HomeMy WebLinkAbout2004-R-12A RESOLUTION AUTHORIZING AN AGENT
TO ACCEPT PENSION LIABILITY ON
BEHALF OF ~__,-~'-~ c~
~ (EMPLOYER)
PUBLIC EMPLOYEES' RETIREMENT FUND
t43 West Market ~t
Indianapolis, IN 4320~2809
(317) 233-4162
Account Number
S) (Title)
/ ~--~"Jc'~J '~{)- ~~1e~4~ ~{'~'~' be, and hereby is, fully authorized and empowered to act on behalf of
/ ~ (Political Sub..division)
and in the name of (/~ ~-~ c>~ ~."~-~t_~r.~ ~,,~,¥,4. as its agent to accept pension liability, pursuant to
- (P~i Subdivision~
lC 5-10.2-3-1 and further to execute and deliver documents related to the Public Employees' Retirement Fund (PERF) of
ndiana. This resolution will remain in full fome and effect until modified or rescinded by subsequent resolution and receipt
hereof in writing by the Director of PERF.
, ',/ /
~ named and not designated by job title, unless such position is an elected position, such as Clerk-
rreasurer,
rhis Resolution supersedes any other Resolution you have on tile. Therefore, please include all__agents past and current who will
~e authorized to accept pension liability.
Ne require the original signatures of your Governing Body. Copies are not acceptable.
ALrrHORIZIIqG AGENT FOKM KEV. 7/26/1999