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Get OH PEDACKN 2017-2024

to be completed if you are an individual who begins providing personal services to a public employer on or after Jan. 7, 2013 but are not considered by the public employer to be a public employee (e.g., you are an independent contractor) and will not have contributions made to OPERS. This form must be completed not later than 30 days after you begin providing personal services to the public employer. STEP 1: Personal Information Social Security Number Date of Birth Month Day Year First Name.

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