Crews, Jeremy New Emp AcknowledgementCITY OF OKEECHOBEE
MUNICIPAL FIREFIGHTERS PENSION FUND
NEW EMPLOYEES' ACKNOWLEDGEMENT
OF PLAN MEMBERSHIP FORM
TO: Board of Trustees
1. I hereby acknowledge all the terms and conditions of the City of
Okeechobee Municipal Firefighters' Pension Fund, and
S
2, I have been furnished with a Summary Plan Description.
gnu
of Member
NEW EMPLOYEE INFORMATION:
DATE OF HIRE: ' 18 26 8
DEPARTMENT:
JOB TITLE:
STARTING SALARY: $ 31,o)510 0 A NUALLY
LEGAL NAME: c eremu A kin ('xgws
G.S- to
Date
DATE OF BIRTH:
SOCIAL SECURITY NO:
ADDRESS:
Board of Trustees: Date Accepted:
By:
❑Emailed to Pian Administrator ❑Original to Personnel Flle ❑Employee Copy with Plan
Summary attached
on: by:.