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Bureau of Human Resources

January 10, 1996


TO: Heads of Departments, Personnel Officers, Directors of Administrative Services, Payroll Officers, Affirmative Action Officers
SUBJECT: Worksheet Form for 1996 Retirement Incentive Program


A supply of five Worksheet Forms (Per Form 120) is being provided to the Personnel Office of each department and agency.  The Worksheet Form is a three-part form, and copies must be routed as indicated.

Part One (DEPARTMENT) of the Worksheet Form must be completed by the Personnel Office for each department employee who retires effective December 1, 1995, January 1, 1996, February 1, 1996, March 1, 1996 and April 1, 1996.  Part Two (EMPLOYEE) must be complted by the employee and/or department, and signed and dated by the employee.   The Worksheet Form will have to be completed retroactively for employees who retired on December 1, 1995 and January 1, 1996.

Part One of the Worksheet Form must report the base salary that is in effect at the time of termination.  For all participants other than seasonal-position employees, this base Salary is reported under the Annual $ field of the Salary Change Code & Reason section of the employee's Human Resource Profile.  Base salary does not include any of the special pay add-ons.  For seasonal-position employees, the base salary for the last season completed must be reported.

For employees who elect the lump-sum payment (Option 1), the Personnel Office must enter in the Option 1 box of the Worksheet Form the amount determined by dividing the base salary amount by four and rounding to nearest cent.

For employees who elect monthly payments (Option 2), the Personnel Office must enter the whole number quotient obtained by dividing the lump-sum payment amount by 171.94 in the left column of the Option 2 box and enter the remainder of the lump-sum payment amount in the right column of the Option 2 box.

Departments and agencies are asked to remind participants that they must also file their Intent-To-Retire Form with the Maine State Retirement System by February 1, 1996.   This form is provided by or available from the Maine State Retirement System.


Nancy J. Kenniston, Director