Missouri Majority Vote Referendum Process for Social Security and Medicare Coverage for Political Subdivisions and/or Instrumentalities of the State

Similar documents
Policy 610 Ratification Checklists

New Mexico Recreation & Parks Association Constitution & By-Laws

AMENDED BY-LAWS OF RIVERVIEW TERRACE HOMEOWNER S ASSOCIATION INC. 16 NOVEMBER 2011 ARTICLE I OFFICES AND DEFINITIONS

BYLAWS PUBLIC RISK MANAGEMENT ASSOCIATION MINNESOTA CHAPTER, INC. (MN PRIMA)

PAWNEE NATION OF OKLAHOMA. Election Act. of the Pawnee Nation

Oklahoma Constitution

BYLAWS KINGSWOOD HOMEOWNERS ASSOCIATION, INC. All terms as used herein shall have the same definitions as in the Articles of Incorporation.

Follow this and additional works at:

AMENDED BYLAWS OF OTTER CREEK HOMEOWNERS ASSOCIATION

AGREEMENT BETWEEN HARRIS COUNTY AND Harris County Municipal Utility District No. 55, RELATING TO JOINT ELECTIONS TO BE HELD MAY 4, 2019

LAKE LOTAWANA ASSOCIATION BY LAWS

RICHLAND COUNTY, NORTH DAKOTA HOME RULE CHARTER PREAMBLE

BYLAWS OF THE PRESERVE PROPERTY OWNERS ASSOCIATION, INC. an Alabama nonprofit corporation ARTICLE I THE ASSOCIATION

RULES OF PROCEDURE FOR THE STATE CONVENTION

OPERATING POLICY. POLICY TITLE: ANNUAL MEMBERSHIP MEETING VOTING PROCEDURES SECTION The Board of Directors NUMBER 2.1 DATE PROCEDURES

CFA SOCIETY NEW MEXICO, INC. AMENDED AND RESTATED BYLAWS July 2018

AMENDED AND RESTATED BYLAWS OF LAKEMONT HIGHLANDS DIVISION II HOMEOWNERS ASSOCIATION

Article 1 Sec moves to amend H.F. No as follows: 1.2 Delete everything after the enacting clause and insert: 1.

BYLAWS BRANSON/LAKES AREA CHAMBER OF COMMERCE AND CONVENTION & VISITORS BUREAU

BY-LAWS OF SECTION OF YOUNG LAWYERS MARYLAND STATE BAR ASSOCIATION, INC. As Approved June 12, 2008

Voting by Mail. Before you fill out the application, it is recommended that the voter read over all the instructions on the back of the application.

AN ACT to repeal 6.34 (1) (b) and 6.87 (4) (a) 2.; to consolidate, renumber and

IC Chapter 8. Centers for Independent Living

AGREEMENT BETWEEN HARRIS COUNTY AND THE WOODLANDS TOWNSHIP, RELATING TO JOINT ELECTIONS TO BE HELD NOVEMBER 4, 2014

Partnership for Emergency Planning

BYLAWS OF THE FRESNO COUNTY RETIRED EMPLOYEES ASSOCIATION

ARTICLE I GENERAL PROVISIONS

BYLAWS OF SLATER MILL PLANTATION HOMEOWNERS ASSOCIATION, INC.

AMENDED CHARTER OF THE CITY OF WAUCHULA, COUNTY OF HARDEE, STATE OF FLORIDA 2004

Tavistock Country Club By-Laws

Trial Forms & Procedural Requirements for Trials of Brothers

BYLAWS OF THE JAMES CITY COUNTY REPUBLICAN COMMITTEE ARTICLE I NAME ARTICLE II ORGANIZATION ARTICLE III OBJECT

GOLDEN RAIN FOUNDATION OF WALNUT CREEK BYLAWS ARTICLE I GENERAL PURPOSES AND OFFICES

JACKSON COUNTY SOUTHAMPTON FALLS HOMEOWNERS ASSOCIATION BY-LAWS. Article I Name and Location

POLICY. The Ministry of Community and Social Services has issued a Resource Guide setting out the Ministry s key requirements for running elections;

BYLAWS OF AIRLINES LODGE 1731 INTERNATIONAL ASSOCIATION OF MACHINISTS AND AEROSPACE WORKERS. ARTICLE I - Name and Object

In this by-law and all other by-laws of the Association, unless the context otherwise requires:

