Louisiana Administrative Code
Title 32 - EMPLOYEE BENEFITS
Part I - General Provisions
Chapter 7 - Group Benefits Policy and Planning Board
Section I-717 - Petition Form

Universal Citation: LA Admin Code I-717

Current through Register Vol. 50, No. 9, September 20, 2024

A. Nominating Petition. Nominations will be submitted on a form substantially in compliance with the following.

We the undersigned OGB enrollees are retired teachers or retired school employees/retired state employees and hereby nominate

______________ for membership on the Office of Group Benefits

Policy and Planning Board.

Signature

Printed Name

Last 4 of SSN

Agency

Date

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

I hereby certify the persons signing this petition are retired teachers or other school employees/retired state employees and OGB retired enrollees as of the specified nomination date.

_________________________________________________________

OGB Chief Executive Officer or his/her designated representative

AUTHORITY NOTE: Promulgated in accordance with R.S. 42:801(C) and 802(B)(1).

Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.