not available for the rest of the payment. See IRS Form 4972 for additional information on lump sum distributions and how you elect the special tax treatment. IV. SURVIVING SPOUSES, ALTERNATE PAYEES, AND OTHER BENEFICIARIES In general, the rules summarized above that apply to payments to employees also apply to payments to surviving spouses of employees, spouses or former spouses who are "alternate payees" and all other non-spousal beneficiaries. You are an alternate payee if your interest in the Plan results from a "qualified domestic relations order," which is an order issued by a court, usually in connection with a divorce or legal separation. If you are a surviving spouse, you may choose to have a payment that can be rolled over, as described in Part I above, paid in a DIRECT ROLLOVER to a traditional or Roth IRA or to an eligible employer plan or paid to you. If you have the payment paid to you, you can keep it or roll it over yourself to a traditional IRA or to an eligible employer plan. Thus, you have the same choices as the employee. If you are a non-spousal beneficiary, you may choose to have a payment that can be rolled over. The distribution must be a direct trustee-to-trustee transfer to your IRA that was set up to receive the distribution. The transfer will be treated as an eligible rollover distribution and the receiving plan will be treated as an inherited IRA. If you are a surviving spouse, an alternate payee, or another beneficiary, your payment is not subject to the additional 10% tax described in Part III above, even if you are younger than age 59½. If you are a surviving spouse, an alternate payee, or another beneficiary, you may be able to use the special tax treatment for lump sum distributions as described in Part III above. If you receive a payment because of the employee's death, you may be able to treat the payment as a lump sum distribution if the employee met the appropriate age requirements, whether or not the employee had 5 years of participation in the Plan. HOW TO OBTAIN ADDITIONAL INFORMATION This notice summarizes only the federal (not state or local) tax rules that might apply to your payment. The rules described above are complex and contain many conditions and exceptions that are not included in this notice. Therefore, you may want to consult with a professional tax advisor before you take a payment of your benefits from your Plan. Also, you can find more specific information on the tax treatment of payments from qualified employer retirement plans in IRS Publication 575, Pension and Annuity Income, and IRS Publication 590, Individual Retirement Arrangements. These publications are available from your local IRS office, on the IRS’ Internet Web Site at www.irs.gov, or by calling 1-800-TAX-FORMS.

SAMPLE

foothill -de anza community college districthr.fhda.edu/_downloads/final faculty sample packet_09 05...

Documents