By-Laws MT. POCAHONTAS PROPERTY OWNERS ASSOC., INC. 386 OLD STAGE ROAD ALBRIGHTSVILLE, PA REVISED JULY 12, 2014

STATUTES of the CONFEDERATED TRIBES of the UMATILLA INDIAN RESERVATION As Amended through Resolution No (December 11, 2017) ELECTION CODE

TITLE 6 ELECTIONS (ELECTION COMMISSION)

WHEREAS, the Village of Buffalo Grove is a Home Rule Unit pursuant to the Illinois

BYLAWS. of the FIBROMYALGIA WELL SPRING FOUNDATION

COUNTY OF GORDON. This Agreement is made as of the of, 2013, by and between Gordon

The Fairways of Herons Glen Association, Inc. - By-Laws as amended November 11, 2013, Page 1

WOODSIDE PARK HOMEOWNERS ASSOCIATION - UNITS 1, 2, 3, AND 4 BYLAWS (As of April 14, 2018) The purposes and objectives of the Association are:

BY-LAWS OF THE POWAY FEDERATION OF TEACHERS

Rules of Election of Academic Senate of Faculty

THE SCHOOL BOARD OF BROWARD COUNTY, FLORIDA RESOLUTION

RULES OF GOVERNANCE for the BOARD OF TRUSTEES of WESTERN SULLIVAN PUBLIC LIBRARY. ADOPTED: 14 AUGUST 2000 REVISED: 9 January 2017 ARTICLE I NAME

THE REPUBLICAN PARTY OF VIRGINIA BEACH CITY COMMITTEE BYLAWS October 12, 2015

SONS OF ERIN CAPE COD, INC. West Yarmouth, MA. CONSTITUTION AND BYLAWS CONSTITUTION

ASHTON HALL HOMEOWNERS ASSOCIATION, INC., a North Carolina Nonprofit Corporation

NC General Statutes - Chapter 163 Article 20 1

RULES OF THE DEMOCRATIC PARTY OF THE STATE OF NEW MEXICO

MPEA. Constitution & By-Laws. Table of Contents MPEA CONSTITUTION 2 ARTICLE III... 2

1. Scope of application This Act regulates the election of Members of the European Parliament in Estonia.

JAMAICA BEACH PROPERTY OWNERS BY-LAWS

ORDER CALLING SCHOOL BUILDING BOND ELECTION

Vermont Frequently Asked Questions TABLE OF CONTENTS

Rule 701. Assignment of judges to courts.

LFN CY 2016 Municipal Levy Cap Referendum Procedures. January 25, 2016

Have you read your State Enabling Legislation? Presented by: Linda Yelverton, LA Mary Griffin, TN

AMENDED and RESTATED BYLAWS. TOWNE MEADOWS HOMEOWNERS ASSOCIATION An Arizona nonprofit corporation

Home Rule Charter. Approved by Hillsborough County Voters September Amended by Hillsborough County Voters November 2002, 2004, and 2012

BY-LAWS OF WILDEWOOD OWNERS ASSOCIATION, INC. A NON-PROFIT CORPORATION DATED: 31 MARCH, 1989

CAMELOT ESTATES ASSOCIATION BY-LAWS. ARTICLE I Purpose

(Amended May, 2014) BYLAWS

The name of the Corporation is Woburn Youth Hockey Association, Inc.

NC General Statutes - Chapter 163A Article 21 1

LEGAL PROFESSION ACT

CONTRACT FOR PROFESSIONAL SERVICES BETWEEN CHURCHILL COUNTY, NEVADA AND XXXXXXX. FOR INDIGENT LEGAL SERVICES

GENERAL ASSEMBLY OF NORTH CAROLINA SESSION

CONSTITUTION FOR AFSCME LOCAL 3336

NEW YORK CITY PARALEGAL ASSOCIATION - BYLAWS

FORREST LAKE TOWNHOUSE ASSOCIATION, INC. AMENDMENT TO THE BY-LAWS: NOMINATING & ELECTIONS

Charter of Incorporation & Bylaws

ORANGE COUNTY REGISTRAR OF VOTERS 1300 S.GRAND AVENUE, BLDG. C SANTA ANA, CA (714)

ARTICLES OF ASSOCIATION OF THE CITY DEMOCRATIC CLUB OF SAN FRANCISCO

Articles of Incorporation and Bylaws

Articles of Incorporation and Bylaws

ELECTION GUIDELINES NEA - IEA - LOCAL

ELECTION BROCHURE FOR CONDOMINIUM ASSOCIATIONS

ORDINANCE NO. WHEREAS, the City Council ordered to call an election for City Councilmembers to be held on May 7, 2016, pursuant to Texas law; and,

