Csc 1 Form PDF Details

In the intricate landscape of public service employment, the CSC 1 form emerges as a critical document primarily utilized within the framework of Section 211 of the New York State Retirement and Social Security Law. This detailed application facilitates a process through which public employers can request a pension waiver, enabling retirees to re-enter public service under specific conditions without forgoing their pension benefits. The form delineates a clear distinction from Section 212 employments, setting a unique criterion that excludes disability retirees. It requires comprehensive information from the requesting employer and the retiree, encompassing personal details, the nature of the proposed employment, and the anticipated duration of the waiver, which caps at a maximum of two years. Notably, the form mandates a demonstration of due diligence in the recruitment process, necessitating evidence of a bona fide effort to fill the position with a non-retired individual and the rationale behind the necessity or preference for a retiree. Additionally, it underscores the importance of a retiree's qualifications and the alignment of their re-employment with the interests of government service. For retirees seeking re-employment within a year of their retirement, the form introduces further stipulations to prevent a direct transition back into their previous roles without a significant change in duties. The procedural rigor echoed in the CSC 1 form emphasizes a balanced approach, aiming to leverage the expertise of retirees while safeguarding against potential conflicts of interest or undue advantage. Moreover, it embodies an element of accountability through the inclusion of certification sections for both the appointing authority and the retiree, underscoring the serious legal implications and the commitment to accuracy and honesty in the application process.

QuestionAnswer
Form NameCsc 1 Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other names New York State Retirement and Social Security Law 211

Form Preview Example

Albany, NY 12239

SECTION 211 APPLICATION

Application for Pension Waiver Pursuant to Section 211 of the

New York State Retirement and Social Security Law

CSC-1 (9/19)

NOTE: THIS FORM IS TO BE COMPLETED IN DETAIL AND SUBMITTED BY THE APPOINTING AUTHORITY. USE THIS FORM ONLY FOR EMPLOYMENT UNDER SECTION 211. DO NOT USE FOR EMPLOYMENT UNDER SECTION 212. DISABILITY RETIREES ARE NOT ELIGIBLE FOR EMPLOYMENT UNDER SECTION 211.

 

Requesting Employer

 

 

 

 

 

 

Retiree’s Last Name, First Name, and Middle Initial

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer’s Mailing Address, Street, City, State, Zip

 

 

Retiree’s Mailing Address, Street, City, State, Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title of Position to be Filled by Retiree

 

 

 

Job Code (State agency use only)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Jurisdictional Classification of Position

 

 

 

Appointment Type

 

Duration of Waiver

Anticipated

 

A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Two-Year Maximum)

Annual

 

SECTION

 

Non-Comp. (

 

Policy Influencing Non-Policy Influencing)

 

 

 

Permanent

 

 

 

 

 

Earnings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Temporary

 

From

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Exempt

Competitive

Unclass.

Labor

Other

 

 

 

Provisional

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

To

 

 

 

 

 

 

Name of Previous Public Employer

 

 

 

Retirement System

 

 

 

 

 

 

 

 

 

 

Will the retiree be employed by his or her former employer, as that term is defined in Retirement and Social Security Law

 

(RSSL) §210?

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, the signatories will ensure compliance with the RSSL §211 Earnings Limitations referred to on page 4 of this

 

 

application.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retiree’s SSN

 

 

 

 

Retiree’s Date of Birth

 

 

 

 

Retiree’s Retirement System Number

 

 

 

 

 

 

Date of Retirement

 

Type of Retirement

Service

Disability

 

Anticipated Annual Pension Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

IMPORTANT: Has the retiree previously been granted a waiver under section 211 prior to October 7, 2008

 

 

Yes

 

No

 

If yes, when?

From

To

 

 

 

 

 

For what position?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IF YES, COMPLETE NOTE 1 and NOTE 3. IF NO, COMPLETE NOTE 2 and NOTE 3.

 

 

 

 

 

 

 

NOTE 1 – Pre-October 7, 2008 criteria (attach all documentation and additional sheets as necessary)

 

 

1. Fully describe the duties of the position for which the waiver is requested.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Fully explain the minimum qualifications of the position. Official civil service qualifications must be used for

 

 

 

recruitment.

NOTE: Where minimum qualifications are established by the agency (unclassified service, exempt

 

 

 

and other) they must be included in the recruitment advertising.

 

 

 

 

 

 

 

 

 

B

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

A formal recruitment effort must be conducted to determine that there are no other qualified non-retirees available for

 

3.

 

 

recruitment. If recruitment efforts are fruitless, such as hard to recruit or unique appointment process, you must

 

 

 

provide a detailed explanation.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Otherwise, check that you have completed and provided the following documentation:

 

 

 

 

 

Fully describe your recruitment efforts such as, conspicuous posting of the employment opportunity within the organization, public advertising, and evidence that the New York State Job Service has been contacted in the recruitment effort.

