PRINT ALL INFORMATION www.lasersonline.org Visitor Information Sheet P.O. Box 44213, Baton Rouge, LA 70804-4213 225.922.0600 · Toll-Free 1.800.256.3000 Form MSD41 R042020 Today's Date Last Name Middle Name Member's First Name SECTION 1: MEMBER/VISITOR INFORMATION Social Security Number SECTION 2: PURPOSE OF TODAY'S VISIT (Check all that apply) Date Birth Date Zip Code State Email Address Evening Area Code/Phone Number City Daytime Area Code/Phone Number Mailing Address No Yes Would you like your address changed to the above if it does not agree with our records? (Retirees only) If yes, please sign below: What is your current status? DROP Active Working after DROP Retired Inactive Visitor's Name (if different than member) Regular Retirement/IBO Estimate DROP Estimate Actuarially Reduced Retirement Estimate After DROP Estimate Rehired Retiree Return to Work DROP/IBO Account Withdrawal Refund of Contributions Disability Retirement Estimate Tax Withholding Change Survivor Benefit Information Purchase of Service Other _______________________ Anticipated Date of Retirement Beneficiary's Date of Birth Sick Leave Balance Annual Leave Balance (-300 hours) LASERS OFFICE USE ONLY Walk-In (no scheduled appointment) Scheduled Appointment - in person Visitors without appointments will be seen as time permits and may experience a delay. Check one: Anticipated Date of Retirement Beneficiary's Name Relationship to Member Are you currently on Leave Without Pay (LWOP) ? Yes No Scheduled Appointment - phone Scheduled Appointment - video LASERS Staff Member:
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PRINT ALL INFORMATION www.lasersonline.org
Visitor Information Sheet
P.O. Box 44213, Baton Rouge, LA 70804-4213 225.922.0600 · Toll-Free 1.800.256.3000
Form MSD41 R042020
Today's DateLast NameMiddle NameMember's First Name
SECTION 1: MEMBER/VISITOR INFORMATION
Social Security Number
SECTION 2: PURPOSE OF TODAY'S VISIT (Check all that apply)
Date
Birth Date
Zip CodeState
Email AddressEvening Area Code/Phone Number
City
Daytime Area Code/Phone Number
Mailing Address
No YesWould you like your address changed to the above if it does not agree with our records? (Retirees only)
If yes, please sign below:
What is your current status? DROPActive Working after DROP Retired Inactive
Visitor's Name (if different than member)
Regular Retirement/IBO Estimate
DROP Estimate
Actuarially Reduced Retirement Estimate
After DROP Estimate
Rehired Retiree Return to WorkDROP/IBO Account Withdrawal
Refund of Contributions
Disability Retirement Estimate
Tax Withholding ChangeSurvivor Benefit Information
Purchase of Service
Other _______________________
Anticipated Date of Retirement
Beneficiary's Date of Birth
Sick Leave BalanceAnnual Leave Balance (-300 hours)
LASERS OFFICE USE ONLY
Walk-In (no scheduled appointment)
Scheduled Appointment - in person
Visitors without appointments will be seen as time permits and may experience a delay.
