Forms/Kits/Handbooks

• Forms

  • Affirmation of Marital Status

    To be used to certify that the retiring member is single at the time of retirement. The member's signature must be notarized.

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    Affidavit for Missing Spouse

    Affidavit for Missing Spouse

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    Affidavit to receive 1099

    To be used to receive deceased Member's 1099

    Download Form

    Affidavit for the collection of personal property

    Affidavit for collection of personal property (Small Estate)

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    Direct Deposit Form

    To be used by the retiring member to have their pension benefit automatically direct deposited into a designated bank account.

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    Employer Certification of Termination for a Re-Employed PERA Retiree

    To be used for a termination of a return-to-work PERA retiree. This form must be completed and submitted to PERA upon the return-to-work retiree's termination.

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    Income Tax Withholding

    To be used by the retiring member to instruct PERA about taxes to be deducted from the retiree's pension check.

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    Spousal Consent Form

    To be used by the retiring member and their spouse to ensure the spouse is aware of the member's selected form of payment and choice of beneficiary.

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    Spousal Consent Form - Judicial/Magistrate Retirement

    To be used by the retiring member in the Judicial Retirement Act or the Magistrate Retirement Act and their spouse to ensure the spouse is aware of the member's selected form of payment and choice of beneficiary.

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• Kits

  • PERA Retirement Kit

    Instructions detailing the 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