Aside from 211 experience, if any, indicate if retiree has unique skill sets and/or if the position requires unique skill sets.

YOU MUST post for a reasonable duration and explain how you determined the appropriate posting period. Fully describe where you posted as well as the expected volume of circulation. Consider factors such as salary of position and location when determining the duration of posting.

YOU MUST advertise for the salary you offer or explain why the salary is commensurate with experience. Attach a copy of the recruitment announcement and advertisement.

You must specify the results of your recruitment effort and supply details regarding candidate responses to advertisements, interviews, and available candidates.

SECTION B

CSC-1 (8/16)

Page 2 of 4

5.Fully discuss how the individual is duly qualified, competent and physically fit to perform the duties. (Note that the retiree must be qualified to perform the duties of the position, and this fact must be affirmed by signing the Certification.)

6.Describe how employment of the retiree is in the best interest of government service.

NOTE 2 – Post-October 7, 2008 criteria (attach all documentation and additional sheets as necessary):

1. Is the retiree seeking re-employment within one year of retirement

Yes

No (If no, skip ahead to question #3.)

If yes, what is the date of retirement?

Title of position retired from:

2.If within one year of the date of retirement, the retiree is barred from having the same duties and responsibilities. Fully explain how retiree will have different duties and responsibilities than performed in the prior position.

3.Fully explain the minimum qualifications of the position. Official civil service qualifications must be used for recruitment. NOTE: Where minimum qualifications are established by the agency (unclassified service, exempt

and other) they must be included in the recruitment advertising.

4.YOU MUST select ONE of the following and provide detailed documentation and explanation that (attach additional sheets as necessary):

a) There is an urgent need for his or her services in such position as a result of an unplanned, unpredictable, and unexpected vacancy where sufficient time is not available to recruit a qualified individual and that such hiring shall be deemed as non-permanent rather than a final filling of such position. An explanation must be provided on the circumstances which created the unplanned, unpredictable, and unexpected vacancy for which a retiree is needed (for example, did the previous incumbent resign, transfer to another position, etc.) or that recruitment efforts are fruitless, such as hard to recruit or unique appointment process.

OR

b) I have undertaken extensive recruitment efforts to fill such vacancy and as a result thereof, have determined that there are no available non-retired persons qualified to perform the duties of such position. Documentation that the employer has undertaken extensive recruitment efforts to fill such vacancy must be provided. The documentation must support the fact that there are no available non-retired persons qualified to perform the duties of such position.

Check that you have completed and provided the following documentation:

Fully describe your recruitment efforts such as, conspicuous posting of the employment opportunity within the organization, public advertising, and evidence that the New York State Job Service has been contacted in the recruitment effort.

Aside from 211 experience, if any, indicate if retiree has unique skill sets and/or if the position requires unique skill sets.

YOU MUST post for a reasonable duration and explain how you determined the appropriate posting period. Fully describe where you posted as well as the expected volume of circulation. Consider factors such as salary of position and location when determining the duration of posting.

YOU MUST advertise for the salary you offer or explain why the salary is commensurate with experience. Attach a copy of the recruitment announcement and advertisement.

You must specify the results of your recruitment effort and supply details regarding candidate responses to advertisements, interviews, and available candidates.

CSC-1 (8/16)

Page 3 of 4

 

5. Fully describe, in detail, your future recruitment plan to fill this position on a permanent basis with a qualified non-

 

retiree.

 

 

 

 

 

 

 

 

 

 

6. Fully describe how the individual is duly qualified, competent and physically fit to perform the duties of such position.

 

 

 

 

 

 

7. Fully explain how employment of the retiree is in the best interest of government service.

 

 

 

 

 

 

 

 

 

 

 

NOTE 3

 

 

 

 

 

 

 

Certification By Appointing Authority

 

A

I, the appointing authority, hereby affirm under penalties of perjury as provided for in Article 210 of the Penal Law, that the statements

made herein (and on attached papers) are true and correct, to the best of my knowledge, and that I have determined that the

SECTION

applicable criteria prescribed for approval under section 211 have been satisfied and appropriate documentation has been provided.

 

 

 

 

 

 

 

 

 

* Signature of Appointing Authority

Date

 

Print Name and Title

Telephone Number

 

*NOTE: Only persons with the lawful authority to appoint may certify this form. Appointing Authorities comprised of

 

boards or commissions must attach a current resolution which certifies the information requested in NOTE 3.

 

 

Certification By Retiree

 

 

I hereby affirm that under penalties of perjury as provided for in Article 210 of the Penal Law, that the statements made in

B

this application are true and correct, to the best of my knowledge, and if applicable, I acknowledge that I am barred from

performing the same duties and responsibilities that I performed in the position from which I retired for one year following

SECTION

my retirement.

