New Mexico Educational Retirement Board Exemption Form

The information in this form is required in creating or updating your retirement record and is important when processing your personnel/payroll documents.

Employee Information

I am exempt from having New Mexico Educational Retirement Contributions deducted from my payroll check due to one or more of the following reasons:  

1.______

2.______

3.______

4.______


5.______

 Substitute Instructor. (Not Hired as a Part-time Instructor)  

Assignment not to exceed 25% FTE (full-time equivalency) annually.  

Any CNM Employee who is a CNM student enrolled in a degree or certificate program.  

Current Retiree from a New Mexico Educational Institution certified for the Return to Work Program (RTW).

Current Retiree from a New Mexico Educational Institution.
Name of Institution:  ________________________________

 

_____________________________________                      ___________________________
Employee Printed name                                                            Social Security Number

_____________________________________                      ___________________________
Employee Signature                                                                  Date

Employer Certification

This is to certify that the above person is exempt from New Mexico Educational Retirement Contributions.

Verification information is provided by student, payroll or personnel records.

_____________________________________                      ___________________________
Business Office                                                                         Date

                           Payroll - ORIGINAL                             Human Resources - COPY