Standard Work Day and
Reporting Resolution for
Elected and Appointed Officials
RS 2417-A
(Rev.09/18)
Please type or print clearly
in blue or black ink
Employer Location Code
SEE INSTRUCTIONS FOR COMPLETING FORM ON REVERSE SIDE
BE IT RESOLVED, t
hat the ______________________________________________/ _______________ hereby established the following standard work days for these titles and will
(Name of Employer)
(Location Code)
report the officials to the New York State and Local Retirement based on their record of activities:
Received Date
Title: Standard
Work Day:
(Hrs/day)
Min. 6 hrs
Max. 8 hrs
Name:
(First and Last)
Social
Security
Number:
(Last 4
digits)
NYSLRS ID: Tier 1
(Check
only if
member if
Tier 1)
Current
Term
Begin & End
Dates:
(mm/dd/yy-
mm/dd/yy)
Record of
Activities
Result:*
Not Submitted:
(Check only if
official did not
submit their
Record of
Activities)
Elected Officials:
Appointed Officials:
I, ______________________________________________, secretary/clerk of the governing board of the ____________________________________, of the State of New York,
(Name of Secretary or Clerk)
(Circle one)
(Name of Employer)
do hereby certify that I have compared the foregoing with the original resolution passed by such board at a legally convened meeting held on the _______ day of _________, 20____
on file as part of the minutes of such meeting, and that same is a true copy thereof and the whole of such original.
IN WITNESS WHEREOF, I have hereunto set my hand and the seal of the __________________________________________ on this ______ day of _____________, 20_____,
(Name of Employer)
______________________________________________________.
(Signature of Secretary or Clerk)
Affidavit of Posting: I, _________________________________________ being duly sworn, deposes and says that the posting of the Resolution began on
(Name of Secretary or Clerk)
_____________________ and continued for at least 30 days. That the Resolution was available to the public on the:
(Date)
Employer’s website at: _______________________________________________________
Official sign board at: _______________________________________________________
(seal)
Main entrance Secretary or Clerk’s office at: _______________________________________ Page ________ of _________ (for additional rows, attach a RS 2417-B form.)

SUPERVISOR
ROBERT VALENTINE
11/19/18-12/31/19
26.67
COUNCILPERSON
CYNTHIA SMITH
1/1/16-/12/31/19
13.34
COUNCILPERSON
RYAN WENSLEY
1/1/17-12/31/19
6
WALTER POPAILO
1/9/17-12/31/21
.17
HISTORIAN
6
CLFTON PATRICK
1/1/19-12/31/19
18.95
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

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30
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

MAY 30, 2019
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
1
3
Instructions for completing the Standard Work Day and Reporting Resolution
A.
Title:
B.
Standard
Work
Day:
(Hrs/day)
Min. 6
hrs
Max. 8.
hrs
C.
Name:
(First and
Last)
D.
Social
Security
Number:
(Last 4
digits)
E.
NYSLRS ID:
F.
Tier 1:
(Check only
if member
is in Tier 1)
G.
Current
Term Begin
and End
Dates:
(mm/dd/yy-
mm/dd/yy)
H.
Record of
Activities
Result*:
I.
Not
Submitted :
(Check only
if official
did not
submit their
Record of
Activities
Elected Officials:
Highway 8.00 John Smith 0000 R11111111 1/1/2010- 32.79
Superintendent 12/31/2013
Receiver of 6.00 Michelle 1111 R22222222 X 1/1/2010- NA
Taxes Jones 12/31/2014
Town Justice 6.25 Michael Hall 2222 R33333333 1/1/2010- X
12/31/2011
Appointed Officials:
Planning Board 7.00 Joseph Gray 3333 R44444444 1/1/2010- 17.54
Member 12/31/2010
A. Title: All paid elected and appointed officials (who are active members of the Retirement System) and are not paid hourly and do not
participate in a employer’s time keeping system that consists of a daily record of actual time worked and time charged to accruals
must be listed. For the purpose of the regulation, an “appointed official” is someone who is appointed by an elected official, an
appointed official or governing board. They hold an office in an organization or government and participate in the exercise of
authority. This also includes appointees of elected and appointed officials such as deputies, assistants or confidential secretaries.
