<p> Faculty Retirement Checkout Form – Eligible, Full-time Faculty – Brigham Young University</p><p>If a faculty member is terminating employment rather than retiring, use the EMPLOYMENT TERMINATION CHECKOUT FORM, available online at http://www.byu.edu/hr/managers/forms or contact Benefits Services, ext. 2-4716.</p><p>Name: ______BYU I.D. # ______</p><p>Retirement Date: ______Dept/College ______</p><p>____ Mail my W-2 to my mailing address listed on Route Y under Personal Information</p><p>STEP 1: FACULTY MEMBER – no later than THREE MONTHS prior to retirement, the faculty member should go to Benefits Services, D-240 ASB, ext. 2-4716, to initiate the retirement process.</p><p>____ Master Retirement Plan (complete forms) ____ Outstanding Loans (DMBA/TIAA-CREF) ____ Medical/ Dental options ____ Flexible Spending Account (FSA) ____ Life Insurance options ____ Mailing Address (update information) ____ Savings Plans (DMBA/ TIAA-CREF) ____ Copy of this completed form to Faculty Personnel</p><p>STEP 2: DEPARTMENT – no later than ONE WEEK prior to retirement:</p><p>I. AREAS – the department is responsible for contacting the following areas to inform them of the faculty member’s retirement date and to encourage the retiring faculty member to resolve any outstanding accounts: ____ Keys (ext. 2-5521) The department should coordinate the return/issuing of all keys ____ Library/LRCs (ext. 2-5634 or 2-6061) Return all books/materials and pay any fines ____ Bookstore (ext. 2-2470) Return Bookstore department charge card, if one was issued to you ____ JP Morgan Chase Card (ext. 2-3872) Return corporate card to Travel Management Services, C-141 ASB ____ JP Morgan Purchasing Card (ext. 2-4702) Return purchasing card to Treasury Services, A-153 ASB ____ Accounts Receivable (ext. 3-6634) Resolve any outstanding accounts (e.g., tuition bills, etc.) ____ Remembrance Fund (ext. 2-6641) Notify of retirement date (if participating in Remembrance Fund) ____ Signature Card (ext. 2-7829) Notify the Signature Card Office of your retirement date and arrange for payment of any outstanding charges II. PROPRIETARY RIGHTS – the department is responsible for cancelling the retiring faculty member’s procurement access to the following: ____ CashNet system ____ eProcurement ____ Financial System ____ Research Grants and Contracts NOTE: Post-retirement access to any residual faculty funds may be allowable, through department proxy only, for up to 3 consecutive years immediately following retirement by proposal to the dean. III. EQUIPMENT ____Equipment or supplies Return all equipment, software and supplies to department. If, in rare situations, a retiree is to retain any equipment, software or supplies, the “Authorization to Purchase or Transfer Equipment or Supplies” form must be completed.</p><p>IV. DEPARTMENT: ______/ ______(Authorized Signature) (Date)</p><p>STEP 3: EXIT INTERVIEW – faculty desiring to schedule an exit interview should contact Faculty Relations, ext. 2-7017, D-341 ASB.</p><p>NOTE: The department should allow sufficient time to finalize arrangements (e.g., keys, part-time office space, release from all financial authorizations and responsibilities, equipment, software and supplies return, etc.) with retiring faculty. For questions regarding post-retirement employment and research activity, contact Faculty Relations, ext. 2-7017.</p><p>AAVP – Faculty 02/2012 Original to Faculty Personnel, D-353 ASB; copy to Benefits Services, D-240</p>