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JRJ Beneficiary Service Agreement Sample Contracts

Appendix C: JRJ Beneficiary Service Agreement (secondary term of service)
JRJ Beneficiary Service Agreement • December 20th, 2023

The following form should be used only in cases wherein a previously selected JRJ beneficiary has fulfilled his/her initial 3-year service obligation and has agreed to commit to an additional year of service obligation in exchange for those additional benefits.

Standard Contracts

Appendix D: JRJ Beneficiary Service Agreement (Acknowledgment of Benefit)
JRJ Beneficiary Service Agreement • December 17th, 2020

Note to JRJ State Administering Agencies: the following form should be used only in cases where a current JRJ beneficiary has not yet fulfilled his/her initial 3-year service obligation, but remains eligible for JRJ benefits. Upon fulfilling his/her initial 3-year service obligation, the JRJ beneficiary may exit the program or, if selected to receive additional JRJ benefits, should execute the JRJSLRP – Secondary Term of Service document (see Appendix D above).

Appendix C: JRJ Beneficiary Service Agreement (secondary term of service)
JRJ Beneficiary Service Agreement • December 17th, 2020

§10671, such incentive having been offered above and beyond the incentive(s) from which I have already benefitted from in exchange for a term of service that I have fulfilled, I hereby agree as follows:

Appendix D: JRJ Beneficiary Service Agreement (Acknowledgment of Benefit)
JRJ Beneficiary Service Agreement • December 17th, 2020

Note to JRJ State Administering Agencies: the following form should be used only in cases where a current JRJ beneficiary has not yet fulfilled his/her initial 3-year service obligation, but remains eligible for JRJ benefits. Upon fulfilling his/her initial 3-year service obligation, the JRJ beneficiary may exit the program or, if selected to receive additional JRJ benefits, should execute the JRJSLRP – Secondary Term of Service document (see Appendix D above).

Appendix D: JRJ Beneficiary Service Agreement (Acknowledgment of Benefit)
JRJ Beneficiary Service Agreement • December 20th, 2023

The following form should be used only in cases where a current JRJ beneficiary has not yet fulfilled his/her initial 3-year service obligation but remains eligible for JRJ benefits. Upon fulfilling his/her initial 3-year service obligation, the JRJ beneficiary may exit the program or, if selected to receive additional JRJ benefits, should execute the JRJSLRP – Secondary Term of Service document.

Appendix B: JRJ Beneficiary Service Agreement (first time participant)
JRJ Beneficiary Service Agreement • December 17th, 2020

Note to JRJ State Administering Agencies: the following form should be used only in cases wherein a JRJ program applicant has been selected to participate for the first time.