Section R2-8-511. Required Documentation and Calculations for Other Public Service Credit

A.      An eligible member who requests to purchase other public ser- vice credit under A.R.S. § 38-743 shall provide to the ASRS a completed Affidavit of Other Public Service form, signed and dated by the member, and notarized, that includes the follow- ing:

1.        The member’s full name;

2.        The member’s Social Security number;

3.        Other names used by the member during employment with the other public service employer, if applicable;

4.        The name and mailing address of the other public service employer;

5.        The position the member held while working for the other public service employer;

6.        A contact name and telephone number of an individual in the other public service employer’s human resources department who can verify employment, if known;

7.        The years and months by fiscal year of other public ser- vice the member worked and wishes to purchase;

8.        If the other public service employer was a non-ASRS employer, a statement of whether the member partici- pated in the non-ASRS employer’s retirement plan;

9.        If the member participated in a non-ASRS public service employer’s retirement plan, the name of the retirement plan, identifying whichever one of the following applies:

a.         The approximate date the member took a return of retirement contributions;

b.        The plan is non-contributory and the member is not eligible for benefits from the plan; or

c.         That, if not using all of the retirement contributions as a pre-tax rollover, the member will request a return of retirement contributions and forfeit all rights to any benefits from the plan and provide the ASRS with documentation that the member has for- feited all rights to benefits from the plan no later than the due date specified on the SP invoice; and

10.     Acknowledgement that:

a.         Knowingly making a false statement or falsifying or permitting falsification of any record of the ASRS with an intent to defraud ASRS is a Class 6 felony, pursuant to A.R.S. § 38-793;

b.        The service purchase transaction is subject to audit and if any errors are discovered, the ASRS shall adjust a member’s total credited service with the ASRS, or if the member is already retired, adjust- ments to the member’s credited service will affect the member’s retirement benefit; and

c.         If an audit determines that the member is eligible for a benefit from the other public service employer’s retirement plan, the member is required to take nec- essary steps to forfeit the benefit, and if the forfei- ture is not completed within 90 days of being notified of the audit results, the service credit pur- chase listed on this application will be revoked and any funds paid to purchase the service credit will be refunded to the member.

B.       The amount the member shall pay to purchase other public ser- vice credit is determined as provided in R2-8-506.

Historical Note

New Section made by final rulemaking at 11 A.A.R. 2640, effective June 30, 2005 (Supp. 05-2). Amended by final rulemaking at 12 A.A.R. 4667, effective December 5, 2006 (Supp. 06-4).