The Plan’s Request for Evaluation of Employment Form must be completed in full if you would like a determination from your Area Administrative Office regarding whether the reemployment you are engaged in meets the Plan's definition of Suspendible Employment.

You may also use this form to request an advance determination regarding reemployment you are contemplating in the future. Included with this form is a document explaining the Plan’s Suspension of Benefit Rules.

Click the following for more details about the Plans Suspension of Benefit Rules:

If You Are Between Ages 60 and 65

If You are Ages 65 and Older

To help you understand what the Plan considers to be Suspendible Employment, the downloadable form provided below contains the four crucial questions that must be answered before a determination can be reached.

To download a Request for Evaluation of Employment Form, you will need Adobe® Acrobat® Reader™ on your computer:

Downloadable Form (Adobe® Acrobat® PDF™, 161K)

Once you download the form to your computer, you can print it, fill it in and mail it back to an Area Administrative Office. (You cannot send the form via e-mail.)

If you don't have Acrobat Reader installed, you can get the latest version of this free software by clicking the Adobe icon to the left. This takes you to the software download page at Adobe's web site.

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