Please refer
to the Final Approach Form Instructions for the specific numbers required for this form.
1. * NAME:
SPOUSE:
* ADDRESS:
* CITY:* ST:* ZIP:
* PHONE:* BIRTHDATE:
CELL:
SPOUSE BIRTHDATE:
FAX:
EMPLOYEE NO:
BASE:
* EMAIL ADDRESS:
2. Gross
Airline Earnings History: (include
401K contributions & profit sharing)
PREVIOUS YEAR'S
EARNINGS:2007
3. *
2ND PREV YEAR'S
EARNINGS:2006
per month you expect
3RD PREV YEAR'S
EARNINGS:2005
to fly:
4TH PREV YEAR'S
EARNINGS:2004
Actual and/or projected
5TH PREV YEAR'S
EARNINGS:2003
Equipment/Division/Seat
6TH PREV YEAR'S
EARNINGS:2002
5.
* 2008
4. OPTIONAL: For an estimate of your PC-3
(PBGC) benefit also include:6.
* 2009
YEARS:
2001
2000
2010
EARNINGS:
2011
2012
From
this year's *2007* Retirement Benefit Statement (posted on Jetnet
2013
in March) and your Super Saver
Statement dated 12/31/2007:2014
2015
7. AIRCAL YEARLY FIXED ANNUITY (if appl):2016
8. * FINAL AVERAGE SALARY: (page
1)2017
8. * YEARS OF AA CREDITED SERVICE: (page 1)2018
AIRCAL plus AA YRS SERVICE: (if appl)2019
8. * COMPANY UNITS: (page 1, right column)2020
8. OPTIONAL UNITS: (page 1, right column)2021
8. * TOTAL UNITS: (page 1, right column)2022
8. * BASIC ACCUMULATION: (page 1, right column)
8. OPTNL CONTRIBUTIONS ($ AMOUNT): (p1,rt col)12. Number of Vacation
9. 401K ACCOUNT BALANCE: (12/31/2007) defer to after retirement:
10. B FUND OPTIONAL CONTRIBUTION RATE:
11. 401K SUPER SAVER CONTRIBUTION RATE:
11. 401K ANNUAL CATCH-UP AMOUNT OR "MAX":
Withdrawal
Longevity Analysis Scenario Information (if uncertain, enter best estimates):
13. Other "qualified" funds (IRA's, pensions,etc.) available for
retirement (est. value at age 60):
14. Planned gross monthly withdrawal (including taxes) from all of your
"qualified" funds:
15. Alternate gross monthly withdrawal (including taxes) from all of your
"qualified" funds:
16. Planned date after retirement of first monthly withdrawal from your
"qualified" funds:
17. Other "non-qualified" (taxable) funds available for retirement
(estimated value at age 60):
Planned gross monthly withdrawal
(including taxes) from all of your "non-qualified" funds:
Alternate gross monthly withdrawal
(including taxes) from all your "non-qualified" funds:
Planned date after retirement of first
monthly withdrawal from your "non-qualified" funds:
18. Option planned for your A Fund (Lump Sum, Life-Only, Survivor Annuity, Period
Certain):
If
Surv, 50%, 75%, or 100%:
If
Period Certain,10, 15, or 20 years.:
19. If you will be or are receiving a Military Retirement, estimated monthly
annuity at age 60:
If you elected a Supplemental Survivor
Benefit, enter percentage of survivor benefit:
20. Age to
begin drawing Social Security benefits: Retiree:
Spouse:
21. Estimated marginal tax rate in retirement: Federal:
State:
Comments or Additional
Information:
Representative:
