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Get Leave Of Absence (loa) - The Public Employees Benefits Agency

) This form is to be provided to the Public Employees Pension Plan (PEPP) within 90 calendar days of the member s return to work from a leave of absence. Once the 90 day period lapses the member has no further option regarding the leave of absence. If the member elects to contribute to PEPP for the period of leave, contributions must begin within 90 calendar days of the member s return to work (refer to Section B). SECTION A: MEMBER INFORMATION (Please print) PEPP Member Number Mailing Addre.

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