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<p class="MsoNormal" align="center" style="text-align:center"><b>PERS Forms<o:p></o:p></b></p>
<p class="MsoNormal" align="center" style="text-align:center"><b>Salary Breakdowns (SBD) versus Salary Certification forms (Sal Certs)<o:p></o:p></b></p>
<p class="MsoNormal"><b><o:p> </o:p></b></p>
<p class="MsoNormal">Over the years there have always been some questions on the difference between the Salary Breakdown and Salary Certification forms and what they are used for. This has also caused confusion on how to complete these forms correctly.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">A <u>Salary Certification</u> has been historically used when the member has submitted their retirement or benefit application and PERS staff needs this information to correctly calculate the member's benefit.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><u>Salary Breakdowns (SBD)</u> have been historically used during an eligibility study to verify whether an employee has met the retirement plan's qualification criteria for a specific year. In general, an employee must work at least 600
hours in a year to qualify for both IAP contributions and retirement service credits for that year. A plan eligibility study is generally triggered by a specific event; the employee believes there may be a problem on their account, has requested a benefit
estimate or has requested a Data Verification. In these cases a SBD can be requested for specific year's the employee has worked for your agency. The SBD is used to verify the hours worked each month in the year being requested. More recently, PERS staff
has begun using the reported salary amounts during their preliminary review for Data Verification requests.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Electronic PERS reporting and recent legislation have impacted how PERS administers the plan requirements. Many old processes have been reviewed and updated. One such recent change is in how the SBD is to be completed.
<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">In the past, employers were asked to enter the hours worked and salary earned (but generally not paid) for each month the employee worked in the specific year being requested. The change is that, while you will still enter hours worked
for the month they were worked, you will enter the salary in the month it was actually paid.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Example: <o:p></o:p></p>
<p class="MsoListParagraphCxSpFirst" style="margin-left:.25in;text-indent:-.25in;mso-list:l0 level1 lfo1">
<![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]>In this scenario the employee was hired 2/15/2002.
<o:p></o:p></p>
<p class="MsoListParagraphCxSpMiddle" style="margin-left:.25in;text-indent:-.25in;mso-list:l0 level1 lfo1">
<![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]>The hours worked in February are entered into the "Hours" field for February.
<o:p></o:p></p>
<p class="MsoListParagraphCxSpMiddle" style="margin-left:.25in;text-indent:-.25in;mso-list:l0 level1 lfo1">
<![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]>However, the salary earned in February was paid in March, and is entered in the "Salary" field for March.<o:p></o:p></p>
<p class="MsoListParagraphCxSpLast" style="margin-left:.25in;text-indent:-.25in;mso-list:l0 level1 lfo1">
<![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]>Additionally, since both February and March salary was paid in March, the total salary for both months is entered in the "Salary" field for March.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Year: 2002<o:p></o:p></p>
<p class="MsoNormal"> Salary Breakdown data:<o:p></o:p></p>
<table class="MsoTableGrid" border="0" cellspacing="0" cellpadding="0" style="margin-left:5.4pt;border-collapse:collapse;border:none">
<tbody>
<tr style="height:13.95pt">
<td width="90" valign="top" style="width:67.5pt;background:#DDDDDD;padding:0in 5.4pt 0in 5.4pt;height:13.95pt">
<p class="MsoNormal" align="center" style="text-align:center">Pay Period End<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;background:#DDDDDD;padding:0in 5.4pt 0in 5.4pt;height:13.95pt">
<p class="MsoNormal" align="center" style="text-align:center">Pay date<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;background:#DDDDDD;padding:0in 5.4pt 0in 5.4pt;height:13.95pt">
<p class="MsoNormal" align="center" style="text-align:center">Monthly Wages<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;border-top:double windowtext 1.5pt;background:#DDDDDD;padding:0in 5.4pt 0in 5.4pt;height:13.95pt">
<p class="MsoNormal" align="center" style="text-align:center">Month<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;border:none;border-top:double windowtext 1.5pt;background:#DDDDDD;padding:0in 5.4pt 0in 5.4pt;height:13.95pt">
<p class="MsoNormal" align="center" style="text-align:center">Hours<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;border:none;border-top:double windowtext 1.5pt;background:#DDDDDD;padding:0in 5.4pt 0in 5.4pt;height:13.95pt">
<p class="MsoNormal" align="center" style="text-align:center">Salary<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border-top:double windowtext 1.5pt;border-left:none;border-bottom:none;border-right:double windowtext 1.5pt;background:#DDDDDD;padding:0in 5.4pt 0in 5.4pt;height:13.95pt">
<p class="MsoNormal" align="center" style="text-align:center">Contributions<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">12/31/2001<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">1/1/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">January<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">0<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">1/30/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">2/1/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">February<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">80<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">2/28/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">3/1/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$1,200.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">March<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">176<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$3,700.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$222.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">3/31/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">3/29/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">April <o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">168<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">4/30/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">5/1/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">May<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">176<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$5,000.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$300.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">5/31/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">5/31/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">June<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">160<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">6/30/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">7/1/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">July<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">176<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$150.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">7/31/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">8/1/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">August<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">184<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$5,000.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$300.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">8/31/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">8/30/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">September<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">168<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">9/30/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">10/1/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">October<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">184<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$150.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">10/31/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">11/1/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">November <o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">168<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$5,000.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$300.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">11/30/2002<o:p></o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">11/29/2002<o:p></o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$2,500.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">December<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;border:none;border-bottom:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">176<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;border:none;border-bottom:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$0.00<o:p></o:p></p>
</td>
</tr>
<tr>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal"><o:p> </o:p></p>
</td>
<td width="90" valign="top" style="width:67.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal"><o:p> </o:p></p>
</td>
<td width="102" valign="top" style="width:76.5pt;border:none;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$23,700.00<o:p></o:p></p>
</td>
<td width="104" valign="top" style="width:78.3pt;border:none;border-bottom:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal">TOTAL<o:p></o:p></p>
</td>
<td width="62" valign="top" style="width:.65in;border:none;border-bottom:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="center" style="text-align:center">1896<o:p></o:p></p>
</td>
<td width="87" valign="top" style="width:65.0pt;border:none;border-bottom:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$23,700.00<o:p></o:p></p>
</td>
<td width="96" valign="top" style="width:71.8pt;border-top:none;border-left:none;border-bottom:double windowtext 1.5pt;border-right:double windowtext 1.5pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" align="right" style="text-align:right">$1,422.00<o:p></o:p></p>
</td>
</tr>
</tbody>
</table>
<p class="MsoNormal"> <o:p></o:p></p>
<p class="MsoNormal">Due to these changes, starting September 1, 2012, we will no longer accept salary breakdown and salary certification information submitted on forms other than the ones we provide to you.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">If you have questions, please contact the DAS Centralized PERS Services Team.
<o:p></o:p></p>
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