Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to access the document and open it for editing.
2. In the Title field, list all elected and appointed officials who are active members of the Retirement System, ensuring to include only those with policy-making authority.
3. Enter the complete first and last name of each official in the Name field for proper identification.
4. Provide the last four digits of the official’s Social Security Number in the designated field for identification purposes.
5. Include the official’s Registration Number for identification in the respective column.
6. Specify the Standard Work Day in hours, ensuring it reflects between six to eight hours as this will be used for the calculation of days worked.
7. Indicate the Term Begins and Ends dates for each official, ensuring that both dates are specified and not left blank.
8. Select 'Y' for Yes or 'N' for No in the Participates in Employer’s Time Keeping System column depending on whether the official participates in the timekeeping system.
9. Fill in the Days/Month field based on the official's record of activities for the previous three months, indicating an average of days worked.
10. If the official is a Tier 1 member, check the corresponding box; otherwise, leave it unchecked.
11. Check the Not Submitted box if the official has not submitted a record of activities within the required timeframe.
12. Once completed, have the designated clerk sign the form, indicating the date of enactment.
13. Post the resolution on a public website or the official sign-board as required for at least 30 days.
14. After ensuring all fields are accurately filled, you can save changes, download, print, or share the completed form online.

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