Forms/Kits/Handbooks

PERA offers publications about its benefits and services that can be an invaluable resource. All publications and forms are available to download or print in PDF format.

  • Forms

    • Affidavit for Free Military Service

      To be used by a members called to active military service while actively employed by a PERA affiliated-employer to certify the dates of employment and military service.

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      Application for Pension

      To be filled out when applying for pension.

      Download Form

      Application for Volunteer Firefighter Pension

      Application for Volunteer Firefighter Pension

      Download Form

      Attorney's Instructions & Model Dividing PERA Benefits

      Attorney instructions for Orders Dividing PERA Retirement Benefits

      Download Form

      Attorney's Instructions Order Changing Form of Payment

      Attorney's Instructions Order Changing Retirement Benefits Form of Payment

      Download Form

      Beneficiary Designation

      To be used by an active member to designate a survivor and refund beneficiary to receive a death benefit after the death of the member. This is a new form that combines both beneficiary designations.

      Download Form

      Beneficiary Spousal Consent Form

      To be used for a spouse to consent if member is selecting a beneficiary other than the spouse.

      Download Form

      Change in PERA Records

      To be used by all active members to notify PERA of a change of address, a change of name or a change of social security number.

      Download Form

      Change in Retirement Date

      To be used to change a member's retirement date after the member has submitted a completed retirement kit to PERA.

      Download Form

      Co-Payee Request for Refund

      To be filled out by co-payee if requesting to withdraw member contributions.

      Download Form

      Co-Payee Request for Rollover

      To be filled out by a co-payee if requesting a rollover of member contributions.

      Download Form

      Member Enrollment for State Legislator Member Coverage Plan 2

      Enrollment form for state legislator members.

      Download Form

      Member Request for Refund

      To be filled out by PERA member if requesting to withdraw member contributions.

      Download Form

      Member Request for Rollover

      To be filled out by PERA member if requesting a rollover of member contributions.

      Download Form

      PERA Request Form

      To be used by an active member who wishes to request an estimate of benefits (must be within 3 years of retirement); cost calculations for air time, with drawn service, or military service; prepare a service credit verification or request a PERA Retirement Kit.

      Download Form

      Re-evaluation Application for Disability Retirement Benefits

      Reevaluation Application for Disability Retirement Benefits

      Download Form
  • Kits

    • PERA Retirement Kit

      Instructions detailing the Retirement Process

      Download Kit

      PERA Disability Retirement Kit

      Instructions detailing the Disability Retirement Process

      Download Kit

      PERA Disability Retirement Kit Forms

      Forms required for the Disability Retirement Process

      Download Kit

      PERA Volunteer Firefighter Retirement Kit

      Instructions detailing the Volunteer Firefighter Retirement Process

      Download Kit
  • Handbooks

    • PERA Member Handbook

      A guide for members.

      Download Handbook

      Magistrate Member Handbook - Member Prior to 07/01/2014

      A guide for Magistrate Judges who took the bench prior to July 1, 2014.

      Download Handbook

      Judicial Member Handbook - Member Prior to 07/01/2005

      A guide for Judges/Justices who took the bench prior to July 1, 2005.

      Download Handbook