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Larry Clark Lawson aka Gloucester County, Va. School Bus Garage Thief
- 1. V取G帆虹N THE C取CUIT COURT FOR GLOUCESTER COUNTY CoⅢmOnWe盆I也of V噛Ⅱia LARRY CLARK LAWSON Race: W址晦 Sex: M独e DO旗03/10/1962 SSN;臆￣二二 Capias Address: 668 Fic虹e FeⅡ Rd. M甜1eWS, VA 23 109 D e捷血d a直を 聖堂錐重虹鱒畦型 CAP船糎R圏QUⅢ迎肋 血d王ct皿en書:CR1 8000 1 47-00 VCC: LAR-2707-F9 U宣c工ass範ed F瓦ooy OTN:073CR1 8000 14700 The Cirand Jury sitting on May 7, 201 8, charges哩in血e Courty of Choucester, Virg壷a,也e above-named defenda耽 On or about March 23, 201 7 though Apri噂201 7’did wrong紬ly and frandule叫 鵬’dispose o亀conceal’Or embezzle property’having a value of $200"OO or more, belonging to Gしoucester Couny in vioIation of § 18.2-1埴8.2-95 o弛e Code ofVirginia (1 950) as ame皿ded. Grand Jury Wi血ess : Special Age皿R・ Eley 閑A皿eB班 [ユNotameB址 G間近JⅢy耳o曹e皿 Cp 一く 置 .Q ヱ∴元 図 音字三軍.ニ) ; 「 「. ;￣- 薩圏 雲霞賢喜田 自認 `ち●=ごく;雪`▼ 丁驚き羊の 嘘 韓‡ ざまで轟年子亀 田1電着 eA珊聯0職0脚職0 話 手 霊 . - C ︹ 回 国 相 国 田 G ﹁ 中 隊 * i - - - 〇 〇 . ? ・ 雲 三 三 ・ ﹂ P ÷ 綜
- 2. ’才 VIRGINEA: IN THE CIRCUFT COURT FOR THE COUNTY or GLOUCESTER COMMONWEALTH OF VIRGINIA, Ca§e No.: CR重8-重47, CR18-重48 Lawson, Larry Clark ㌫議s now’血e Commo耶Veam and provides血e following Bill of Parfroulars. h也e instant ca§e,血e Co蘭ooweal血asserts that the evidence wilI show: 1. Between March 23プ20工7 and Apri1 19, 2017’the defendant, Larry Lawson qereinafter, ‘・the defendant’) was empIoyed as血e Forema早of the GIou∞Ster County Public SchooI Gar呼 alereinafte了`the garage). This garage lS reSPOnSible for mal血g repairs and perfommg maiutenance on vehicles and buses ouned and operated by也e Gloucester County. 2. A§ Foreman’血e defendaut was reaponsible for purchasing parts’toOIs’and o血enequ呼ent for the garage as needed to comp厩e various repairs on courty vehicles. He did this on a regular basjs throughout his te関e as garage Forem狐 On Jtry 30, 2013血e defendant垂融a Gloucester county purchasing Card EmpIoyee Agreeme皿t. As part o弛at agreement’也e defendant acknowledged that he had received and reviewed也e estabIished poficies and procedures for the鵬of the GIoucester Courrty Purchasing Card. This purchasing card was.to be鵬d only for items under $2,000. Ⅷene鵬r也e defendant warited to make a purchase over $2,000 he was required to obtain approval from Anrie Lanan’the 。irector of血e Transportation Departmeut. prior to the incideut in question’When making purchases for iteus over $2,000, the defendaut had regularly sought Lanan’s approval. Notablyプthe est亜shed purchasing policies specifroally prohibited the stru血ring or 頭tting ofinvoices or p耽hases in order to ciroumveut the $2,000 purchasing limit. 3. On or about March蓬2017血e defendaut purchased a Millemafro 252 Welder using Gloucester Courty Public School ft皿ds. The welder cost over $2,000, and也e defen.daut never soughi authorization from Lanan for the p鵬hase. The de軸dant proceeded to StruC如re the purchase in the following ma皿er in order to concea冊rom oversight by his S岬餅Visor孤d sides申出e筆)p脚Ⅵ覆輪q脚em錨地. When making血e purchase’血e defendant infomed the saleapuson tha弛e courd not charge 血e velder to血e Courrty credit card ifthe purchase amo鵬was over $1,500,皿s袖rount is considerably less than the $2,000 1imit and wouId hav弛avn les attentio皿tO也e purchase Were it to be reviewed by I‘anan and Co皿ty血ance personnel. The defendant then asked the salesperson if the paymeuts oould be split iuto two separate puehasesプeach reflec血g
