Fillable CERTIFICATION OF ELIGIBILITY FOR CRITICAL SHORTAGE TEACHERS AND ADMINISTRATORS (VIRGINIA RETIREMENT SYSTEM)

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CERTIFICATION OF ELIGIBILITY FOR CRITICAL SHORTAGE TEACHERS AND ADMINISTRATORS (VIRGINIA RETIREMENT SYSTEM)

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VRS-160 (Rev. 07/20)
*D-0000WART*
CERTIFICATION OF ELIGIBILITY FOR CRITICAL SHORTAGE
TEACHERS AND ADMINISTRATORS
Retirees of the Virginia Retirement System (VRS) employed in critical shortage positions as defined by the Superintendent
of Public Instruction must complete this form at the time of employment and by September 1 of each year as long as they
continue to be employed in a critical shortage position. The employer must certify the form and send it to VRS.
3. Name (First, Middle Initial, Last)
4. Social Security Number
5. VRS Retirement Date 6. Employer at Time of Retirement 7. Teaching License Number and Expiration Date
No: Exp:
8. Post-Retirement Employment Information
Enter information about all positions you have held with VRS-participating employers since your VRS retirement date:
Dates Employed Critical Shortage
Employer Fr
om To Employment Status Position?
Substitute/Part-time Full-time Yes No
Substitute/Part-time Full-time Yes No
9. Current Critical Shortage Position Information
School: Hire Date:
Assignment: Annual Contract Salary: $
10. Retiree Certification
I certify that the information on this form is accurate. I understand that falsification of this information could result in the loss
of VRS retirement benefits during my time of employment with the named school board. I have read the following
statements and meet the following requirements:
• I did not: 1) retire with a reduced VRS benefit under an early retirement incentive program (ERIP), 2) retire under the
Transitional Benefits Program or the Workforce Transition Act (WTA) with an enhanced monthly VRS benefit, or 3)
retire on VRS disability retirement.
• I have had a complete break in service, including part-time employment, from all VRS employers for at least 12
consecutive months.
• Prior to my VRS retirement date, I had no pre-arranged employment commitment, either verbal or written, with this
school division.
• I am licensed and endorsed in my area of assignment by the Virginia Board of Education.
• I have been assigned to work in a critical shortage position as defined by the Code of Virginia and the Department of
Education. I understand this position is contingent on it being identified as a critical shortage position and that it may not
qualify as a critical shortage position as defined by the Code of Virginia and the Department of Education beyond the
current school year.
Retiree Signature Date
11. Employer Certification
I certify this individual will work in a critical shortage position as defined by the Code of Virginia and the Department of
Education or three or fewer qualified applicants applied for this position. This position may not qualify as a critical shortage
position as defined by the Code of Virginia and the Department of Education beyond the current school year. I further certify
that the individual is licensed and endorsed for this position and that I did not make a pre-employment commitment, either
verbal or written, to this individual prior to his or her VRS retirement date.
School Division Superintendent or Designee Signature Date
School Division Superintendent or Designee Printed Name
1. Employer Code
2. Employer (School Division) Name
VIRGINIA RETIREMENT SYSTEM
P.O. Box 2500
Richmond, VA 23218-2500
Toll-free 1-888-827-3847
Fax 804-786-9718
www.varetire.org
Clear Form
VRS-160 (Rev. 07/20)
COMPLETING THE CERTIFICATION OF ELIGIBILITY FOR CRITICAL SHORTAGE
TEACHERS AND ADMINISTRATORS
Virginia Retirement System (VRS) retirees who are licensed to teach in Virginia may teach full-time in a critical
shortage position and continue to receive VRS retirement benefits if certain eligibility requirements are met.
After you complete this form, submit it to your employer for certification. Your employer must send the form to
VRS at the time you are initially hired and each year thereafter by September 1.
To be eligible:
• You must be receiving a monthly VRS retirement benefit;
• You must teach in a designated critical shortage position as defined by the Code of Virginia and
Department of Education;
• You must have had a break in service for at least 12 consecutive months during which you did not work in
any full-time, part-time or volunteer position, including coaching and substitute teaching, with any VRS-
participating employer, or working for a contractor with any VRS-participating employer;
• You must not have: 1) retired with a reduced VRS benefit under an early retirement incentive program
(ERIP), 2) retired under the Transitional Benefits Program or the Workforce Transition Act (WTA) with an
enhanced monthly VRS benefit, or 3) retired on VRS disability retirement;
• You must be licensed and endorsed for your assigned position by the Virginia Board of Education; and
• Prior to your VRS retirement date, you must not have had a pre-arranged commitment, either verbal or
written, for post-retirement employment as a critical shortage teacher or administrator.
Retiree Responsibilities
When completing the form:
• In Box 6, enter the name of the school division for which you worked at the time of your VRS retirement.
• In Box 7, enter your Virginia teaching license number and its expiration date.
• In Box 8, enter information about all positions you have held with VRS-participating employers since your
retirement. (Additional employment history may be provided on a separate page if needed.)
• In Box 9, enter information about the critical shortage position you are filling. This includes the name of the
school at which you are working for the school division identified in Boxes 1 and 2, the date you were hired
for the position, the assignment you have been given, and your annual contract salary.
• After completing the form, carefully read the certification statements in Box 10, sign and date the form.
• After you have signed and dated the form, submit the form to your employer for certification.
Employer Responsibilities
• Verify the information entered by the retiree.
• Read the employer certification statement, sign and date the form.
• After completing the certification, send the form to VRS.
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CERTIFICATION OF ELIGIBILITY FOR CRITICAL SHORTAGE TEACHERS AND ADMINISTRATORS (VIRGINIA RETIREMENT SYSTEM)

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Completed 15 September 2020

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