413.3E1 - Severance Plan Acknowledgement of Receipt

The undersigned classified employee acknowledges receipt of the severance plan stated below:

  • Early retirement plan policy #413.3
  • Early retirement plan application form
  • Early retirement plan beneficiary designation

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

The undersigned classified 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 Designee Witness                                                                         Date