- 3. 、テ less than $ 1,500・ The saleaperson a即essed his reservafro騰about this procedure and asked whether it ves perm鵬d by the County. In response担e defendant assured him that he had reeeived proper authoriza缶on from his superv主s9rs tO StruCture血e sale in this way.皿s was not true’but with亜s false assurance the salesperson structured血e puehase at the d塊nd餌鵬req鵬st. Additionally, the true cost ofthe welder was軸into two sepaIute and distinct invoices. Arc3 created one血mice for the welde叩riced at $l ’499.99, and another for an item dubbed aく蝕Ier Accessory Package],, priced at $942.01. The accessory package did not exist, hovever. Arc3 does not make or se櫨an accessory package fdr that particufar welder. 血洗a壇the defendant,s request they created a fic癌rous product name and placed it on an eutirely s印rate invoice. Ths made it appear as though血ere油e two items being Puehased直也weIl below the $2,000血rfu These invoice§ Were also m}mbered sapaI融y and given s印arate invoice dates. Further’the timing of the purchases uns mahipulated as weu The defendant placed也e Origjnd order fd壇e welder over血e phone on Mach 23rd and paid the紐st insta址ent Of $1,499.99 on咄date. He then iustrmcted Arc3 to walt several days before charging血e SeCond installment of$942・01 " T龍s ome again contributed to也e illusion軸the defendaut bought two un地ed items on tve saparafe dates’and further ooncealed the purchase from Co皿を0V頃Sig虹 4. The whder was then shipped toぬe gar謁e to the軸ndon ofLany Lavson at血e defendant’s request・ When it姐ived on Thursday’Mach 30th the defendant told the Arc3 deIivery man that he was叫supposed to deliver the items untiIぬe f班owing week. The fonoung weck WaS apring break, when nobody would be at the garage to wi血ess the delivery excapt the The defendan弛en instrueted the delivery皿an tO Place the we塩in an outbullding that was COlloquiaHy knoun as the `亀e barn.・, This building was Iocated beside the garage and was Primarily鵬d for storage of tires and ol壇uipmeut. New equipment was not typically Later that day an employee wi軸e garage weut into也e tire bam and noticed血at也e welder had been covered with black plastic trash bags. Vhen that empIoyee approached a few other empIoyees and asked if he could use itブnObody knew why血e new weIder was there, inc頓ng the assistant Foreman. The garage aheady had a榊cking welder that perfomed 血e exact sane functious as the new one. By the mommg s鵬ぬe next day the we]der hnd dis軸eared from the tire bam. A佳. gi g了 笥讐露盤器嵩嘉認諾諾瀧露霊霊‡During that conversalon the defchdaut was confronted about糞婆出missing items beIongmg to the garage’to include the welder. VAen asked where it was, he first c班med that it was in the garnge in the nddle ofthe wck station where血e other heavy equlPment
- 4. ●ァタ 、了 W謎帥ica重ly k印t. adminis批正uve leave. That conversation ended融the defendaut being placed on A勝也的珊S血現地組融萌誼y融e印ge航ok軌也e neW哩 but it was not there' The only融er on the premi§eS騒血e originaI融er that was stfil in good working order and being鵬d by也e garage・ Lanan immediate]y informed Ciemnieckifeat the new extra融der w楓s st蝿sslng, and Ciemniecki cal]ed也e defendaut and asked ifthere ves any姐ng else he融ed to tell t血This tiIne, the defendaut claimed that he had ]oaned it out to Tat Fox’a ffiend ofhis and the