CERTIFICATION OF PAYROLL DEDUCTIONS

Scroll down or click on a field in the image for more information

INFORMATION SHOWN ON THE CERTIFICATION

NAME, MEMBERSHIP NUMBER, AND SOCIAL SECURITY NUMBER — Information that identifies the individual member.

ACCUMULATED BASE SALARY — Total base salary on creditable service from January 1st to the date of certification. This amount will be shown as Accumulated Base Salary on the next Quarterly Report of Contributions.

SALARY THIS QUARTER — Base salary from the date of certification to the end of the current calendar quarter. (For members paid through State Centralized Payroll this field will read "Biweekly.")

FULL PENSION RATE — The member's percentage rate of full pension contribution.

PENSION DEDUCTION — Amount of pension contribution on base salary this quarter computed by multiplying the Rate of Contribution by the salary for the quarter. (For members paid through State Centralized Payroll this field will read "Biweekly.")

SUPPLEMENTAL ANNUITY COLLECTIVE TRUST — Percent of base salary that the member wishes to voluntarily contribute to the Supplemental Annuity Collective Trust (Chapter 123, P. L. 1963). Contributions shall be in even dollar amounts rounded to the nearest dollar ($0.50 and over rounded to the next highest dollar).

CONTRIBUTORY INSURANCE EFFECTIVE — Effective date of contributory insurance deductions. All deductions must be remitted with the first Quarterly Report of Contributions.

INSURABILTTY REQUIRED — Special cases in which the member must have a medical examination to qualify for contributory insurance coverage. In some cases, a medical examination may also be required for noncontributory insurance coverage.

DATE OF BIRTH, DATE OF ENROLLMENT, DATE OF TRANSFER, MONTHS OF PRIOR SERVICE, AND ENROLLED AS — Items of information which determine service credit prior to enrollment and the type of membership under which the member may retire.

ALL DEDUCTIONS BEGIN — The date when deductions from the salary of the member begin.

NUMBER OF PAYMENTS, AMOUNT PER PAYMENT, AND TOTAL AMOUNT OF OBLIGATION — Status of various obligations on certification date.

IMPORTANT — When this form is used to certify new or revalued arrears or loan schedules, only the information pertaining to the new deduction is shown. Normal deductions are still due for any period in which the member was employed. Previously certified arrears or loan deductions are replaced by the new deduction. The certification which establishes an arrears or loan is to be added to the deduction made for normal pension.

NAME OF EMPLOYER AND LOCATION NUMBER — Employer name and identification number.

COMMENTS — Additional comments regarding this certification.

QUESTIONS OR FOR MORE INFORMATION

If you have specific questions regarding the Certification of Payroll Deductions, you may call the Division's Office of Client Services at (609) 292-7524, write to the Division of Pensions and Benefits, PO Box 295, Trenton, NJ 08625-0295, or send us email.