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HomeMy WebLinkAbout2006-04-27 - Agendas - Final Firemen's Pension and Relief Fund Meeting Agenda April 27, 2006 A meeting of the Fayetteville Firemen's Pension and Relief Fund will be held at 11:00 AM on April 27, 2006 in Room 326 of the City Administration Building 1. Approval of the Minutes: • March 30, 2006 Meeting Minutes 2. Approval of the Pension List: • May, 2006 Pension List 3. New Business: • Glen Shackelford Retirement from DROP • Danny Farrar Retirement from DROP • Jim Rose Statement — TIF Lawsuit 4. Old Business: • Elections — Nominations — Pete Reagan and Marion Doss • Non-Return of Affidavit for Dwayne McChristian - Received 5. Longer Investments: • Revised Investment Policy — The Board Needs to Sign • Email Regarding Proxy Vote • Longer View • Monthly Report • 1St Quarter — Quarterly Report Firemen's Pension and Relief Fund Board of Trustees Meeting Minutes March 30, 2006 Page 1 of 8 Firemen's Pension and Relief Fund Board of Trustees Meeting Minutes March 30, 2006 A meeting of the Fayetteville Firemen's Pension and Relief Fund Board of Trustees was held at 11 :00 AM on March 30, 2006 in Room 326 of the City Administration Building. Pete Reagan called the meeting to order. Present: Marion Doss, Danny Farrar, Dennis Ledbetter, Pete Reagan, Sondra Smith, Trish Leach, Accounting, Elaine Longer and Kim Cooper, Longer Investments. Absent: Mayor Coody and Ronnie Woods. Approval of the February 23, 2006 Meeting Minutes: Marion Doss moved to approve the February 23, 2006 meeting minutes. Dennis Ledbetter seconded the motion. Upon roll call the motion passed 5-0. Mayor Coody and Ronnie Wood were absent. Approval of the April, 2006 Pension List: Pete Reagan: Is the pension amount the same as last month? Sondra Smith: No it is not, it has been reduced by the amount that Dwayne McChristian receives. His check is $109.27. Marion Doss moved to approve the April, 2006 pension list. Danny Farrar seconded the motion. Upon roll call the motion passed 5-0. Mayor Coody and Ronnie Wood were absent. Old Business: Elections: Copy of Nomination Letter: A copy of the letter that was sent out regarding the elections was given to the board. Non-Return of Affidavits: Dwayne McChristian: Dennis Ledbetter: We discussed the non return of affidavit for Dwayne McChristian and Jeannie Lane at the last meeting, did we receive those? Firemen's Pension and Relief Fund Board of Trustees Meeting Minutes March 30, 2006 Page 2 of 8 Sondra Smith: We have received Jeannie Lane's but we have not received Dwayne McChristian's. I talked to Mr. McChristian by phone and he said he was going to be out of town and he would get it us eventually. His check has been stopped. Trish Leach, Accounting: When he does send it, unless the Board tells us otherwise, we will run the back pay when we run the pension checks for everyone else. We will not make a special check run for him, unless you tell us you want something done differently. If he is not in a hurry for it we feel like it should just be a part of the regular check run. New Business: NCPERS — Support for Shareholders Proposals on Political Disclosure & Board Oversight: Pete Reagan: This is some information on what NCPERS does. Last year the Governor of California tried to change from a defined benefit plan to a defined contribution plan for public employees in California. That initiative failed but there was a lot of money spent by companies who at that time we had stock in that donated money to that campaign. It asks in the NCPERS letter that we approach our investment advisor and ask them before they vote if we have any of these companies like this on a list and that these companies provide us with a list of contributions. The institutional shareholders services are asking these companies to place on line and to provide to us a listing of monies from these companies that have been donated towards these campaigns. I think it would be appropriate that we pursue this on behalf of our pension fund. Danny Farrar moved that we share this information with Elaine Longer and ask her to participate. Marion Doss seconded the motion. Dennis Ledbetter: If they look at this they will correspond back to us so we will have a copy of their correspondence in reference to this? Pete Reagan: What I assume will happen is that when she receives the proxy voting, because that is part of her job as our investment advisor, that she will ask us if these companies are on a good list or a bad list or if they provided this information to their shareholders. I would hope that is the way that happens but we will need to check with Elaine when she comes in. Upon roll call the motion passed 5-0. Mayor Coody and Ronnie Wood were absent. Act 2094 of 2005: Pete Reagan: This is ethics and accountability for local board plan members. Sondra Smith: I have also enclosed a copy of Senate Bill 154, it states in this Bill under Section (B) (i) (3) that annual statements and affidavits from each Board member shall be collected by the Board or Municipal Treasurer. One copy of this statement and affidavit shall be filed with the Secretary of State. It does not state what kind of affidavit and it does not give you a copy of an affidavit. I do not know if it is something that we are going to have to devise I will have to get with the State. Firemen's Pension and Relief Fund Board of Trustees Meeting Minutes March 30, 2006 Page 3 of 8 Pete Reagan: On the first page it states that as a Board member if you are taken out to lunch, taken on a trip, taken to dinner or receive any type of gifts as a Board member then you have to disclose that. That is what that is saying. Sondra Smith: Right, but they did not give us any type of affidavit form for you to sign stating that you did not receive any gifts. The invitation that we receive every year from the investment firm in Little Rock to go to the race tracks would be considered a gift if we accepted the invitation. You would have to disclose that if you went on the trip. If you haven't accepted any gifts there is no problem. Dennis Ledbetter: Is this the same thing that you have to do if you run for office. Sondra Smith: It is similar. This will have to be completed every year. This had to be submitted with our report that had to be mailed to PRB before the end of March. The Mayor went ahead and certified that no one on this board received any gifts for 2005. Trish Leach: Elaine Longer sent Mayor Coody a letter stating that she had not given any gifts other than pens and calendars. So with that letter from Elaine he signed the form. Pete Reagan: It says these gifts include but are