Dear <<Name of Director>>:
(Use for PERS or TPAF members
only [1])
<<Name of employee>> is employed by <<name
of location>> in the position of <<title>>
and is an active member of the <<TPAF or PERS, choose
one>> with at least ten years of credited
service.
OR
(Use for PFRS and SPRS members
only [1])
<<Name of employee>> is employed by <<name
of location>> in the position of <<title>>
and is an active member of the <<PFRS or SPRS, choose
one>> with at least four years of credited
service.
We believe that <<name
of the employee>> is totally and permanently disabled
and can no longer perform his/her assigned duties. Since
we are unable to provide an alternative <<PFRS-, TPAF-,
PERS-, or SPRS-, choose one>> covered position with
duties capable of being performed by the employee, <<name
of the employee>> should be approved for a disability
retirement benefit from the <<PFRS, TPAF, PERS, or
SPRS, choose one>>.