Check one:
Anticipated Date of Retirement
Beneficiary's Name Relationship to Member
Are you currently on Leave Without Pay (LWOP) ? Yes No
Scheduled Appointment - phone Scheduled Appointment - video
LASERS Staff Member:
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Type of retirement (DROP, Service, IBO, Actuarially Reduced, Disability, After DROP, Rehired Retiree)
Leave (explain 300 hrs/200 hrs of sick if applicable)
Beneficiary (Service, DROP/IBO
Retirement date (discuss best date for member)
VISITOR INFORMATION SHEET:
DO ESTIMATES (remember to image all estimates) AND EXPLAIN EACH PORTION OF ESTIMATE:
Retirement date - if DROP, explain 60 day window and 36 month participation
Retirement calculation to get benefit
FAC (what we used to come up with average)
Leave (current balance provided by member)
While in DROP (Work vs. Retirement System)
DROP estimate
Explain each portion of the estimate, reviewing the different options available
IBO/Regular estimate
Explain positive and negative aspects for IBO and DROP
Always do an estimate for the 3 yr comparison for IBO
Tax implications
LA state tax exempt: Sched. E
Self Funded COLA - include in all estimates along with explanation of how it works and System Generated COLA's
Explain IBO (where money comes from) & how to utilize IBO chart to calculate lump sum amounts
SDP - State tax exemption and loss of exemptionMoney reported as income
20% for lump sums and possible 10% penalty - option to rollover leave lump-sum payment
EXPLAIN RETIREMENT TIMELINE:
IBO rollover time period and leave payment
45 days until preliminary benefit (all required documents must be received before a benefit is payable) and 120 days for final
REVIEW THE RETIREMENT READINESS GUIDE:
Self Service - how to register and the benefits (show the member website and how to navigate to the self service)
Social Security and Medicare information
DROP/IBO account SDP and how to contact Great West
Insurance deductions - how it is set up, pay 1 - 2 months in advance, HR is always the point of contact and why
Credit unions & RSEA
VISITOR CHECKLIST - LASERS OFFICE USE ONLYSocial Security NumberMember's Name Date of Appointment Analyst's Initials
Actuarially Reduced Retirement estimate
Disability estimate
Explain approval process
Currently on Leave without pay (LWOP)?
Earnings limits
After DROP estimate
Rehired Retiree estimate
Leave
Lump sum payment Conversion to serviceRollover
Retirement Education
Member Organization Tools
AAPS
Review Leave Chart
Re-employed Retiree Options
Required Forms Required Documents
PRINT ALL INFORMATION
www.lasersonline.org
Visitor Information Sheet
P.O. Box 44213, Baton Rouge, LA 70804-4213
225.922.0600 · Toll-Free 1.800.256.3000
Form MSD41
R042020
SECTION 1: MEMBER/VISITOR INFORMATION
SECTION 2: PURPOSE OF TODAY'S VISIT (Check all that apply)
Would you like your address changed to the above if it does not agree with our records? (Retirees only)
What is your current status?
LASERS OFFICE USE ONLY
Visitors without appointments will be seen as time permits and may experience a delay.
Check one:
Are you currently on Leave Without Pay (LWOP) ?
LASERS Staff Member:
VISITOR INFORMATION SHEET:
DO ESTIMATES (remember to image all estimates) AND EXPLAIN EACH PORTION OF ESTIMATE:
EXPLAIN RETIREMENT TIMELINE:
REVIEW THE GUIDE TO RETIREMENT:
LAGNIAPPE INFORMATION BOOKLET:
VISITOR CHECKLIST - LASERS OFFICE USE ONLY
VISITOR INFORMATION SHEET:
DO ESTIMATES (remember to image all estimates) AND EXPLAIN EACH PORTION OF ESTIMATE:
EXPLAIN RETIREMENT TIMELINE:
REVIEW THE GUIDE TO RETIREMENT:
LAGNIAPPE INFORMATION BOOKLET:
VISITOR CHECKLIST - LASERS OFFICE USE ONLY
VISITOR INFORMATION SHEET:
DO ESTIMATES (remember to image all estimates) AND EXPLAIN EACH PORTION OF ESTIMATE:
EXPLAIN RETIREMENT TIMELINE:
REVIEW THE RETIREMENT READINESS GUIDE:
VISITOR CHECKLIST - LASERS OFFICE USE ONLY
8.0.1291.1.339988.308172
bar_code: SOLARISCURRENTDATE: SOLARISMEMBERLASTNAME: SOLARISMEMBERMIDDLENAME: SOLARISMEMBERFIRSTNAME: SSNBARCODE: *SOLARISMEMBERSSN: DateTimeField1: birth_date: ZipCode: State: email: eve_phone: City: day_phone: mailing_address: CheckBox2: 0TextField1: visitor_name: Bene_DOB: Sick_Leave: Annual_Leave: Bene_Name: Bene_Relationship: Visit_Recap: Name_of_LASERS_Staff: initials:
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