CSS2HTML: WEB7219.XDP

As an authorized representative of the public school district listed above, I certify the above-referenced retired member is

employed as a bus driver for the school district in the current school year.

School Bus Driver Exemption Certification

SC Public Employee Benefit Authority

202 Arbor Lake Drive

Columbia, SC 29223

Employee name

Social Security number

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 7219
Revised 8/17/2026
Sign in blue or black ink

Authorized representative (printed name)

Authorized representative (signature)

Title/position

Date

EMPLOYEE INFORMATION

Please contact PEBA's Customer Service with any questions at 803.737.6800, 888.260.9430 or peba.sc.gov.

For compensation earned during the 2026-2027 fiscal year, the earnings limitation does not apply to a retired member of the South

Carolina Retirement System or the Police Officers Retirement System who is hired by a public school district as a school bus driver.

AUTHORIZATIONS

Beginning on July 1, 2026, pursuant to the following proviso in the General Appropriations Act:

Date of retirement

SCHOOL DISTRICT INFORMATION

Employee's date of hire

School district

Employee's position title

School district employer code

Employee's expected annual compensation