Forms

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.

Application for Disability Retirement Benefits
Application for Disability Retirement Benefits

Application for Pension
To be filled out when applying for pension.

Application for Volunteer Firefighter Pension
Application for Volunteer Firefighter Pension

Attorney's Instructions & Model Dividing PERA Benefits
Attorney instructions for Orders Dividing PERA Retirement Benefits

Attorney's Instructions Order Changing Form of Payment
Attorney's Instructions Order Changing Retirement Benefits Form of Payment

Authorization to Release Information
To be used to give authorization to release information.

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.

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

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.

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.

Co-Payee Request for Refund
To be filled out by co-payee if requesting to withdraw member contributions.

Co-Payee Request for Rollover
To be filled out by a co-payee if requesting a rollover of member contributions.

Examining Physician's Statement for Disability Benefits
Examining Physician's Statement for Disability Benefits

Member Enrollment for State Legislator Member Coverage Plan 2
Enrollment form for state legislator members.

Member Request for Refund
To be filled out by PERA member if requesting to withdraw member contributions.

Member Request for Rollover
To be filled out by PERA member if requesting a rollover of member contributions.

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.

Re-evaluation Application for Disability Retirement Benefits
Reevaluation Application for Disability Retirement Benefits

Kits

PERA Retirement Kit
Instructions detailing the Retirement Process

PERA Disability Retirement Kit
Instructions detailing the Disability Retirement Process

PERA Disability Retirement Kit Forms
Forms required for the Disability Retirement Process

PERA Volunteer Firefighter Retirement Kit
Instructions detailing the Volunteer Firefighter Retirement Process

Handbooks

PERA Member Handbook
A guide for members.

Magistrate Member Handbook - Member Prior to 07/01/2014
A guide for Magistrate Judges who took the bench prior to July 1, 2014.

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.

Application for a Retiree - Judge or Magistrate
To be used by a PERA retiree returning to work for a PERA affiliated-employer as a Judge or Magistrate.

Affidavit for Missing Spouse
Affidavit for Missing Spouse

Application for a Reemployed PERA Retiree
To be used by a PERA retiree returning to work for a PERA affiliated-employer.

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

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.

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.

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.

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

Kits

PERA Retirement Kit
Instructions detailing the Retirement Process

PERA Volunteer Firefighter Retirement Kit
Instructions detailing the Volunteer Firefighter Retirement Process

Handbooks

PERA Member Handbook
A guide for members

Forms

Application for PERA Membership
To be used by a new employee enrolling with PERA for the first time or by an existing member when beginning work with a new affiliated employer.

Contribution Remittance (DFA Only)
To be used by employers submitting payment of PERA employee and employer contributions.

Employer Certification Form
To be used to certify a member's wages prior to retirement.

Employee Certification for Free Military Service
To be used by the employer to certify the dates of employment prior to and immediately after activation into military service.

Employee Exclusion from PERA Membership (General)
To be used by seasonal or temporary employees, part-time employees (working less than 20 hours a week), student employees, retired ERA, JRA, MRA members and independent contractors for exclusion from PERA membership.

Employee Exclusion from PERA Membership PERA Retiree - Elected Official
To be used by PERA retirees who are elected to office for exclusion from PERA membership.

Employee Exclusion From PERA Membership Elected Official
To be used by elected officials for exclusion from PERA membership.

Employee Exclusion From PERA Membership Private Retirement Program
To be used by an employee of a PERA affiliated-employer who accepts a different private retirement from their employer other than PERA.

Employer's Report of Disability
Employer's Report of Disability

PERA Pay Rate Change Certification
To be used when an employee has had a change in pay or compensation.

PERA Termination Notice (DFA Only)
To be used for all members who are terminating their position from a PERA employer regardless of the length of employment. If a member is transferring to a position with another PERA-affiliated employer, then the Employer's Certification of Transfer to Another PERA Entity section should be completed.

State Transfer
To be used by members who are employed by the State of New Mexico and are transferring to a new job between state agencies.

PERA SmartSave Voya Sponsor Web Access Request
PERA SmartSave Deferred Compensation Form for Employers.

PERA SmartSave Authorization Agreement for ACH and Payroll Reporting
PERA SmartSave Deferred Compensation Form for Employers.