Forms

FOR ACTIVE MEMBERS - Information & forms for members who are currently working for PERA affiliated employers or that have contributions on account with PERA

  • Application for Membership (Updated 8/05/2015) - 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.
  • Beneficiary Designation (Posted 8/04/2015) - 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.
  • Change in PERA Records (Posted 8/04/2015) - 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.
  • PERA Request Form (Updated 8/04/2015) - 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.
  • PERA Early Out Request Form (Posted 8/04/2015) - To be used by an active member employed by Bernalillo County, the City of Albuquerque, the City of Rio Rancho or the City of Santa Fe who are using these employer's early out programs and are requesting an estimate of benefits, cost calculations for air time, withdrawn service, or military service.
  • Affidavit for Free Military Service (Posted 8/04/2015) - 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.
  • Member Request For Refund/Rollover Form - To be used by a member who has terminated their position with a PERA-affiliated employer and wishes to refund or rollover their member account. The employer contributions are not available for refund. (posted 8/11/2015)
  • PERA Termination Notice Form - 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. (posted 8/11/2015)
  • Important Information for Refunding Members (Posted 4/18/2013)
  • State Transfer Form (Posted 8/04/2015) - To be used by members who are employed by the State of New Mexico and are transferring to a new job between state agencies.
  • 1099R Instructions for Recipient - Instructions for people who have received a refund of their PERA employee contributions or are receiving a monthly pension benefit. (Posted 7/1/2010)

FOR STATE LEGISLATOR MEMBER COVERAGE PLAN 2 - Information & forms for members who are currently elected as a state legislator or lieutenant governor.

FOR RETIRING MEMBERS - Information & forms for members who are preparing to retire from a PERA affiliated employer

  • PERA Information Sheet (Updated 8/04/2015) - To be used as an information sheet to start your retirement paperwork.
  • Application for Pension (Posted 8/04/2015) - To be used when a member is applying for a retirement pension.
  • Application for Pension for Volunteer Firefighter (Updated 8/04/2015) - To be used when a volunteer firefighter is applying for a retirement pension.
  • Affirmation of Marital Status (Posted 8/04/2015) - To be used to certify that the retiring member is single at the time of retirement. The member's signature must be notarized.
  • Spousal Consent Form (Posted 8/04/2015) - 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 (Updated 8/04/2015) - 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.
  • Direct Deposit Form (Updated 8/04/2015) - To be used by the retiring member to have their pension benefit automatically direct deposited into a designated bank account.
  • Tax Deduction Form (Updated 8/14/2015) - To be used by the retiring member to instruct PERA about taxes to be deducted from the retiree's pension check.
  • PERA Disability Retirement Kit and Forms - Information about retirement from PERA with a disability including the initial forms. If you are considering applying for a disability retirement, please contact PERA at 1-800-342-3422 and ask for the disability administrator. (Updated 8/04/2015)
  • Application for a Re-employed PERA Retiree (Posted 8/04/2015) - To be used by a PERA retiree returning to work for a PERA affiliated-employer.
  • 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. (Updated 8/04/2015)

FOR EMPLOYERS - Information & forms for PERA affiliated employers

  • Contribution Remittance (Posted 8/04/2015) - To be used by employers submitting payment of PERA employee and employer contributions.
  • Member Request For Refund/Rollover Form - To be used by a member who has terminated their position with a PERA-affiliated employer and wishes to refund or rollover their member account. The employer contributions are not available for refund. (posted 8/11/2015)
  • PERA Termination Notice Form - 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. (posted 8/11/2015)
  • Employer Certification for Retiring Employees - To be used by employers to certify to PERA the last day of employment and the last month of earned salary.
  • Employer Certification for Free Military Service (Updated 8/04/2015) - To be used by the employer to certify the dates of employment prior to and immediately after activation into military service.

LEGAL FORMS

  • Model Order Dividing Retirement Benefits (Updated 8/07/2014) - To be used by an active or retired member to divide the community interest in PERA retirement benefits and to directly pay an ex-spouse his or her share of benefits.

EXCLUSIONS - Information & forms for employees of a PERA affiliated-employer who are requesting exclusion from PERA membership

VOLUNTEER FIREFIGHTERS - Information & forms for volunteer firefighters