Current Employees

Enrollment


Enrollment Form

This form must be completed by every new member. The form may be provided by the employer.


Member Information Changes


Change of Name and/or Address Form

This form allows working and terminated vested members to update home addresses.


Primary Change of Beneficiary

This form allows a member to change the primary beneficiary they elected at their time of employment.


Secondary Change of Beneficiary

This form allows a member to change the secondary beneficiary they elected at their time of employment.


Disability Application Packets


Ordinary Disability Application

This packet contains everything needed to file for non-work-related disability retirement if you have sufficient service to apply.


Work Related Disability Application

This packet contains everything needed to file for disability retirement if you become permanently incapacitated while on the job.


Financial Worksheets


IRS Form W-4P for 2017

Use this form to change the amount withheld from monthly pension benefits for Federal Income Tax purposes.


Chapter 218:12 VI 2017 Worksheet

Complete this worksheet annually to determine your IRS contribution limit for Optional Service Purchases.


Chapter 218:9 III 2017 Worksheet

Complete this worksheet annually to determine your IRS contribution limit for Additional Contributions.


Report a Violation


Compliance Report Form

Use this “Whistle Blower” form to report any suspected wrongdoing by Retirement Staff or Trustees.


Additional Contributions


2017 Additional Contribution Packet

This packet contains everything you need to enroll in the voluntary “Additional Contribution “ program.


Additional Contribution Deposit Form

Use this form to make a one-time lump sum deposit to your previously established Additional Contribution account.


Additional Contribution Deduction Change

Use this form to change or stop weekly payroll deductions for Additional Contributions.


Post Termination


Refund Application – Direct Rollover Form

Contains everything needed to close your account if after leaving employment when not planning to collect a lifetime monthly retirement […]


Vested Termination


Election to Vest Benefits After Termination – More Than 5 Years of Service

For those who have left employment after more than 5 years and wish to leave their funds in the Plan.