not limited to trips and meals, each Board member receiving such gifts or compensation must provide a written statement disclosing them and their value. These statements are to be collected by the local Board or Municipal Treasurer and retained on file. We also have to send a copy of those once a year to the Secretary of State. Marion Doss: It sounds like we complied then. Sondra Smith: I just wanted to make you aware of this new law. A lot of times you would not think about someone taking you out to dinner that that would be considered a gift if they are taking you out to dinner because you sit on this Board. You will have to keep up with gifts during the year if you receive any. Patricia Leach: There has to be a dollar limit that you have to report. I get the impression that next year the Mayor is going to want to see all of your statements. This was a new requirement this year. Kimberly Skelton — Letter to her Bank A copy of the letter that was written to Kim Skelton's bank was given to the Board. Sondra Smith: She is buying a home so her bank needed a letter stating when her pension amount ends and how much she draws each month. Arkansas Fire and Police Pension Review Board — Board Rules Sondra Smith: Just for your convenience I put a copy of the Arkansas Fire and Police Pension Board Rules in your packet. It is the most current copy that is on their website. This report tells you about actuarial soundness, cash flow reports and other general information. Firemen's Pension and Relief Fund Board of Trustees Meeting Minutes March 30,2006 Page 4 of 8 Longer Investments Monthly Report: Elaine Longer: On page 1 we have the update through February 28, 2006. Through last night the stocks are up another 2% to 2.25% month to date, so we have had a pretty good start to the year. When we wrote the year end newsletter which was in mid December we said that the relative valuation of stocks versus bonds has really improved even more last year because earnings were up about 20%, the stock market was flat for the year so that lowered the valuation on the stock market yet again coming off a similar type of flat year the year before. We thought that your reasonable expectation of this year would be of high single digits to low double digits return in the stock market. As of last night you are up about 7% in stocks. I think that with this run that we have we can get to the high single digits before May and then we will probably enter into a consolidation period leading into the elections in November. Those mid term elections will start to cause the market a little bit of concern. We will probably end the year still with the expectations that we had coming into the year, high single digits to low double digits on the equity side. The fixed income side we are having a year similar to last year with the continued increase in interest rates both at the Fed level with the short term interest rates rising again this week and then also the 10 year to 30 year interest rates have started to move higher. About a month ago we took off all the long bond positions in your bond portfolio and we were able to sell those bonds at a pretty high gain at 107 3/4 and we paid 98 to par on those so we booked about an 8 point gain. Those bonds have moved down in price to about 102 3/4 so we missed that five point decline in the long end of the market. But we just thought that given some of the strength in the economic numbers and the fact that we have a new Fed chairman that is going to put his stamp on the policy that we had some risk on the long end of the bond market so we took the gains and we rolled those into shorter maturities with high coupons. That is a little bit different that what we had expressed in our year end newsletter because some things changed. We decided to be a little bit more safe as far as the bonds are concerned. We can get 5% to 5 %2 % now in short term maturities with one year to two year call features. We bought a 6% bond recently that was a ten year maturity with 3 years of call protection. These are interest rates that we haven't seen for about four or five years. The first page shows that you are at about 50% stocks. You are currently at 50% in domestic stock and then you have another 5% in the foreign stocks so we are right at the limit of 55% that we have been authorized to. Dennis Ledbetter moved to approve the Equity Overage. Danny Farrar seconded the motion. Upon roll call the motion passed 5-0. Mayor Coody and Ronnie Wood were absent. Elaine Longer: Anther thing that we will talk about when we get to the policy review is the investment policy it calls for a 10% equity portfolio limit on foreign investments. Foreign investments was your strongest performing asset class last year so your cost on your foreign mutual funds is $421,000 but the market value is $500,000 so we have moved over the 10% of total equity portfolio in foreign. What we have done in all of our investment policies for all of our clients this year is to lift the restriction on foreign. That is something that I would like to have addressed at this meeting as far as the policy is concerned. You are over that 10% limit and then if you include a couple of the stocks that we own as well as the mutual funds you would be even farther over the 10% limit because of the appreciation that has taken place in the foreign side relative to the domestic stocks last year. You can either say that you want to keep it at 10%, I would not recommend that. We have amended all of our investment policies for our clients because the United States now is only about 56% of the world equity market. So if your policy calls for 90% of your stocks to be held in US stocks you are really limiting yourself as far as participation in the rest of the market. If you don't feel comfortable with lifting your restrictions completely you can maybe move it to 25% or 30% and if bounce up against that window then we can come back and talk about it again. Firemen's Pension and Relief Fund Board of Trustees Meeting Minutes March 30, 2006 Page 5 of 8 Pete Reagan: Elaine, are you referring to Page (4) (e)? Elaine Longer: Yes. Pete Reagan: What are you recommending that we change that to? Elaine Longer: ' You have an option of either keeping it there, that is not a recommendation or expanding the limit to 25% or 35% which would easily incorporate what you have in your portfolio at this time and give us a little bit of room or you can lift the restriction completely. Pete Reagan: And your recommendation is to lift it completely? Elaine Longer: That is what we have done with all of our other accounts. Danny Farrar moved to lift the limit