Termination of Retired Member Working Under Earnings Limit
SC Public Employee Benefit Authority
202 Arbor Lake Drive
Columbia, SC 29223
Social Security number (last 4)
THE LANGUAGE USED IN THIS DOCUMENT DOES NOT CREATE ANY CONTRACTUAL RIGHTS OR ENTITLEMENTS AND DOES NOT CREATE A CONTRACT BETWEEN THE MEMBER AND THE SOUTH CAROLINA PUBLIC EMPLOYEE BENEFIT AUTHORITY. THE SOUTH CAROLINA PUBLIC EMPLOYEE BENEFIT AUTHORITY RESERVES THE RIGHT TO REVISE THE CONTENT OF THIS DOCUMENT.
Form 7217
Revised 10/5/2020
Sign in blue or black ink
Employer (authorized signature)
Please contact PEBA's Customer Contact Center with any questions at 803.737.6800 or 888.260.9430, or www.peba.sc.gov.
As an authorized representative of the covered employer for which the above-referenced retired member is employed, I certify that the member has terminated employment and is no longer working for this entity.
Pursuant to Sections 9-1-1790(A) and 9-11-90(4)(a) of the South Carolina Code of Laws, a member who retires from the South Carolina Retirement System (SCRS) or the Police Officers Retirement System (PORS) after January 1, 2013, and subsequently returns to covered employment, after having been retired for at least 30 consecutive days, may earn up to $10,000 each calendar year without affecting his retirement benefits. The earnings limitation does not apply if the member was at least 62 years old at retirement (57 years old for PORS) or is employed in certain exempt positions. If the retired member who is subject to the earnings limit continues in service after earning $10,000 in a calendar year, the member's monthly retirement benefit is discontinued during the member's period of service for the remainder of the calendar year.
For the proper administration of the earnings limitation, when a retired member who is subject to the earnings limitation terminates covered employment, this form should be completed by an authorized employer representative and submitted to PEBA.