owner ofFox’§ Auto Rapair when ciemniecki told hin that he had to bring the welder back inmed圭a助the defendaut aSked ifhe could have融i1 5:30 p.m・ that day"as he was unsure how quickly he could g鏡it back. VAen也e defendaut ev軸ually brought the w繭back to也e garnge塩that 薙皿○○皿心e扇押出五〇鵡s鼠os王互on wi醐ou∞軸Co叫 The defendant never me血ed the structuring of the pay脚誼u血e welder to anyone thoughout the d秘fu questiom No one ever saw the whder at TabもFbx’s garage, and也e whereabouts ofthe welder were u血uoⅧ姐9 days. 6豊霊藷慧霊器議豊誌慧器盤。還 危nds. .-￣一書-・「 I, Be事min A. Shute’do hereby certify that {血e copy ofthe foregoing Bill ofParticulars WaS Sent via email this -L day of上2±五二一一, 2018 to Noah Weisberg, attOmey for the defendant.
- 5. VRGIN塩胴唖C開聞COURT OF珊COUNTY OF GLOUCESTER Hearing Date‥ January 4. 2019 Judge: Honorable Je蹄ey W. Shaw COMMONWEALTH OF V取GINRA LARRY CLARK LAWSON, Defendant SSN: ⅩⅩⅩ-ⅩX-4工93 DOBこ03/10-1962 SEX二Ma王e FED恥L INFORMATION PROCES§鵬STANDARDS CoDE: 073 CR1 8000147-00, CR1 8000148-OO This case came beforeぬe Court f油症f血e defendant’Lerry Clark Lawson, who appeared on bai履d in persori with his afromeys heretofore retainedENoah D. Weisberg and Jo血 F. Hau卦The Como珊ealth was r印sented byHoljy B. Smith. The defendant §tands before也e Court indicted for the following felony o臓nses: 0衛nseⅡ包c貼ng弧章皿ber VirginiaCriueCode o「Ad鳳inis【加●u CodeSec技on 工8.2-工11 CaseNumber CR18000147_00 073C且1800014700 0鯨油鳩eDa転03偽作O17 【VeseOりI LAR-2了07ゼ9 Descridon:EMBEZZLE LA良2707ゼ9 073C良1800014800 ○蹄nseD減e:03123伍017 M藍NT>=$200 18揖11 cR18000148-00 Descn飯場;EM斑ZZ職鵬N丁→=$200 The Courtwas advised by也e drfenda垂CounSel for the defendatry and the Attoney for 血e Commo鵬al血that try had entered into a plea agreement fn this caseJ and such agreement in writing was presented to the Court and捌ed as partofthe record. The defendaut was a耽lgned as charged in the indictment in Case No・ CR1 8000 147-00 and, after being advised by counseL pleaded GUILTY to馳e indictInent w蝿plea was tendered 二￣￣二⊥ ∴ by the defchdantin person. The Cond made inqulry and was o弛e opln】0抽the plea was made free串telligently, and voinntarily融an understanding of the nature of the change against him andぬe consequenees ofhis plea, and o弛e waiver of trial by jury and of appeal, and l
- 6. the Court accapted the plea of gu坤・ The Court heard a §umary ofthe evidence, Which eVidence也e defendant by counsel stipulated, ifpresented’Would be sufficient to su§taln a COnVietion of the o範se軸hat tlris Court has jurisdiction. VAerouponぬe Cout accepted the Plea agreement andJ having accepted the plea of g哩y’found也e defendant GtJELTY as charged in血e indict軸t in Case No. CRI8000147-00. The Coun OREERS that inposition of sentence be conrfuued to Apri1 23, 201 9, at 930 a.m・ Tbe Com D聴CTS a Probation O鎚cer ofthis courtto thoroughly inv9Stigate and rePO軸pon the history of the accused prier to軸encing as required by Virg壷a Code § 19.2-299. Pursu輔o the plea agreement and apon motion o弛e como鵬al也・s Attomey, and With the concurrence ofcounse幌the defendan担e Court 。R晩RSぬe indictI]暇t in C貧se N〇・臓工8000148-00 is Nd重職聡OS魁QⅦ. And tbe defendaut is allowed to depat 勘吋TER亜s ○○ユニday ofJa皿ary, 2019. 2 克d宮e
- 7. ￣ ● Virginia Courts Case Infomation System [重]両案三三二]田口亘] GIoucester County Circuit - Criminal Division C別記De屯的 Page l of2 ≡≡=≡≡≡≡-￣￣二〇“-十〒 Final Di§POSition 臣豊tionCode: DispositionDate: ConcludedBy:04/23/2019 GuiltyPlea PmendedCharge: PmendedCodeSection: rmendedChargeType: i 臆 臆臆臆 http:〃ewsocis l.courts. state.va.us/CJI SWeb/CaseDetail.do 05/06/20 1 9