completely. Dennis Ledbetter seconded the motion. Pete Reagan: We have a motion to lift the limit on foreign completely and remove item (e) from the investment policy. I will open it for discussion. Marion Doss: I am not too crazy about removing the limits entirely. I can see bumping it up some but I am not real comfortable in removing it entirely. Dennis Ledbetter: If we went to 25% and we start bumping that you can come back and let us know? Elaine Longer: We can do that because we monitor everything in your policy monthly so if there is anything that we start to bump up against we will come back and tell you. Danny Farrar: Your other clients just removed it so that you would not have to come back to them every time? Elaine Longer: Yes, because every account that we have has an investment policy so this way we do not have to worry about, if we see a stock we would like to buy we can buy it and not have to worry about if we are hitting a restriction. Dennis Ledbetter: This is a pretty good size fund that we have and 25% is a pretty good amount of money. Elaine Longer: If you take the mutual funds plus the stocks that you have right now you are about 17% so 25% still gives us running room. Pete Reagan: I have no problem with taking it completely off, the reason is because who our current investment folks are now, if Elaine is happy with it, I am happy with it. I appreciate her bringing that to our attention. I would hate to see that down the road we would have to sell a bond or mutual fund or anything because it would make us go over our limit and there was more money to be made in that stock. Elaine Longer: We would come back and tell you that so that you had another option, 25% would be 25% of your total equity exposure which is not 25% of the portfolio. Firemen's Pension and Relief Fund Board of Trustees Meeting Minutes March 30,2006 Page 6 of 8 Pete Reagan: So this is just equity only. Elaine Longer: Yes. Pete Reagan: The motion is to do away with (4) (e). Dennis Ledbetter: I want everybody comfortable with it. Danny Farrar: Yes. Pete Reagan: I have no problem with it. Marion Doss: I have a problem with removing the limit entirely. I would rather have a limit on it. Dennis Ledbetter: What if we do 50% that would give us quite a bit, of running room. Elaine Longer: I can't visualize where we would go to 50% that is a very high limit. The reason that we would lift the limits completely is not because I intend to go to 50% or 60% but just so we don't have to worry about that. Since you are a public pension fund we are watching you policy all the time so if you are more comfortable with 25% that is not a problem. Danny Farrar moved to amend his motion to change the investment policy to read investments in international securities will be limited to 50% of the equity portfolio at cost. Dennis Ledbetter seconded the motion. Dennis Ledbetter: I think that if we do the 50% we have some room to work with and over the next quarter or two we will have a better idea. Marion Doss: Well Elaine said a few minutes ago that she can not envision going to 50%. This does put a limit on it and if any thing changes we can look at it. Upon roll call the motion passed 5-0. Mayor Coody and Ronnie Wood were absent. Elaine Longer: 50% is just like lifting the limit completely because we are not going to get there. We may bump up against 25% but we are not going to bump up against 50%. Page 4 gives your market value as of February 28th it was about $9.3 million. The total income on the portfolio is 3.3% income return and that's with only 45% being invested in bonds. You still have a real good floor as far as your income return is concerned; $286,000 comes in just from your bond certificates. Page 5 is updated for March 24th just to give you an idea as to what the stock market has done since then. The market value on page 9 is $9.33 million, that is up about $30,000 and then we are up a little bit more this week. Things are still moving along pretty well for this year. Firemen's Pension and Relief Fund Board of Trustees Meeting Minutes March 30, 2006 Page 7 of 8 Page 10 shows your realized gains year to date through February 28th they were about $114,000. Net income is approximately $30,000. You have made more than that because the appreciation in the portfolio is higher than the realized gains plus the income. The realized gains are the gains that we have taken on the stocks. Page 11 has your largest positions; the brokers have been very strong, in fact they are both at new highs again today. We have trimmed them a little bit because they were full positions for us; a full position is about 3% of portfolio. Sometimes the market valuation improves and it goes above that so we trim it back a little bit so we have taken some gains on those and maintained a 3% position. Page 12 we are overweight the capital side of the economy, we think corporate America is in great shape, much better than the household sector. We are overweight corporate, capital goods and energy. We are underweight the consumer, slightly underweight financial and slightly underweight healthcare. Page 13 are the distributions and contributions from inception to date. The distributions have been $3.485 million, contributions have been $622,000. Page 14 your beginning value is $9.9 million and then deposits net of withdraws have been about $2.7 million. The investment return has been about $2.1 million. We have almost kept up with the withdraws but not quite. Your returns are listed and you can see that last year, 2005 was kind of flat with the exception of the foreign funds being up about 21%. The overall return was about 1.6%. This year to date through February 28 we are showing 5% return and through today that is about 7% on stocks. Foreign was up about 3.1%, fixed income is flat again. You are still earning the interest income on your bonds but as interest rates continue higher the price of the bonds keep getting marked down so the net return shows a flat return. As soon as we get to the end of this tiding cycle you will start seeing that your fixed income return is more in line with your coupon on the bond. In this environment where interest rates are rising the bonds that are already outstanding are not worth as much as the ones that are being issued today that carry higher coupons. That is why the price goes down; you don't lose money because as long as you hold them to maturity you still get your bond. The total is up about 2.5%, last night about 3.3% so you are still annualizing net of all expenses the 6.4% above your actuary return of 6%. Pete Reagan: Elaine thank you so much for that report. We