B. Standard Work Day: The minimum number of hours that can be established for a standard work day (SWD) is six, while the
maximum is eight. A SWD is the denominator to be used for the days worked calculation; it is not necessarily always the number of
hours a person works. For example, if a board member only attends one three-hour boarding meeting per month, you must still
establish a SWD between six and eight hours as the denominator for their record of activities (ROA) calculation.
C. Name: The official’s complete first and last name must be included for identification purposes.
D. Social Security Number: The last four digits of the official’s Social Security Number must be included for identification purposes.
For security purposes, the last four digits of the Social Security Number can be omitted from the publicly posted version.
E. NYSLRS ID: The official’s NYSLRS ID must be included for identification purposes. For security purposes, the NYSLRS ID can be
omitted from the publicly posted version.
F. Tier 1: If the official is a Tier 1 member, this box should be checked. Tier 1 members are not required to keep an ROA.
G. Current Term Begin & End Dates: All officials listed on the Resolution must have a specified Term End date. Leaving this column
blank or listing ‘Tenure/At Pleasure’ is not acceptable. If the official does not have a designated term, the current term for the official
who appointed them to the position should be used. If they are appointed by the governing board, the chairman of the board’s term
should be used.
H. Record of Activities Result*: This column must be left blank if an official does not submit their required sample three-month ROA.
To determine the average number of days worked per month, you must divide the total number of hours documented on the three-
month ROA by three months to get a one-month average number of hours worked. Then, the one-month average number of hours
worked must be divided by the SWD to get the average number of days worked per month.
I. Not Submitted: This column must be checked if an official has not submitted the required sample three-month ROA within the 150
day requirement, regardless of whether they are being reported by another employer for the same period. If the Retirement System
receives such a Resolution, it will contact the official to notify them of the consequences of not submitting the ROA.
Once passed, the Resolution must be posted on your public website for a minimum of 30 days or if a website isn’t available to the public,
on the official sign-board or at the main entrance to the clerk’s office. A certified copy of the Resolution and Affidavit of Posting must be
filed with the Office of State Comptroller within 45 days of the adoption. The Resolution and Affidavit can be submitted via the Submit
Resolution for Official link in Retirement Online.
*To determine the number of days worked to include on the monthly report for the various payroll frequencies, please refer to the
Calculating Days Worked instructions available in the ‘Reporting Elected & Appointed Officials’ section of our website:
http://www.osc.state.ny.us/retire/employers/elected_appointed_officials/index.php
Standard Work Day and
Reporting Resolution for
Elected and Appointed Officials
RS 2417-A
(Rev.09/18)
Please type or print clearly
in blue or black ink
Employer Location Code
SEE INSTRUCTIONS FOR COMPLETING FORM ON REVERSE SIDE
BE IT RESOLVED, t
hat the ______________________________________________/ _______________ hereby established the following standard work days for these titles and will
(Name of Employer)
(Location Code)
report the officials to the New York State and Local Retirement based on their record of activities:
Received Date
Title: Standard
Work Day:
(Hrs/day)
Min. 6 hrs
Max. 8 hrs
Name:
(First and Last)
Social
Security
Number:
(Last 4
digits)
NYSLRS ID: Tier 1
(Check
only if
member if
Tier 1)
Current
Term
Begin & End
Dates:
(mm/dd/yy-
mm/dd/yy)
Record of
Activities
Result:*
Not Submitted:
(Check only if
official did not
submit their
Record of
Activities)
Elected Officials:
Appointed Officials:
I, ______________________________________________, secretary/clerk of the governing board of the ____________________________________, of the State of New York,
(Name of Secretary or Clerk)
(Circle one)
(Name of Employer)
do hereby certify that I have compared the foregoing with the original resolution passed by such board at a legally convened meeting held on the _______ day of _________, 20____
on file as part of the minutes of such meeting, and that same is a true copy thereof and the whole of such original.
