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Home My WebLink About06-81 KATHY' S NOTE - SIGNATURE BLOCK PLACED ONTO THIS WORD DOCUMENT IN CASE IT IS NEEDED FOR ATTACHMENT TO ADOBE RESOLUTION DOCUMENT Resolution No. 06-81 IMFR out of state credit authorization for Sean R. Stegall Kathy - See adobe C-14 for this resolution. There is no word version of this document . s/Ed Schock Ed Schock, Mayor Presented: April 12, 2006 Adopted: April 12, 2006 Omnibus Vote: Yeas: 7 Nays: 0 Attest: s/Dolonna Mecum Dolonna Mecum, City Clerk M OUT-OF-STATE CREDIT AUTHORIZATION FIMRF Form 6.33 (Rev. 6/99) • INSTRUCTIONS AND REQUIREMENTS ON REVERSE SIDE PLEASE PRINT OR TYPE Member's First Name Middle Intial Last Name Social Security Number Sean R. Stegall Member Mailing Address City,State,and ZIP Current Position Assistant City Manager Current Employer Name Employer Number City of Elgin 03347 Certification by Member certify that I was an employee of 1 0 i /�7",�'�ji V Dt,� /2/_V / Name of Local Government /e.4 /v C ")d' from /1, �99Bto • 4 old',Name of State ��JJ� // to "Date in the position(s)of nr,r,S/41 such service having been covered under /''G w /K. ,sT4/c 4‘7~,-/- /� /e �� Name of Public Emplo ee Pension System whose address is �T LS-�[ 42-2 9 Street City State Zip Code and that I have irrevocably forfeited all service credits in said pension system and am not entitled to benefits of any type therefrom. I understand that no service credit will be established under the Illinois Municipal Retirement Fund until I have made the required payment to IMRF. 0:062 r l Q .gV2 93/_ s?3O JMember's Signatur Member's Daytime Telephone No. Certification by Clerk or Secretary of Governing Body I certify that a regular or special meeting held on April 12, 200(he City Council Date Name of Governing Body of the City of Elgin, Illinois authorized the granting of service credits for out-of-state service with Name of Governmental Unit the out-of-state governmental unit named herein from May 18, 1998 to December 1, 200C(not to exceed 120 Date Date months for the above named member). April 12, 2006 Dolonna Mecum, City Clerk Clerk or Secretary Signature Illinois Municipal Retirement Fund 2211 York Road, Suite 500, Oak Brook Illinois 60523-2374, 630/368-1010 Service Representatives 800/A SK-IMRF (1-800-275-4673) IMRF Form 6.33 (Rev. 6/99) M OUT-OF-STATE CREDIT AUTHORIZATION IMRF Form 6.33 (Rev. 6/99) INSTRUCTIONS AND REQUIREMENTS ON REVERSE SIDE PLEASE PRINT OR TYPE --- --- ----------- Member's First Name Middle Intial Last Name Social Security Number Sean R. Stegall Member Mailing Address City,State,and ZIP Current Position Assistant City Manager Current Employer Name Employer Number City of Elgin 03347 Certification by Member !! L 1� I certify that I was an employee of �y G f *7 '/1./ea/ / Name of Local Government lam^ from leg/ /1, /99Bto ° // ,2,100 Name of State // to • -bate in the position(s)of / / Ch i /19/: such service having been covered under /14 1.fV � ',.v i ,?44- 4 1 r-e-7,GsT 7C,1he-4 n [/ me of Public Emplo /lo ee Pension System J whose address is /U s717 f�✓e e-71 /ace: 2-.2 7 t1 Street City State Zip Code and that I have irrevocably forfeited all service credits in said pension system and am not entitled to benefits of any type therefrom. I understand that no service credit will be established under the Illinois Municipal Retirement Fund until I have made the required payment to IMRF. 0D 0(0 Member's Si natur Member's Daytime Telephone No. 9 Y P I i Certification by Clerk or Secretary of Governing Body I certify that a regular or special meeting held on April 12, 2096 City Council Date Name of Governing Body of the City of Elgin, Illinois authorized the granting of service credits for out-of-state service with Name of Governmental Unit the out-of-state governmental unit named herein from May 18, 1998 to December 1, 2000(not to exceed 120 Date Date months for the above named member). April 12, 2006 Dolonna Mecum, City Clerk Clerk or Secretary Signature Illinois Municipal Retirement Fund 2211 York Road, Suite 500, Oak Brook Illinois 60523-2374, 630/368-1010 Service Representatives 800/ASK-IMRF (1-800-275-4673) IMRF Form 6.33 (Rev. 6/99) • M OUT-OF-STATE CREDIT AUTHORIZATION FIMRF Form 6.33 (Rev. 6/99) INSTRUCTIONS AND REQUIREMENTS ON REVERSE SIDE PLEASE PRINT OR TYPE Member's First Name Middle Intial Last Name Social Security Number Sean R. Stegall Member Mailing Address City, State,and ZIP Current Position Assistant City Manager Current Employer Name Employer Number City of Elgin 03347 Certification by Member I certify that I was an employee of •y Q 1 7'W/kt-� Ny /�/ / Name of Local Government ✓ea/TL k from leg �O/ /996 _ to ri� r // m Name of State //�� to -Date in the position(s)of Ars:s"an r ail f/ i4 P/ such service having been covered under /VCW i'0/K. 3-7-x/e free >1.7e0-24,11-- /� 1 Name of Public Employee Pension System/� y whose address is //U ...5-74•71€ f% e� A147 jt/ 4�.2 Street City State Zip Code and that I have irrevocably forfeited all service credits in said pension system and am not entitled to benefits of any type therefrom. I understand that no service credit will be established under the Illinois Municipal Retirement Fund until I have made the l required payment to IMRF. -3 a i 6' gv2- 934 .s-'3o /D a Member's Si natur Member's Daytime Telephone No. g y F- 1 Certification by Clerk or Secretary of Governing Body I certify that a regular or special meeting held on April 12, 200§1e City Council Date Name of Governing Body of the City of Elgin, Illinois authorized the granting of service credits for out-of-state service with Name of Governmental Unit the out-of-state governmental unit named herein from May 18, 1998 to December 1, 200C(not to exceed 120 Date Date months for the above named member). April 12, 2006 Dolonna Mecum, City Clerk bi{-te44.is__ Date Clerk or Secretary Signature Illinois Municipal Retirement Fund 2211 York Road, Suite 500, Oak Brook Illinois 60523-2374, 630/368-1010 Service Representatives 800/ASK-IMRF (1-800-275-4673) IMRF Form 6.33 (Rev.6/99)