passed a motion before you got here to support the NCPERS request when you vote our proxies, to make sure the companies disclose the amount of contributions they make. To use an example last year in California there were a lot of companies that made contributions to the Governor's cause to change pension benefits from a defined benefit to a defined contribution plan. Elaine Longer: We will read this and then if we can't get the information from the companies before we vote the proxy do you want us not to vote the proxy? Pete Reagan: If we know they are on a bad list. We want them to know that we are keeping an eye on them and that we don't have an investment advisor that is just voting proxies. If everybody makes a statement that says we want you to disclose what you are contributing to these campaigns then I am sure that they will do it. Elaine Longer: Typically when we vote a proxy we are voting on a list of items that they are asking you to vote on, if it doesn't have anything to do with this do you want us to vote the proxy as we would for other share holders? Firemen's Pension and Relief Fund Board of Trustees Meeting Minutes March 30,2006 Page 8 of 8 Pete Reagan: Yes. We are just asking them to disclose. That is company money that could have been shown as a profit. I think it is the share holder's responsibility to know what kind of money they are handing out. Elaine Longer: I just want to make sure I understand what you want us to do because we can't request that information from them, usually if we are voting a proxy it is just a number of items that they are asking for a yes or a no vote on. We can still vote that proxy like we would vote for others unless there is something pertaining to this and you want us to vote no. I don't know that we can secure the information to be able to vote the proxy in a timely manner unless it appears on the proxy. Kim Cooper: I think what this is saying is that these four companies have a proposal that has been put in by the share holders including the NCPERS and you just want us to vote for that? Pete Reagan: Yes. What I am forecasting is that NCPERS will spearhead this and ask that all United States companies disclose this. We would like for you to relay that information to us. Elaine Longer: We can monitor it and if we see anything related to this Kim can email you. Pete Reagan: Yes. Dennis Ledbetter: I think our vote was that you handle this the way you feel is best for us. Meeting Adjourned at 11 :50 AM. FIREMEN'S RELIEF AND PENSION May 2006 THE FOLLOWING ARE THE OBLIGATIONS OF THE FIREMEN'S RELIEF FUND FOR THE MONTH OF AUGUST. YOU ARE HEREBY INSTRUCTED TO ISSUE CHECKS TO THE PAYEES, IN THE AMOUNTS SHOWN, AND FOR THE PURPOSE SO STATED. Act 1373 DATE OF Regular Mo Year To Date Future EMP#RETIREMENT NAME Benefit Reg Benefit Supplement Fed Tax St Tax Net Q 79 11/99 ARMSTRONG (DILL), PAMELA 1,812.74 9,063.70 300.00 100.00 1,412.74 R 177 4/04 BACHMAN, EDDIE 2,618.55 13,092.75 479.27 119.82 2,019.46 S 74 3/86 BAIRD, JULIA 1,802.08 9,010.40 350.00 145.00 1,307.08 V 2 3/75 BLACKARD, PAUL 109.27 546.35 109.27 V 63 5172 BOLAIN, ANN 109.27 546.35 109.27 R 68 7/99 BONADUCE, MICHAEL 2,988.76 14,943.80 475.38 2,513.38 S 44 9/86 BOUDREY, BETTY MRS. 2,477.42 12,387.10 300.00 50.00 2,127.42 R 45 9/86 BOUDREY, HOWARD 2,089.28 10,446.40 2,089.28 R 49 7/88 BOUDREY, JACK 1,647.63 8,238.15 287.68 50.00 1,309.95 V 5 5172 CASELMAN, ARTHUR 131.13 655.65 131.13 R 57 5/90 CATE, ROY 1,788.90 8,944.50 1,788.90 V 6 4/68 CHRISTIE, ARNOLD 109.27 546.35 109.27 V 8 10!76 COUNTS, WAYNE 109.27 546.35 109.27 R 77 11/99 DILL,GARY JOHN 1,812.75 9,063.75 100.00 1,712.75 188 12/05 DOSS, MARION H 5,376.91 26,884.55 800.00 320.00 4,256.91 R 11 2/76 FARRAR,ALONZO 998.86 4,994.30 998.86 R 192 4/06 FARRAR, DANNY 4,155.36 4,155.36 207.00 207.00 3,741.36 R 38 5/84 FRALEY, JOSEPH G. 1,768.12 8,840.60 200.00 15.00 1,553.12 R 170 5/03 FREEDLE, LARRY 3,816.75 19,083.75 500.00 100.00 3,216.75 R 92 03/02 GAGE,TOMMY 2,596.69 12,983.45 226.00 50.00 2,320.69 V 34 6/79 HARRIS, JAMES E. 109.27 546.35 109.27 V 70 11/99 HARRIS, MARY RUTH 109.27 546.35 109.27 Q 182 10/04 JENKINS, EILEEN 1,788.75 8,943.75 350.00 100.00 1,338.75 R 93 06/02 JENKINS, JOHN 1,788.76 8,943.80 350.00 100.00 1,338.76 R 86 07/01 JOHNSON,ROBERT 3,073.47 15,367.35 500.00 100.00 2,473.47 R 64 4/95 JORDAN, CHARLIE 2,274.95 11,374.75 150.00 50.00 2,074.95 S 76 5/88 JUDY, JAN 1,647.63 8,238.15 200.00 50.00 1,397.63 R 37 3/84 KING, ARNOLD D. 1,522.37 7,611.85 300.00 47.00 1,175.37 R 54 5/89 KING, ARVIL 1,711.21 8,556.05 130.00 50.00 1,531.21 V 12 3/60 LANE, HOPE MRS 109.27 546.35 109.27 R 13 10/67 LAYER, MERLIN 456.22 2,281.10 456.22 R 173 12/03 LEDBETTER, DENNIS 3,775.80 18,879.00 650.00 200.00 2,925.80 V 181 10/04 LEE, VIOLA LOUISE 109.27 546.35 109.27 R 51 10/88 LEWIS, CHARLES 1,647.63 8,238.15 75.00 25.00 1,547.63 R 40 9/85 LOGUE, PAUL D. 2,868.28 14,341.40 325.00 75.00 2,468.28 R 50 9/88 MASON, LARRY 1,631.25 8,156.25 137.61 25.00 1,468.64 R 39 4/85 MC ARTHUR, RONALD A. 1,753.74 8,768.70 150.00 50.00 1,553.74 V 35 2/82 MC CHRISTIAN, DWAYNE *" 327.81 546.35 327.81 R 15 4/77 MC WHORTER, CHARLES 1,334.51 6,672.55 150.00 1,184.51 R 29 8/81 MILLER, DONALD 1,304.07 6,520.35 125.00 25.00 1,154.07 R 73 2/00 MILLER,KENNETH 3,180.02 15,900.10 325.00 75.00 2,780.02 V 42 2/86 MOORE, JAMES H. 109.27 546.35 109.27 V 176 4/04 MORRIS,'DIXIE E. 125.66 628.30 125.66 V 62 10/68 MORRISON, ELIENE 136.59 682.95 136.59 R 48 7/88 MULLENS, DENNIS W. 2,191.30 10,956.50 2,191.30 R 184 3/05 NAPIER, LONNIE 3,518.28 17,591.40 110.00 88.00 3,320.28 R 46 5/88 OSBURN, TROY 1,899.66 9,498.30 200.00 38.00 1,661.66 R 81 02/01 PHILLIPS,LARRY 2,765.09 13,825.45 2,765.09 R 53 2/89 POAGE, LARRY 2,346.70 11,733.50 300.00 100.00 1,946.70 R 186 06/05 REAGAN, PETE 3,535.71 17,678.55 3,535.71 V 22 4/73 REED, JOE 109.27 546.35 109.27 S 172 12/03 SCHADER, MADGE 1,386.01 6,930.05 1,386.01 R 41 9/85 SCHADER, TROY 1,524.99 7,624.95 57.00 25.00 1,442.99 R 190 04/06 SHACKELFORD, GLEN 3,647.18 3,647.18 400.00 200.00 3,047.18 S 83 03/01 SKELTON, KIMBERLY 2,434.98 12,174.90 250.00 50.00 2,134.98 S 66 8/98 SKELTON, PAULINE, Deceased 12/30/05 0.00 0.00 0.00 R 36 5/76 SPRINGSTON, CARL 806.19 4,030.95 70.00 17.00 719.19 S 90 03/02 STOUT, IMOGENE W. 767.80 3,839.00 767.80 R 165 12/02 TATE, RALPH 3,668.10 18,340.50 300.00 100.00 3,268.10 V 65 3/66 TUNE, BILLIE SUE 136.59 682.95 136.59 V 27 3/71 TUNE, MILDRED MRS. 136.59 682.95 136.59 R 71 1/00 WARFORD,THOMAS 2,502.72 12,513.60 300.00 2,202.72 R 28 7/68 WATTS, DONALD 437.09 2,185.45 437.09 R 88 01/02 WOOD,RONNIE D 3,077.15 15,385.75 800.00 200.00 2,077.15 R 52 9/88 WRIGHT, RANDALL 1,691.34 8,456.70 200.00_ 