Name   SSN:    
The employee must work for the District a minimum of 10 years in a leave-qualifying capacity to qualify for the retirement leave incentive.
The employee must qualify for immediate retirement under the provisions of the Utah State Retirement guidelines.  
The maximum number of days the District will provide the retirement -leave incentive for is 120 days.  The cash settlement of  
unused accumulated leave will be paid based on the employee's regular salary schedule position in their final contract year   
step and lane value excluding any extensions or salary modifications based upon the following scale.  
Days 1-50 15% Days 51-90 20% Days 91-120 25% *Before 7/1/05 All @25%  
      After 07/01/05 New Scale  
Date of Employment-      
Last Working Day- Assumption      
Salary Contract Days        
Certified Teacher Elementary Principal High School Principal District Office All Staff  
183 205 220 225  
Calculation   (Maximum Available 120) 1-50 Days @ 15%  
Contract Salary Daily Rate Total Accumulated Sick Leave 51-90 Days @ 20%  
Lane 4 Step 25     91-120 Days @ 25%  
  $0.00   $0.00  
(Step & Lane Only, No extra)        
*Note Policy will allow this yearly stipend to be paid all on the June 15th Career Ladder Payroll  
     Only Certified Staff Eligible for Early Retirement~ Below This Line    
$3,000 per year Waive Max       
    Yearly Total Monthly Cost to District  
(Policy Sept. 1 to Aug. 31)        
(Three years our until 65th birthday or when Medicare Eligible)   $0.00  
(Certified Employees Only)~        
Early Retirement Stipend  (Certified Teachers Only) (N/A)$1,500 per year for 3 yrs. or until employee is eligible for Medicare.    
Yearly Stipend (FY20)        
Yearly Stipend (FY21)        
Yearly Stipend (FY22)        
Stipend may be paid on the 6/15/?? CL Payroll or spilt over June, July, and August payrolls.    
Notes:   Sick Leave $0.00 10-027--0050-1000-230
    Insurance $0.00 10-027--0050-1000-240
    Early Retirement $0.00 10-027--0050-1000-235
Employee Signature:     $0.00  
District Offical:        
    Note: The above stipends will not be calculated toward retirement earnings.


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