Npers2430 Form PDF Details

At the heart of managing public employee retirement contributions in Nebraska lies the Npers2430 form, a crucial document that ensures the accurate recording of employment changes among state and county workers. Based in Lincoln, the Nebraska Public Employees Retirement Systems (NPERS) operates from an office on N Street, offering a direct line and even a toll-free number to cater to inquiries. This form is instrumental when a member's employment status changes due to several factors such as resignation, disability, retirement, or even a shift between employers. Specifically designed for instances where an employee's contributions to their retirement plan may be paused, like during seasonal work or a leave of absence, the Npers2430 form also covers the process for reporting final pay details and the reason for the employment termination. By complying with specific statutes, this form ensures that termination is duly noted within the appropriate timeline, thereby upholding the integrity of both the employee's and the employer's records. With clear guidelines for emergencies, like the issuance of an emergency warrant, and provisions for noting changes in employment status, the form is a vital tool for keeping retirement systems up-to-date. It encapsulates a broad spectrum of scenarios, including military leave and other various types of absence from work, underscoring its importance in maintaining accurate and current retirement account records for Nebraska's public employees.

QuestionAnswer
Form NameNpers2430 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesStCoNonCon npers form

Form Preview Example

 

1221 N Street, Suite 325, P.O. Box 94816

NPERS

Lincoln, NE 68509-4816

Fax 402-471-9493

 

402-471-2053 or 800-245-5712

Nebraska Public Employees

www.npers.ne.gov

R e t i r e m e n t S y s t e m s

Last

 

First

 

 

Middle

 

 

 

Plan Type

Name

 

 

 

 

 

Date of Birth

-

-

(Check One)

Social Security Number

-

-

 

Retirement Number

 

 

State

Address

 

 

City

 

 

State

Zip

 

County

Home Phone

Work Phone

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

State/County Non-Contributing Member Form

This form serves as official notification that a member has ceased employment. According to §23-2301 (County) and § 84-1301 (State), termination of employment occurs on the date on which the state/county determines that the member’s employer-employee relationship has dissolved. The employer shall notify NPERS of the date on which termination has occurred. This form is also used if there is any other interruption of a member’s retirement contributions, such as seasonal employment or a leave of absence.

Ceased Employment

Termination Date _____________________________________________________________

Date of Final Pay __________________________ Gross Final Pay $ ___________________

Emergency Warrant Issued?

Yes

No

 

 

 

Reason for Termination

 

 

 

 

 

Resigned

Deceased

 

Disability

Retired

 

 

Transfer from ___________________________ to ____________________________

 

Dismissed - If dismissed, is a grievance or appeal of the termination pending?

Yes

No

Leave or Intermittent Status

Last Pay Date ________________________________________________________________

Reason for Change in Status

 

 

 

Military Leave

Disability

Family Medical

Seasonal/Intermittent

Suspension

Other (explain) ____________________________________________________________

Anticipated Date of Return (if known) _____________________________________________

This certifies that the above information is correct to the best of my knowledge.

 

Agency/County Signature _____________________________________________

Date _______________________

Typed or printed name of Agency Contact _______________________________

Title _______________________

Telephone Number ______________________________________

 

NPERS2430 Rev. 09/05

BAR CODE

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Find out how to prepare Npers2430 Form portion 1

2. Right after this array of blank fields is filled out, go on to type in the suitable information in all these - Leave or Intermittent Status, Last Pay Date, Reason for Change in Status cid, cid Other explain, Anticipated Date of Return if, This certifies that the above, Date, Title, Telephone Number NPERS Rev, and BAR CODE.

Npers2430 Form completion process detailed (step 2)

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