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