INSTRUCTIONS: ARIZONA APPLICATION TO REDEEM PRIOR SERVICE (Form E2)

Present active Arizona elected officials with at least five years of credited service within the state's retirement plan may redeem up to 60 months funds if your prior service or employment was not on account with any other retirement system or plan. This document can be obtained from the website maintained by the Elected Officials' Retirement Plan of the State of Arizona

Arizona Application To Redeem Prior Service E2 Step 1: On the first line of section 1, enter your name.

Arizona Application To Redeem Prior Service E2 Step 2: On the second line, enter your Social Security number.

Arizona Application To Redeem Prior Service E2 Step 3: On the third line, enter your date of birth.

Arizona Application To Redeem Prior Service E2 Step 4: On the fourth line, enter your telephone number.

Arizona Application To Redeem Prior Service E2 Step 5: On the fifth line, enter your email address.

Arizona Application To Redeem Prior Service E2 Step 6: On the sixth line, enter your complete address.

Arizona Application To Redeem Prior Service E2 Step 7: On the first line of section 2, enter the name of your current employer.

Arizona Application To Redeem Prior Service E2 Step 8: Enter the date you entered office on the second lien.

Arizona Application To Redeem Prior Service E2 Step 9: Enter your current position on the third line and your current annual salary rate on the fourth line.

Arizona Application To Redeem Prior Service E2 Step 10: On the first line of section 3, enter the name of your previous employer.

Arizona Application To Redeem Prior Service E2 Step 11: Enter the date of your hire on the second line and your position and title on the third line.

Arizona Application To Redeem Prior Service E2 Step 12: Enter the date of your termination on the fourth line and your position and title at that time on the fifth line.

Arizona Application To Redeem Prior Service E2 Step 13: Section 4 is only for those seeking partial redemption. Enter the beginning date of the first line.

Arizona Application To Redeem Prior Service E2 Step 14: Enter the ending date on the second line and the total number of months on the third line.

Arizona Application To Redeem Prior Service E2 Step 15: Sign and date the bottom of the page.