24 CAR pt. 20, Appendix B. Attachment 2 - Arkansas Fire and Police Local Plans Deferred Retirement Option Plan (DROP): Member Election Form

Arkansas Fire and Police Pension Review Board Attachment 2 ARKANSAS FIRE AND POLICE LOCAL PLANS DEFERRED RETIREMENT OPTION PLAN (DROP) MEMBER ELECTION FORM I hereby elect the DROP as my retirement benefit option from the pension plan in place of the normal retirement benefit. I understand that in electing the DROP I have agreed to the following statements: 1. * The amount of the DROP payments will be $ per month. This amount includes all service and age 60 bonuses that I have earned to this date. This amount is the same as if I retired today. 2. * I understand that the monthly benefit that I will receive at the end of the DROP period is the exact same amount stated in item 1, regardless of any pay raises I receive or extra years of accrued service. 3. I understand that at the end of the DROP period I will have the option to receive the DROP account as a lump sum or convert the DROP account to a monthly annuity amount. 4. I understand that the DROP account will remain in the pension fund until I leave the department. I do not have the ability to withdraw from the DROP account until I terminate covered employment. 5. I have elected to begin the DROP on . The DROP will end at the earlier of when I terminate covered employment or ________________ (5 years from above date, or 10 years, for eligible pension funds). 6. I understand that neither the pension fund nor the department has given any tax advice concerning the way the DROP account is taxed. I have or will consult my own tax advisor for this information. * Two exceptions to these rules: Age 60 bonuses (for members with over 25 years of service at the time of enrollment in DROP) begin at age 60 whether still on DROP or not; raises given to retirees that are also given to DROP participants. Member Signature Date Plan Representative Date Attachment 2 (Continued) ARKANSAS FIRE AND POLICE LOCAL PLANS DEFERRED RETIREMENT OPTION PLAN (DROP) MEMBER ELECTION FORM DESIGNATION OF BENEFICIARY I hereby designate the following beneficiary to receive any benefits from my DROP account if I die prior to my termination of covered employment: Date Signature of Member Please select one of the following: I certify that to the best of my knowledge, the above named Member is single or that his spouse cannot be located. Date Signature of Plan Representative Or Notary I certify that I have agreed with my spouse on the selection of the above beneficiary or beneficiaries. I understand that if I am not the named beneficiary, I will not be entitled to benefits under the plan. Signature of Spouse Date I certify that I have witnessed the spouse’s signature above. Date Signature of Plan Representative Or Notary