BYLAWS OF THE STATE CENTRAL COMMITTEE OF THE REPUBLICAN PARTY OF LOUISIANA (AMENDED 04/25/2015)

ORDINANCE NO. THE CITY COUNCIL OF THE CITY OF MISSION VIEJO DOES HEREBY ORDAIN AS FOLLOWS:

2018 E LECTION DATES

Town of Sturbridge Charter

BYLAWS CONGRESSIONAL PLACE HOMEOWNERS' ASSOCIATION, INC. (As Amended Effective November 13, 2011)

GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2011 SESSION LAW HOUSE BILL 925

RESOLUTION NUMBER 3402

BYLAW Executive Branch

BYLAWS of the NATIONAL TREASURY EMPLOYEES UNION CHAPTER 282

TWELFTH NORTHERN MARIANAS COMMONWEALTH LEGISLATURE AN ACT

BY-LAWS, RULES AND REGUALTIONS OF THE REPUBLICAN PARTY OF LARAMIE COUNTY STATE OF WYOMING ARTICLE I THE REPUBLICAN PARTY

SAMPLE FORM a volunteer poll worker with the county registrar of voters; a licensee of the California Board of Accountancy;

AMENDED AND RESTATED BYLAWS OF CROSS POINTE HOMEOWNERS ASSOCIATION OF PINELLAS, INC.

BYLAWS OF DISTRICT LODGE W-24 INTERNATIONAL ASSOCIATION OF MACHINISTS & AEROSPACE WORKERS AFL-CIO PREAMBLE

BY-LAWS OF EAST LAKE LOT OWNERS ASSOCIATION, INC. P.O. Box 147 Nineveh, In (NOT FOR PROFIT) Revised: July 2011 ARTICLE I - NAME

Bylaws of the Intelligent Transportation Society of New Mexico. A Chapter of ITS America

BYLAWS OF Tucson Unit 356, AMERICAN CONTRACT BRIDGE LEAGUE (Includes Changes from Annual Meetings, 19 November 2000 & 12 October 2008)

Transcription:

Missouri Majority Vote Referendum Process for Social Security and Medicare Coverage for Political Subdivisions and/or Instrumentalities of the State The procedures described herein are primarily based on RSMo 105.300-353 and Section 218 of the Social Security Act. A political subdivision s governing body of the State may request a majority vote referendum be conducted to determine if those employees performing services in positions covered by a retirement system desire social security and/or medicare coverage. The referendum may be requested for social security and medicare (Full FICA) coverage or for Medicare-only coverage. Authorization for the conduct of a referendum for social security and/or medicare purposes shall be requested by a resolution adopted by the governing body of the political subdivision. The resolution shall be provided by the Office of Administration/Division of Accounting (OA) (see Exhibit A). The originally signed and properly certified resolution shall be filed with OA. Upon receipt of the executed resolution, OA shall establish the date on which the referendum will be held. The referendum must be held no less than 90 days (or more for military, see below) after the Notice of Referendum is distributed to eligible employees. OA shall, upon receipt of the resolution, prepare the Notice of Referendum that shall contain the date(s), time(s) and location(s) of the referendum (see Exhibit B). The notice shall be given by the political subdivision, not less than 90 days prior to the date set for the referendum (plus 60 more days if they have employees on military leave), to all employees who are eligible members of the system, including those on leave of absence. Such notice shall be given to each current employee who is in a position under the retirement system on the date the notice is given. Notice should be given by personal delivery, first-class mail or e-mail. A hard copy of the notice must be posted on applicable bulletin boards of the political subdivision. The notice may be posted on the web site or Intranet of the political subdivision. Have the entity confirm to OA that the Notice was distributed. The political subdivision shall prepare a listing, in a paper or electronic format designed by the OA, of the eligible members of the retirement system as of the date of Notice of Referendum (see Exhibit C). This listing shall be furnished to the OA no later than fifteen (15) business days after the date of Notice of Referendum and will establish the initial pool of members eligible to vote in the referendum and that a simple majority will determine passage or failure. The political subdivision shall provide periodic updates to the listing based on applicable resignations and terminations, up to and including the date of the referendum. OA, in conjunction with the Social Security Administration, the political subdivision and any employee groups, will organize and conduct educational workshops for the eligible employees during the 90 day notice period. The educational workshops will

