The Oregon state employee news., December 01, 1969, Page 8, Image 8

Page 8
DECEMBER, 1969
OREGON STATE EMPLOYEE NEWS
PERS Members:
If you w ant to place either 25% or
Remember, any employee w ho is a
50% of your retirement contributions
member of the PERS may complete part
into stocks, you must complete this form
'A ' of the form. Part 'B' may only be
and mail it to the Public Employees' Re­
completed by employees w ho w ere ac­
tirem ent Board, 1400 S.W. Fifth, Port­
tive members of the PERS on Jan. 1,
land, 97201, no later than Dec. 31. Extra
1968.
forms are available w here you work.
Form RS-A25-D
EMPLOYE’S NOTICE OF ELECTION
TO
PUBLIC EMPLOYES RETIREMENT BOARD
Employer’s Name:
___________________ '
__________
■ -
Employe’s N a m e __________________________________________________________________ N u m b e r___________________
Employe’s Address —C__________________________________________________:
A
B
_
Effective w ith the calendar year following the date shown below, I wish to participate in the Variable Annuity
Program as follows:
I
□ I hereby elect to place 25% of the retirem ent contributions that are w ithheld from my paycheck into the V ariable
A nnuity Account.
Q
Ï YxereVcy e le c t t o p la c e 50*7c o f tine r e t i r e m e n t c o n t r ib u t io n s t b a t a r e w i t h h e l d fr o m
m y p a y c h e c k in to t h e V a r i a b l e
A n n u i t y A c c o u n t.
In addition to the above, I hereby elect to place 10% of my account balance as of my original participation'date w ith
the Variable A nnuity Program for the following num ber of years: (This election m ay be made at any tim e but once
made is irrevocable.)
□ 1 yr.
□ 2 yrs.
□ 3 yrs.
□ 4 yrs.
□ 5 yrs.
This amount, plus the amount that I have elected to place into the Variable Annuity Account from my paychecks,
should be credited to my account for the purpose of purchasing a Variable Annuity.
I UNDERSTAND THAT IN ORDER TO MAKE THIS ELECTION ON MY PAST CONTRIBUTIONS, I MUST ELECT
TO PUT EITHER 25% OR 50% OF MY MONTHLY CONTRIBUTIONS INTO THE VARIABLE ANNUITY ACCOUNT.
I ALSO UNDERSTAND THAT THESE ELECTIONS ARE IRREVOCABLE AND THAT I HAVE READ THE STAT­
UTORY PROVISIONS ON THE REVERSE SIDE OF THIS FORM.
Date .............¡1,__:_________________L-i S ig n a tu re __ ________ ________
Witness ____i______ ______________ _____________________ __________ ■
_____ -
Date
■
'_____ ■
.___________ ,______
'
To he acceptable, this form must he witnessed.
IMPORTANT
PLEASE READ CAREFULLY, as your action in this matter will affect your benefits at the time of your retirement.
Investment in stocks will be made by the Oregon Investment Council. Individual members may not select the specific
stocks to be bought or sold. Your interest in the fund w ill depend on the market. If the market goes up, your in­
vestment will improve. If the market goes down, your investment will suffer. Over a period of years, it is assumed
that there will be both upswings and downswings in the market.
A member may elect at any time to participate in the plan. Therefore, a member may elect to put nothing in stocks
at this time but may wait until 1971 or some later date before starting to participate. Money will start to be put into
equities in the January immediately following election. A member who starts with 25% of his money in equities may
at some following year increase to 50%. BUT a member cannot reduce or cancel his election to participate in stocks.
Please give this subject study before making your decision.
THIS ELECTION WILL NOT BECOME EFFECTIVE UNTIL THE 1st OF JANUARY FOLLOWING THE DATE ON
WHICH IT HAS BEEN FILED WITH THE PUBLIC EMPLOYES RETIREMENT BOARD, 1400 S. W. FIFTH PORT­
LAND, OREGON 97201.