25.00 1,466.34 109 796.82 516 681.24 0.00 11 129.94 2 971.82 95 695.06 DATE OF Regular Mo Year To Date Future EMP#RETIREMENT NAME Benefit Reg Benefit Supplement Fed Tax St Tax Net DROP DATE DROP EMPLOYEES NEW BENEFITS 03/01/03 MAHAN, MARSHALL 4,077.28 03/01/03 PIERCE, JOEY 3,647.18 04/01/03 O'NEAL, TEDDY 4,120.99 WE, THE UNDERSIGNED, DO SOLEMNLY SWEAR THAT THE ABOVE OBLIGATIONS ARE JUST AND CORRECT; THAT NO PART THEREOF HAS BEEN PREVIOUSLY PAID; THAT THE PENSION PAYMENTS SO CHARGED ARE IN ACCORDANCE WITH THE ACTIONS OF THE BOARD OF TRUSTEES OF THE FIREMEN'S RELIEF AND PENSION FUND; THAT THE SERVICES OR SUPPLIES FURNISHED, AS THE CASE MAY BE, WERE ACTUALLY RENDERED OR FURNISHED;AND THAT THE CHARGES MADE THEREFORE DO NOT EXCEED THE AMOUNT ALLOWED BY LAW OR THE CUSTOMARY CHARGE FOR SIMILAR SERVICES OR SUPPLIES SECRETARY CHAIRMAN AND PRESIDENT ACKNOWLEDGEMENT STATE OF ARKANSAS ) COUNTY OF WASHINGTON) SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF 2005. NOTARY PUBLIC MY COMMISSION EXPIRES : YTD 68Io-9810-5335-oD 406,884.42 516681.24 -109796.82 6810-9810%5335-M 0.00 #REFI #REF! Drop Payoutllntrest Checks to Drop Retirees 355,912.59 YTD Column 762,797.01 Difference 0.00 "(should be off Supplemental amount for DROP part) ***Note: Dwayne McChristian's check for May will include March-May, he was not paid in March or April, due to Pension Affidavit not being turned in until 4110106 Fayetteville Firemen's Pension and Relief Fund \ Deferred Retirement Option Plan (DROP) Distribution Election Form To be completed by Employee with regard to the distribution of his DROP account balance. Glen L. Shackelford April 10, 2006 Member Name (please print) Retirement Date Please select option A, B, or C: A. The Fayetteville Firemen's Pension and Relief Fund is directed to make full payment to me, the member, less 20%federal withholding tax. i understand that the entire amount of distribution from my DROP account will be reported to the Internal Revenue Service. Signature of Member Date B. The Fayetteville Firemen's Pension and Relief Fund is directed to mail my full distribution to: Glen L. Shackelford IRA Rollover (Name of Annuity Provider) for deposit. 1 understand that the entire amount of distribution from my DROP account will be reported to the Internal Revenue Service. ,a%nature of Member Date C. The Fayetteville Firemen's Pension and Relief Fund is directed to mail $ (fill in the amount) of my distribution to (Name of Annuity Provider) for deposit. The remainder will be paid directly to me, the member, less 20% Federal withholding tax. 1 understand that the entire amount of distribution from my DROP account will be reported to the Internal Revenue Service. Signature of Member Date (To be completed by the Annuity Provider If option B or C is selected) In accordance with the above authorization of the depositor, we agree to deposit the forthcoming distribution amount from the Fayetteville Firemen's Pension and Relief Fund in the following account: TypeofAccount: (Mllntheblank) Glen L. Shackelford IRA Rollover Charles Schwab & Co Inc . Custodian I(we) certify that the account is a qualified account, as defined by the Internal Revenue Service, to receive -� distributions, from the Fayetteville Firemen's Pension and Relief Fund, on which the income tax may be deferred. Longer Investments Inc. Annuity Provider ized Sigr�ahxe P.O. Box 1269 April 12, 2006 Mailing Address Date Fayetteville, AR 72702 479-443-5851 city State Zip Telephone Number Return to: Fremen's Pension and Relief Fund City of Fayetteville 113 West Mountain Fayetteville, AR 72701 Page 1 of 2 k FIREMEN'S PENSION & RELIEF FUND AFFIDAVIT State of Arkansas ) )s5: ysa- is— County of Washington ) I, - `� Z- �� i �� do solemnly swear that: 1. I am a former firefighter for the City of Fayetteville, Arkansas, Fire Department. I am the spouse/former spouse/widow of a former firefighter for the City of Fayetteville, Arkansas, Fire Department, and that I have not remarried since becoming eligible for benefits. I am an eligible dependent of a former firefighter for. the City of Fayetteville, Arkansas, Fire Department and submitted the attached school affidavit for verification of school attendance. 2. I presently receive benefits from the Fayetteville Firemen's Pension and Relief Fund and I am eligible to continue receiving the pension fund benefits as governed under state law. 3. My personal information is as follows: Address: IQCL rc" vi�(0-0► k ( t� Telephone: _( q 7 j ) & Y 3 - 33 7 Social Security No.: 3 Birth date: q PLEASE LIST ALL BENEFICIARIES BELOW: (complete if you are the retiree) NAME SOCIAL SECURITY NO. BIRTH DATE RELATIONSHIP 97 DATED this l0 day of_-I cvl� AFFIANT (signature) Parent/Guardian Signature SUBSCRIBED AND SWORN TO before me, a Notary Public, this /4-023%11ay of �O6 . ztoz-to-60 S uo1SU Notary Publi uvv-o!lgnd tiLION p H11WS 3NIHl3 yldaNOS My Commission Expires: Ives 1810140 (This affidavit is required annually by the FiremenAs Pension and Relief Fund Board of Trustees and must be properly executed and returned to the Fayetteville City Clerk, 113 West Mountain, Fayetteville, Arkansas, 72701 by January 31'` of each year.) (Revised 11/03) working schedule Glen Shackelford Balance prior to payroll 8 adjustment Sub Project Project # 62082 1 Retirement Benefit $ 131,710.86 2 Employer Match $ 8,376.54 3Interest $ 4,404.07 4 Future Supplement $ 762.00 Total $ 145,253.47 4/18/2006 CADocuments and Settings\ssmith.000\Local Settings\Temp\Calculation of Shackelford Retirement Funds ti UL/ L9/ VU LU.JL VL JUL JIJ U..Ud Vi op V• .'UJ FAYEPFEV= FIREMEN'S PENSION AND RELIEF FUND 1 DEFERRED RETIREMENT OPTION PLAN (DROP) MEMBER ELECTION FORM (Beneficiary Designation) filen L� sxl _ r�3a-Fs-6g �s of INS& Member SSN - DOB Address City State zip lyj Spouse SSN DOB Le r-IC6 Years of Seivice Date of Employment Witness DIC)�JATION OF BENEFIf "Y I hereby designate the following beneficiary to receive any benefits from the DROP plan if I die prior to my termination of employment:e Name Relationship -� 57 1 Signature of Member Dale _03 j: Please select one of the following (if spouse is not selected as beneficiary): I certify that to the best of my knowledge, the above-named member is single or dw his spouse cannot be located. Signature of Pian Representative/Notary Date I certify that I have agreed with my spouse on the selection of the above-named beneficiary or beneficiaries. I understand. that if I am not named beneficiary, I will not be entitled to benefits under the Plan. Signature of Spouse Date I certify that I have witnessed the above spouse's signature. Signature. of Plan RepreseutativelNotary Date