be offered for each eligible employee to inform them of the rights and benefits that may accrue to them, their dependents and survivors if their services are covered under social security and/or medicare. Additionally, the educational workshops shall include an explanation of the tax liabilities to which they will be subject if coverage is chosen and also an explanation of the referendum process. Depending on the entity s preference, these Educational Sessions can be conducted via a webinar or in person. (It is recommended to schedule educational meetings nearer the date of the Notice so individuals can utilize the Notice Period to research individual impact and be well informed at the date of the vote.) Each eligible employee member of the retirement system, on or before the referendum date, shall be supplied with a referendum election ballot devised by the OA. The ballot will contain provisions for an election by the member whether he/she desires to be covered for social security and/or medicare. The balloting process may be conducted in two separate ways: o If the ballots are to be supplied to a contact at the entity, the ballot shall be sent by a trackable means (UPS or FedEx) to that single contact. Each ballot must be accompanied with instructions as to the date it must be returned to the contact person in sealed double envelope process. A listing should be provided for each eligible voter to sign as having received their ballot. Failure by the eligible voter to properly execute and return a ballot on the referendum date shall be deemed a non-returned ballot and does not count as a Yes vote favoring social security and/or medicare coverage. o If an in-person vote is scheduled, the ballots will be distributed on-site by an OA representative. Each ballot is secured with assurance that only ONE ballot is distributed to each eligible voter. Voters will be issued a single ballot, cast a vote, and deposit the ballot into a secured ballot box for counting at the end of the allotted voting period. Because of the nature of a limited time onsite vote, there may be a need for Absentee Ballots for individual eligible voters who cannot attend the on-site voting period. In this case ADVANCE Absentee Ballots must be requested by those eligible voters. i. Employees who will not be present or who otherwise will be unable to cast a ballot on the referendum date may request an absentee ballot from the political subdivision. This request shall be made in advance with a deadline agreed upon with the entity, on an absentee ballot request form supplied by the OA. ii. The request must include the member's name, home address and reason for being absent from the referendum. OA will send the absentee ballot request forms and absentee ballots to the political subdivision prior to the referendum date to ensure distribution to the requesting eligible voters. iii. The absentee ballot shall be completed during the days prior to the referendum date. The member will place the completed absentee ballot in a sealed inner envelope, then a sealed outer envelope with their name, and return to the political subdivision s designated Majority Vote Referendum Procedures 2

contact person. The sealed ballot will be given to OA representative on the day of the on-site referendum. Failure to properly execute and return an absentee ballot within the established absentee period shall be deemed a non-returned ballot and cannot be counted as a favorable vote for social security and/or medicare coverage. The OA will count the ballots and summarize the election of the eligible members, in a paper or electronic format designed by the OA (see Exhibit E). OA and any witnesses will sign the attestation to confirm the integrity of the count. OA will forward to the political subdivision a signed copy of the referendum results. Certification of the Referendum. Under federal law, the following conditions shall be followed when conducting the referendum: 1) The referendum will be held by secret, written ballot on the question of whether members of a retirement system wish coverage under the Agreement of January 1, 1951; 2) The opportunity to vote will be given and limited to eligible employees identified below: o Those eligible employees who are members of the retirement system on the date the referendum is held, AND o Those employees in a position under the retirement system both at the time the referendum notice is given and on the date the referendum is held. 3) All members of the system will be given at least 90 days' notice regarding the referendum; 4) The referendum will be conducted under the supervision of the Governor, agency or person designated by the Governor; and 5) A majority of the eligible employees of the retirement system must vote in favor of coverage before coverage can be extended. This requirement is satisfied by the Certification of Referendum signed by the State Administrator if the vote is in favor of coverage (see Exhibit F). The OA, after the conduct of a successful referendum, shall furnish, pursuant to RSMo 150.350, the political subdivision two, partially completed, Plan and Agreement document. The Plan and Agreement, and its associated Resolution, shall be executed by the governing body of the political subdivision no later than sixty (60) days after the date of the referendum. Upon receipt of the executed Plan and Agreement or Amendment from the political subdivision, OA will countersign all originals and return one original to the entity. An original must be retained by OA in the entity file. OA shall execute a modification to the Agreement of January 1, 1951 and submit such modification to the Social Security Administration. Such modification must Majority Vote Referendum Procedures 3

provide language to include coverage to those services performed by individuals in positions covered by the retirement system. Any excluded positions covered by the retirement system must also be noted on the modification. Upon receipt of an executed (signed) modification from the Social Security Administration, the OA shall notify the political subdivision that coverage has been accepted and provide a copy of the Mod. The political subdivision will initiate payment of the applicable taxes, if such payment has not already been made, to the IRS based on the appropriate IRS instructions. If the majority of the eligible voters do NOT favor social security &/or medicare coverage, the count must be documented as noted above with Exhibit E. If the retirement system group is in a FICA Replacement Plan, then OA will provide SSA Form 1945 for use by the entity in explaining to each retirement system eligible new hire of being in a position not covered by social security. No Modification to the State s Agreement is executed. Majority Vote Referendum Procedures 4

