Form 1420 "Certification of Memorandum of Understanding (Mou) Impairment" - California

What Is Form 1420?

This is a legal form that was released by the California Public Employees' Retirement System - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the California Public Employees' Retirement System;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 1420 by clicking the link below or browse more documents and templates provided by the California Public Employees' Retirement System.

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Download Form 1420 "Certification of Memorandum of Understanding (Mou) Impairment" - California

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California Public Employees’ Retirement System
Financial Office
P.O. Box 942703
Sacramento, CA 94229-2703
TTY: (877) 249-7442
888 CalPERS (or 888-225-7377) phone
www.calpers.ca.gov
Certification of Memorandum of Understanding (MOU) Impairment
Agency Name: _________________
CalPERS ID: _________________
The undersigned is the duly elected or appointed ______________ of ___________ (the “Public
Agency”) and is authorized to execute this Certification of MOU Impairment (the “Certification”)
on behalf of the Public Agency.
The undersigned, as the Public Agency’s authorized signatory, hereby certifies that the terms of
that certain Memorandum of Understanding, dated _______ (the “MOU”), would be impaired by
Public Agency’s compliance with the requirements of one or more provisions of section 7522.30 of
the Government Code. Therefore, pursuant to section 7522.30(f) of the Government Code, Public
Agency is notifying CalPERS that it will not comply with those provisions of section 7522.30 that
would impair the MOU until such time as the MOU expires under its terms, or is terminated,
amended, renewed, or extended.
Notwithstanding an MOU impairment, Public Agency
acknowledges and agrees that the sum total of all member and employer contributions must be paid
when due (whether paid by the employer or the member), and an MOU impairment shall not result
in a reduction of such sum total. Public Agency further acknowledges and agrees that for purposes
of crediting member contributions, CalPERS will treat the member contribution rate for new
members as being the rate described in Government Code section 7522.30(c). The undersigned
agrees that the Public Agency shall immediately notify CalPERS upon the expiration, renewal,
termination, amendment or extension of the MOU, and at such time will fully comply with section
7522.30 of the Government Code.
The undersigned further certifies that, to the best of his or her knowledge, the information provided
below is true, complete and correct in all material respects.
Membership Group Impacted
Type of Impairment
MOU Expiration
(EPMC and/or Cost
Date
Sharing)
Name: ______________________
Signature: ___________________
Title: ______________________
Date:
___________________
my|CalPERS 1420
California Public Employees’ Retirement System
Financial Office
P.O. Box 942703
Sacramento, CA 94229-2703
TTY: (877) 249-7442
888 CalPERS (or 888-225-7377) phone
www.calpers.ca.gov
Certification of Memorandum of Understanding (MOU) Impairment
Agency Name: _________________
CalPERS ID: _________________
The undersigned is the duly elected or appointed ______________ of ___________ (the “Public
Agency”) and is authorized to execute this Certification of MOU Impairment (the “Certification”)
on behalf of the Public Agency.
The undersigned, as the Public Agency’s authorized signatory, hereby certifies that the terms of
that certain Memorandum of Understanding, dated _______ (the “MOU”), would be impaired by
Public Agency’s compliance with the requirements of one or more provisions of section 7522.30 of
the Government Code. Therefore, pursuant to section 7522.30(f) of the Government Code, Public
Agency is notifying CalPERS that it will not comply with those provisions of section 7522.30 that
would impair the MOU until such time as the MOU expires under its terms, or is terminated,
amended, renewed, or extended.
Notwithstanding an MOU impairment, Public Agency
acknowledges and agrees that the sum total of all member and employer contributions must be paid
when due (whether paid by the employer or the member), and an MOU impairment shall not result
in a reduction of such sum total. Public Agency further acknowledges and agrees that for purposes
of crediting member contributions, CalPERS will treat the member contribution rate for new
members as being the rate described in Government Code section 7522.30(c). The undersigned
agrees that the Public Agency shall immediately notify CalPERS upon the expiration, renewal,
termination, amendment or extension of the MOU, and at such time will fully comply with section
7522.30 of the Government Code.
The undersigned further certifies that, to the best of his or her knowledge, the information provided
below is true, complete and correct in all material respects.
Membership Group Impacted
Type of Impairment
MOU Expiration
(EPMC and/or Cost
Date
Sharing)
Name: ______________________
Signature: ___________________
Title: ______________________
Date:
___________________
my|CalPERS 1420