Date of Birth - - Retirement Calc #

  Service Time years and  months          Approximate Average Salary $      

     
  Group 1 (All Regular Employees)                    Vet Status Not a veteran    Veteran
  Group 4 (Police Officers and Firefighters)

Option C Beneficiary*        Date of Birth  - -
Exclude from estimate

*Only your spouse, former spouse who has not remarried, child, mother,
father or sibling may be designated under Option C.