EXHIBIT A RESOLUTION TO REQUEST AUTHORIZATION OF REFERENDUM WHEREAS, Section 105.353 RSMo establishes procedures whereby members of retirement systems in political subdivisions may obtain social security coverage; and WHEREAS, it is deemed to be desirable that the [entity name], a political subdivision of the State of Missouri, obtain said social security coverage for certain coverage groups of its employees; and WHEREAS, the [entity name] desires to establish social security coverage pursuant to Section 218 [42 U.S.C. 418] of the Social Security Act and Section 105.350 RSMo for those positions of members of the [retirement system] to include services performed by such individuals employed in positions covered by said retirement system as members of a coverage group established by Section 218(d) of said Act. NOW, THEREFORE, BE IT RESOLVED, that the [entity name], desiring to offer social security coverage to services performed by its employees in positions covered by [retirement system], respectfully requests the Governor of the State of Missouri to authorize the necessary majority vote referendum among the eligible employees of said deemed retirement system as to whether a majority of such employees favors social security coverage. If said majority favors coverage, an agreement will be entered into by this governing body; and BE IT FURTHER RESOLVED, that notice of the majority vote referendum shall be given to eligible members of the [retirement system] not less than ninety days prior to the conduct of such referendum; and BE IT FURTHER RESOLVED, that after the end of the ninety day notice period, a majority vote referendum shall be conducted in accordance with the requirements of Section 218(d) of the Social Security Act and applicable state and federal laws and regulations; that each eligible member of [retirement system], who received the ninety day notice of the referendum, shall be furnished a ballot for the majority vote referendum to permit the member to elect whether or not services should be excluded from or included under the State of Missouri s Social Security Agreement as hereinbefore provided. Such coverage will be effective as to services performed on and after [date of coverage], only if a majority of the [entity name] [retirement system] members who are eligible to vote in the referendum vote in favor of Social Security coverage for which will then require an agreement to be made with the State of Missouri. CERTIFICATION We do hereby certify that the foregoing is a true and original copy of a Resolution adopted by the governing body [entity name] on, 20. Signed: (Board President) Date: Signed: (Board Secretary) Date:

EXHIBIT B NOTICE OF SOCIAL SECURITY REFERENDUM [NOTICE DATE] Notice is hereby given that a referendum will be conducted by the Missouri State Social Security Administrator to determine whether eligible employees of the [ENTITY NAME] members of [RETIREMENT SYSTEM NAME] favor the adoption of coverage under the Old Age, Survivors, and Disability Insurance (OASDI) programs (Social Security coverage). The Social Security Act provides for benefits under the federal OASDI programs, if the eligibility criteria for the program are met. Benefits under these programs are monthly payments made to retired persons, families whose wage earner has died, and workers who are unable to work because of a physical or mental impairment. Workers qualify for such protection when they have been employed for the mandatory minimum amount of time and made contributions to Social Security through payroll taxes. There is no financial need requirement for OASDI programs. Once a worker qualifies for protection, his or her family may also be eligible for benefits. Detailed program information can be obtained at www.ssa.gov or by visiting a local Social Security Administration office. Each employee of the [ENTITY NAME] who is a member of [RETIREMENT SYSTEM NAME] on [NOTICE DATE], and who continues to be an employee member of said retirement system on the official day of the referendum, [VOTE DATE], will have the right to vote. If majority of those eligible to vote favor coverage, [ENTITY NAME] s [RETIREMENT SYSTEM NAME] members will be entitled to benefits under the programs Social Security administers. In addition, each [ENTITY NAME] s [RETIREMENT SYSTEM NAME] member will continue, or begin, contributing to Social Security through payroll taxes as required by the Federal Insurance Contributions Act. The referendum will be conducted for the eligible voters of: [ENTITY NAME] Ballots will be distributed in advance of the vote date. To be valid, a cast ballot must be received in a sealed envelope by [CONTACT PERSON] no later than: [TIME am/pm]. [DAY OF WEEK], [FULL CALENDAR DATE] This notice is posted in accordance with the requirement under the Missouri Revised Statutes and the Social Security Act that all eligible employees be given at least 90-days notice of such referendum. An educational meeting has been scheduled with eligible employees of the [ENTITY NAME] on [DATES OF SESSIONS], at which time your individual questions will be answered concerning your rights and liabilities regarding the referendum. Questions regarding this referendum may be directed to: Vandee DeVore, Deputy State Social Security Administrator Office of Administration, Division of Accounting PO Box 809 Jefferson City, MO 65102-0809 (573)751-1987 218agreements@oa.mo.gov

