Affidavit of Employment for Retirement
STATE OF California
COUNTY OF Fresno
BEFORE ME, the undersigned authority, personally appeared [YOUR NAME], who, after being duly sworn, deposes and states as follows:
1. Personal Information
I, [YOUR NAME], residing at Fresno, CA 93701, hereby affirm the details of my employment with [YOUR COMPANY NAME] as part of my application for retirement benefits.
2. Employment Details
Position: Senior Project Manager
Date of Employment: I was employed by [YOUR COMPANY NAME] beginning on 01/15/2050.
Date of Termination: My employment with [YOUR COMPANY NAME] ended on 10/31/2084.
Duration of Employment: I was employed with [YOUR COMPANY NAME] for a total of 34 years and 9 months.
3. Confirmation of Employment Terms
I confirm that during my employment with [YOUR COMPANY NAME], I was:
Classified as full-time.
Paid on a bi-weekly basis.
Eligible for employee benefits, including but not limited to health insurance, retirement plan, and paid time off.
4. Purpose of Affidavit
This affidavit is provided as evidence of my employment with [YOUR COMPANY NAME] to satisfy requirements for retirement benefits from the California State Retirement Agency.
5. Acknowledgment
I, [YOUR NAME], affirm under penalty of perjury that the information provided in this affidavit is true and accurate to the best of my knowledge.
FURTHER AFFIANT SAYETH NOT.
[YOUR NAME]
Date: 10/31/2084
NOTARY ACKNOWLEDGMENT
STATE OF California
COUNTY OF Fresno
Sworn to (or affirmed) and subscribed before me by means of physical presence, this 31st day of October, 2084, by [YOUR NAME], who is personally known to me or has produced a California Driver’s License as identification.
Sarah Jones
Notary Public, State of California
Commission Number: 98765432
Commission Expiration Date: 12/31/2085
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