- 9. 6/27/2019 Code ofVirginia Title 5上l. Pensions, Benefits, and Retil・ement Chapter l ・ Virginia Retirement System § 5 l・日24・13. Loss ofbene卸s; Certain felony convictions. A. No person sha= be entitled to any ofthe be11efits ofthis tit]e as provided in this section if(i) he is COnVicted ofa felony and (ii) the person’s empIoyel・ detemines that the felony arose from misconduct OCCu皿1g On Orafter July l, 201 ], in any position in which the person was a membercovered for 一・eti「ement purposes under any 「etirement system administered by the Board. Prio「 to making any such deteminatioll・ the empIoye「 sha11 glVe the person reasonable prlOr Written notice and pl.OVide an OPPO血両y to be heal.d. The empIoyer's detemination may be appealed in a manne「 consistent with Subsection B・ and no fu「ther proceedings sha= follow the decision ofthe circし一it court. The empIoyeI・・s determination sha11 become final 10 calendar days afterthe date ofthe initial determination ifno appea=s 制ed’Or the date ofthe decision ofthe circuit court ifan appea=s filed. A reversal by the circし高t court of the empIoyer’s determination shal圧ender the determillation nu= and void. B. Proceedings for 「eview ofthe determination ofthe empIoyer may be made by the member filing a 11Otice ofappeal within five workdays ofrecelPt Ofthe detemination. Within five workdays thereafter, the empIoyer sha11 transmit, tO the clerk ofthe circuit court in theju「isdictio】1 Whe「e the empIoye一・ is Iocated, a COPy Ofthe record. The coutt, On mOtion ofthe member’may lSSue a Writ ofcertiora「i reqし1皿ng the empIoyer to transmit the reco「d on or before a certain date. Within 30 days ofrecelPt Ofsuch records, the COurt, S誼Ing Without a」ury, Shall hear the appeal o-1 the record and such additiollal evidence as may be necessary to resoIve a11y COntrOVerSy aS tO the correctness ofthe record. The cou巾in its discretion, may receive such other evidence as the ends ofjustice require. The court may a飾rm the detemination ofthe empIoyer ol￣ may reve「Se Or mOdify the detemination. The decision ofthe court sha11 be rendered no later than the珊eenth day from the date ofthe conclusion ofthe hearing▲ The decision ofthe coし血Shall be final and sha11 not be appealable. The circuit court hearing shall be at no cost to the Commonwealth or the member. C. The Board sha= implement the relinqしIishment ofbenefits under this title as soon as practicable after the empIoyer no描es the Board ofits final detemination that the member-s felony conviction arose from misconduct in any position in which the member was a member in service. D. 1fthe person is or becomes a membe「 in service after relinquishment ofbenefits under subsection C, he Sha= be entitled to the benefits under this title based solely on his service occし1rrlng after the re=nquishment. E・ Notwithstanding any provision of law to the cont重・ary’any SerVice credit lost from relinquishment of benefits unde「 subsectio-1 C shall be ineligible for subsequent purchase. F. The goveming body ofany locality served by a constitutionaI o飾cer sha11 be considered that o鮒cer's empIoyel● for purposes ofthis section. 2011,C.483;2012,CC. 56, 349.
