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.
Download FormApplication for Volunteer Firefighter Pension
Application for Volunteer Firefighter Pension
Download FormAttorney's Instructions & Model Dividing PERA Benefits
Attorney instructions for Orders Dividing PERA Retirement Benefits
Download FormAttorney's Instructions Order Changing Form of Payment
Attorney's Instructions Order Changing Retirement Benefits Form of Payment
Download FormBeneficiary 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 FormBeneficiary Spousal Consent Form
To be used for a spouse to consent if member is selecting a beneficiary other than the spouse.
Download FormChange 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 FormChange 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 FormCo-Payee Request for Refund
To be filled out by co-payee if requesting to withdraw member contributions.
Download FormCo-Payee Request for Rollover
To be filled out by a co-payee if requesting a rollover of member contributions.
Download FormMember Enrollment for State Legislator Member Coverage Plan 2
Enrollment form for state legislator members.
Download FormMember Request for Refund
To be filled out by PERA member if requesting to withdraw member contributions.
Download FormMember Request for Rollover
To be filled out by PERA member if requesting a rollover of member contributions.
Download FormPERA 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 FormRe-evaluation Application for Disability Retirement Benefits
Reevaluation Application for Disability Retirement Benefits
Download Form
-
- Kits
-
PERA Disability Retirement Kit
Instructions detailing the Disability Retirement Process
Download KitPERA Disability Retirement Kit Forms
Forms required for the Disability Retirement Process
Download KitPERA Volunteer Firefighter Retirement Kit
Instructions detailing the Volunteer Firefighter Retirement Process
Download Kit
-
- Handbooks
-
Magistrate Member Handbook - Member Prior to 07/01/2014
A guide for Magistrate Judges who took the bench prior to July 1, 2014.
Download HandbookJudicial Member Handbook - Member Prior to 07/01/2005
A guide for Judges/Justices who took the bench prior to July 1, 2005.
Download Handbook
-