J Y FAYE MMVILLE FIREMEN'S PENSION AND REEF FUND DEFmuum RE'PIRENIENT OPTION PLAN (DROP) MEMBER ELECTION FORM } I hereby elect the DROP as my retirement benefit option from the pension plan 'in place of normal retirement benefit. I understand that in electing DROP, I have agreed to the following statements: * 1. The amount of the DROP payments will be 7-P" '- per month. This amount includes all service and age 60 bonuses that 1 have earned to this date. This amount is the same as if I retired today. * 2. I understand -that the monthly benefit that I will .rrceive at the end of the DROP period is the exact same amount stated in Item 1, regardless of any pay raises I receive or extra years of service I may work 3. I understand that at the end of the DROP period I will have the option to receive the DROP account as a lump sum or convert the DROP account to a monthly annuity account or any other method of payment as provided for in the current Rules and Regulations of DROP. 4. I understand that the DROP account will remain in the pension fund until withdrawn in accordance with the Rules and Regulations of the DROP plan. I do not have the ability to withdraw from the DROP account until the time of my departure. 5. I have elected to begin the DROP on DROP will end at the earlier of when I resign or (5 years from . the above date, unless authorizations to participate in DROP shall-be specifically extended by the Arkansas Statutes). 6. I understand that neither the pension fund nor the Department has given any tax advice concerning the way the DROP account is taxed. I have, or. will nonsuit, my own tax advisor for this information. 7. I have read the Rules and Regulations pertaining to DROP. *Two eaeeptioas to theserales: Age 60 b (fo members wit4 ovse 25 yew of service when than go onto DROP) begin at ags 6o whether still on OP or not; raises given to retirees are alae given se DROP participants. Member Signature 'Date _ _ X1131 b3- • Spouse si Lure Date Plan Representative Date The following is an excerpt from the original DROP Member Election Form: IMPORTANT NOTICE Attomeys for the Fayetteville Firemen's Pension and Relief Fund Board of Trustees has advised that there may be serious potentsl tax consequences as a result of participating in the Deferred Retirement Option Plan (DROP, A.C.A. &24—t 1—BSO) as follows.- An ollows.An application for a letter of determination as to the tax deferral status of the Firemen's Pension and Relief Fund Plan and Trust has never been tied with the IRS. Also, no detemhinaton request has been made for the Deferred Retirement Option Plan (DROP), an amendment to the pension and relief fund plan and trust. Reliance on another State's qualfficaton is not permitted. An adverse ruling on the tax deferred status of the plan could have serious detrimental tax consequences to each participant DROP distributions will be treated as ordinary income in the year constnxtive receipt occurs and rollover into an otherwise qualified plan, IRA, or other invesbnentmaynot be possible. By not acting to formally tax qualify the plan, an array of possible options for the DROP participants may not be available. We strongly urge you to seek advice from a competent tax accountant and/or an attorney before parlicipa3tng in the DROP program. You assume the risk of such adverse tax consequences if YOU elect to participate. i s 1 understand that the Fayetteville Firemen's Pension and Relief Fund has no liability for any adverse tax consequences which may accrue to me as a participant in the-DROP plan._ 6 Ll F or Slgrmdum Data i Page 2 of 2 GENERAL FIRE PENSION Prepared: 1/22/2003 Name: Glenn Shackelford Date of Retirement: > Emp # 110 ' SS# 432-15-6985 DOH: 5/3/1982 Yrs Srv: 20 :. .Hourly Rate: 13.601 Hours Base: 31272.00 EMT/Hazmat Pay: - Annual Salary 44,502.47 Annual Benefit (at 90% of salary) 40,052.22 1112 of Annual Benefit 31337.69 Additional yrs beyond 20: - $20.00 0.00 Monthly benefit 31337.69 Daily benefit 109.73 /j/ LZ• VV IYJY �-1 YVi VY VrY• Va VV V • ,yr v - IMPORTANT NOTICE Attorneys for the Fayetteville Fireman's Pension and Relief Fund Board of Trustees has advised that there may be serious potential tax consequences as a result of participating in the Deferred Retirement Option Plai► (DROP, . A.C.A. §24-11-830) as follows: AN APPLICATION FOR A LETTER OF DETEFMIIN TION AS TO THE TAX DEFERRAL STATUS OF THE FIRE,NAN'S PENSION AND RELIEF FUND PLAN AND TRUST HAS NEVER BEEN FILED WITH THE IRS. ALSO, NO DETF.LtI MNATION REQUEST' HAS BEEN NADP' FOR THE DEFERRED RBTItEMENT OPTION PLAN (DROP) , AN. ANSNDHENT TO THE PENSION AND RELIEF FUND PLAN AND TRUST. RELIANCE ON ANOTHER STATE'S QUALIFICATION IS NOT PBRNITTED- AN ADVERSE RULING . ON THE TAX DEFERRED STATUS OF THE PLAN . COULD HAvE SERIOUS DETRIMENTAL TAX CONSEQUENCES TO EACH PARTICIPANT. DROP DISTRIBUTIONS WILL BE TREATED AS ORDINARY INCOME IN THE YEAR CONSTRUCTIVE RECEIPT OCCURS OR AND ROLLOvBii INTO AN OTHERWISE QUALIFIED PLAN, OTHER INVESTMENT MAY NOT BE POSSIBLE. BY NOT ACTING TO FORMALLY TAX QUALIFY THE PLAN, AN ARRAY OF POSSIBLE OPTIONS FOR THE DROP PARTICIPANTS NAY NOT BE AVAILABLE- we strongly urge you .to seek advice from a competent tax accountant and/or attorney before participating in the DROP `1 program. You assume the risk of such adverse tax consequences if, you elect to participate. 2 03 ez i v l i 1 � s Fayetteville Firemen's Pension and Relief Fund Deferred Retirement Option Plan (DROP) Distribution Election Form To be completed by Employee with regard to the distribution of his DROP account balance. Danny M. Farrar April 17 , 2006 Member Name (please print) Retirement Date Please select option A, B, or C: A. The Fayetteville Firemen's Pension and Relief Fund is directed to make full payment to me, the member, less 20% federal withholding tax. I understand that the entire amount of distribution from my DROP account will be reported to the Internal Revenue Service. Signature of Member Date B. The Fayetteville Firemen's Pension and Relief Fund is directed to mail my full distribution to: Danny M. Farrar IRA Rollover (Name of Annuity Provider) for deposit. I understand that the entire amount of distribution from my DROP account will be reported to the Internal Revenue Se ice. gnatur of ember Date C. The Fayetteville Firemen's Pension and Relief Fund is directed to mail $ (fill in the amount) of my distribution to (Name of Annuity Provider) for deposit. The remainder will be paid directly to me, the member, less 20% Federal withholding tax. I understand that the entire amount of distribution from my DROP account will be reported to the Internal Revenue Service. Signature of