- 10. ぐ で EMPLOYER REQUEST FOR FORFEITURE OF MEMBER BENEF書丁S VIRCINIA RETIREMENT SYSTEM P.O" Box 2500 ◆ Richmond, Virginia 23218-2500 ToII Free l ・888"VARETiR (827-3847) Fax 804・786-971 8 W肌VaI℃〔i鳩・ o付 1" SocialSecurityNumber 2■ EmpIoyerCode Complete thjs fo「m to notify VRS that a member has been convicted of a falony fo「 misconduct assocjated with the member’s perfe「ma=Ce Ofjob duties and that all VRS 「eIated benefits must be forfeited. This form is Submitted to VRS after any appeais the membe「 may make in regards to the termination of emp-oyment a「e Ciosed, Additiona=nfo「mation about empioyer 「esponsib輔es is atfached. PART A. MEMBER INFORMATION PART B. EMPしOYER AUTHORIZATION The membe「 refere=Ced above has been convicted of a feIony for misconduct associated with the member’s Perfomance ofjob duties with this empIoyer. I unde「stand that submitti=g this fom wi= ca=Ce冊e fo=ow`ng‥ 1) Payment of a= futu「e VRS retirement benefits including the heaIth insurance c「edit. 2) Basic g「oup life insu「ance. This aIso makes the member ineIigible to converf the po-icy言f jt has not ai「eady been COnVerted to a pe「sonaI policy and the member has not aIready 「etired. 3) Optional group life insurance, if it has not aiready been converfed to a pe「sona- poIicy. 4) Reti「ee heaIth insura=Ce eIigib帥ty. 5) E看jgib冊y to receive any Defined Contribution Pian funds paid by a VRS-Parficipating empIoye「. 6) Vi「ginia Sickness and Disab冊y P「og「am (VSDP) o「 Virginia LocaI Disab航ty P「og「am (VLDP) benefits if the membe「 is receiving bene冊S at the time of notification of the conviction. 7) Any open VSDP orVLDP Iong-te「m Care Claims and the 「ight to retain futu「e cove「age. l certy that・ Pu「Suant tO Code of Wrg面a § 51.1-124.13- the empIoyee was provided notice of this empIoyer’s dete「mination and an oppo血nity to be heard rega「ding this empIoye「,s decis-On. l ce申y fu輔e「 that any appeals P「OCeSS WaS COmPleted and a finaI determination was made, Autho「ized Sig nature VRS-180 (Rev. 12/15) ⅢⅢ書胴案書剛Ⅲ酬看剛
- 11. ( ABOUT THE REQUEST FOR FORFE-TURE OF MEMBER BENEFITS if an emp!oyee is convicted of a felony for misconduct occurrIng On Or a債e「 Ju-y l, 201 1 and you have determined that the feIony was in association with the perfo「mance of the empIoyee,s job duties, uSe this fo「m tO request the empIoyee forfeit a-1 VRS benefits incIuding aII benefits administered by VRS and benefits of the Optional Retirement Plans (ORP) administered by ce軸col-eges and unive「sities as authorized by VRS, Prio「 to VRS being notified of a fo輔ue of benefits, a finel determination of whether the felony conviction a「OSe Out Of the perfermance of the empIoyee’s job duties must be made. The membe「 js ailowed to appeaI you「 determination言nc-uding a judiciai review, before the te「mination of benefits may be co=Sidered final. The p「ocess for the appeai is as foIIows: You must p「ovide the empIoyee with w「itten notification that you a「e reviewIng the ci「cumstances su「「ounding the feIony conviction to dete「mine if the conviction was associated with the performance of the empIoyee’s job. You must also allow the empIoyee a reasonab-e oppo血nity to be hea「d du「ing this 「eview process. You「 dete「mination that the empIoyee,s feIony conviction