IN WITNESS WHEREOF, I have hereunto set my hand and the seal of the __________________________________________ on this ______ day of _____________, 20_____,
(Name of Employer)
______________________________________________________.
(Signature of Secretary or Clerk)
Affidavit of Posting: I, _________________________________________ being duly sworn, deposes and says that the posting of the Resolution began on
(Name of Secretary or Clerk)
_____________________ and continued for at least 30 days. That the Resolution was available to the public on the:
(Date)
Employer’s website at: _______________________________________________________
Official sign board at: _______________________________________________________
(seal)
Main entrance Secretary or Clerk’s office at: _______________________________________ Page ________ of _________ (for additional rows, attach a RS 2417-B form.)
TOWN OF CHESTER
SUPERVISOR
6
ROBERT VALENTINE
11/19/18-12/31/19
26.67
COUNCILPERSON
6
CYNTHIA SMITH
1/1/16-/12/31/19
13.34
COUNCILPERSON
6
RYAN WENSLEY
1/1/17-12/31/19
24.62
6
WALTER POPAILO
1/9/17-12/31/21
.17
HISTORIAN
6
CLFTON PATRICK
1/1/19-12/31/19
18.95
LINDA A. ZAPPALA
TOWN OF CHESTER
22
MAY
19
TOWN OF CHESTER
30
MAY
19
LINDA A. ZAPPALA
MAY 30, 2019
WWW.CHESTER-NY.GOV
1786 KINGS HGIHWAY, CHESTER, NY 10918
1
3
Instructions for completing the Standard Work Day and Reporting Resolution
A.
Title:
B.
Standard
Work
Day:
(Hrs/day)
Min. 6
hrs
Max. 8.
hrs
C.
Name:
(First and
Last)
D.
Social
Security
Number:
(Last 4
digits)
E.
NYSLRS ID:
F.
Tier 1:
(Check only
if member
is in Tier 1)
G.
Current
Term Begin
and End
Dates:
(mm/dd/yy-
mm/dd/yy)
H.
Record of
Activities
Result*:
I.
Not
Submitted :
(Check only
if official
did not
submit their
Record of
Activities
Elected Officials:
Highway 8.00 John Smith 0000 R11111111 1/1/2010- 32.79
Superintendent 12/31/2013
Receiver of 6.00 Michelle 1111 R22222222 X 1/1/2010- NA
Taxes Jones 12/31/2014
Town Justice 6.25 Michael Hall 2222 R33333333 1/1/2010- X
12/31/2011
Appointed Officials:
Planning Board 7.00 Joseph Gray 3333 R44444444 1/1/2010- 17.54
Member 12/31/2010
A. Title: All paid elected and appointed officials (who are active members of the Retirement System) and are not paid hourly and do not
participate in a employer’s time keeping system that consists of a daily record of actual time worked and time charged to accruals
must be listed. For the purpose of the regulation, an “appointed official” is someone who is appointed by an elected official, an
appointed official or governing board. They hold an office in an organization or government and participate in the exercise of
authority. This also includes appointees of elected and appointed officials such as deputies, assistants or confidential secretaries.
B. Standard Work Day: The minimum number of hours that can be established for a standard work day (SWD) is six, while the
maximum is eight. A SWD is the denominator to be used for the days worked calculation; it is not necessarily always the number of
hours a person works. For example, if a board member only attends one three-hour boarding meeting per month, you must still
establish a SWD between six and eight hours as the denominator for their record of activities (ROA) calculation.
C. Name: The official’s complete first and last name must be included for identification purposes.
D. Social Security Number: The last four digits of the official’s Social Security Number must be included for identification purposes.
For security purposes, the last four digits of the Social Security Number can be omitted from the publicly posted version.
E. NYSLRS ID: The official’s NYSLRS ID must be included for identification purposes. For security purposes, the NYSLRS ID can be
omitted from the publicly posted version.
F. Tier 1: If the official is a Tier 1 member, this box should be checked. Tier 1 members are not required to keep an ROA.
G. Current Term Begin & End Dates: All officials listed on the Resolution must have a specified Term End date. Leaving this column
blank or listing ‘Tenure/At Pleasure’ is not acceptable. If the official does not have a designated term, the current term for the official
who appointed them to the position should be used. If they are appointed by the governing board, the chairman of the board’s term
should be used.
