Employer Medical Form by dst11719

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									                                                          Employer Remittance Report for Employee                                                                                                            Local School Districts and
                                                 and Employer Matching Contributions for Fiscal Year 2010 - 2011                                                                                               Regional Cooperative
                                                                              Kentucky Teachers' Retirement System                                                                                                 Organizations
                                                                      479 Versailles Road, Frankfort, Kentucky 40601-3800                                                                         KTRS Use Only
                                                                               (502) 848-8640 or 1-888-891-2696                                                                                   JV Number

Part A                                                                                                                                                              Unit Number
Pay Period - From                                                                                                                                                   Employer Name
              - To                                                                                                                                                  Pay Date

Part B                                                     Members Before July 1, 2008                               Members On/After July 1, 2008
                                                                                     Employer Matching                                      Employer Matching                  Employer                   Employer

                                                                                        for Employees                                         for Employees                Contribution                    cost for

                                                           Employee                      Paid from                    Employee                  Paid from                to Retiree Medical            Critical Shortage

                                                         Contributions                Federal Programs               Contributions           Federal Programs             Insurance Fund                 Positions *                   Totals
A. Gross Salaries Paid to Members for Period                                                                                                                                                  -
B. Contribution Rate for Members                          10.105%                        13.355%                      10.855%                  14.105%                      0.250%                       11.920%
C. Gross Amount Due to KTRS                                               -                              -                           -                          -                             -                            -
D. Payroll Adjustments
E. Net Amount Due KTRS                                                    -                              -                           -                          -                             -                            -                    -

Part C                                                                                   YOU MUST NOW INCLUDE CONTRIBUTIONS FOR ACTIVE, PART-TIME,
Remittance Recap                                                                                    SUBSTITUTE, AND RETIRED MEMBERS
                            Check Number                  Amount                         Amount          Amount           Amount            Amount                                                       Amount                        Total
                                                                                                                                                                                                                                                -
                                                                                                                                                                                                                                                -
                                                                                                                                                                                                                                                -
                                                                                                                                                                                                                                                -
                                                                                                                                                                                                                                                -
                                                                                                                                                                                                                                                -
                                                                                                                                                                                                                                                -
F. Remittance Should Agree with Totals on E                               -                              -                           -                          -                             -                            -                    -
                                                                                                                                                                                                                                                -
* If you report an amount in the Critical Shortage Column you must attach the Critical Shortage Form - Click Here for Form


                       I hereby certify that the amounts reported above and transmitted herewith represent the complete and correct deductions from and
                       proper matching for salaries of members of the Teachers' Retirement System of the State of Kentucky.



                                                                                                                                                     Chief Payroll Officer

                                                                                                        Click Here for Instructions for this Form


                                                                                                                                                                                                                               Form R-1 District
                                                       Employer Remittance Report Instructions
                                                                                                                                                   Back to form

Part A
Verify your KTRS unit number and enter the fiscal year. Enter your unit name as employer. Enter the pay date for which the
employees actually receive their paychecks. Enter the pay period, the actual period of time the paycheck covers. The pay dates
should agree with those reported on the calendar submitted to KTRS at the beginning of the fiscal year. KTRS uses this information
to verify compliance with KRS 161.560 which requires that contributions be forwarded to KTRS within 15 calendar days after the
employees are actually paid. Employers immediately accrue a late penalty equal to 1% of any late contributions and are assessed
another 1% for each additional 30 days such penalties are unpaid.

Contributions must be reported on a fiscal year basis (July 1 to June 30). It is important that fiscal year information be entered
correctly, especially for payments made in July. Do not report prior year corrections on this form. Prior year contributions should be
remitted separately with a detailed letter.




Part B
A. Enter gross salaries paid to all KTRS members (active, part-time, substitute, and retired including critical shortage)
Please note specific columns for Members Before July 1, 2008, Members On/After July 1, 2008, Employer Contribution to Retiree Medical Insurance Fund,
and Critical Shortage Contributions. Gross salary includes payment for summer school, home instruction, extension service and any other compensation
paid for professional services.

B. KTRS contribution rate for employee contributions, employer contributions, employer contributions to retiree medical insurance fund, and critical shortage
contributions. Please note the different rates for Members Before July 1, 2008 and Members On/After July 1, 2008. Also note the rates for Employer
Contribution to Retiree Medical Insurance Fund and Critical Shortage.

C. Mulitply line A times line B for all columns. Enter the amount here.

D. If total amounts withheld from the members individual checks do not equal the amounts calculated in line
C, enter the difference here. Line D can also be used to make corrections to previously reported amounts for this fiscal
year. Contact KTRS if you have any questions. Our phone number is (502) 848-8640 or 1-888-891-2696.

E. Actual amounts remitted to KTRS are entered here. Line C plus or minus the adjustments on line D will equal this
line. Add the amounts in all the columns. Enter the total amount in the total column.




Part C
KTRS will record the data exactly as it is reported in this section, please complete Part C fully, ensuring that all check numbers
are listed, all amounts are recorded in the proper column and only one line is used per check. Please remit as few checks as possible.
For example, KTRS will accept one check for the total employee and matching contributions due. Enter each check number individually,
listing the employee and matching amounts in the appropriate columns and the total check in the total column. Personal checks should not
be reported on this form.

F. Add and enter amounts in each column. The amount in the total column must agree with the amount in the total column, line E.




If you report an amount in the Critical Shortage Column you must complete and attach the Critical Shortage Reporting Form.
Please report for each member in a critical shortage position the name, SSN, earnings for the period, and contribution amount.




The chief payroll officer should verify and sign the R-1. Retain a copy of this report for your records and send the original copy to:

                                                                  Accounting Department
                                                            Kentucky Teachers' Retirement System
                                                                    477 Versailles Road
                                                                 Frankfort, KY 40601-3800

Proper information on your R-1 forms should assist you in preparing your Annual Report at the end of the year.

                                                                                                                                                Form R-1 District
                                                                                                                               FY 2008-09

                               Critical Shortage                                                            Local School Districts and
                               Reporting Form                                                                 Regional Cooperative
                    Kentucky Teachers' Retirement System                                                          Organizations
             479 Versailles Road, Frankfort, Kentucky 40601-3800                                  KTRS Use Only
                      (502) 848-8640 or 1-888-891-2696                                            JV Number                 _____________
Part A
                                                                                                  Unit Number ________________
Pay Period           From _______________                                                         Employer __________________
                     To _________________                                                         Pay Date __________________


Part D                               YOU MUST COMPLETE THE FOLLOWING FOR EACH CRITICAL SHORTAGE MEMBER
                              Name                       SSN               Earnings for Period             Amount                     Total




                     I hereby certify that the amounts reported above and transmitted herewith represent the complete and correct deductions from and
                     proper matching for salaries of members of the Teachers' Retirement System of the State of Kentucky.




                                                                                                    Chief Payroll Officer


                                      PLEASE READ THE INSTRUCTIONS ON THE REVERSE SIDE


                                                                                                                            Form R-1 District

								
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