San Diego County Office of Education - Download as DOC by BYh5mmL

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									Date:       ______________



To:         San Diego County Office of Education
            Retirement Reporting Unit
            640l Linda Vista Rd. Room 605
            San Diego, CA 92111-7399
            FAX 858-279-2953 Phone 858-292-3691

From:       _______________________
            _______________________
            _______________________

Subj:       Request for Approval to Pay Off Schedule Pay

The __________________________________School District requests
the State Teachers’ Retirement System to approve the payment of
an Off-schedule Lump Sum Bonus. The following information is
furnished for consideration of this request.

      1.    Class of Employees or Bargaining Unit name is:
            _____________________________________________________
      2.    Date to be paid: ____________________________________
      3.    Payment applies to pay period(s) from
            ________thru______
      4.    Terms and Conditions are: _____Percentage or $_______
            amount. The percentage or dollar amount is computed
            on ________________________________ with the following
            condition(s)__________________________________________
            ______________________________________________________

      5.    The source of funding is:_____________________________
      6.    District contact person_______________________________
            Phone# ___________________ FAX _______________________


Sincerely,


Title: ________________________________

Enclosure

								
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