Member Date (To be completed by the Annuity Provider if option B or C is selected) In accordance with the above authorization of the depositor, we agree to deposit the forthcoming distribution amount from the Fayetteville Firemen's Pension and Relief Fund in the following account: Type of Account: (fill in the blank) Danny M. Farrar IRA Rollover Charles Schwab & Co Custodian Account Number : 8147-6433 I(we) certify that the account is a qualified account, as defined by the Internal Revenue Service, to receive distributions, from the Fayetteville Firemen's Pension and Relief Fund, on which the income tax may be deferred. Longer Investments Inc . l Annuity Provider Auth rized Signature P. O. Box 1269 April 18 , 2006 Mailing Address Date Fayetteville , AR 72702 479-443-5851 City State Zip Telephone Number Return to: Firemen's Pension and Relief Fund City of Fayetteville 113 West Mountain Fayetteville, AR 72701 Page 1 of 2 The following is an excerpt from the original DROP Member Election Form: IMPORTANT NOTICE Attorneys for the Fayetteville Firemen's Pension and Relief Fund Board of Trustees has advised that there may be serious potential tax consequences as a result of participating in the Deferred Retirement Option Plan (DROP, A.C.A. &24-11-830) as follows: An application for a letter of determination as to the tax deferral status of the Firemen's Pension and Relief Fund Plan and Trust has never been tiled with the IRS. Also, no determination request has been made for the Deferred Retirement Option Plan (DROP), an amendment to the pension and relief fund plan and trust. Reliance on another State's qualification is not permitted. An adverse ruling on the tax deferred status of the plan could have serious detrimental tax consequences to each participant. DROP distributions will be treated as ordinary income in the year constructive receipt occurs and rollover into an otherwise qualified plan, IRA, or other investment may not be possible. By not acting to formally tax qualify the plan, an array of possible options for the DROP participants may not be available. We strongly urge you to seek advice from a competent tax accountant and/or an attorney before participating in the DROP program. You assume the risk of such adverse tax consequences if you elect to participate. understand that the Fayetteville Firemen's Pension and Relief Fund has no liability for any adverse tax consequences which may accrue to me as a participant in the DROP plan. emb r Signature Date Page 2 of 2 w-4P Withholding Certificate for OMB No. 1545-0074 artment of the Treasury Pension or Annuity Payments �OQ 6 Internal Revenue Service Purpose. Form W-4P is for U.S. citizens, resident aliens, or their pages 3 and 4. Your previously filed Form W-41P will remain in. estates who are recipients of pensions, annuities (including effect if you do not file a Form W-41P for 2006. commercial annuities), and certain other deferred compensation. What do I need to do? Complete lines A through G of the Use Form W-413 to tell payers the correct amount of federal income Personal Allowances Worksheet. Use the additional tax to withhold from your payment(s). You also may use Form worksheets on page 2 to adjust your withholding allowances for W-4P to choose (a) not to have any federal income tax withheld itemized deductions, adjustments to income, certain credits, or from the payment (except for eligible rollover distributions, or multiple pensions/more-than-one-income situations. If you do payments to U.S. citizens delivered outside the United States or its not want any income tax withheld (see Purpose above), you can possessions) or (b) to have an additional amount of tax withheld. skip the worksheets and'go directly to the Form W-41P below. Your options depend on whether the payment is periodic, nonperiodic, or an eligible rollover distribution, as explained on Sign this form. Form W-4P is not valid unless you sign it. Personal Allowances Worksheet (Keep for your records.) A Enter "1" for yourself if no one else can claim you as a dependent . • . . . . . . . . . . . . . A j • You are single and have only one pension; or • You are married, have only one pension, and your 1 d « spouse has no income subject to withholding; B B Enter : sp 1 9� or • Your income from a second pension or a job, or your spouse's pension or wages (or the total of all) is $1,000 or less. C Enter "12" for your spouse. But, you may choose to enter "-0-" if you are married and have either a spouse who has income subject to withholding or you have more than one source of income subject to withholding. (Entering "r0-" may help you avoid having too little tax withheld.) . . . . . . . . . . . . . . . . . . . C D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return . . . . D 0 E Enter "1" if you will file as head of household on your tax return . . . . . . . . . . . . . . . . E F Child Tax Credit (including additional child tax credit): • If your total income will be less than $55,000 ($82,000 if married), enter "2" for each eligible child. • If your total income will be between $55,000 and $84,000 ($82,000 and $119,000 if married), enter "1" for each eligible child plus "1" additional if you have four or more eligible children . . . . . . . . . . . . . F G Add lines A through F and enter total here. (Note. This may be different from the number of exemptions you claim i on your tax return.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► G • If you plan to itemize or claim adjustments to income and want to reduce your withholding, For see the Deductions and Adjustments Worksheet on page 2. accuracy, • If you have more than one source of income subject to withholding or a spouse with income complete subject to withholding and your combined income from all sources exceeds $35,000 ($25,000 if all married), see the Multiple Pensions/More-Than-One-Income Worksheet on page 2 to avoid worksheets having too little tax withheld. that apply. • If neither of the above situations applies, stop here and enter the number from line G on line 2 of Form W-41P below. ------------ Cut here and give Form W-41P to the payer of your pension or annuity. Keep the top part for your records. ------------- Form ------------Form W=4P Withholding Certificate for OMB No. 1545-0074 Department of the Treasury Pension or Annuity Payments r�oo� Internal Revenue 0-evenue Service For Privacy Act and Paperwork Reduction Act Notice, see page 4. pe or print your full name. Your social security number M. ;:7AfZW q,31 ) !S : 3 6s Home i address (number and street or rural route) Claim or identification number 22005r S h(f6 :5T. (if any) of your pension or City or town, state, and ZIP code annuity contract Complete the following applicable lines. ) 1 Check here if you do not want any federal income tax withheld from your pension or annuity. (Do not complete lines 2 or 3.) ► ❑ 2 Total number of allowances and marital status you are claiming for withholding from each periodic pension or annuity payment. (You may also designate an additional dollar amount on line 3.) . . . . . . . . . . ► (Enter numberS`1aTe,,a2 Marital status: El Single Single Married ❑ Married, but withhold at higher "Single" rate of allowances.) 