Retirement Incentive Pay Program Revocation Form

Instructions: (1) provide information requested below; (2) check an option box and provide appropriate information; (3) sign and submit your completed Revocation Form.  

Once you click "Submit" at the end of the form, your Revocation Form will be recorded and a copy of your responses will be emailed to the email address you provided. It is recommended that you provide a personal email address to ensure you have continued access to your email receipt. 

If you have any questions or concerns regarding the Retirement Incentive Pay Program, please contact the Los Angeles Police Protective League at:

  • Corina Lee - (213) 792-1089; corinalee@lappl.org
  • Jerretta Sandoz - (213) 545-4903; jerrettasandoz@lappl.org
  • Debbie Thomas - (424) 653-4433; debbiethomas@lappl.org

If you have any general retirement questions, you may contact Los Angeles Fire and Police Pensions via telephone at 213-279-3100 or via email at DROPSP@lafpp.com.

You may also view responses to frequently asked questions (FAQs) regarding the Retirement Incentive Program here: https://cao.lacity.org/RIP/RIP_FAQ_FINAL.pdf

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Email *
First Name and Last Name *
City Employee Identification (EID) Number *
Serial Number *
Personal Telephone Number *

I am requesting to revoke my participation in the Retirement Incentive Pay Program by the next full pay period after submission of this revocation form.

 
Note: This is a significant decision. You are strongly encouraged to discuss this with the Los Angeles Police Protective League and Los Angeles Fire and Police Pensions prior to making any final decisions.

 *

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

 *
Employee Signature *
A copy of your responses will be emailed to the address you provided.
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