H. Record of Activities Result*: This column must be left blank if an official does not submit their required sample three-month ROA.
To determine the average number of days worked per month, you must divide the total number of hours documented on the three-
month ROA by three months to get a one-month average number of hours worked. Then, the one-month average number of hours
worked must be divided by the SWD to get the average number of days worked per month.
I. Not Submitted: This column must be checked if an official has not submitted the required sample three-month ROA within the 150
day requirement, regardless of whether they are being reported by another employer for the same period. If the Retirement System
receives such a Resolution, it will contact the official to notify them of the consequences of not submitting the ROA.
Once passed, the Resolution must be posted on your public website for a minimum of 30 days or if a website isn’t available to the public,
on the official sign-board or at the main entrance to the clerk’s office. A certified copy of the Resolution and Affidavit of Posting must be
filed with the Office of State Comptroller within 45 days of the adoption. The Resolution and Affidavit can be submitted via the Submit
Resolution for Official link in Retirement Online.
*To determine the number of days worked to include on the monthly report for the various payroll frequencies, please refer to the
Calculating Days Worked instructions available in the ‘Reporting Elected & Appointed Officials’ section of our website:
http://www.osc.state.ny.us/retire/employers/elected_appointed_officials/index.php
Standard Work Day and
Reporting Resolution for
Elected and Appointed Officials
RS 2417-A
(Rev.09/18)
Please type or print clearly
in blue or black ink
Employer Location Code
SEE INSTRUCTIONS FOR COMPLETING FORM ON REVERSE SIDE
BE IT RESOLVED, t
hat the ______________________________________________/ _______________ hereby established the following standard work days for these titles and will
(Name of Employer)
(Location Code)
report the officials to the New York State and Local Retirement based on their record of activities:
Received Date
Title: Standard
Work Day:
(Hrs/day)
Min. 6 hrs
Max. 8 hrs
Name:
(First and Last)
Social
Security
Number:
(Last 4
digits)
NYSLRS ID: Tier 1
(Check
only if
member if
Tier 1)
Current
Term
Begin & End
Dates:
(mm/dd/yy-
mm/dd/yy)
Record of
Activities
Result:*
Not Submitted:
(Check only if
official did not
submit their
Record of
Activities)
Elected Officials:
Appointed Officials:
I, ______________________________________________, secretary/clerk of the governing board of the ____________________________________, of the State of New York,
(Name of Secretary or Clerk)
(Circle one)
(Name of Employer)
do hereby certify that I have compared the foregoing with the original resolution passed by such board at a legally convened meeting held on the _______ day of _________, 20____
on file as part of the minutes of such meeting, and that same is a true copy thereof and the whole of such original.
IN WITNESS WHEREOF, I have hereunto set my hand and the seal of the __________________________________________ on this ______ day of _____________, 20_____,
(Name of Employer)
______________________________________________________.
(Signature of Secretary or Clerk)
Affidavit of Posting: I, _________________________________________ being duly sworn, deposes and says that the posting of the Resolution began on
(Name of Secretary or Clerk)
_____________________ and continued for at least 30 days. That the Resolution was available to the public on the:
(Date)
Employer’s website at: _______________________________________________________
Official sign board at: _______________________________________________________
(seal)
Main entrance Secretary or Clerk’s office at: _______________________________________ Page ________ of _________ (for additional rows, attach a RS 2417-B form.)
TOWN OF CHESTER
SUPERVISOR
6
ROBERT VALENTINE
11/19/18-12/31/19
26.67
COUNCILPERSON
6
CYNTHIA SMITH
1/1/16-/12/31/19
13.34
COUNCILPERSON
6
RYAN WENSLEY
1/1/17-12/31/19
6
WALTER POPAILO
1/9/17-12/31/21
.17
HISTORIAN
6
CLFTON PATRICK
1/1/19-12/31/19
18.95
LINDA A. ZAPPALA
TOWN OF CHESTER
22
MAY
19
TOWN OF CHESTER
30
MAY
19
LINDA A. ZAPPALA
MAY 30, 2019
WWW.CHESTER-NY.GOV
1786 KINGS HGIHWAY, CHESTER, NY 10918
1
3
Instructions for completing the Standard Work Day and Reporting Resolution
A.
