407.4E1 - Severance Plan Acknowledgement of Receipt

The undersigned licensed staff employee acknowledges receipt of the early retirement plan stated below:

• Early retirement plan policy #407.4
• Early retirement plan application form
• Early retirement plan spouse and dependent identification form

The undersigned licensed staff employee acknowledges that the application and participation in the early retirement plan is entirely voluntary.

The undersigned licensed staff employee acknowledges that the school district recommends the employee contact legal counsel and the employee’s personal accountant regarding participation in the early retirement plan.

 

 

_________________________________________                                ______________________
                      Employee Signature                                                                                     Date

 

 

_________________________________________                                ______________________
           Superintendent/or Building Principal                                                                  Date