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! X W" W" R " ' B : A p p l i c a t i o n f o r P r e - R e t i r e m e n t R e d u c t i o n i n T i m e B a s e ( P R T B )
N a m e o f A p p l i c a n t : F O R M T E X T C S U N I D # : F O R M T E X T
D e p a r t m e n t : F O R M T E X T M a i l C o d e : F O R M T E X T C o l l e g e : F O R M T E X T
A c a d e m i c Y e a r i n w h i c h P R T B i s t o b e g i n : F O R M T E X T
P a r t i c i p a t i o n m a y c o m m e n c e a t t h e b e g i n n i n g o f a n a c a d e m i c y e a r , o r w h e n a p p r o p r i a t e a t t h e b e g i n n i n g o f t h e f i s c a l y e a r . S e c t i o n 3 0 . 1 o f t h e f a c u l t y C o l l e c t i v e B a r g a i n i n g A g r e e m e n t s t a t es,The Pre-Retirement Reduction in Time Base (PRTB) shall be available to tenured faculty unit employees who have reached the age of fifty-five (55) years subject to the following conditions: a.) That such a tenured faculty unit employee requests entry into PRTB at least six (6) months prior to the beginning of the fiscal year or academic year in which s/he desires to participate in PRTB. The President may waive the required request time limits. b.) That such a tenured faculty unit employee shall not have reached the age of sixty-five (65) at the time of requested entry into PRTB; or, if a member of STRS, such an employee shall not have reached the age of sixty-four (64) at the time of requested entry into PRTB. c.) That such a request is granted by the President. The President shall respond to such a request no later than sixty (60) days after receipt of such a request. d.) That the President shall provide the potential participant in PRTB with an appointment letter which shall indicate the terms of the reduction in time base. The faculty unit employee shall provide the President with a written statement of acceptance of the reduction in time base.
Select one of the following work schedules:
FORMCHECKBOX Two-thirds (2/3) in time base of Full-Time.
FORMCHECKBOX One-half (1/2) in time base of Full-Time.
FORMCHECKBOX One-third (1/3) in time base of Full-Time.
By signing this form, I recognize that this request, if granted, will be pursuant to Article 30 of the Faculty Bargaining Agreement. I have read the requirements of Article 30 concerning eligibility and believe that I am eligible to participate in the program. If my request is granted, I agree to abide by the terms and conditions of Article 30 of the Faculty Collective Bargaining Agreement available at: HYPERLINK "https://www2.calstate.edu/csu-system/faculty-staff/labor-and-employee-relations/Documents/unit3-cfa/article30.pdf" https://www2.calstate.edu/csu-system/faculty-staff/labor-and-employee-relations/Documents/unit3-cfa/article30.pdf I am eligible to participate in PRTB up to maximum period of (5) consecutive five years. PERS deductions shall be at full-time rate of pay. PRTB not eligible for Sabbatical Leaves or leaves with pay. Sick leave credit hours will be accrued on pro-rata basis based on your PRTB time base. The time base of a PRTB participant shall be considered full-time for the purpose of restrictions on additional employment as provided in Article 36, Additional Employment. I understand that irrespective of my PRTB time base, I am subject to 25% additional employment per Article 30. I understand that once my request is granted, the change is irreversible and I may not return to full-time employment.
_____________________________________________________ _____________________________
Signature of applicant Date
Forward to Department Chair
I do d o n o t r e c o m m e n d a p p r o v a l .
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
S i g n a t u r e o f D e p a r t m e n t C h a i r D a t e
F o r w a r d t o C o l l e g e D e a n
I d o d o n o t r e c o m m e n d a p p r o v a l.
______________________________________________________ _____________________________
Signature of College Dean Date
Forward to the Office of Faculty Affairs
I have reviewed this application in accordance with Article 29 of the Faculty Bargaining Agreement. PRTB participation is hereby approved for no more than five years beginning with the ________-________ academic year and ending with the ________-________ academic year.
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Signature of Provost & Vice President for Academic Affairs Date
FA Office Use Only - Distribution: HR College Dean Department Chair Applicant Faculty Affairs
Page PAGE 2 of NUMPAGES 1 Questions: Contact Faculty Affairs at Extension 2962; University Hall 225; MD 8220; Fax 5933
Revised: 08/21/2006
Page PAGE 1 of 1 Questions: Contact Faculty Affairs at Extension 2962; University Hall 225; MD 8220; Fax 5933
U: Forms: PRTB Application Revised: 01/30/2018
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