3 Additional amount, if any, you want withheld from each pension or annuity payment. (Note. For periodic payments, you cannot ter an amount here vfithout entering the number (including zero of allowances on line 2.) ► $ Your signature Date 0- Cat. No. 10225T Form W-4P (2006) FIREMEN'S PENSION & RELIEF FUND AFFIDAVIT State of Arkansas ) )ss: County of Washington �^,) I, �, y M• 7`"�`/� � , do solemnly swear that: I am a former firefighter for the City of Fayetteville, Arkansas, Fire Department. I am the spouse/former spouse/widow of a former firefighter for the City of Fayetteville, Arkansas, Fire Department, and that I have not remarried since becoming eligible for benefits. I am an eligible dependent of a former firefighter for the City of Fayetteville, Arkansas, Fire Department and submit the attached school affidavit as verification of my school attendance. 2. I presently receive benefits from the Fayetteville Firemen's Pension and Relief Fund and I am eligible to continue receiving the pension fund benefits as governed under state law. 3. My personal information is as follows: Address: 2805 �S' r oo `,.s A l r-e s� SP2 IA16I tL-e . r 7 76 z Telephone: _( q7 9 ) j,:,X7-Z} 3 34 Social Security No.: 3 - 150' - 3S Birth date: �4- f— s PLEASE LIST ALL BENEFICIARIES BELOW: (complete only if you are the retiree) NAME SOCIAL SECURITY NO. BIRTH DATE RELATIONSHIP �--// C413 -- c{S-3 q�v DATED this / 7 day of A FIANT (s' ture Parent/Guardian Signature SUBSCRIBED AND SWORN TO before me, a Notary Public, this / day of fir Notary PublicZZ ����FF PILO H O�i� My Commission Expires: ale :j: pTAR f (This affidavit is required annually by the Firemen's Pension and Relief Fund Board of Trustees and must be properMcuted alto 0 returned to the Fayetteville City Clerk, 113 West Mountain, Fayetteville, Arkansas, 72701 by January 31St of eachy'j, )`. Bt.�G (Revised 11/03) ��49+f •'• • • ' •• ,�1 . t working schedule Danny Farrar Balance prior to payroll 9 adjustment Sub Project Project# 62085 1 Retirement Benefit $ 96,368.04 2 Employer Match $ 6,480.88 3Interest $ 666.93 4 Future Supplement $ 450.00 Total $ 103,965.85 This is only a preliminary figure! The actual amount will be calculated after Final Pay Check 0 4/18/2006 CADocuments and Settings\ssmith.000\Local Settings\Temp\Calculation of Farrar Retirement Funds ti FAYETTEVU-I E FIREMEN'S. PENSION AND RELIEF FUND DEFERRED REIZRE lV1ENT OPTION PLAN (DROP) MEMBER ELECTION FORM I hereby` elect..the DROP as. my retirement benefit option from the pension plan in-place of normal._retirement:benefit`- I understand that in electing DROP, I have agreed-to the:following statements: * 1. The amount of the =DROP payments will be $ 6074 It per month.. . This amount includes all service and age -60 bonuses that I have earned.tot this date. This amount is 'the same as I :retired today. * 2.. I understand that the:monthly benefit that 'I will receive at the endof the DROP period-is:the-exact same amount stated in Item 1, regardless of<any pay raises I receiveor extra. years of service I: may work. 3..:I. understand. that at:the end of the-DROP period I will have the option°to receive the DROP`account as a lump. sum:or convert the DROP .account-to a monthly annuity account or any other method of.payment as 10f*..the current Rules and Regulations;of DROP.- 4. ROP4. I understand that the DROP account will remain in the pension fund until withdrawn in accordance with the Rules and Regulations of the DROP plan_ I do not have the:ability- to. withdraw from the DROP account until the time of my departure•. 5. I have elected to begin the DROP on i'1 A4 m2ooq DROP will end at the earlier of when I resign or (5 years from the above date, unless authorizations to participate in DROP shall-be specifically extended by the Arkansas Statutes). .6. I understand that neither the pension fund nor the Department has given any tax advice concerning the way the DROP account is taxed. I have, or will consult, my own tax advisor for this information. 7. I have read the Rules and Regulations pertaining to DROP. *Two exceptions to these rules: Age 60 bonuses (for members with over 25.years of service when they go onto DROP) .`,begin at age 60 whether on DROP or not; raises given to reur�ees�aare also given to DROP participants. Me S' Date Spouse Signature Date Plan Representative c Date. Fayetteville Firemen's Pension and Relief Fund Deferred Retirement Option Plan (DROP) Member Election Form Beneficiary Design"on , 41111 Member SSN DOB Address rI City I. state Zip h eres4 . J 30 Y15 2t3 1/- 26-62 Spouse SSN DOB Years of Service Date of EmpfayrnentAMID Designation of Weneficiary I hereby designate the following beneficiary to receive any benefits from the DROP plan if 1 die prior to my termination of empb r rc c�J FE Relationship © - a-9- 0 �Ign, of Member Date COMPLETE THIS SECTION ONLY IF SPOUSE IS NOT SELECTED AS BENEFICIARY If Spouse is not selected as beneficiary please select one of the following: I certify that to the best of my knowledge, the above-named member Is single or that his spouse cannot be located. Signature of Plan Representative or Notary Date I certify that 1 have agreed with my spouse on the selection of the above named beneficiary or beneficiaries, understand that N I am not named beneficiary, I will not be entitled to benefits under the Plan. Signature of Spouse Date I certify that 1 have witnessed the above spouse's signature. Signature of Plan Representative or Notary Date n .o To: Marion Doss, Assistant Fire Chief From: Battalion ChiefDanny Farrar 04-19-2004 Drop Retirement Please enroll me in the Drop retirement program effective 04-13-04. GENERAL FIRE PENSION Prepared: 4/23/2004 Name: Danny Farrar Date of Election: 05/01/04 Emp # 156 .SS# 431-15-3465 DOH: 8/17/1981 termed 5/9/83, rehired 11/18/95. Repaid contr flume not emp Yrs Srv: 20 Hourly Rate: . 15.961 Hours Base: 3,272.00 EMT/Hazmat Pay: Annual Salary 52,224.39 Annual Benefit (at 90% of salary) 477001.95 1\12 of Annual Benefit 31916.83 Additional yrs beyond 20: 0 $20.00 0.00 Monthly benefit 39916.83 Daily benefit 128.77 Ulei 7