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413.2E1 Resignation and Request for Retirement Assistance

Code No 413.2E1

RESIGNATION AND REQUEST FOR RETIREMENT ASSISTANCE

    I, _____________________________, born on _________________, hereby submit my resignation effective at the end of the ______ school year to the Board of Directors of the Grinnell-Newburg Community School District and elect the early retirement assistance benefits available to non-certified employees in the Grinnell-Newburg Community School District.  This resignation is subject to the acceptance of my application for early retirement assistance benefits.

Print Full Name __________________________________________________

Signed ___________________________________ Date _________________

The resignation and request for early retirement assistance was accepted by the Board of Directors on the _____ day of _________________, 20__, by action as noted in the minutes of the Board.

                _______________________________________________
    
            Secretary of Board of Directors
    
            Grinnell-Newburg Community School District

Approved: 11/9/16
Reviewed: 12/14/22

Grinnell-Newburg Community School District, Grinnell, Iow