ࡱ> CEB'` bjbjLULU .0.?.?RRRR ^t2y{{{{{{$,hyy:,A IvR: \0RN N AN A    Form A - Application for USS Flexible Retirement Quotation Section 1 To be completed by member of staff making the request SurnameTitleForename(s)Employee NumberUCL EmailUCL DepartmentDetails of request:Date of proposed flexible retirement dateRequested working hours per weekRequested Working pattern (number of days per week, working times per day)Proposed percentage of USS benefits to be taken at this flexible retirement event (min 20% - max 80%)Is this the 1st or 2nd flexible retirement event?Employees Declaration: I confirm the following, in making this application: I have read the UCL Work Life Balance Policy I have had an informal discussion with my line manager/Head of Department, regarding my request to reduce my hours, how my request may be considered, and the effect this proposed change may have on my department. I have used the USS Flexible Retirement modeller and obtained provisional figures. I have also read the USS Flexible Retirement Factsheet (both available on the USS web). I have noted that if the request is approved, a minimum 3 months notice after approval date is required, to allow for pension processing in accordance with USS requirements. On receipt of a full flexible retirement quotation as provided by USS, I reserve the right to withdraw this request. Signed: .. Date:  Section 2 To be completed by Line Manager Managers Declaration: I confirm the following, in supporting this application: I have read the UCL Work Life Balance Policy. I have held an informal meeting with the applicant. The above request is compatible with the needs of the department. I acknowledge that upon receipt of the full flexible retirement quotation as provided by USS, the applicant reserves the right to withdraw the application. Signed: Date: Name: . Job Title:...  :;<~  2 9 k l m n +³³¡h)#h-%hSe5CJOJQJ^JaJhSeCJH*OJQJ^JaJhSeCJOJQJ^JaJ h-%hSeCJOJQJ^JaJhSe6CJOJQJ^JaJhSe5CJOJQJ^JaJ;<~^}kd$$Ifl0B L t0644 laytSe  9r $IfgdSe  9r gdSe $ 9r a$gdSess  9r $IfgdSe}kd$$Ifl0B L t0644 laytSess  9r $IfgdSe}kd0$$Ifl0B L t0644 laytSess  9r $IfgdSe}kd$$Ifl0B L t0644 laytSess  9r $IfgdSe}kd`$$Ifl0B L t0644 laytSess  9r $IfgdSe}kd$$Ifl0B L t0644 laytSe  ss  9r $IfgdSe}kd$$Ifl0B L t0644 laytSe  0 1 ss  9r $IfgdSe}kd($$Ifl0B L t0644 laytSe1 2 L } ~ sss  9r $IfgdSe}kd$$Ifl0B L t0644 laytSe~  sss  9r $IfgdSe}kdX$$Ifl0B L t0644 laytSe   ss  9r $IfgdSe}kd$$Ifl0B L t0644 laytSe  2 g i  8 9 [ k ssbbbbbsss & F 9r $IfgdSe  9r $IfgdSe}kd$$Ifl0B L t0644 laytSe k l m n L*+L}}llll & F 9r $IfgdSe  9r gdSejkd $$Ifl " t0644 laytSe  9r $IfgdSe L\vjkd$$Ifl " t0644 laytSe  9r $IfgdSe,1h. A!"#$% $$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh55#v#v:V l t065L5ytSe$$If!vh5J!#vJ!:V l t065"ytSe$$If!vh5J!#vJ!:V l t065"ytSe<`< SeNormalCJ_HmH sH tH DAD Default Paragraph FontRi@R  Table Normal4 l4a (k(No List4`4 SeHeader  9r 0;<~ 012L}~2gi89[klmnL*+L\v@0@0@0@0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0@0 @0 @0 @0@0 @0 @0 @0 @0 @0 @0@0@ 0@ 0@ 0@ 0@ 0@0@0@0@0 @0 @0@0@0@0@ 0@ 0@ 0@ 0@0@0@0@0@0@0 @0 012~2gilmn0@0A@00 0B0C@00 0D0E@00 0F0G@00 0H0I@00 0J0K@00 0L0M@00 0N0O@00 0P0Q@00 0R0S@00 0T0U@00 0000 0000 00000000 00U500T00R00 00 00 00 00 1 ~  k L  8@0(  B S  ?z|33336EAKh12Q~ 012}~lm@::s::@UnknownGz Times New Roman5Symbol3& z Arial?5 z Courier New;Wingdings"1hc[d[!s !s !242qHP)?Se2:Form A - Application for USS Flexible Retirement Quotationucyzrliucyzrli  Oh+'0$ 4@ ` l x<Form A - Application for USS Flexible Retirement Quotationucyzrli Normal.dotucyzrli1Microsoft Office Word@F#@v@`Yv!s՜.+,0$ hp|  UCL ' ;Form A - Application for USS Flexible Retirement Quotation Title  "#$%&'()*+,-./013456789;<=>?@ADRoot Entry FPvFData 1Table!b WordDocument.0SummaryInformation(2DocumentSummaryInformation8:CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q