Edit Form

Fill in a Valid Hawaii Pts Enrollment Template

The Hawaii PTS Enrollment Form is a crucial document for part-time, temporary, and seasonal employees of the State of Hawaii who wish to participate in the Deferred Compensation Retirement Plan. Completing this form accurately ensures that you can receive your distribution check without delays after separating from service. Don’t miss out on securing your financial future—fill out the form by clicking the button below.

Edit Form

Structure

For part-time, temporary, and seasonal employees of the State of Hawaii, the PTS Enrollment Form serves as a crucial gateway to the Deferred Compensation Retirement Plan. This form is not just a piece of paperwork; it’s a vital step in ensuring your financial security after your service ends. Completing this form accurately is essential; any missing or incorrect information could delay your distribution check. The form requires you to provide identifying and employment details, including your name, address, and social security number, as well as information about your department and position. Additionally, you’ll need to designate a beneficiary, someone who will receive your funds in the unfortunate event of your passing. There are also important questions regarding any other state employment or retirement benefits you may have, which could affect your contributions. Lastly, the form includes a certification section where you confirm the accuracy of your information and acknowledge your understanding of the plan’s contribution structure. Remember, this is a significant commitment, and taking the time to fill out the PTS Enrollment Form correctly will help safeguard your financial future.

Sample - Hawaii Pts Enrollment Form

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

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)?	Yes	No
	Retirement System (ERS)?
2)	Are you an ERS retiree collecting monthly retirement benefits?	Yes	No
2)

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

➤ PDF

File Attributes

Fact Name	Details
Purpose	The Hawaii PTS Enrollment Form is designed for part-time, temporary, and seasonal/casual employees to enroll in the Deferred Compensation Retirement Plan.
Submission Requirement	Completing and returning the form is mandatory. Failure to do so may delay or prevent the distribution of retirement funds after separation from service.
Beneficiary Information	Employees must provide information about a beneficiary, including their name, relationship, and address, to ensure proper distribution of funds in case of death.
Other Employment Disclosure	Employees are required to disclose if they are employed in other state jobs or if they are retirees collecting benefits from the State Employees’ Retirement System (ERS).
Governing Law	This form is governed by the Internal Revenue Code and the Americans with Disabilities Act of 1990, which mandates accessibility for individuals with special needs.

Please rate Fill in a Valid Hawaii Pts Enrollment Template Form

4.79

(Superior)

19 Votes

Discover Popular Templates

Ono Hawaiian Bbq Careers - Applying to Ono Hawaiian BBQ? Our application ensures all candidates are evaluated fairly, focusing on qualifications and experience.

When engaging in a real estate transaction, it is essential to utilize a Texas Real Estate Purchase Agreement form to avoid any ambiguities. This legally binding document outlines the terms and conditions of the sale, acting as a roadmap for both the buyer and seller. To facilitate a smooth process, you can find additional resources and fill out the form by visiting Texas PDF Forms.

Tdi Hawaii Form - Employers must submit wage information and employment details as part of their statement to facilitate the claim's processing.

Hawaii Llc Annual Fees - The requirement for legibly typed or printed information in black ink reduces the risk of processing errors.