was associated with the performance of the empIoyee’s job wi" become finai within lO caIenda「 days of making the determination if no appeaI is fifed, O「 uPOn the date of the ci「cuit courf’s decision if the emp-oyee fiIes an appeal. The emp-oyee wiIl have five business days afte=eCe-VIng the notification of the decision to fi-e an appeal. If the empioyee does not appeal, yOur determinatjon becomes finaI. If the empIoyee notifies you of an appeaI二 ・ You must submit a copy ofthe 「eco「ds to the c-erk ofthe circuit court in thejurisdiction in which the decision was made. You must p「ovide this information within five business days of the empIoyee,s notification that they wish to appeai, ● The Courf, On mOtion ofthe emp!oyee’may -SSue a Writ of ∞rfiorari 「equi「看ng the empIoyer to transmit the 「ecord on or before a cerfain date〇 ・ Within 30 days, the courf (S軸g without a jury) must a耐m o「 「everse your determinatlOn and rende「 its decision within 1 5 days f「om the conclusion of the hea「ing. The courtis decision becomes the final On∞ a final determination is made that the falony conviction was associated with the empIoyee,s job, COmPlete this form and send it to VRS. Note‥ If at any time the empioyee’s fe!ony convjction is ove血rned, yOu muSt COntaCt VRS to ensure the empioyee’s VRS benefits are reinstated. VRS-180 (Rev. 12I15)
- 12. VRS BENEFITS AFFECTED BY THiS REQUEST Defined Benefit Plans Reti「eme巾 The empIoyee forfeits the right to a 「eti「ement bene冊 Refunds if the empIoyee is vested at the time of termination, a refund of the conl師butions and而erest oredited to the empIoyee’s member ∞n緬bution account wili be avaifable" Nomvested empIoyees are etigible for a 「efund of membe「-Paid ∞n描butions and inte「est and any ∞山師butions a= emPIoye「 may have ∞n師buted on the behaIf of the empIoyee prior to July l, 2010. If the empioyee is re-emPioyed in a ∞Vered position’肌e refunded servi∞ may nOt be purchased. if a 「efl」nd has not been paid and the empIoyee is reuemp-oyed in a ∞Vered pos師On, the servi∞ cannOt be used to determine: . Futu「e 「eti「eme巾bene触s, ● EIigib輔y for the Virginia Sickness and Disabifty Prog「am (VSDP) orthe VIrgjnia Locai Disab冊y Program NLDP), ● PIan l o「PIan2designation, ● Age to use forVSDP orVLDP Long Term Care premium, ● Group life coverage amounts or 「etention of ∞Verage after terminatio面om the subsequent empIoyment, and ● Health insurance ored冊the empIoyee retires from hjs subsequent empIoyer or goes on Iong-term disabiI時 Hea皿insurance Credit The empIoyee is not eIigible fo「 the hea冊nsurance c「edit・一f the empIoye。 is paid any heaIth insurance Credit prio「 to no珊cation of帥e軸aI determination, VRS刷I not recove「 payments made什om the sta巾Of Payment tO the date no帥ed of肌e finaI determination. Defined Contribution Pians The emp!oyee fo軸s the e申Oyer-Paid contri掴ons and eamings on those contributions. Orty empIoyee+ Paid ∞ntributions and eam-ngS 「emain in the pa巾cipant,s a∞Ou巾. Optional R〔掘rement Plans The empIoyee forfeits the erpIoye「-Paid ∞軸帥ons and eamings on those ∞軸butions. Orty empIoyee+ Paid ∞ntributions and eamIngS 「emain in the pa巾icipant’s a∞Ou血 457 Defe什ed Compensation Plan Emp看oyer non-elective (disc「etionary) con師butions and eamings a「e forfeited, The empIoyee retains the empIoyee-Paid contributions and eam-ngS. Cash Match Plan EmpIoyer-Paid con師butions and eam`ngS are forfeited. Virginia SupplementaI Retirement Plan EmpIoyeトPaid ∞ntributions and eamlngS a「e forfeited. Basic Group Life lnsurance Coverage is forfctted unless the employee converfed the basic 9「OuP Iife insu「ance to a persona巾刷Cy Prior to the no揃cation of the finaI detemination, VRS-180 (Rev. 12/15)
