Hawaii Pts Enrollment Form PDF Details

The Hawaii PTS Enrollment Form is a vital document for Part-Time, Temporary, and Seasonal/Casual Employees of the State, signaling the commencement of their deferred compensation retirement plan. This comprehensive form requires careful completion, as it covers several critical sections including personal identifying and employment information, beneficiary designation, additional employment details, and a certification section that demands the employee's signature to attest to the accuracy of the information provided. It emphasizes the importance of thoroughness in filling out the form, as any failure to provide complete and correct information might not only delay the distribution of benefits but could also result in financial penalties or back taxes due to non-compliance with the Internal Revenue Code. Furthermore, the form includes essential notes for employees who might be simultaneously employed in other state jobs or are retirees receiving benefits, highlighting the need for clear communication to avoid issues with payroll deductions. The document also aligns with the Americans with Disabilities Act of 1990, ensuring accessibility for individuals requiring special needs or auxiliary aids. As the initial step towards securing a deferred compensation retirement plan, the form represents a critical pathway for workers to ensure their financial stability post-employment, mandating a 7.5% deduction of gross wages for the retirement plan, while clarifying that contributions towards Social Security are not made, but Medicare contributions are expected.

QuestionAnswer
Form NameHawaii Pts Enrollment Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesstate of hawaii pts deferred compensation retirement plan, LEEWARD, retiree, CFP

Form Preview Example

STATE OF HAWAII

PTS DEFERRED COMPENSATION RETIREMENT PLAN

for Part-Time, Temporary, and Seasonal/Casual Employees of the State

ENROLLMENT FORM

Please type or print in ink. Complete ALL information. Failure to complete and return this form may delay or prevent receiv- ing your distribution check after you separate from service.

Send your completed form to:

National Benefits Services, LLC, P.O. Box 6980, West Jordan, UT 84084

SECTION I – IDENTIFYING/EMPLOYMENT INFORMATION

NAME (LAST, FIRST, MIDDLE INITIAL)

ADDRESS

CITY

STATE ZIP

HOME PHONE

HI

SOCIAL SECURITY NUMBER

DATE OF BIRTH

M

 

 

F

 

 

 

DEPARTMENT

 

 

UNIVERSITY OF HAWAII

DIVISION/SCHOOL

LEEWARD COMMUNITY COLLEGE

POSITION TITLE(S)

SECTION II – BENEFICIARY INFORMATION (List person to whom you wish to leave your money in case of your death.)

NAME (LAST, FIRST, MIDDLE INITIAL)

RELATIONSHIP

SOCIAL SECURITY #

 

 

 

 

ADDRESS

CITY

STATE

ZIP

 

 

 

 

SECTION III – OTHER EMPLOYMENT INFORMATION

1)

Are you employed in any other State job(s)?

Yes

No

 

If YES, with what department(s)? _________________________________

 

 

 

a) Do these other job(s) provide you membership in the State Employees’

Yes

No

 

Retirement System (ERS)?

 

 

 

2)

Are you an ERS retiree collecting monthly retirement benefits?

Yes

No

 

 

IMPORTANT: If you answer YES to Questions #1a or #2 above, be sure to notify your employer immediately to prevent problems with payroll deductions related to the PTS Deferred Compensation Retirement Plan.

The Plan Booklet can be made available to individuals who have special needs or who need auxiliary aids for effective communication (i.e., large print or audiotape), as required by the Americans with Disabilities Act of 1990. For more information, please call CFP/LSW at 596-7006 (neighbor islands may call toll-free at 1-800-600-7167).

SECTION IV – SIGNATURE (CERTIFICATION SECTION)

I certify that the above information is accurate. I understand that any incomplete/inaccurate information may result in back taxes and/or penalties imposed by the Internal Revenue Code. A copy of the PTS Deferred Compensation Retirement Plan Employee Information Booklet has been given to me. I understand that I will not contribute to Social Security, but will contribute to Medicare. I understand that 7.5% of my gross wages shall be deducted from each paycheck and deposited into the PTS Deferred Compensation Retirement Plan.

EMPLOYEE’S SIGNATURE

DATE

PTS Enrollment Form Rev. 01/10

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PTS completion process clarified (step 1)

2. Given that the last array of fields is complete, you'll want to add the needed specifics in SECTION II BENEFICIARY, RELATIONSHIP, SOCIAL SECURITY, CITY, STATE ZIP, Are you employed in any other, If YES with what departments a Do, Retirement System ERS, Are you an ERS retiree collecting, Yes Yes Yes, No No No, and IMPORTANT If you answer YES to allowing you to go to the 3rd step.

Part number 2 for filling in PTS

Concerning Are you employed in any other and SECTION II BENEFICIARY, make sure you review things in this section. Both of these could be the most important fields in this file.

3. This third step is pretty simple, IMPORTANT If you answer YES to, and PTS Enrollment Form Rev - all of these empty fields is required to be filled in here.

PTS conclusion process shown (step 3)

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