Laserfiche WebLink
b. To establish eligibility for benefits for a Domestic Partner, a Declaration of <br /> Domestic Partnership shall be required as follows: <br /> (1) Declaration of Domestic Partnership—The employee and Domestic <br /> Partner shall be required to sign,under penalty of perjury, a declaration of <br /> Domestic Partnership in a form provided by the City of Everett Human <br /> Resources Department that: <br /> (a)they meet the definition of"Domestic Partner" as provided in <br /> Section 1 of this Resolution now or as hereafter amended; and <br /> (b)the employee shall notify the City of Everett Human Resources <br /> Department within 30 days of the termination of the Domestic <br /> Partnership; and <br /> (c)they understand the consequences of making intentionally false <br /> or misleading statements on the declaration, including employee <br /> discipline up to and including termination, loss of benefits and the <br /> requirement that the employee reimburse the City of Everett for the <br /> cost of providing benefits for which the domestic partner was <br /> ineligible; and <br /> (d)they are attaching proof of at least three of the following: <br /> (i)joint mortgage or lease; <br /> (ii) designation of domestic partner as beneficiary for life <br /> insurance; <br /> (iii) designation of domestic partner as beneficiary for <br /> retirement contract; <br /> (iv) designation of domestic partner as beneficiary in <br /> employee's will; <br /> (v) designation of domestic partner as agent under a <br /> durable property and health care powers of attorney; <br /> (vi)joint checking account; <br /> (vii)joint credit account; <br /> (viii)Washington State registration as a domestic <br /> partnershi.. <br /> i ` %cs - <br /> COUNCIL MEMBER I TRODUCING RESOLUTION <br /> PASSED AND APPROVED THIS 31 DAY OF October , 2007 <br /> BREN i STONE* ER, CO CIL PRESIDENT <br />