- 13. OptionaI Group Life Insurance Cove「age is forfeited unIess the empIoyee has converted the optiona- g「oup life insu「ance to a persona- policy PrlO「 tO the notification of the final dete「mination. Health lnsurarce (State EmpIoyees) The empioyee lS nOt eIigible for retiree health insurance. Virginia Sickne:S and DisabiIity Program (VSDP) and Virginia 」ocal DisabiIity Program (VLDP) !f the empIoyee lS reCeiving VSDP or VLDP bene冊s at the time of notification of the finai determination, the benefit stops. VRS w帥not 「ecover ciaim payments made from the date of the c-aim approvai to the date notified of the final determination. If the emp!oyee is rehi「ed into a VSDP or VLDP eligib-e position, those benefits w帥be based on the new empIoyment period. VSDP or VLDP Long"Tem Care PIans If the empIoyee is in cIaim at the time ofthe軸aI determination, the bene冊stops and coverage is canceled With no coverage 「etention availab皿y" VRS w冊Ot reCOVer C-aim payments made from the date of the claim aPPrOVai to the date notified of the血al determination. 1f the empIoyee has a-ready converfed ∞Ve「age Prio「 to =Otification of the finai dete「mination, the empIoyee js ine`igib-e to 「etain the empIoye「-Paid coverage. Premiums f「Om the date of conve巾ng to the date no帥ed of the final dete「mination a「e not 「efunded. Commonweaith of Vi「ginia Voluntary G「oup Long-Term Care lnsurance The empIoyee is eIigibie to retain cove「age" VOLSAP The empIoyee is not entitled to bene冊S under VOLSAP, VRS-180 (Rev. 12/15)
- 14. CER丁IFICAT看ON OF EXCEPT漢ON FROM GENERAL EARLY RET看REMENT PROVISIONS ViRGINIA RETIREMENT SYSTEM P.O・ Box 2500 ◆ Richmond, Vi「ginia 23218"2500 Toll F「ee l -888-VARETIR (827-3847) WM肌Va鳩的さ. 0岬 1. SocialSecu「ifyN u調be 「 2. EmpIoye「Code 3. EmpIoyerName Empioyees in positions such as agency head appointed by a state boa「d, ∞mmission o「 ∞unCil, conS皿面onal Offl∞rs Whose offices a「e aboiished, Or SChooi division superintendents appointed by a Schooi Board, as described …der Sections 51.1-155.1 a=d 51.155.2 of the Code of VIrdinia and who are involunta申y separated fron service w軸20 or more years of creditable service may retire w輸unreduced benefits if the emp-oyee is at least age 60 w軸a mernbership date on or after July l, 2010, O「 at least age 50 w軸a membership date prio「to Ju母1,2010. The empIoye「 must ∞mPIete this form at the time of the i=VO-untary separation and subm剛to VRS. Any f血Ire empIoyment in a covered VRS position刷i nuI冊y l肌is ce珊ication and the membe「刷I again be suhiect to generaI ea‖yれetirement provisions inciuding reduced benefits. PART A. EMP」OYEE INFORMATlON 4. N a me (Fi「St,MiddIe面tiai,Last) 5. A dd 「eSS (St「eet,City,StateandZip+4) 6. D at eofS epa 調tion 7, Po Sitjo nTitle 8. Sj g natur e Date PART B. E州P」OYER CERTIFICATION VRS-8 (Rev. 07113) ⅢⅢ書胴I書酬書書剛酬