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�""�`'---�"'�' NOTICE OF APPOINTMENT OF AUTHORIZED AGENT <br /> ' IMRF Form 2.20 (Rev. 10/2014) <br /> INSTRUCTIONS <br /> • The governing body of an IMRF employer(including townships)can appoint any qualified party as the employer's IMRF <br /> Authorized Agent. <br /> • The governing body makes the appointment by adopting a resolution. <br /> • The clerk or secretary of the governing body must certiry the appointment(see Certification below). <br /> • Mail the completed form to the Illinois Municipal Retirement Fund. <br /> • A copy of the completed form should be retained by the employer. <br /> • The new Authorized Agent will need to register for a new User ID on IMRF Employer Access. <br /> EMPLOYER NAME EMPLOYER IMRF I.D.NUMBER <br /> it of Decatur Illinois 03340 <br /> AUTHORIZED AGENT'S SALUTATION LAST NAME FIRST NAME MIDDLE INITIAL JR.,SR.,II,ETC. <br /> ❑Dr. ❑Mr. [�Mrs. ❑Ms. Hawbaker Melinda M <br /> TYPE OF GOVERNING BODY <br /> DATE APPOINTMEN MADE(M IDD/YYYY) EFFECTIVE DATE OF APPOINTMENT(MM/DD/YYYY) POSITION TITLE <br /> 10/19/15 10/19/15 Comptroller <br /> Powers and duties delegated to Authorized Agent pursuant to Sec. 7-135 of Illinois Pension Code by governing body(P.A.97-0328 <br /> removed the requirement that the Authorized Agent be a participant in IMRF to file a petition or cast a ballot): <br /> To file Petition for Nominations of an Executive Trustee of IMRF QYes ❑No <br /> To cast a Ballot for Elect' n of an Executive Trustee of IMRF �tfes ❑No <br /> 0 <br /> X 10/15/15 <br /> SIGNATURE OF A ORIZED AGENT NAMED ABO E DATE(MM/DD/YYYY) <br /> CERTIFICATION <br /> I, Debra r_ Bri c�ht , do hereby certify that I am City Clerk <br /> NAME CLERK OR SECRETARY <br /> ofthe Citv of Decatur, IL <br /> NAME OF EMPLOYER <br /> and the keeper of its books and records and the foregoing appointment and delegation were made by resolution duly adopted on the <br /> date indicated. <br /> � <br /> SEAL <br /> SIGNATURE OF CLERK OR SECR RY <br /> BUSINESS ADDRESS <br /> All correspondence and communications with the Authorized Agent are to be addressed as follows: <br /> NAME(IF DIFFERENT FROM ABOV� <br /> MS. rs. ❑ Ms. <br /> BUSINESS ADDRESS <br /> 1 Gar K. Anderson Plaza <br /> CITY STATE AND ZIP+4 <br /> Decatur, IL 62523 <br /> DAYTIME TELEPHONE NO.(with Area Code) ALTERNATE TELEPHONE NUMBER(with Area Code) <br /> 217-450-2234 217-450-2203 <br /> FAX NO.(with Area Code) EMAIL ADDRESS <br /> IMRF <br /> 2211 York Road Suite 500 Oak Brook,IL 60523-2337 <br /> Employer Only Phone:1-800-728-7971 Member Services Representatives 1-800-ASK-IMRF(1-800-275-4673) Fax(630)706-4289 <br /> IMRF Form 2.20(Rev.10/2014) www.imrf.Org <br />