 

 

 

 

 

 

 

 

 

 

 

 

Fully describe how prior duties of the position differ (attach additional sheets as necessary).

 

 

X

 

 

 

 

 

 

Signature of Retiree

 

 

 

Date

 

SECTION

E-mail Notification – Distribution of final determination will be sent through e-mail. Please provide current e-mail addresses.

 

 

 

 

 

 

Requesting Employer

 

 

E-mail Address

 

 

 

 

 

 

Retiree

 

 

E-mail Address

 

 

Retirement System

 

 

E-mail Address

 

 

Disbursing Officer

 

 

E-mail Address

 

 

 

 

 

 

For Civil Service Commission Operations Use Only

 

D

Final Determination

 

 

 

Comments/Recommendations

 

Approve From _____________To _______________

 

 

SECTION

 

 

Disapprove

 

 

 

 

 

 

 

 

 

 

 

 

X

 

 

 

 

 

 

Signature

 

 

 

Date

 

CSC-1 (8/16)

Page 4 of 4

GENERAL INFORMATION

Section 150 of the Civil Service Law provides, generally, that a retiree's pension shall be suspended during periods of reemployment in the public service. Section 211 of the Retirement and Social Security Law provides for the reemployment of a retiree under certain circumstances without loss or diminution of pension. This Law has several requirements which are reviewed by the State Civil Service Commission in reaching a determination. Section 212 of the Retirement and Social Security Law provides for the reemployment of a retired public employee, with an earnings limitation (currently $30,000), without loss or diminution of pension. However, there are no earnings limitations on or after the calendar year in which the retiree attains age sixty-five. Information on current limitation and procedures for approval is available from the New York State Retirement System. http://www.osc.state.ny.us/retire/

Commission approval is not approval of an appointment. For agencies subject to the Civil Service Law, the appointment must meet the requirements of all applicable laws, including the Civil Service Law, rules and regulations, and policies for that agency. Questions about civil service appointments should be directed to the agency having jurisdiction. For further information regarding the New York State Civil Service Commission please visit our web site at http://www.cs.ny.gov/commission/.

EARNINGS LIMITATIONS

If the retiree returns to work for a former employer, the earnings may be subject to earnings limitations. The term "former employer" means the state or a political subdivision, public corporation, school district, board of cooperative educational services, county vocational education and extension board, or an agency or organization which contributes as a participating employer in a retirement system or pension plan administered by the state or any of its civil divisions, which directly paid the salary or compensation of a retired person at any time during the two years immediately preceding his/her retirement and who paid the salary on which the retiree's retirement allowance is based.

Please see Retirement and Social Security Law §211 for details regarding these earning limitations.

Return form to:

Municipal Service Division

New York State Civil Service Commission

Albany, New York 12239

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1. To begin with, once filling in the Csc 1 Form, start with the area containing subsequent blanks:

Writing part 1 in Csc 1 Form

2. After this section is done, you should insert the essential specifics in N O T C E S, Fully describe the duties of the, Fully explain the minimum, recruitment and other they must be, NOTE Where minimum qualifications, B A formal recruitment effort, recruitment If recruitment efforts, Otherwise check that you have, Fully describe your recruitment, Aside from experience if any, unique skill sets, YOU MUST post for a reasonable, Fully describe where you posted as, YOU MUST advertise for the salary, and advertisements interviews and so you can go further.

Step # 2 of completing Csc 1 Form

3. Through this stage, take a look at retiree must be qualified to, Describe how employment of the, NOTE PostOctober criteria, Is the retiree seeking, Yes, No If no skip ahead to question, If yes what is the date of, If within one year of the date of, Fully explain the minimum, recruitment and other they must be, and NOTE Where minimum qualifications. These will need to be completed with highest precision.

Csc 1 Form conclusion process explained (part 3)

In terms of If within one year of the date of and NOTE Where minimum qualifications, ensure that you review things here. The two of these are certainly the most important fields in this file.

4. Completing recruitment and other they must be, YOU MUST select ONE of the, sheets as necessary, a There is an urgent need for his, I have undertaken extensive, b there are no available, Check that you have completed and, Fully describe your recruitment, Aside from experience if any, unique skill sets, YOU MUST post for a reasonable, Fully describe where you posted as, and B N O T C E S is essential in this fourth form section - make sure to devote some time and take a close look at every empty field!

Filling in section 4 in Csc 1 Form

5. This last stage to submit this form is pivotal. Be sure to fill out the displayed blanks, like Fully describe where you posted as, YOU MUST advertise for the salary, and advertisements interviews and, before submitting. Failing to do this could give you an incomplete and possibly invalid form!

Stage # 5 of filling in Csc 1 Form

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