Title:
B.
Standard
Work
Day:
(Hrs/day)
Min. 6
hrs
Max. 8.
hrs
C.
Name:
(First and
Last)
D.
Social
Security
Number:
(Last 4
digits)
E.
NYSLRS ID:
F.
Tier 1:
(Check only
if member
is in Tier 1)
G.
Current
Term Begin
and End
Dates:
(mm/dd/yy-
mm/dd/yy)
H.
Record of
Activities
Result*:
I.
Not
Submitted :
(Check only
if official
did not
submit their
Record of
Activities
Elected Officials:
Highway 8.00 John Smith 0000 R11111111 1/1/2010- 32.79
Superintendent 12/31/2013
Receiver of 6.00 Michelle 1111 R22222222 X 1/1/2010- NA
Taxes Jones 12/31/2014
Town Justice 6.25 Michael Hall 2222 R33333333 1/1/2010- X
12/31/2011
Appointed Officials:
Planning Board 7.00 Joseph Gray 3333 R44444444 1/1/2010- 17.54
Member 12/31/2010
A. Title: All paid elected and appointed officials (who are active members of the Retirement System) and are not paid hourly and do not
participate in a employer’s time keeping system that consists of a daily record of actual time worked and time charged to accruals
must be listed. For the purpose of the regulation, an “appointed official” is someone who is appointed by an elected official, an
appointed official or governing board. They hold an office in an organization or government and participate in the exercise of
authority. This also includes appointees of elected and appointed officials such as deputies, assistants or confidential secretaries.
B. Standard Work Day: The minimum number of hours that can be established for a standard work day (SWD) is six, while the
maximum is eight. A SWD is the denominator to be used for the days worked calculation; it is not necessarily always the number of
hours a person works. For example, if a board member only attends one three-hour boarding meeting per month, you must still
establish a SWD between six and eight hours as the denominator for their record of activities (ROA) calculation.
C. Name: The official’s complete first and last name must be included for identification purposes.
D. Social Security Number: The last four digits of the official’s Social Security Number must be included for identification purposes.
For security purposes, the last four digits of the Social Security Number can be omitted from the publicly posted version.
E. NYSLRS ID: The official’s NYSLRS ID must be included for identification purposes. For security purposes, the NYSLRS ID can be
omitted from the publicly posted version.
F. Tier 1: If the official is a Tier 1 member, this box should be checked. Tier 1 members are not required to keep an ROA.
G. Current Term Begin & End Dates: All officials listed on the Resolution must have a specified Term End date. Leaving this column
blank or listing ‘Tenure/At Pleasure’ is not acceptable. If the official does not have a designated term, the current term for the official
who appointed them to the position should be used. If they are appointed by the governing board, the chairman of the board’s term
should be used.
H. Record of Activities Result*: This column must be left blank if an official does not submit their required sample three-month ROA.
To determine the average number of days worked per month, you must divide the total number of hours documented on the three-
month ROA by three months to get a one-month average number of hours worked. Then, the one-month average number of hours
worked must be divided by the SWD to get the average number of days worked per month.
I. Not Submitted: This column must be checked if an official has not submitted the required sample three-month ROA within the 150
day requirement, regardless of whether they are being reported by another employer for the same period. If the Retirement System
receives such a Resolution, it will contact the official to notify them of the consequences of not submitting the ROA.
Once passed, the Resolution must be posted on your public website for a minimum of 30 days or if a website isn’t available to the public,
on the official sign-board or at the main entrance to the clerk’s office. A certified copy of the Resolution and Affidavit of Posting must be
filed with the Office of State Comptroller within 45 days of the adoption. The Resolution and Affidavit can be submitted via the Submit
Resolution for Official link in Retirement Online.
*To determine the number of days worked to include on the monthly report for the various payroll frequencies, please refer to the
Calculating Days Worked instructions available in the ‘Reporting Elected & Appointed Officials’ section of our website:
http://www.osc.state.ny.us/retire/employers/elected_appointed_officials/index.php