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HI22Los Angeles Unified School District Benefits Administration APPLICATION FOR CONTINUATION OF HEALTH BENEFITS (Complete this form at least 3 months before you retire)Employee NumberLast NameAddressFirst
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How to fill out classified resignationretirement form

01
Step 1: Obtain a copy of the classified resignation/retirement form from your employer.
02
Step 2: Carefully read the instructions provided with the form to understand the requirements and guidelines for filling it out.
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Step 3: Fill in your personal information, including your name, address, and contact details.
04
Step 4: Provide the date of your resignation or retirement.
05
Step 5: Indicate the reason for your resignation or retirement.
06
Step 6: If necessary, provide additional details or explanation in the designated section.
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Step 7: Sign and date the form.
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Step 8: Submit the completed form to your employer or the designated department.
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Step 9: Keep a copy of the filled-out form for your records.

Who needs classified resignationretirement form?

01
Employees who are classified and wish to resign or retire from their current position need the classified resignation/retirement form.
02
This form is typically required by employers to properly process and document an employee's resignation or retirement.
03
It helps ensure that the necessary information is provided and that the resignation or retirement is handled in accordance with company policies and procedures.
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The classified resignation/retirement form is a document used by employees in classified positions to formally resign or retire from their job, ensuring proper processing of their departure.
Employees holding classified positions within an organization are required to file the classified resignation/retirement form when they choose to resign or retire.
To fill out the classified resignation/retirement form, the employee must provide personal information, reason for resignation or retirement, effective date, and any other required information as specified by their employer.
The purpose of the classified resignation/retirement form is to officially document an employee's intent to leave their position, ensuring a clear record for both the employee and employer for administrative and legal purposes.
The form typically requires the employee's name, position, department, reason for leaving, effective date of resignation or retirement, and any additional comments or information requested by the employer.
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