R-287 - 10/28/1980 - IMRF - Resolutions =11,4 Ity.
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10E14),77-
ILLINOIS MUNICIPAL RETIREMENT FUND
IN s,...,,4.1...er nrAe.Cri.catio, !Ihrtf"..5.,..',E.:ii
. . OMITTED SERVICE CREDIT AUTHORIZATION
(See instructions on reverse sidei
Social Security Number
; /...._ Charles ii'. DeWitt _324-.3.0-8873
, Member ;,:!..ress Present Position
1 . 5 Lariat Lane Lemont, IL 60439 Insvectqr _
En-..,:c.,e•',..vne Employer Number
Village of Oak BroolLA2:C21a=_k5ZZ____'___
Certification by Authorized Agent .
I certify that earnings for the above named member shown in the following statement are in agreement with
the governmental unit's payroll rec:.-dS.
Ean........ •tirtel',.1221tntit21.,..L.....„214 19......_ 19...j_ 4 .'.
• January
42000
— 1 . i
f ,.. .
Febr;:ary ' ! . 252.00 . 420:00 I ,
March • 462.00 : 429_t90
OuarterlyTotal - 714.0U-7-T:i6o,cto .:. . . ..,. .
April • '' 434.00 ' 420.00 1 •
May 672.00 . _6.30.00 1
_
June ' 504.00 420.00 I
0eryTataI
_.. 1 610. I _ __ _____*_-___;__________
July • 122.00 ______------
[Aug r ust i .. 392.00 ' 462.00 ' •
Sep,tember ! 434.00 I 210.00
loctotieOreanerly Total 1.148.00 ! 1,120 00 !
i____
511.00
1 • . ,
ifslovember ' 525.00
' 1 ..: . . . •
. . . i
LI.7,eci:mber .420.00
: Quarter, Total 1 4 6 00 -
.
j
Grand Total ,.
i___ ....314 (5:1 JQQ_
' E .61.med,...14_4(ea
• Date . Oture of Authorizt Agent •
•
Resolution by Governing Body •
•
WHEREAS. earnings for the above named member should have been but were not reported to the Illinois Municipal
Retirement Fund for participation for 1 years and 8 months;
RESOLVED.that it is the finding of this Village of Oak Brook • that: •
Name of Governing BO* '
1. The member was employee in a position normally requiring the performance of duty during 600'bows or more pet. .
Year.during the years and months shown above; '
2. None of the service of the member during these years and months was in a probationary position of tour month .
or less:
3 The member is currently employed in a participating position:and
FURTHER RESOLVED. that the governing body agrees to accept theobligetion due MOW for employer contributions with
interest thereon payable through future employer contributions rind to accept the charges for employer and employee social
security taxes if such taxes have not-been paid on the omitted service timings.
FURTHER PESOLNED. that the authorized clent is hereby authorized 01,Vi itneeted to rne a certified copy of this -
resolution and all other pertinent forms and documents With the iiiinois Municipal Retirement Fund.
Certification by Clerk or Secretary of Governing Body
I. Marianne Lakosil _ ___ _______,the., Village Clerk -......_of . .
Name Clerk or Secretary
Village of Cok Fir.oak : .do hereby certify that I am the'
• Nam:,or d.:mei••••,-11:,!it
keer-.:••• of its records and that the forogou,? ,s a true and correct copy of n resolution duly adopted by its governing
t.:.•!...at a meeting hold on the_2.S.tC day o:
,....
.1.. . ,.... .' \-•
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