SOCIAL SECURITY COVERAGE REFERENDUM REGISTER Missouri State Social Security Administrator PO Box 809 Jefferson City, MO 65102-0809 EXHIBIT C Social Security Number Name I certify that this is a true and complete list of all employees of the [ENTITY NAME], who are members of {RETIREMENT SYSTEM NAME] as of {NOTICE DATE], the date of the Notice of Referendum. Signed Title Date

Request for Absentee Ballot EXHIBIT D An employee may request an absentee ballot for the upcoming Social Security coverage referendum using this form. This request should be made in writing, when an employee may be absent on the day of the vote. The request must include the employee's name, and address to mail the ballot. Return this completed request to {your designated contact person no later than }. This allows time for processing and mailing a ballot to you, and then you submitting your ballot to [the designated contact] by [vote date]. He/She will submit all Absentee Ballots to the State Social Security Administrator to be included in the final vote count. Request for Absentee Ballot The Missouri Revised Statutes provide the procedure whereby employees of a political subdivision who are covered by a retirement system may obtain social security coverage through a favorable vote of the majority of the eligible voting pool. As an eligible voter, I hereby request an absentee ballot from the Missouri State Social Security Administrator. Entity: [ENTITY NAME] Name: (Please Print) Signed: Date: Please provide the address to send the ballot: _[TYPICALLY PROVIDE THE ENTITY ADDRESS] Please contact the Missouri State Social Security Administrator if you have any questions. Vandee DeVore, Deputy State Social Security Administrator Missouri Office of Administration/Division of Accounting PO Box 809 Jefferson City, MO 65102-0809 E-mail: 218agreements@oa.mo.gov Voice: (573) 751-1987

EXHIBIT E [ENTITY NAME] Social Security Coverage Referendum [REFERENDUM DATE] Number of Eligible Voters Majority YES votes required to pass VOTE COUNT: Yes No Ballots Deemed invalid Ballots Not Returned Number of Eligible Voters Not Voting Total of Vote Count Categories (should equal # of Eligible Voters) Did majority of eligible voters accept Social Security coverage under Section 218? : YES NO By the delegated authority vested in the State Social Security Administrator, I attest the above information to be true and accurate. Vandee DeVore, Deputy State Social Security Administrator Date Witnesses: (optional) Signature Printed Name

Certification of Referendum Section 218 (d)(3) of the Social Security Act EXHIBIT F Pursuant to authority vested in me for this purpose by the Governor of the State of Missouri, this is to certify that: (a) A referendum by secret ballot was held on [REFERENDUM DATE] on the question of whether services of employees of the [ENTITY NAME], as members of the [RETIREMENT PLAN NAME] should be excluded from or included under the agreement entered into on July 13, 1951 by the State of Missouri and the Commissioner of Social Security pursuant to Section 218 of the Social Security Act; (b) An opportunity to vote in such referendum was given, and was limited to eligible employees (as defined in Section 218(d) of such Act) of such system; (c) Not less than ninety days notice of such referendum was given to all such employees; (d) Such referendum was conducted under the supervision of [OA REPRESENTATIVE NAME], duly designated to conduct such referendum; and (e) A majority of the eligible employees voted in favor of including service of the members of the [RETIREMENT PLAN NAME] under the agreement entered into on July 13, 1951 by the State of Missouri and the Commissioner of Social Security pursuant to Section 218 of the Social Security Act. No referendum has previously been held in the political subdivision on the question of whether members of the [RETIREMENT PLAN NAME] should be excluded or included under the agreement entered into on July 13, 1951 by the State of Missouri and the Commissioner of Social Security, pursuant to Section 218 of the Social Security Act. Done this day of, 20 Signature Designated Official State Administrator