1. (a) This section applies only to a claim of a public employer that is not the first public employer.
2. (b) A claim must be on a form approved by the state board of accounts and signed and certified as correct by the public employer's chief executive officer.

3. (c) The claim must provide the following information:

   1. (1) The individual's full name.
   2. (2) The individual's hire date and end date of employment with the public employer submitting the claim.
   3. (3) The individual's certification date.
   4. (4) The total amount of the first public employer's claim.

   5. (5) The total amount for which the public employer submitting the claim seeks reimbursement in accordance with section 11 of this chapter. The amount must be expressed as:

      1. (A) a dollar amount; and
      2. (B) a percentage of the total amount stated in subdivision (4).

4. (d) The claim must be accompanied by copies of the claim forms of:

   1. (1) the first public employer, without the copies of documents submitted under section 14(d) of this chapter; and
   2. (2) any other preceding public employer.

As added by P.L.20-2025, SEC.1.