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 (Posted 12/04/2012) - 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 4/11/2013) - 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 12/04/2012) - 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 3/27/2013) - 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 12/04/2012) - 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using these employer's early out programs and are requesting an estimate of benefits, cost calculations for air time, withdrawn service, or military service.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 12/04/2012) - 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.
  • Termination Notice (Posted 12/10/2012) - To be used by members who are terminating their position and wish to withdraw their PERA contributions. The member's last PERA affiliated public employer must certify this form if it has been less than one year since the termination date. If it has been longer than one year, the last employer does not need to complete the top portion of the form. Requests for cash refunds may now be direct deposited. The direct deposit form MUST accompany the PERA Termination Notice if a direct deposit is requested.
  • Important Information for Refunding Members (Posted 4/18/2013)
  • State Transfer Form (Posted 12/04/2012) - 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 (Posted 12/04/2012) - To be used as an information sheet to start your retirement paperwork.
  • Application for Pension (Posted 12/04/2012) - To be used when a member is applying for a retirement pension.
  • Application for Pension for Volunteer Firefighter (Posted 12/04/2012) - To be used when a volunteer firefighter is applying for a retirement pension.
  • Affirmation of Marital Status (Posted 12/04/2012) - 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 12/04/2012) - 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 (Posted 12/04/2012) - 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 9/11/2013) - To be used by the retiring member to have their pension benefit automatically direct deposited into a designated bank account.
  • Tax Deduction Form (Updated 12/18/2012) - 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. (Posted 10/29/2012)
  • Application for a Reemployed PERA Retiree (Posted 12/04/2012) - 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. (posted 4/23/2013)

FOR EMPLOYERS - Information & forms for PERA affiliated employers

  • Contribution Remittance (Posted 6/11/2009) - To be used by employers submitting payment of PERA employee and employer contributions.
  • Termination Notice (Posted 6/03/2011) -To be used by members who are terminating their position and wish to withdraw their PERA contributions. The member's last PERA affiliated public employer must certify this form if it has been less than one year since the termination date. If it has been longer than one year, the last employer does not need to complete the top portion of the form. Requests for cash refunds may now be direct deposited. The direct deposit form MUST accompany the PERA Termination Notice if a direct deposit is requested.
  • 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 (Posted 6/1/2011) - 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 (Posted 10/18/2011) - 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