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Purchasing Retirement Credit for a Period of Interrupted Service Due to Extended Illness Please print or type in black ink. Please do not staple pages. Section A. Tell us about yourself. FIRST NAMEMILAST
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Interrupted service can occur due to various reasons such as power outages, technical difficulties, or maintenance work.
Any individual or organization experiencing an interruption in service is required to file a report.
To fill out interrupted service due to, provide details of the interruption including date, time, duration, and any impact it had.
The purpose of reporting interrupted service is to document and track instances of service interruptions for analysis and improvement.
Information such as the cause of interruption, affected services, duration, impact on users, and any mitigation measures taken must be reported.
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